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Fusegi A, Nomura H, Ueki A, Abe A, Kamata M, Misaka S, Aoki Y, Tanigawa T, Yunokawa M, Kanao H. Ovarian surveillance including endometrial cytology for patients with hereditary breast and ovarian cancer before risk-reducing salpingo-oophorectomy: A retrospective analysis. J Obstet Gynaecol Res 2024. [PMID: 38528763 DOI: 10.1111/jog.15935] [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: 08/19/2023] [Accepted: 03/17/2024] [Indexed: 03/27/2024]
Abstract
AIM Ovarian surveillance in women with hereditary breast and ovarian cancer who do not undergo risk-reducing salpingo-oophorectomy has been controversial. Therefore, this study aimed to demonstrate the clinical features of ovarian surveillance at our institution using a technique that combines serum cancer antigen 125 measurements, transvaginal ultrasonography, and uterine endometrial cytology. METHODS We retrospectively examined 65 women, who had not undergone risk-reducing salpingo-oophorectomy diagnosed with hereditary breast and ovarian cancer between 2000 and 2021 at our hospital. Clinical information was obtained and analyzed through a chart review. The details of the treatment course were reviewed for patients who had developed ovarian cancer. RESULTS Overall, 5 of the 65 women were diagnosed with ovarian cancer based on abnormal findings during periodic surveillance. All patients who developed ovarian cancer were asymptomatic, even if the cancer was at an advanced stage. Two of the 65 patients had endometrial cytology abnormalities, both of whom had ovarian cancer. All patients who developed ovarian cancer underwent primary debulking surgery, and complete gross resection was achieved. None of the patients experienced ovarian cancer recurrence. CONCLUSIONS The ovarian surveillance strategy at our institution for women with hereditary breast and ovarian cancer who do not undergo risk-reducing salpingo-oophorectomy can identify asymptomatic ovarian cancer and contribute to achieving complete gross resection during primary surgery. Ovarian surveillance may contribute to a reduction in ovarian cancer mortality.
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Affiliation(s)
- Atsushi Fusegi
- Department of Gynecologic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hidetaka Nomura
- Department of Gynecologic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Arisa Ueki
- Department of Clinical Genetic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Akiko Abe
- Department of Gynecologic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Mayumi Kamata
- Department of Gynecologic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Satoki Misaka
- Department of Gynecologic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoichi Aoki
- Department of Gynecologic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Terumi Tanigawa
- Department of Gynecologic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Mayu Yunokawa
- Department of Gynecologic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
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Kanao H, Kanno M, Fusegi A, Aoki Y, Omi M, Tanigawa T, Okamoto S, Nomura H. Transperineal endoscopic approach with GelPOINT V-path in laparoscopic pelvic exenteration for postirradiated recurrent cervical cancer. Gynecol Oncol Rep 2023; 50:101291. [PMID: 37860080 PMCID: PMC10583053 DOI: 10.1016/j.gore.2023.101291] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/21/2023] Open
Abstract
Pelvic exenteration (PE) is a highly invasive procedure associated with high morbidity and mortality rates. Laparoscopy is a promising option to reduce this invasiveness, and laparoscopic PE significantly reduces blood loss and shortens hospital stays. In the case of a large tumor with invasion to the surrounding organs, laparoscopic dissection around the pelvic floor is sometimes problematic owing to restrictions on handling instruments. To overcome these limitations, we performed a transperineal endoscopic approach using the GelPOINT V-path in addition to laparoscopic PE. This approach enabled dissection around the pelvic floor without the abovementioned obstacles under magnified visualization. As a result, we could dissect the pelvic floor precisely with a reduction of the dead pelvic space, which might contribute to reduced rates of postoperative complications while ensuring oncologic outcomes.
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Affiliation(s)
- Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo 135-8550, Japan
| | - Motoko Kanno
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo 135-8550, Japan
| | - Atsushi Fusegi
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo 135-8550, Japan
| | - Yoichi Aoki
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo 135-8550, Japan
| | - Makiko Omi
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo 135-8550, Japan
| | - Terumi Tanigawa
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo 135-8550, Japan
| | - Sanshiro Okamoto
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo 135-8550, Japan
| | - Hidetaka Nomura
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koutouku, Tokyo 135-8550, Japan
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Kanno M, Yunokawa M, Kurihara N, Aoki Y, Omi M, Tanigawa T, Kanao H. Efficacy of intra-abdominal cytoreductive surgery in advanced endometrial cancer with distant metastasis. J Gynecol Oncol 2023; 34:e77. [PMID: 37477100 PMCID: PMC10627751 DOI: 10.3802/jgo.2023.34.e77] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/28/2023] [Accepted: 06/22/2023] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVE The efficacy of intra-abdominal cytoreductive surgery in patients with endometrial cancer and distant metastasis is equivocal. We investigated the effectiveness of such surgical treatment and whether it should be performed before or after chemotherapy (CT). METHODS This study included patients with an International Federation of Gynecology and Obstetrics stage IVB endometrial cancer who received initial treatment at our hospital between January 2006 and December 2017. RESULTS We retrospectively reviewed 67 patients with stage IVB endometrial cancer with distant metastases and classified them into preceding surgery (PS, n=23), chemotherapy followed by a surgery (CS, n=27), and CT (n=17) groups. We examined the achievement of resection with [R (1)] or without [R (0)] intra-abdominal macroscopic residue and survival. The median survival time for R (0) was 44 (95% confidence interval [CI]=9-not available [NA]) months in the PS group and 27 (95% CI=11-NA) months in the CS group. The median survival time for R (1) was 9 (95% CI=0-24) months in the PS group and 12 (95% CI=7-19) months in the CS group. The similar prognosis in both groups was worse with R (1) than with R (0). The survival curve for R (1) in the resection groups was similar to that of the CT group. CONCLUSION Achieving resection without intra-abdominal macroscopic residue for endometrial cancer with distant metastases, whether before or after CT, could extend patients' survival.
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Affiliation(s)
- Motoko Kanno
- Department of Gynecologic Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
| | - Mayu Yunokawa
- Department of Gynecologic Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
- Department of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Nozomi Kurihara
- Department of Clinical Planning and Strategy, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoichi Aoki
- Department of Gynecologic Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Makiko Omi
- Department of Gynecologic Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Terumi Tanigawa
- Department of Gynecologic Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroyuki Kanao
- Department of Gynecologic Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
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Shimada M, Yoshihara K, Tanigawa T, Nomura H, Hamanishi J, Fujiwara S, Tanabe H, Kajiyama H, Mandai M, Aoki D, Enomoto T, Okamoto A. An attempt to establish real-world databases of poly(ADP-ribose) polymerase inhibitors for advanced or recurrent epithelial ovarian cancer: the Japanese Gynecologic Oncology Group. J Gynecol Oncol 2023; 34:e62. [PMID: 37116954 PMCID: PMC10157342 DOI: 10.3802/jgo.2023.34.e62] [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: 03/20/2023] [Accepted: 04/16/2023] [Indexed: 04/30/2023] Open
Abstract
The development of new treatments for gynecological malignancies has been conducted mainly through collaborative international phase III trials led by the United States and Europe. The survival outcomes of many gynecological malignancies have greatly improved as a result. Recent large-scale genome-wide association studies have revealed that drug efficacy and adverse event profiles are not always uniform. Thus, it is important to validate new treatment options in each country to safely and efficiently provide newly developed treatment options to patients with gynecological malignancies. The Japanese Gynecologic Oncology Group (JGOG) is conducting 5 cohort studies (JGOG 3026, 3027, 3028, 3030, and 3031) to establish real-world data (RWD) of poly(ADP-ribose) polymerase (PARP) inhibitor use in patients with advanced or recurrent epithelial ovarian cancer. The RWD constructed will be used to provide newly developed PARP inhibitors for women with advanced or recurrent ovarian cancer in a safer and more efficient manner as well as to develop further treatment options. In 2022, The JGOG, Korean Gynecologic Oncology Group, Chinese Gynecologic Cancer Society, and Taiwanese Gynecologic Oncology Group established the East Asian Gynecologic Oncology Trial Group to collaborate with East Asian countries in clinical research on gynecologic malignancies and disseminate new knowledge on gynecologic malignancies from Asia. The JGOG will conduct a collaborative integrated analysis of the RWD generated from Asian countries and disseminate real-world clinical knowledge regarding new treatment options that have been clinically implemented.
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Affiliation(s)
- Muneaki Shimada
- Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan
- Tohoku University Advanced Research Center for Innovations in Next-Generation Medicine, Sendai, Japan.
| | - Kosuke Yoshihara
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Chuo, Japan
| | - Terumi Tanigawa
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroyuki Nomura
- Department of Obstetrics and Gynecology, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Junzo Hamanishi
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Satoe Fujiwara
- Department of Obstetrics and Gynecology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Hiroshi Tanabe
- Department of Gynecology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Showa-ku, Japan
| | - Masaki Mandai
- Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Chuo, Japan
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, Jikei University School of Medicine, Tokyo, Japan
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Nomura H, Abe A, Fusegi A, Yoshimitsu T, Misaka S, Murakami A, Matsumoto T, Tsumura S, Kanno M, Aoki Y, Netsu S, Omi M, Tanigawa T, Okamoto S, Omatsu K, Yunokawa M, Kanao H, Habano E, Arakawa H, Kaneko K, Ueki A, Haruyama Y, Inari H, Ueno T. Impact of the coverage of risk-reducing salpingo-oophorectomy by the national insurance system for women with BRCA pathogenic variants in Japan. Sci Rep 2023; 13:1018. [PMID: 36658289 PMCID: PMC9852267 DOI: 10.1038/s41598-023-28304-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 10/12/2022] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
To determine the impact of the coverage of risk-reducing salpingo-oophorectomy (RRSO) and mastectomy (RRM) as well as genetic testing for BRCA pathogenic variants by the national insurance system in Japan. We compared the clinical background of women who underwent RRSO at our institution before and after its coverage by the national insurance system. Those who underwent RRSO between January 2017 and December 2019 and between April 2020 and March 2022 were classified as Period. A and B, respectively. Overall, 134 women underwent RRSO during the study period. In Period A and B, 45 and 89 women underwent RRSO for the study period was 36 and 24 months, respectively. Compared with Period A, the number of women who underwent RRSO per month increased by threefold in Period B (p < 0.01). In addition, the number of women who underwent surgery for breast cancer along with RRSO increased in Period B (p < 0.01). Although the number of women who underwent concurrent RRM with RRSO in Period B increased, the difference was not statistically significant. Compared with Period A, the number of women diagnosed with BRCA pathogenic variant increased by 3.9-fold, and the proportion of women who underwent concurrent hysterectomy at the time of RRSO decreased from 66 to 7.9% in Period B (p < 0.01). Owing to the introduction of the national insurance system, the number of women who underwent RRSO and concurrent surgery for breast cancer at the time of RRSO increased in Japan.
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Affiliation(s)
- Hidetaka Nomura
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan.
| | - Akiko Abe
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Atsushi Fusegi
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Teruyuki Yoshimitsu
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Satoki Misaka
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Atsushi Murakami
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Tsuyoshi Matsumoto
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Shiho Tsumura
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Motoko Kanno
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Yoichi Aoki
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Sachiho Netsu
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Makiko Omi
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Terumi Tanigawa
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Sanshiro Okamoto
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Kohei Omatsu
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Mayu Yunokawa
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Hiroyuki Kanao
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto-Ku, Tokyo, 135-8550, Japan
| | - Eri Habano
- Department of Clinical Genetics, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiromi Arakawa
- Department of Clinical Genetics, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Keika Kaneko
- Department of Clinical Genetics, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Arisa Ueki
- Department of Clinical Genetics, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yurie Haruyama
- Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hitoshi Inari
- Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takayuki Ueno
- Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
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Aoki Y, Kanao H, Fusegi A, Omi M, Okamoto S, Tanigawa T, Nomura H, Omatsu K, Tonooka A. Indocyanine green-guided sentinel lymph node mapping during laparoscopic surgery with vaginal cuff closure but no uterine manipulator for cervical cancer. Int J Clin Oncol 2022; 27:1499-1506. [PMID: 35705758 DOI: 10.1007/s10147-022-02197-7] [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: 02/25/2022] [Accepted: 05/22/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lymph node metastasis is a critical prognostic factor in cervical cancer. Considering the potential complications of lymphadenectomy and desirability of avoiding systemic lymphadenectomy, accurate intraoperative prediction of the existence of lymph node metastasis is important in patients undergoing surgery for cervical cancer. We evaluated the feasibility and value of indocyanine green (ICG) use for sentinel lymph node (SLN) mapping during laparoscopic surgery performed for cervical cancer. METHODS This single-center cohort study included 77 patients undergoing a new laparoscopic radical surgery method with pelvic lymphadenectomy for early-stage cervical cancer. The surgery, performed without using a uterine manipulator, included creation of a vaginal cuff. Bilateral ICG-guided SLN mapping and rapid histopathological examination were performed, and results were analyzed in relation to final histopathologic diagnoses. RESULTS The SLN pelvic side-specific detection rate was 93.5%, sensitivity (SLN-positive cases/SLN-detected pelvic lymph node-positive cases) was 100%, intraoperative negative predictive value (NPV) was 97.8%, and final pathological NPV was 100%. The detection rate was significantly lower for tumors ≥ 2 cm in diameter than for tumors < 2 cm in diameter. Micrometastases were missed by intraoperative examination in 3 cases. CONCLUSION The high NPV suggests the feasibility and usefulness of ICG-based SLN mapping plus rapid intraoperative examination for identification of metastatic SLNs. Use of ICG-based mapping for intraoperative identification of SLNs in patients undergoing this new laparoscopic surgery method for early-stage cervical cancer was particularly effective for tumors < 2 cm in diameter. However, incorporating a search for micrometastases into rapid intraoperative histopathologic examination may be necessary.
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Affiliation(s)
- Yoichi Aoki
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Atsushi Fusegi
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Makiko Omi
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Sanshirou Okamoto
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Terumi Tanigawa
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Hidetaka Nomura
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Kohei Omatsu
- Department of Gynecologic Oncology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Akiko Tonooka
- Department of Clinical Pathology, Cancer Institute Hospital, Tokyo, Japan
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Tanigawa T, Takeshima N, Ishikawa H, Nishio S, Usami T, Yamawaki T, Oishi T, Ihira K, Kato H, Goto M, Saito M, Taira Y, Yokoyama M, Shoji T, Kondo E, Mori A, Yokoi T, Iwasa-Inoue N, Hirashima Y, Nagasawa T, Takenaka M, Mikami M, Sugiyama T, Enomoto T. Paclitaxel-carboplatin and bevacizumab combination with maintenance bevacizumab therapy for metastatic, recurrent, and persistent uterine cervical cancer: An open-label multicenter phase II trial (JGOG1079). Gynecol Oncol 2022; 165:413-419. [PMID: 35487773 DOI: 10.1016/j.ygyno.2022.04.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 12/28/2021] [Revised: 04/15/2022] [Accepted: 04/15/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This multicenter, open-label, phase II study aimed to evaluate the efficacy and safety of paclitaxel-carboplatin, bevacizumab, and bevacizumab-based maintenance therapy for metastatic, recurrent, and persistent uterine cervical cancer. METHODS Patients with measurable diseases that were not adapted to regional therapies, such as surgery or radiotherapy, and were systematic chemotherapy-naïve were eligible. The participants received paclitaxel (175 mg/m2), carboplatin (AUC 5), and bevacizumab (15 mg/m2) every three weeks until disease progression or unacceptable adverse events occurred. The primary endpoint was progression-free survival (PFS). The secondary endpoints were overall response rate (ORR), overall survival (OS), safety, and time to treatment failure. RESULTS Sixty-nine patients were analyzed using our protocol. The median paclitaxel- carboplatin therapy duration was six cycles; 40% of patients received bevacizumab maintenance therapy. The median PFS was 11.3 months. The median OS was not reached; the median time to treatment failure was 5.9 months. The ORR was 79.7% [95% confidence interval (CI) 63.8-88.4]; 16 patients (23.2%) showed complete response (CR) and 39 patients (56.5%) showed partial response (PR). The median PFS was 14.3 months (95% CI 7.3-17 months) for the 25 patients who received maintenance therapy and 7.4 months (95% CI 6.1-11 months) for nonrecipients (p = 0.0449). Gastrointestinal perforation/fistulas occurred in four patients (5.6%), all of whom had a history of radiation therapy. CONCLUSIONS Paclitaxel-carboplatin and bevacizumab therapy is an acceptable and tolerable treatment for advanced or recurrent cervical cancer.
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Affiliation(s)
- Terumi Tanigawa
- Department of Gynecology, The Cancer Institute Hospital of JFCR, Tokyo, Japan.
| | - Nobuhiro Takeshima
- Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi, Japan
| | - Hideki Ishikawa
- JGOG1079 Data Center, Medical Research Support, Osaka, Japan
| | - Shin Nishio
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Fukuoka, Japan
| | - Tomoka Usami
- Department of Obstetrics and Gynecology, Ehime University School of Medicine, Ehime, Japan
| | - Takaharu Yamawaki
- Department of Obstetrics and Gynecology, Ise Red Cross Hospital, Mie, Japan
| | - Tetsuro Oishi
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, Tottori, Japan
| | - Kei Ihira
- Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Hokkaido, Japan
| | - Hisamori Kato
- Department of Gynecology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Mayako Goto
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Hyogo, Japan
| | - Motoaki Saito
- Department of Obstetrics and Gynecology, Tokyo Jikei kai Medical University School of Medicine, Tokyo, Japan
| | - Yusuke Taira
- Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan
| | - Masatoshi Yokoyama
- Department of Obstetrics and Gynecology, Saga University School of Medicine, Saga, Japan
| | - Tadahiro Shoji
- Department of Obstetrics and Gynecology, Hachinohe Red Cross Hospital, Aomori, Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan
| | - Atsushi Mori
- Department of Obstetrics and Gynecology, Nagano Municipal Hospital, Nagano, Japan
| | - Takeshi Yokoi
- Department of Obstetrics and Gynecology, Kaizuka City Hospital, Osaka, Japan
| | - Naomi Iwasa-Inoue
- Department of Obstetrics and Gynecology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | | | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University school of Medicine, Iwate, Japan
| | - Motoki Takenaka
- Department of Obstetrics and Gynecology, Gihu University School of Medicine, Gihu, Japan
| | - Mikio Mikami
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan
| | - Toru Sugiyama
- Department of Obstetrics and Gynecology, St. Mary's Hospital, Fukuoka, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata, Japan
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8
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Nomura H, Sugiyama Y, Nishino S, Ikki A, Murakami A, Matsumoto T, Fusegi A, Omi M, Aoki Y, Abe A, Tanigawa T, Netsu S, Okamoto S, Omatsu K, Yunokawa M, Kanao H. Clinical Management of Atypical Endometrial Cells of Undetermined Significance Followed by Negative Cytology. Acta Cytol 2022; 66:420-425. [PMID: 35421861 DOI: 10.1159/000524145] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/15/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION In Japan, endometrial cytology is widely performed to evaluate the status of the endometrium in women with suspected endometrial cancer. A new classification system for endometrial cytology has recently been used: the Yokohama system, based on a descriptive reporting format. This study aimed to clarify the triage for patients with atypical endometrial cells of undetermined significance (ATEC-US) when followed by negative endometrial cytology. METHODS We enrolled patients diagnosed with ATEC-US at the Cancer Institute Hospital between January 2016 and December 2017, based on the following inclusion criteria: (1) ATEC-US diagnosed by office endometrial cytology, with or without office endometrial biopsy; (2) follow-up endometrial cytology was performed 3-6 months after initial sampling, with a negative result for malignancy; and (3) no prior history of conservative treatment with progestin for endometrial cancer or atypical endometrial hyperplasia (ATEC-A). Among eligible patients, we analyzed those later diagnosed by endometrial biopsy with ATEC-A or carcinoma. RESULTS Among 187 patients, 65 met the inclusion criteria. Forty-two patients (64.6%) were observed for more than 24 months. Two patients (3.1%) developed ATEC-A during a median observation time of 26.5 months; the times to diagnosis were 32 months and 22 months. DISCUSSION/CONCLUSION No patient developed ATEC-A or worse within 1 year. For patients with ATEC-US, if negative cytology is obtained at the next examination, a close follow-up is not necessary.
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Affiliation(s)
- Hidetaka Nomura
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yuko Sugiyama
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shogo Nishino
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ai Ikki
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Atsushi Murakami
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tsuyoshi Matsumoto
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Atsushi Fusegi
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Makiko Omi
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoichi Aoki
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Akiko Abe
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Terumi Tanigawa
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Sachiho Netsu
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Sanshiro Okamoto
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kohei Omatsu
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Mayu Yunokawa
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroyuki Kanao
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
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9
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Kanno M, Yunokawa M, Nakabayashi M, Omi M, Ikki A, Mizusaki M, Nishimura M, Shimizu Y, Okamoto K, Tanaka Y, Fusegi A, Netsu S, Kurita T, Aoki Y, Tanigawa T, Matoda M, Okamoto S, Nomura H, Omatsu K, Sugiyama Y, Utsugi K, Takeshima N, Kanao H. Prognosis and adjuvant chemotherapy for patients with positive peritoneal cytology in stage IA endometrial cancer. Sci Rep 2022; 12:166. [PMID: 34997003 PMCID: PMC8741827 DOI: 10.1038/s41598-021-03975-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 12/06/2021] [Indexed: 12/19/2022] Open
Abstract
This study evaluated the influence of positive peritoneal cytology (PPC) on the prognosis of patients with stage IA endometrial cancer, and the usefulness of adjuvant chemotherapy in their treatment. We retrospectively analyzed the data of patients with stage IA endometrial cancer admitted in our hospital between 2005 and 2015. Among 989 patients who underwent peritoneal cytology, 135 (13.7%) had PPC. Multivariate analysis extracted several independent risk factors for recurrence in stage IA patients, including those with PPC. Adjuvant chemotherapy did not cause a significant difference in the 5-year relapse-free survival rate in patients with PPC (p = 0.78). Similarly, the 5-year recurrence-free survival rate with or without chemotherapy was not different among type II cancer patients (p = 0.11). However, the baseline risk of 5-year relapse-free survival without chemotherapy in patients with PPC and type II was very low (66.7%). While PPC was an independent risk factor for recurrence in stage IA endometrial cancer, adjuvant chemotherapy did not influence the survival rate in patients with PPC. While it is controversial whether adjuvant chemotherapy should be administered in stage IA uterine cancer with only PPC as a prognostic factor, it should be considered for early-stage patients who have multiple risk factors for recurrence.
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Affiliation(s)
- Motoko Kanno
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Mayu Yunokawa
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan. .,Department of Medical Oncology, The Cancer Institute Hospital of JFCR, Tokyo, Japan.
| | - Makoto Nakabayashi
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Makiko Omi
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Ai Ikki
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Megumi Mizusaki
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Mai Nishimura
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Yusuke Shimizu
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Kota Okamoto
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Yuji Tanaka
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Atsushi Fusegi
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Sachiho Netsu
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Tomoko Kurita
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Yoichi Aoki
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Terumi Tanigawa
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Maki Matoda
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Sanshiro Okamoto
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Hidetaka Nomura
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Kohei Omatsu
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Yuko Sugiyama
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Kuniko Utsugi
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Nobuhiro Takeshima
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Hiroyuki Kanao
- Department of Gynecology, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
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Yamane N, Ikeda A, Tomooka K, Saito I, Maruyama K, Eguchi E, Suyama K, Fujii A, Shiba T, Tanaka K, Kooka A, Nakamura S, Kajita M, Kawamura R, Takata Y, Osawa H, Steptoe A, Tanigawa T. Salivary Alpha-Amylase Activity and Mild Cognitive Impairment among Japanese Older Adults: The Toon Health Study. J Prev Alzheimers Dis 2022; 9:752-757. [PMID: 36281680 DOI: 10.14283/jpad.2022.51] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND There is growing interest in examining objective markers for early identification and behavioral intervention to prevent dementia and mild cognitive impairment in clinical and community settings. OBJECTIVE To investigate the association between salivary alpha-amylase as an objective measure of psychological stress response and mild cognitive impairment for the implication of psychological stress in the development of mild cognitive impairment. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study involved 865 participants aged ≥ 65 years. A saliva sample was collected in the morning, and the levels of salivary alpha-amylase were assayed. Mild cognitive impairment was evaluated using the Japanese version of the Montreal Cognitive Assessment; a score < 26 was indicative of mild cognitive impairment. A multivariable logistic regression model was used to examine the association of salivary alpha-amylase and mild cognitive impairment after adjusting for age, sex, current drinking status, current smoking status, body mass index, hypertension, diabetes mellitus, physical activity, education, social support, social network, and heart rate variability. RESULTS Salivary alpha-amylase was associated with mild cognitive impairment (the multivariable-adjusted odds ratio [95% confidence interval] for the 1-standard deviation increment of log-transformed salivary alpha-amylase was 1.24 [1.07-1.44]). This significant association persisted after adjusting for various confounding factors. CONCLUSION Elevation of salivary alpha-amylase was associated with mild cognitive impairment among Japanese community-dwelling older adults. This suggests that salivary alpha-amylase is a useful objective marker of psychological stress responses associated with mild cognitive impairment.
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Affiliation(s)
- N Yamane
- Takeshi Tanigawa, MD, PhD, Department of Public Health, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. Phone: +81 (3) 5802-1049 Fax: +81 (3) 3814-0305,
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11
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Kanao H, Aoki Y, Fusegi A, Omi M, Nomura H, Tanigawa T, Okamoto S, Kurita T, Netsu S, Omatsu K, Yunokawa M. Feasibility and Outcomes of "No-Look No-Touch" Laparoscopic Radical Trachelectomy for Early-Stage Cervical Cancer. J Clin Med 2021; 10:jcm10184154. [PMID: 34575265 PMCID: PMC8467639 DOI: 10.3390/jcm10184154] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/12/2021] [Accepted: 09/14/2021] [Indexed: 12/28/2022] Open
Abstract
Intraoperative tumor manipulation and dissemination may compromise the survival of women with early-stage cervical cancer who undergo laparoscopic surgery. This study aimed to examine survival and obstetrical outcomes related to laparoscopic radical trachelectomy (LRT) with a “no-look no-touch” technique in 40 women. This technique incorporates five measures to prevent tumor spillage and damage to the uterine artery perfusion. Five LRTs were aborted because of positive nodes or positive surgical margins. Compared with those of type III laparoscopic radical hysterectomy, the surgical outcomes of LRT in 35 patients were acceptable: operative time (380 min), estimated blood loss (140 mL), length of hospital stay (15 days), and lengths of excised parametrium and vagina. During follow-up (median, 41.3 months), the 5-year disease-free survival and overall survival were 95.0% (95% CI: 69.5–99.3%) and 100%, respectively. Of the nine patients (26%) who attempted pregnancy, seven conceived (nine pregnancies, 76%). Eight were delivered by term cesarean section, while one was miscarried in the first trimester. Our study suggests that the no-look no-touch technique may be effective in reducing the risk of recurrence and improving obstetrical outcomes during LRT for early-stage cervical cancer.
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Affiliation(s)
- Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo 135-8550, Japan; (Y.A.); (A.F.); (M.O.); (H.N.); (T.T.); (S.O.); (S.N.); (K.O.); (M.Y.)
- Correspondence: ; Tel.: +81-3-3520-0111; Fax: +81-3-3570-0343
| | - Yoichi Aoki
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo 135-8550, Japan; (Y.A.); (A.F.); (M.O.); (H.N.); (T.T.); (S.O.); (S.N.); (K.O.); (M.Y.)
| | - Atsushi Fusegi
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo 135-8550, Japan; (Y.A.); (A.F.); (M.O.); (H.N.); (T.T.); (S.O.); (S.N.); (K.O.); (M.Y.)
| | - Makiko Omi
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo 135-8550, Japan; (Y.A.); (A.F.); (M.O.); (H.N.); (T.T.); (S.O.); (S.N.); (K.O.); (M.Y.)
| | - Hidetaka Nomura
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo 135-8550, Japan; (Y.A.); (A.F.); (M.O.); (H.N.); (T.T.); (S.O.); (S.N.); (K.O.); (M.Y.)
| | - Terumi Tanigawa
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo 135-8550, Japan; (Y.A.); (A.F.); (M.O.); (H.N.); (T.T.); (S.O.); (S.N.); (K.O.); (M.Y.)
| | - Sanshiro Okamoto
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo 135-8550, Japan; (Y.A.); (A.F.); (M.O.); (H.N.); (T.T.); (S.O.); (S.N.); (K.O.); (M.Y.)
| | - Tomoko Kurita
- Department of Gynecologic Oncology, Hospital of the University of Occupational and Environmental Health, Fukuoka 807-8556, Japan;
| | - Sachiho Netsu
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo 135-8550, Japan; (Y.A.); (A.F.); (M.O.); (H.N.); (T.T.); (S.O.); (S.N.); (K.O.); (M.Y.)
| | - Kohei Omatsu
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo 135-8550, Japan; (Y.A.); (A.F.); (M.O.); (H.N.); (T.T.); (S.O.); (S.N.); (K.O.); (M.Y.)
| | - Mayu Yunokawa
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo 135-8550, Japan; (Y.A.); (A.F.); (M.O.); (H.N.); (T.T.); (S.O.); (S.N.); (K.O.); (M.Y.)
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12
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Nomura H, Ikki A, Fusegi A, Omi M, Aoki Y, Netsu S, Tanigawa T, Matoda M, Okamoto S, Omatsu K, Nakajima T, Ueki A, Tonooka A, Kanao H. Clinical and pathological outcomes of risk-reducing salpingo-oophorectomy for Japanese women with hereditary breast and ovarian cancer. Int J Clin Oncol 2021; 26:2331-2337. [PMID: 34453642 DOI: 10.1007/s10147-021-02020-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 05/09/2021] [Accepted: 08/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND To clarify the clinical as well as pathological outcomes in Japanese women with germline pathogenic BRCA1/2 variants who underwent risk-reducing salpingo-oophorectomy (RRSO). METHODS This prospective study examined the rate of occult cancer and primary peritoneal cancer after RRSO at our institution in the period from 2011 to 2020. Clinical records of genetically confirmed patients with germline pathogenic BRCA1/2 variants who desired to undergo RRSO were reviewed. Specimens obtained during RRSO were pathologically diagnosed as per SEE-FIM protocol. All the participants underwent magnetic resonance imaging (MRI) about 1 month preoperatively. RESULTS One hundred and seventeen women underwent RRSO during this period. Of these, the numbers of women with germline pathogenic BRCA1 and BRCA2 variants were 72 and 45, respectively. The mean observational time after RRSO was 35.8 months. Despite negative preoperative screening results, three (2.6%) serous tubal intraepithelial carcinoma and three (2.6%) invasive carcinomas were identified. Of the three invasive carcinomas cases, two were International Federation of Gynecology and Obstetrics (FIGO) stage I primary fallopian tube cancer, and the third case was double cancer (ovarian cancer and fallopian tube cancer) with FIGO stage IC3. CONCLUSIONS The rate of occult neoplasms was similar to those reported by studies performed in other countries. Although women with occult cancer were diagnosed with FIGO stage I, the MRI performed 1 month preoperatively did not show any such malignant findings. Thus, RRSO is the only promising method that can improve the prognosis in women with germline pathogenic BRCA1/2 variants.
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Affiliation(s)
- Hidetaka Nomura
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto City, Tokyo, 135-8550, Japan.
| | - Ai Ikki
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto City, Tokyo, 135-8550, Japan
| | - Atsushi Fusegi
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto City, Tokyo, 135-8550, Japan
| | - Makiko Omi
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto City, Tokyo, 135-8550, Japan
| | - Yoichi Aoki
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto City, Tokyo, 135-8550, Japan
| | - Sachiho Netsu
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto City, Tokyo, 135-8550, Japan
| | - Terumi Tanigawa
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto City, Tokyo, 135-8550, Japan
| | - Maki Matoda
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto City, Tokyo, 135-8550, Japan
| | - Sanshiro Okamoto
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto City, Tokyo, 135-8550, Japan
| | - Kohei Omatsu
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto City, Tokyo, 135-8550, Japan
| | - Takeshi Nakajima
- Department of Clinical Genetics, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto City, Tokyo, Japan
| | - Arisa Ueki
- Department of Clinical Genetics, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto City, Tokyo, Japan
| | - Akiko Tonooka
- Division of Pathology, Cancer Institute, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto City, Tokyo, Japan
| | - Hiroyuki Kanao
- Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake 3-8-31, Koto City, Tokyo, 135-8550, Japan
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13
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Nomura H, Omi M, Netsu S, Aoki Y, Tanigawa T, Kurita T, Matoda M, Okamoto S, Omatsu K, Kanao H. Positive surgical margin is an independent predictor of overall survival of patients with vulvar squamous cell carcinoma. J Obstet Gynaecol Res 2021; 47:3990-3997. [PMID: 34365709 DOI: 10.1111/jog.14962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/18/2021] [Revised: 05/03/2021] [Accepted: 07/22/2021] [Indexed: 11/29/2022]
Abstract
AIM It is uncertain whether curative surgical treatment or a less radical surgery with adjuvant treatment should be provided to preserve function in patients with vulvar squamous cell carcinoma (SCC) that is adjacent to the urethra, anus, and vagina. The aim of this study was to investigate the surgical margin in patients with vulvar SCC with regard to local recurrence and overall survival. METHODS Thirty-four patients were identified as having a diagnosis of vulvar SCC without distant metastasis. They had been treated surgically with curative intent at the Cancer Institute Hospital. Clinical data were analyzed retrospectively. RESULTS Rates of 5-year local recurrence-free survival among patients with positive, <3-mm, <5-mm, <8-mm, and ≥8-mm surgical margins were 32%, 30.3%, 42.5%, 55.5%, and 73%, respectively. Rates of 5-year overall survival of patients with positive, <3-mm, <5-mm, <8-mm, and ≥8-mm surgical margins were 15.5%, 53.8%, 58.8%, 67.6%, and 83.3%, respectively. In the multivariable analysis, a tumor size of more than 2-cm (hazard ratio [HR] = 17.7, 95% confidence interval [CI] = 1.39-226) and a positive surgical margin (HR = 0.0092, 95% CI = 0.011-0.53) were risk factors for local recurrence, and a lymph node involvement (HR = 1.41, 95% CI = 0.31-6.43) and a positive surgical margin (HR = 0.0046, 95% CI = 0.011-0.53) were significant risk factors for overall mortality. CONCLUSIONS To improve the prognosis, thorough resection with an adequate surgical margin is needed. But narrow surgical margin may be acceptable, particularly to preserve the function of adjacent organs.
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Affiliation(s)
- Hidetaka Nomura
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Makiko Omi
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Sachiho Netsu
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yoichi Aoki
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Terumi Tanigawa
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tomoko Kurita
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Maki Matoda
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Sanshiro Okamoto
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kohei Omatsu
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroyuki Kanao
- Department of Gynecology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
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14
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Kato K, Omatsu K, Okamoto S, Matoda M, Nomura H, Tanigawa T, Aoki Y, Yunokawa M, Kanao H. Early oral feeding is safe and useful after rectosigmoid resection with anastomosis during cytoreductive surgery for primary ovarian cancer. World J Surg Oncol 2021; 19:77. [PMID: 33722264 PMCID: PMC7962404 DOI: 10.1186/s12957-021-02186-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/04/2021] [Indexed: 12/14/2022] Open
Abstract
Background The aim of this study was to investigate the safety and clinical usefulness of early oral feeding (EOF) after rectosigmoid resection with anastomosis for the treatment of primary ovarian cancer. Methods We performed a retrospective review of all consecutive patients who had undergone rectosigmoid resection with anastomosis for primary ovarian, tubal, or peritoneal cancer between April 2012 and March 2019 in a single institution. Patient-related, disease-related, and surgery-related data including the incidence of anastomotic leakage and postoperative hospital stay were collected. EOF was introduced as a postoperative oral feeding protocol in September 2016. Before the introduction of EOF, conventional oral feeding (COF) had been used. Results Two hundred and one patients who underwent rectosigmoid resection with anastomosis, comprised of 95 patients in the COF group and 106 patients in the EOF group, were included in this study. The median number of postoperative days until the start of diet intake was 5 (range 2–8) in the COF group and 2 (range 2–8) in the EOF group (P < 0.001). Postoperative morbidity was equivalent between the groups. The incidence of anastomotic leakage was similar (1%) in both groups. The median length of the postoperative hospital stay was reduced by 6 days for the EOF group: 17 (range 9–67) days for the COF group versus 11 (8–49) days for the EOF group (P < 0.001). Conclusion EOF provides a significant reduction in the length of the postoperative hospital stay without an increased complication risk after rectosigmoid resection with anastomosis as a part of cytoreductive surgery for primary ovarian cancer.
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Affiliation(s)
- Kazuyoshi Kato
- Department of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan. .,Present address: Department of Obstetrics and Gynecology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Kohei Omatsu
- Department of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Sanshiro Okamoto
- Department of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Maki Matoda
- Department of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Hidetaka Nomura
- Department of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Terumi Tanigawa
- Department of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Yoichi Aoki
- Department of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Mayu Yunokawa
- Department of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
| | - Hiroyuki Kanao
- Department of Gynecology, Cancer Institute Hospital, 3-8-31 Ariake, Koutou-ku, Tokyo, 135-8550, Japan
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Kanao H, Aoki Y, Omi M, Nomura H, Tanigawa T, Okamoto S, Chang EJ, Kurita T, Netsu S, Matoda M, Omatsu K, Matsuo K. Laparoscopic pelvic exenteration and laterally extended endopelvic resection for postradiation recurrent cervical carcinoma: Technical feasibility and short-term oncologic outcome. Gynecol Oncol 2021; 161:34-38. [PMID: 33423805 DOI: 10.1016/j.ygyno.2020.12.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/23/2020] [Accepted: 12/22/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Surgery is the only treatment for cervical cancer recurrence in a previously irradiated field. Pelvic exenteration (PE) and laterally extended endopelvic resection (LEER) are indicated for select patients; however, morbidity and mortality rates remain high, and new treatment modalities are required. Laparoscopy optimizes visualization and allows meticulous dissection while also reducing intraoperative blood loss and postoperative complications without worsening the outcomes. We aimed to clarify the feasibility and outcomes of laparoscopic PE and LEER for previously irradiated recurrent cervical cancer. METHODS We prospectively investigated the outcomes of laparoscopic PE and LEER in 28 patients with recurrent cervical carcinoma after radiotherapy. RESULTS Seventeen laparoscopic PEs for central recurrences and 11 laparoscopic LEERs for lateral recurrences were performed. The median operation time and blood loss were 454mins and 285 mL in the PE group, and 562mins and 325 mL in the LEER group, respectively, with no conversions to laparotomy. R0 resection was achieved in all patients in the PE group and 73% in the LEER group. The morbidity and mortality rates were 41% and 0% in PE group, and 55% and 0% in LEER group, respectively. The 2-year disease-free survival and overall survival were 68.9% and 76% in the PE group, and 27.3% and 29.6% in the LEER group, respectively. CONCLUSION Laparoscopic PE is feasible for previously irradiated central recurrent cervical cancer and has acceptable outcomes. Laparoscopic LEER is also feasible for lateral recurrence, but oncologic outcome may be modest in this limited preliminary study. Further studies using a larger sample size with a longer follow-up period is warranted to determine the indications for laparoscopic LEER.
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Affiliation(s)
- Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Tokyo 135-8550, Japan.
| | - Yoichi Aoki
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Tokyo 135-8550, Japan
| | - Makiko Omi
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Tokyo 135-8550, Japan
| | - Hidetaka Nomura
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Tokyo 135-8550, Japan
| | - Terumi Tanigawa
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Tokyo 135-8550, Japan
| | - Sanshiro Okamoto
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Tokyo 135-8550, Japan
| | - Erica J Chang
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA 90033, USA
| | - Tomoko Kurita
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Tokyo 135-8550, Japan
| | - Sachiho Netsu
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Tokyo 135-8550, Japan
| | - Maki Matoda
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Tokyo 135-8550, Japan
| | - Kohei Omatsu
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Tokyo 135-8550, Japan
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA 90033, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA
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Tanigawa T, Matoda M, Omi M, Aoki Y, Netsu S, Nomura H, Okamoto S, Omatsu K, Yunokawa M, Kanao H, Takeshima N. Continuous Administration of Bevacizumab After Disease Progression in Recurrent Ovarian Cancer: A Retrospective Observational Study. Anticancer Res 2020; 40:5285-5290. [PMID: 32878818 DOI: 10.21873/anticanres.14533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/13/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Chemotherapy with additional bevacizumab is the standard treatment for primary and recurrent ovarian cancer. We aimed to investigate the clinical utility and safety of bevacizumab when used in combination with chemotherapy after disease progression. PATIENTS AND METHODS This retrospective, observational study recruited patients treated for recurrent ovarian cancer from 2014 to 2016. We evaluated the effects of bevacizumab with chemotherapy in patients whose disease had progressed following treatment with bevacizumab. We assessed progression-free survival and adverse events. RESULTS Thirty-three patients received post-progression treatment with bevacizumab. The median progression-free survival was 8.7 months (95% confidence interval=5.5-11). The progression-free survival was compared pre- and post-progression treatment, and was longer in platinum-resistant than platinum-sensitive cases after treatment (p=0.06). The most common non-hematological toxicity was proteinuria. The incidence of serious adverse events was low. CONCLUSION Continuous administration of bevacizumab may be beneficial for ovarian cancer patients after disease progression.
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Shirahama R, Tanigawa T, Tomooka K, Fan Yun L, Ikeda A, Wada H, Kales SN. 0653 Positive Effects of Long Term Continuous Positive Airway Pressure Therapy on Blood Pressure in Obstructive Sleep Apnea Patients. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.649] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Obstructive sleep apnea (OSA) is one of the common causes of hypertension. Therefore, we examine the longitudinal effect of continuous positive airway pressure (CPAP) therapy and its adherence on blood pressure among OSA patients.
Methods
One thousand two hundred ninety-three (male 1,130, female 163) patients, who were diagnosed with OSA and underwent CPAP therapy were investigated for longitudinal changes (24 months observation period) in the levels of blood pressure and body weight. The longitudinal analyses were performed by mixed effect model. Multiple Imputation with Chained Equations was also used to impute missing data. Good CPAP adherence is defined as more than 70% of the time using CPAP more than 4hours at all the measuring. Poor CPAP adherence is defined as less than 70% of the time using CPAP more than 4hours at all the measuring time points.
Results
The patient group with good CPAP adherences), compared to poor CPAP adherence, showed significant diastolic blood pressure reduction in 24 months follow-up period (β=-0.13, p=0.03) despite a lack of significant weight loss (β=-0.02, p=0.59). However, no significant associations were found between systolic blood pressure and CPAP adherence (β=-0.14, p=0.11).
Conclusion
CPAP therapy was found to have a longitudinal effect on diastolic blood pressure despite a lack of significant weight loss.
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Affiliation(s)
- R Shirahama
- Department of Public Hearth. Graduate School of Medicine, Juntendo university, Tokyo, JAPAN
| | - T Tanigawa
- Department of Public Hearth. Graduate School of Medicine, Juntendo university, Tokyo, JAPAN
| | - K Tomooka
- Department of Public Hearth. Graduate School of Medicine, Juntendo university, Tokyo, JAPAN
| | - L Fan Yun
- Occupational medicine Residency, Harverd TH Chan School of Public Health, BOSTON, MA
| | - A Ikeda
- Department of Public Hearth. Graduate School of Medicine, Juntendo university, Tokyo, JAPAN
| | - H Wada
- Department of Public Hearth. Graduate School of Medicine, Juntendo university, Tokyo, JAPAN
| | - S N Kales
- Occupational medicine Residency, Harverd TH Chan School of Public Health, BOSTON, MA
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Filomeno R, Ikeda A, Maruyama K, Wada H, Tanigawa T. Excessive daytime sleepiness and alcohol consumption among commercial drivers. Occup Med (Lond) 2020; 69:406-411. [PMID: 31263899 DOI: 10.1093/occmed/kqz091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Commercial drivers suffering from excessive daytime sleepiness (EDS) have been identified as a major cause of road traffic accidents. Alcohol usage directly affects sleep, adversely affecting next-day alertness and performance. AIMS To examine the relationship between alcohol consumption and EDS among commercial truck drivers in Japan and the implications of this on public health. METHODS All participants in this cross-sectional study were commercial motor vehicle drivers from Tokyo and Niigata Prefecture. Participants completed a self-administered questionnaire with details of their age, body mass index, alcohol consumption, Epworth Sleepiness Scale (ESS) score and tobacco usage. Participants' oxygen desaturation index was determined by a pulse oximetry device that participants took home. RESULTS A total of 1422 males registered with the Japan Trucking Association and aged 20-69 years participated. The multivariate-adjusted odds ratio (OR) of EDS among participants aged <43 years was 0.81 (95% confidence interval (CI) 0.47-1.40) for light drinkers, 0.93 (95% CI 0.51-1.70) for moderate drinkers and 0.61 (95% CI 0.21-1.79) for heavy drinkers, compared to non-drinkers. The multivariate-adjusted OR among participants aged ≥43 years was 1.42 (95% CI 0.59-3.45) for light drinkers, 1.53 (95% CI 0.63-3.75) for moderate drinkers and 3.37 (95% CI 1.14-9.96) for heavy drinkers (P for interaction = 0.05). CONCLUSION We found that the association between ESS and alcohol intake was more evident among those aged ≥43 years, who reported higher levels of EDS with increased alcohol consumption.
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Affiliation(s)
- R Filomeno
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - A Ikeda
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Maruyama
- Department of Bioscience, Ehime University Graduate School of Agriculture, Ehime, Japan
| | - H Wada
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - T Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Nomura H, Tanaka Y, Omi M, Netsu S, Aoki Y, Tanigawa T, Kurita T, Matoda M, Okamoto S, Omatsu K, Kanao H, Takeshima N. Surgical outcomes of early-stage primary vaginal nonsquamous cell carcinoma. Int J Clin Oncol 2020; 25:1412-1417. [PMID: 32219631 DOI: 10.1007/s10147-020-01663-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/13/2019] [Accepted: 03/12/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Definitive radiation therapy (RT), using external beam RT and/or brachytherapy, is a standard treatment option for primary vaginal carcinoma. However, this treatment has poor prognosis when applied to vaginal nonsquamous cell carcinoma (non-SCC). We aimed to clarify treatment outcome and surgical safety in early-stage primary vaginal non-SCC. METHODS After receiving approval from the institutional review board, we retrospectively reviewed the clinical records and pathological samples of patients treated at our hospital between 1991 and 2018. Among 49 patients with primary vaginal carcinoma, 12 with histologically confirmed early-stage primary vaginal non-SCC were included in this study. RESULTS In total, 40% of patients with primary vaginal carcinoma treated at our hospital had primary vaginal non-SCC. The average observation time was 34 months (median 53.3 months). Three patients had local recurrence: 2 in pelvic lymph nodes and 1 in the vagina. Furthermore, 2 patients died of their disease. Five-year local control rate of stage I and stage II non-SCC was 75% and 100%, respectively. Disease-specific survival rate of stage I and stage II non-SCC was 81.8% and 100%, respectively. No major morbidity was observed. Three patients required allogeneic blood transfusion, whereas 1 underwent autotransfusion. None of the 12 patients were discharged with self-catheterization. CONCLUSION Five-year local control and disease-specific survival rates of patients surgically treated for vaginal non-SCC were favorable. Therefore, surgery could be a safe and reasonable option for early-stage primary vaginal non-SCC.
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Affiliation(s)
- Hidetaka Nomura
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
| | - Yuji Tanaka
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Makiko Omi
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Sachiho Netsu
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yoichi Aoki
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Terumi Tanigawa
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Tomoko Kurita
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Maki Matoda
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Sanshiro Okamoto
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Kohei Omatsu
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Hiroyuki Kanao
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Nobuhiro Takeshima
- Department of Gynecology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan
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20
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Kanao H, Matsuo K, Aoki Y, Tanigawa T, Nomura H, Okamoto S, Takeshima N. Feasibility and outcome of total laparoscopic radical hysterectomy with no-look no-touch technique for FIGO IB1 cervical cancer. J Gynecol Oncol 2019; 30:e71. [PMID: 30887768 PMCID: PMC6424854 DOI: 10.3802/jgo.2019.30.e71] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 02/20/2019] [Accepted: 02/24/2019] [Indexed: 11/30/2022] Open
Abstract
Objectives Intraoperative tumor manipulation and dissemination may possibly compromise survival of women with early-stage cervical cancer who undergo minimally-invasive radical hysterectomy (RH). The objective of the study was to examine survival related to minimally-invasive RH with a “no-look no-touch” technique for clinical stage IB1 cervical cancer. Methods This retrospective study compared patients who underwent total laparoscopic radical hysterectomy (TLRH) with no-look no-touch technique (n=80) to those who underwent an abdominal radical hysterectomy (ARH; n=83) for stage IB1 (≤4 cm) cervical cancer. TLRH with no-look no-touch technique incorporates 4 specific measures to prevent tumor spillage: 1) creation of a vaginal cuff, 2) avoidance of a uterine manipulator, 3) minimal handling of the uterine cervix, and 4) bagging of the specimen. Results Surgical outcomes of TLRH were significantly superior to ARH for operative time (294 vs. 376 minutes), estimated blood loss (185 vs. 500 mL), and length of hospital stay (14 vs. 18 days) (all, p<0.001). Oncologic outcomes were similar between the 2 groups, including disease-free survival (DFS) (p=0.591) and overall survival (p=0.188). When stratified by tumor size (<2 vs. ≥2 cm), DFS was similar between the 2 groups (p=0.897 and p=0.602, respectively). The loco-regional recurrence rate following TLRH was similar to the rate after ARH (6.3% vs. 9.6%, p=0.566). Multiple-pelvic recurrence was observed in only 1 patient in the TLRH group. Conclusion Our study suggests that the no-look no-touch technique may be a useful surgical procedure to reduce recurrence risk via preventing intraoperative tumor spillage during TLRH for early-stage cervical cancer.
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Affiliation(s)
- Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan.
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.,Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Yoichi Aoki
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Terumi Tanigawa
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Hidetaka Nomura
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Sanshiro Okamoto
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
| | - Nobuhiro Takeshima
- Department of Gynecologic Oncology, Cancer Institute Hospital, Tokyo, Japan
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21
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Matsuo R, Tomooka K, Noda A, Maruyama K, Saito I, Tanigawa T. The effect of sleep disordered breathing and excessive daytime sleepiness on the risk of motor vehicle crash: the toon health study. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.691] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Hayashi T, Wada H, Tanigawa T. Cooperative therapeutic approach of physicians and dentists to patients with sleep apnea in Japan. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.407] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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OSHIMA A, Tomooka K, Ikeda A, Maruyama K, Saito I, Tanigawa T. Association of objective sleepiness with motor vehicle crash among japanese community residents: the toon health study. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.805] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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24
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Tomooka K, Wada H, Sato S, Shirahama R, Kunimatsu-sanuki S, Tanigawa T. Additive effect of visual field defect and daytime sleepiness on motor vehicle crashes among Japanese taxi drivers. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1082] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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25
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Wada H, Kimura M, Shirahama R, Tanigawa T. Funnel chest is associated with sleep-related symptoms in children. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1133] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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26
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Takasaki A, Kurita T, Masuda J, Dohi K, Hoshino K, Tanigawa T, Saito Y, Kitamura T, Kakimoto H, Setsuda M, Makino K, Ichikawa T, Ito M. P1717The clinical impact of intra-aortic balloon pumping for acute coronary syndrome from Mie ACS registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0472] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Intra-Aortic Balloon Pumping (IABP) was widespread used in cases of Acute Coronary Syndrome (ACS) at daily clinical situation in Japan, even though the efficacy of IABP in AMI patients with cardiogenic shock was not proved. The aim of this study was to investigate the efficacy of IABP use in ACS patients in Japan.
Methods
We investigated 2-year all-cause-mortality of 2,660 enrolled ACS patients including 358 patients with IABP and 2,302 patients without IABP from Mie ACS registry.
Results
We compared a 1:1 propensity score-matched cohort of 426 ACS patients with or without IABP (n=213, respectively). 2-year mortality was significantly higher in patients with IABP than without IABP (p=0.02, Figure A). In addition, IABP usage was independent predictor of mortality with hazard ratio of 1.6 by multivariate analysis. However, 2-year mortality was not statistically different between 2 groups only when analyzed patients with shock (p=0.60, Figure B).
Figure 1
Conclusion
IABP was not commonly recommended in ACS patients. However, IABP was might as well used in some situation especially in shock.
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Affiliation(s)
| | - T Kurita
- Mie University Hospital, Tsu, Japan
| | - J Masuda
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - K Dohi
- Mie University Hospital, Tsu, Japan
| | - K Hoshino
- Nagai Hospital, Cardiology, Tsu, Japan
| | - T Tanigawa
- Matsusaka Chuo General Hospital, Cardiology, Matsusaka, Japan
| | - Y Saito
- Suzuka Kaisei Hospital, Suzuka, Japan
| | - T Kitamura
- Suzuka Chuo General Hospital, Cardiology, Suzuka, Japan
| | - H Kakimoto
- Saiseikai Matsusaka General Hospital, Matsusaka, Japan
| | | | - K Makino
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - T Ichikawa
- Kuwana City Medical Center, Kuwana, Japan
| | - M Ito
- Mie University Hospital, Tsu, Japan
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Takasaki A, Kurita T, Masuda J, Dohi K, Hoshino K, Tanigawa T, Saito Y, Kitamura T, Kakimoto H, Setsuda M, Makino K, Ichikawa T, Ito M. P2659Difference of prognostic impact of Killip classification in ACS patients with or without hemodialysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0979] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiovascular deaths are more frequently in hemodialysis (HD) patients compared to general population. However, difference of prognosis of acute coronary syndrome (ACS) patients with or without HD were not well evaluated.
Purpose
The purpose of this study was to evaluate the clinical and prognostic characteristics of ACS patients with HD compared to that of ACS patients without HD.
Methods
We investigated 3427 ACS patients including 63 HD and 3364 non-HD patients between 2013 and 2017 using date from Mie ACS registry, a retrospective and multicenter registry. The primary outcome was defined as all-cause mortality.
Results
HD patients showed significantly higher prevalence of diabetes mellitus, past treatment of coronary artery disease, history of myocardial infarction and Killip ≥2 compared to non-HD patients (p<0.05, respectively). During the follow-up periods (median 719 days), 425 (12.4%) patients experienced all-cause death. HD patients demonstrated the higher all-cause mortality rate compared to that of non-HD patients during the follow-up (11.9% versus 38.1%, p<0.001, chi square). Kaplan Meier survival curves demonstrated that HD and non-HD patients with Killip 1 showed similar 30-day mortality, and Killip ≥2 patients also showed similar prognosis (Left side of figure). On the other hand, all cause mortality at 2 years were higher in Killip 1 HD patients compared to Killip 1 non-HD patients and similar between Killip 1 HD patients and Killip ≥2 non-HD patients in the 30 days landmark analysis (Right side of figure). In addition, cox regression analyses for all cause mortality demonstrated that HD was a strongest independent prognostic factor not of 30-day mortality but of after 30-day mortality with hazard ratio of 4.09 (95% confidential interval: 2.32–7.21, p<0.001).
Figure 1
Conclusion
Careful management are required in chronic phase for ACS patients with HD even in Killip 1 classification.
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Affiliation(s)
| | - T Kurita
- Mie University Hospital, Tsu, Japan
| | - J Masuda
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - K Dohi
- Mie University Hospital, Tsu, Japan
| | - K Hoshino
- Nagai Hospital, Cardiology, Tsu, Japan
| | - T Tanigawa
- Matsusaka Chuo General Hospital, Cardiology, Matsusaka, Japan
| | - Y Saito
- Suzuka Kaisei Hospital, Suzuka, Japan
| | - T Kitamura
- Suzuka Chuo General Hospital, Cardiology, Suzuka, Japan
| | - H Kakimoto
- Saiseikai Matsusaka General Hospital, Matsusaka, Japan
| | | | - K Makino
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - T Ichikawa
- Kuwana City Medical Center, Kuwana, Japan
| | - M Ito
- Mie University Hospital, Tsu, Japan
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Kanao H, Aoki Y, Tanigawa T, Matoda M, Okamoto S, Nomura H, Omatsu K, Kato K, Utsugi K, Takeshima N. En Bloc Resection of an Aggressive Angiomyxoma by a Novel Combination Laparoscopic and Open Perineal Approach. J Minim Invasive Gynecol 2019; 26:598-599. [DOI: 10.1016/j.jmig.2018.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/10/2018] [Accepted: 07/12/2018] [Indexed: 11/30/2022]
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29
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Kanao H, Hisa T, Omi M, Nagashima M, Okamoto S, Aoki Y, Tanigawa T, Matoda M, Okamoto S, Nomura H, Omatsu K, Kato K, Utsugi K, Takeshima N. Laparoscopic Anterior Pelvic Exenteration with Super Radical Parametrectomy for a Recurrent Low-Grade Endometrial Sarcoma That is Resistant to Hormone Therapy and Chemotherapy. J Minim Invasive Gynecol 2019; 26:34-35. [DOI: 10.1016/j.jmig.2018.03.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 03/27/2018] [Indexed: 10/17/2022]
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30
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Aoki Y, Kanao H, Kikuchi I, Nomura H, Okamoto S, Hisa T, Sugihara T, Kitano R, Omatsu K, Tanigawa T, Takeshima N. Comparison of the Technical Feasibility and Safety of Three Contained Morcellation Techniques: A Pilot Study in an Animal Model. J Minim Invasive Gynecol 2018; 26:1288-1296. [PMID: 30562578 DOI: 10.1016/j.jmig.2018.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 09/12/2018] [Revised: 12/05/2018] [Accepted: 12/08/2018] [Indexed: 10/27/2022]
Abstract
STUDY OBJECTIVE To compare 3 laparoscopic contained morcellation techniques in terms of feasibility and safety. DESIGN Pilot study in an animal model (Canadian Task Force classification II-1). SETTING Gynecologic oncology department at a cancer institute in Japan. PATIENTS Porcine model. INTERVENTIONS Three contained morcellation techniques were tested, each multiple times in 1 of 3 anesthetized female pigs: manual morcellation (8 times), dual-site power morcellation (8 times), and single-site power morcellation (6 times). All were tested on beef tongue introduced abdominally. MEASUREMENTS AND MAIN RESULTS The following variables were compared: bag insertion time, morcellation time, bag removal time, total in-bag morcellation time, and the volume of pneumoperitoneum CO2 consumed. Bag rupture was evaluated ex vivo on completion of the procedure. Bag insertion time (in minutes) was significantly greater for dual-site morcellation (10.91 ± 3.38) than for manual (4.58 ± 2.47, p = .003) or single-site power (7.25 ± .77, p = .014) morcellation. Bag removal time (in minutes) was also significantly greater for dual-site morcellation (.85 ± .11 vs .27 ± .14, p<.001, vs .33 ± .59, p = .001). Total in-bag morcellation time, although greatest for manual morcellation at 21.4 ± 10.2 minutes, did not differ significantly between techniques. CO2 consumption was significantly low for manual morcellation. Visual inspection revealed no bag damage when manual morcellation was performed, but bag damage occurred in 3 dual-site cases and in 1 single-site case. CONCLUSION Considering preventing specimen leakage as the main aim of contained morcellation, the bag used for power morcellation needs improvement. Although manual morcellation requires an umbilical wound of about 25 mm, the absence of bag damage, acceptable total morcellation time, relatively low CO2 consumption, and nonuse of a power device, which translate to an economic benefit, lead us to conclude that manual morcellation will remain advantageous into the future.
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Affiliation(s)
- Yoichi Aoki
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan.
| | - Hiroyuki Kanao
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
| | - Iwaho Kikuchi
- Department of Obstetrics and Gynecology, Juntendo Urayasu Hospital (Dr. Kikuchi), Urayasu, Japan
| | - Hidetaka Nomura
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
| | - Syuhei Okamoto
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
| | - Tsuyoshi Hisa
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
| | - Takeru Sugihara
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
| | - Rie Kitano
- Department of Obstetrics and Gynecology, Tsuchiura Kyodo General Hospital (Dr. Kitano), Tsuchiura, Japan
| | - Kohei Omatsu
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
| | - Terumi Tanigawa
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
| | - Nobuhiro Takeshima
- Department of Gynecologic Oncology, Cancer Institute Hospital (Drs. Aoki, Kanao, Nomura, Okamoto, Hisa, Sugihara, Omatsu, Tanigawa, and Takeshima), Tokyo, Japan
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Nomura H, Sugiyama Y, Ito T, Furuta N, Komatsu K, Takazawa Y, Aoki Y, Tanigawa T, Matoda M, Okamoto S, Kanao H, Omatsu K, Kato K, Utsugi K, Takeshima N. Clinical management of the status of atypical endometrial cells using the descriptive reporting format for endometrial cytology. Cytopathology 2018; 30:209-214. [DOI: 10.1111/cyt.12638] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 08/21/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Hidetaka Nomura
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Yuko Sugiyama
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Takahiko Ito
- Department of Cytology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Noriyuki Furuta
- Department of Cytology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Kyoko Komatsu
- Department of Cytology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Yutaka Takazawa
- Division of Pathology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Yoichi Aoki
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Terumi Tanigawa
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Maki Matoda
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Sanshiro Okamoto
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Hiroyuki Kanao
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Kohei Omatsu
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Kazuyoshi Kato
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Kuniko Utsugi
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
| | - Nobuhiro Takeshima
- Department of Gynecology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Koto‐ku Tokyo Japan
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Fukuoka S, Kurita T, Dohi K, Sato Y, Ishise T, Seko T, Tanigawa T, Kitamura T, Miyahara M, Makino K, Ito M. P2706Impact of age on obesity paradox in patients with acute myocardial infarction after primary percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2706] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Fukuoka
- Mie University Hospital, Cardiology, Tsu, Japan
| | | | - K Dohi
- Mie CCU Network, Tsu, Japan
| | - Y Sato
- Mie CCU Network, Tsu, Japan
| | | | - T Seko
- Mie CCU Network, Tsu, Japan
| | | | | | | | | | - M Ito
- Mie CCU Network, Tsu, Japan
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33
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Fukuoka S, Kurita T, Dohi K, Takasaki A, Nakata T, Fujimoto N, Masuda J, Hoshino K, Tanigawa T, Fujii E, Koyabu S, Ito M. P3660Clinical usefulness of instantaneous wave-free ratio for evaluation of coronary artery lesion with prior myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3660] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Fukuoka
- Mie University Hospital, Cardiology, Tsu, Japan
| | - T Kurita
- Mie University Hospital, Cardiology, Tsu, Japan
| | - K Dohi
- Mie University Hospital, Cardiology, Tsu, Japan
| | - A Takasaki
- Matsusaka General Hospital, Cardiology, Matsusaka, Japan
| | - T Nakata
- Mie Prefecture General Medical Center, Cardiology, Yokkaichi, Japan
| | - N Fujimoto
- Mie University Hospital, Cardiology, Tsu, Japan
| | - J Masuda
- Mie University Hospital, Cardiology, Tsu, Japan
| | - K Hoshino
- Nagai Hospital, Cardiology, Tsu, Japan
| | - T Tanigawa
- Matsusaka General Hospital, Cardiology, Matsusaka, Japan
| | - E Fujii
- Mie University Hospital, Cardiology, Tsu, Japan
| | - S Koyabu
- Owase General Hospital, Cardiology, Owase, Japan
| | - M Ito
- Mie University Hospital, Cardiology, Tsu, Japan
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34
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Kimura M, Wada H, Shirahama R, Suzuki Y, Suzuki Y, Maruyama K, Ikeda A, Tanigawa T. 0781 Association Between Snoring and Anxiety in Community-dwelling School Children. Sleep 2018. [DOI: 10.1093/sleep/zsy061.780] [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: 11/12/2022] Open
Affiliation(s)
- M Kimura
- Graduate School of Medicine, Juntendo University, Tokyo, JAPAN
| | - H Wada
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, JAPAN
| | - R Shirahama
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, JAPAN
| | - Y Suzuki
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, JAPAN
| | - Y Suzuki
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, JAPAN
| | - K Maruyama
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, JAPAN
| | - A Ikeda
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, JAPAN
| | - T Tanigawa
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, JAPAN
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35
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Wada H, Kimura M, Tajima T, Shirahama R, Hayashi T, Suzuki Y, Suzuki Y, Sato S, Maruyama K, Endo M, Ikeda A, Tanigawa T. 0773 Sleep Disordered Breathing Based on Symptoms And RDI in Primary School Children with Implication for Prevalence. Sleep 2018. [DOI: 10.1093/sleep/zsy061.772] [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: 11/12/2022] Open
Affiliation(s)
- H Wada
- Juntendo University, Tokyo, JAPAN
| | - M Kimura
- Juntendo University, Tokyo, JAPAN
| | - T Tajima
- Juntendo University, Tokyo, JAPAN
| | | | | | - Y Suzuki
- Juntendo University, Tokyo, JAPAN
| | - Y Suzuki
- Juntendo University, Tokyo, JAPAN
| | - S Sato
- Juntendo University, Tokyo, JAPAN
| | | | - M Endo
- Juntendo University, Tokyo, JAPAN
| | - A Ikeda
- Juntendo University, Tokyo, JAPAN
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Shirahama R, Mtsuzawa Y, Kimura M, Wada H, Tanigawa T, Nishikawa T. 0456 Relation between Primary Aldosteronism and Obstructive Sleep Apnea. Sleep 2018. [DOI: 10.1093/sleep/zsy061.455] [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: 11/13/2022] Open
Affiliation(s)
- R Shirahama
- RESM Sleep Center, Tokyo, JAPAN
- Department of Public hearth, Graduate School of Medicine, Juntendo University, Tokyo, JAPAN
| | - Y Mtsuzawa
- Yokohama Rosai Hospital, yokohama, JAPAN
| | - M Kimura
- Department of Public hearth, Graduate School of Medicine, Juntendo University, Tokyo, JAPAN
| | - H Wada
- Department of Public hearth, Graduate School of Medicine, Juntendo University, Tokyo, JAPAN
| | - T Tanigawa
- Department of Public hearth, Graduate School of Medicine, Juntendo University, Tokyo, JAPAN
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Miyoshi N, Tanigawa T, Nishioka S, Maruyama K, Eguchi E, Tanaka K, Saito I, Yamazaki K, Miyake Y. Association of salivary lactate dehydrogenase level with systemic inflammation in a Japanese population. J Periodontal Res 2018; 53:487-494. [DOI: 10.1111/jre.12537] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2018] [Indexed: 12/01/2022]
Affiliation(s)
- N. Miyoshi
- Department of Epidemiology and Preventive Medicine; Ehime University Graduate School of Medicine; Ehime Japan
| | - T. Tanigawa
- Department of Public Health; Juntendo University Graduate School of Medicine; Tokyo Japan
| | - S. Nishioka
- Department of Diabetes and Molecular Genetics; Ehime University Graduate School of Medicine; Ehime Japan
- Ehime Dental Association; Ehime Japan
| | - K. Maruyama
- Department of Public Health; Juntendo University Graduate School of Medicine; Tokyo Japan
| | - E. Eguchi
- Department of Public Health; Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences; Okayama Japan
| | - K. Tanaka
- Department of Epidemiology and Preventive Medicine; Ehime University Graduate School of Medicine; Ehime Japan
| | - I. Saito
- Department of Basic Nursing and Health Science; Ehime University Graduate School of Medicine; Ehime Japan
| | - K. Yamazaki
- Research Unit for Oral-Systemic Connection; Division of Oral Science for Health Promotion; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Y. Miyake
- Department of Epidemiology and Preventive Medicine; Ehime University Graduate School of Medicine; Ehime Japan
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38
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Nomura H, Sakamoto K, Sugihara T, Okamoto S, Aoki Y, Tanigawa T, Matoda M, Omatsu K, Kanao H, Kato K, Utsugi K, Sugiyama Y, Takeshima N. Oral leukoplakia, a precancerous lesion of squamous cell carcinoma, in patients with long-term pegylated liposomal doxorubicin treatment. Medicine (Baltimore) 2018; 97:e9932. [PMID: 29443777 PMCID: PMC5839861 DOI: 10.1097/md.0000000000009932] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Pegylated liposomal doxorubicin (PLD) has a good safety profile, but long-term use has been associated with development of squamous cell carcinoma of the tongue and oral cavity (SCCTO) in some patients. The study objective was to estimate the prevalence of oral leukoplakia, a known precursor of SCCTO, in patients with ovarian cancer and long-term PLD use.After approval of the institutional review board, medical record of 114 patients who were treated with PLD at our institution between January 2010 and December 2016 were retrospectively reviewed. All those patients have been referred for routine monitoring of oral mucositis every time before administration by a dentist. The patient characteristics included in the evaluation were age, smoking and drinking habits, the PLD dose and schedule, and presence or absence of oral leukoplakia and SCCTO at each oral examination. The relationships of the incidence of oral leukoplakia and patient characteristics were analyzed.The median total PLD dose was 160 (range 40-1550) mg/m. Oral leukoplakia was seen in 6 (5.3%) patients. The median PLD dose, at the time of oral leukoplakia diagnosis, was 685 (range 400-800) mg/m. SCCTO was not found. Univariate analysis revealed that age, Brinkman index, and habitual drinking were not considered as risk factors for oral leukoplakia, and only total PLD dose (OR, 1.470; 95% CI, 1.19-1.91; P < .001) remained as a significant independent risk factor for oral leukoplakia. The ROC curve analysis indicated that the optimal cutoff value of the total PLD dose to predict development of oral leukoplakia was 400 mg/m. The sensitivity was 100% and the specificity was 88.8%. No patient discontinued PLD because of oral leukoplakia or SCCTO.The 2 most important clinical observations were the occurrence of oral leukoplakia in patients with long-term PLD use and that the development of oral leukoplakia was related to a total cumulative dose ≥400 mg/m. Routine oral surveillance is recommended, particularly when the cumulative total dose exceeds 400 mg/m.
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Affiliation(s)
| | - Kimihiko Sakamoto
- Department of Obstetrics and Gynecology, NTT Medical Center, Tokyo, Japan
| | | | | | - Yoichi Aoki
- Department of Gynecology, Cancer Institute Hospital
| | | | - Maki Matoda
- Department of Gynecology, Cancer Institute Hospital
| | - Kohei Omatsu
- Department of Gynecology, Cancer Institute Hospital
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Nomura H, Sugiyama Y, Tanigawa T, Matoda M, Okamoto S, Omatsu K, Kanao H, Kato K, Utsugi K, Takeshima N. Maintenance hormonal therapy after treatment with medroxyprogesterone acetate for patients with atypical polypoid adenomyoma. Jpn J Clin Oncol 2018; 48:255-258. [DOI: 10.1093/jjco/hyx193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/27/2017] [Indexed: 01/20/2023] Open
Affiliation(s)
- Hidetaka Nomura
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
| | - Yuko Sugiyama
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
| | - Terumi Tanigawa
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
| | - Maki Matoda
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
| | - Sanshiro Okamoto
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
| | - Kohei Omatsu
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
| | - Hiroyuki Kanao
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
| | - Kazuyoshi Kato
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
| | - Kuniko Utsugi
- Department of Gynecology, Cancer Institute Hospital, Tokyo, Japan
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Ikeda A, Tanigawa T, Charvat H, Wada H, Shigemura J, Kawachi I. Longitudinal effects of disaster-related experiences on mental health among Fukushima nuclear plant workers: The Fukushima NEWS Project Study. Psychol Med 2017; 47:1936-1946. [PMID: 28374662 DOI: 10.1017/s0033291717000320] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The Fukushima Nuclear Energy Workers' Support (NEWS) Project Study previously showed that experiences related to the Fukushima nuclear disaster on 11 March 2011 had a great impact on psychological states, including post-traumatic stress response (PTSR) and general psychological distress (GPD), among the Fukushima nuclear plant workers. To determine the causal relationship between disaster-related experiences and levels of psychological states, we conducted a 3-year longitudinal study from 2011 to 2014. METHOD PTSR and GPD of the nuclear plant workers were assessed by annual questionnaires conducted from 2011 to 2014. The present study included a total of 1417 workers who provided an assessment at baseline (2011). A total of 4160 observations were used in the present analysis. The relationship between disaster-related experiences and psychological states over time was analysed using mixed-effects logistic regression models. RESULTS A declining influence of disaster-related experiences on PTSR over time was found. However, the impact on PTSR remained significantly elevated even 3 years after the disaster in several categories of exposure including the experience of life-threatening danger, experiences of discrimination, the witnessing of plant explosion, the death of a colleague and home evacuation. The associations between GPD and disaster-related experiences showed similar effects. CONCLUSIONS The effects of disaster-related experiences on psychological states among the nuclear plant workers reduced over time, but remained significantly high even 3 years after the event.
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Affiliation(s)
- A Ikeda
- Department of Public Health,Juntendo University Graduate School of Medicine,Tokyo,Japan
| | - T Tanigawa
- Department of Public Health,Juntendo University Graduate School of Medicine,Tokyo,Japan
| | - H Charvat
- Center for Public Health Sciences, National Cancer Center,Tokyo,Japan
| | - H Wada
- Department of Public Health,Juntendo University Graduate School of Medicine,Tokyo,Japan
| | - J Shigemura
- Department of Psychiatry,National Defense Medical College,Saitama,Japan
| | - I Kawachi
- Department of Social and Behavioral Sciences,Harvard School of Public Health,Boston, MA,USA
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Tomooka K, Tanigawa T, Sakurai S, Maruyama K, Eguchi E, Nishioka S, Miyoshi N, Kakuto H, Shimizu G, Yamaoka D, Saito I. Scalloped tongue is associated with nocturnal intermittent hypoxia among community-dwelling Japanese: the Toon Health Study. J Oral Rehabil 2017; 44:602-609. [PMID: 28548303 DOI: 10.1111/joor.12526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 11/29/2022]
Abstract
Scalloped tongue is considered as a possible clinical finding of obstructive sleep apnoea (OSA). There are few evidence of the association between scalloped tongue and OSA. To examine the association between scalloped tongue and nocturnal intermittent hypoxia (NIH), a surrogate marker of OSA, among a general Japanese population. Study participants were 398 men and 732 women aged 30-79 years who participated in the Toon Health Study from 2011 to 2014. Scalloped tongue was classified into three categories: none, mild and moderate-to-severe. Moderate-to-severe NIH was defined as the 3% oxygen desaturation index of ≥15 events/h during sleep for one night with pulse oximetry. The multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for moderate-to-severe NIH were calculated according to scalloped tongue categories using a logistic regression model. There were 69 (6·1%) moderate-to-severe NIH cases in this population. The multivariable-adjusted ORs (95% CIs) of moderate-to-severe NIH were 1·59 (0·85-2·95) for mild and 2·39 (1·10-5·17) for the moderate-to-severe scalloped tongue group compared with the group without scalloped tongues. When stratified by overweight status (BMI <25 or ≥25 kg m-2 ), the respective ORs (95% CIs) were 2·83 (1·06-7·55) and 4·74 (1·28-17·49) among overweight individuals, and 0·94 (0·40-2·70) and 1·52 (0·57-4·05) among non-overweight individuals. Scalloped tongue was associated with higher prevalence of moderate-to-severe NIH among the general Japanese population and this association was more evident in overweight individuals.
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Affiliation(s)
- K Tomooka
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - T Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - S Sakurai
- Department of Clinical Laboratory Science, Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - K Maruyama
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - E Eguchi
- Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - S Nishioka
- Department of Molecular and Genetic Medicine, Ehime University Graduate School of Medicine, Toon, Japan
| | - N Miyoshi
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Toon, Japan
| | - H Kakuto
- Department of East Asian Traditional Medicine, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - G Shimizu
- Department of East Asian Traditional Medicine, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - D Yamaoka
- Department of East Asian Traditional Medicine, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - I Saito
- Department of Community Health Systems Nursing, Ehime University Graduate School of Medicine, Toon, Japan
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Shirahama R, Wada H, Tanigawa T. 0863 THE ASSOCIATION BETWEEN BRONCHIAL ASTHMA AND SLEEP BREATHING DISORDER IN PRIMARY SCHOOL CHILDREN, A LARGE-SCALE CROSS-SECTIONAL STUDY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.862] [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: 11/12/2022] Open
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43
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Wada H, Kimura M, Shirahama R, Hayashi T, Suzuki Y, Suzuki Y, Maruyama K, Ikeda A, Tanigawa T. 0501 ASSOCIATION BETWEEN SLEEP-RELATED SYMPTOMS AND RESPIRATORY DISTURBANCE INDEX AMONG COMMUNITY-DWELLING SCHOOL CHILDREN. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.500] [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: 11/14/2022] Open
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44
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Igami K, Ikeda A, Maruyama K, Tomooka K, Saito I, Tanigawa T. 0088 RELATIONSHIPS BETWEEN SLEEP DISORDERED BREATHING AND CENTRAL AORTIC PRESSURE IN A COMMUNITY BASED POPULATION: THE TOON HELATH STUDY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.087] [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: 11/14/2022] Open
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Nishino E, Ikeda A, Maruyama K, Saito I, Tomooka K, Tanigawa T. 0089 NOCTURNAL INTERMITTENT HYPOXIA AND CAROTID-ARTERY ATHEROSCLEROSIS IN A GENERAL JAPANESE POPULATION: THE TOON HEALTH STUDY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.088] [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: 11/12/2022] Open
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46
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Murakami A, Maruyama K, Tomooka K, Suzuki Y, Saito I, Tanigawa T. 1024 SLEEP DISORDERED BREATHING AND CHRONIC KIDNEY DISEASE AMONG MIDDLE-AGED AND ELDERLY JAPANESE POPULATION: TOON HEALTH STUDY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1023] [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: 11/14/2022] Open
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47
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Ikeda A, Charvat H, Shigemura J, Tanigawa T. 0325 INSOMNIA IN RELATION TO DISASTER-RELATED EXPERIENCES AMONG FUKUSHIMA NUCLEAR PLANT WORKERS: THE FUKUSHIMA NEWS PROJECT STUDY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.324] [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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48
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Tanisho Y, Shigemura J, Kubota K, Tanigawa T, Bromet EJ, Takahashi S, Matsuoka Y, Nishi D, Nagamine M, Harada N, Tanichi M, Takahashi Y, Shimizu K, Nomura S, Yoshino A. The longitudinal mental health impact of Fukushima nuclear disaster exposures and public criticism among power plant workers: the Fukushima NEWS Project study. Psychol Med 2016; 46:3117-3125. [PMID: 27534897 PMCID: PMC5108304 DOI: 10.1017/s003329171600194x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 07/12/2016] [Accepted: 07/15/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Fukushima Daiichi and Daini Nuclear Power Plant workers experienced multiple stressors as both victims and onsite workers after the 2011 Great East Japan Earthquake and subsequent nuclear accidents. Previous studies found that disaster-related exposures, including discrimination/slurs, were associated with their mental health. Their long-term impact has yet to be investigated. METHOD A total of 968 plant workers (Daiichi, n = 571; Daini, n = 397) completed self-written questionnaires 2-3 months (time 1) and 14-15 months (time 2) after the disaster (response rate 55.0%). Sociodemographics, disaster-related experiences, and peritraumatic distress were assessed at time 1. At time 1 and time 2, general psychological distress (GPD) and post-traumatic stress response (PTSR) were measured, respectively, using the K6 scale and Impact of Event Scale Revised. We examined multivariate covariates of time 2 GPD and PTSR, adjusting for autocorrelations in the hierarchical multiple regression analyses. RESULTS Higher GPD at time 2 was predicted by higher GPD at time 1 (β = 0.491, p < 0.001) and discrimination/slurs experiences at time 1 (β = 0.065, p = 0.025, adjusted R 2 = 0.24). Higher PTSR at time 2 was predicted with higher PTSR at time 1 (β = 0.548, p < 0.001), higher age (β = 0.085, p = 0.005), and discrimination/slurs experiences at time 1 (β = 0.079, p = 0.003, adjusted R 2 = 0.36). CONCLUSIONS Higher GPD at time 2 was predicted by higher GPD and discrimination/slurs experience at time 1. Higher PTSR at time 2 was predicted by higher PTSR, higher age, and discrimination/slurs experience at time 1.
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Affiliation(s)
- Y. Tanisho
- Health and Global Policy Institute, Chiyoda-ku, Tokyo, Japan
| | - J. Shigemura
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - K. Kubota
- Department of Biostatistics, School of Medicine, Yokohama City University, Kanazawa-ku, Yokohama, Japan
| | - T. Tanigawa
- Department of Public Health, School of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - E. J. Bromet
- Department of Psychiatry and Behavioral Science, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - S. Takahashi
- Department of Disaster Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Y. Matsuoka
- Department of Health Care Research, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - D. Nishi
- Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - M. Nagamine
- Division of Behavioral Science, National Defense Medical College Research Institute, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - N. Harada
- Nursing Science of Community Health Care System, Department of Nursing, Tohoku University School of Health Sciences, Sendai, Japan
| | - M. Tanichi
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Y. Takahashi
- Department of Disaster Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - K. Shimizu
- Division of Behavioral Science, National Defense Medical College Research Institute, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - S. Nomura
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
- Rokubancho Mental Clinic, Japan Depression Center, Chiyoda-ku, Tokyo, Japan
| | - A. Yoshino
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
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Furukawa S, Sakai T, Niiya T, Miyaoka H, Miyake T, Yamamoto S, Maruyama K, Ueda T, Senba H, Todo Y, Torisu M, Minami H, Onji M, Tanigawa T, Matsuura B, Hiasa Y, Miyake Y. Diabetic peripheral neuropathy and prevalence of erectile dysfunction in Japanese patients aged <65 years with type 2 diabetes mellitus: The Dogo Study. Int J Impot Res 2016; 29:30-34. [PMID: 27784886 DOI: 10.1038/ijir.2016.40] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 07/13/2016] [Accepted: 10/03/2016] [Indexed: 12/22/2022]
Abstract
Only limited epidemiological evidence exists regarding the relationship between diabetic neuropathy and erectile dysfunction (ED) among Japanese patients with type 2 diabetes mellitus. To investigate the relationship between diabetic neuropathy and ED among Japanese patients with type 2 diabetes mellitus, a multicenter cross-sectional study was conducted in 287 male Japanese patients with type 2 diabetes mellitus, age (19-65 years). Diabetic neuropathy was diagnosed if the patients showed two or more of the following three characteristics: neuropathic symptoms, decreased or disappeared Achilles tendon reflex and/or abnormal vibration perception. ED, moderate to severe ED, and severe ED were defined as present when a subject had a Sexual Health Inventory for Men score <22, <12 and <8, respectively. The prevalence values of diabetic neuropathy and severe ED were 47.0 and 39.0%, respectively. Diabetic neuropathy was independently positively associated with severe ED, but not ED and moderate ED: the adjusted odds ratio was 1.90 (95% confidence interval: 1.08-3.38). No relationships were found between diabetic retinopathy or diabetic nephropathy and ED. Diabetic neuropathy is positively associated with severe erectile dysfunction among Japanese type 2 diabetes mellitus patients aged <65 years.
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Affiliation(s)
- S Furukawa
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan.,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Shitsukawa, Toon, Japan
| | - T Sakai
- Department of Internal Medicine, Yawatahama General City Hospital, Yawatahama, Japan
| | - T Niiya
- Department of Internal Medicine, Matsuyama Shimin Hospital, Otemachi, Matsuyama, Japan
| | - H Miyaoka
- Department of Internal Medicine, Saiseikai Matsuyama Hospital, Matsuyama, Japan
| | - T Miyake
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan
| | - S Yamamoto
- Department of Lifestyle-related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan
| | - K Maruyama
- Department of Public Health, Juntendo University School of Medicine, Bunkyo, Tokyo, Japan
| | - T Ueda
- Department of Internal Medicine, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - H Senba
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan.,Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan
| | - Y Todo
- Department of Internal Medicine, Matsuyama Shimin Hospital, Otemachi, Matsuyama, Japan
| | - M Torisu
- Department of Internal Medicine, Saiseikai Saijo Hospital, Saijo, Japan
| | - H Minami
- Department of Internal Medicine, Ehime Niihama Hospital, Niihama, Japan
| | - M Onji
- Department of Internal Medicine, Saiseikai Imabari Hospital, Imabari, Japan
| | - T Tanigawa
- Department of Public Health, Juntendo University School of Medicine, Bunkyo, Tokyo, Japan
| | - B Matsuura
- Department of Lifestyle-related Medicine and Endocrinology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan
| | - Y Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan
| | - Y Miyake
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Japan.,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Shitsukawa, Toon, Japan
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50
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Fujiwara Y, Kohata Y, Nakahara K, Tanigawa T, Yamagami H, Shiba M, Watanabe K, Tominaga K, Watanabe T, Arakawa T. Characteristics of nighttime reflux assessed using multichannel intraluminal impedance pH monitoring and a portable electroencephalograph. Dis Esophagus 2016; 29:278-84. [PMID: 25604848 DOI: 10.1111/dote.12324] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Gastroesophageal reflux disease (GERD) is strongly associated with sleep disturbances. Although the mechanisms of this association have not been fully elucidated, nighttime reflux plays a central role. However, the detailed characteristics of nighttime reflux occurring during sleep are unknown. The aim of the present study was to examine the characteristics and prevalence of nighttime reflux in the natural sleep environment of GERD patients. Seventeen patients experiencing daily moderate-to-severe heartburn and/or regurgitation were studied using multichannel intraluminal impedance pH monitoring and electroencephalography off-proton pump inhibitor treatment. Nighttime reflux was divided based on reflux type (liquid or gas), acidity (acidic, weakly acidic, or alkaline) and extent (distal only or proximal migration) according to the standard criteria. Nighttime phases were divided as follows: recumbent-awake before falling asleep, nonrapid eye movement, rapid eye movement, awakening from sleep, and post-awakening in the morning. Among 184 nighttime refluxes, 43 (23%) occurred during recumbent-awake before falling asleep, 28 (15%) during nonrapid eye movement, 14 (8%) during rapid eye movement, 86 (46%) during awakening from sleep, and 13 (7%) during post-awakening in the morning. Liquid reflux was more common in awakening during sleep (92%), nonrapid eye movement (100%), and rapid eye movement (100%) compared with awakening before falling asleep (68%). The prevalence of proximal migration was significantly lower in nonrapid eye movement and rapid eye movement than in the other phases. There were no differences in acidity and bolus clearance time among the phases. Thirteen (65%) of 20 events with GERD symptoms had nighttime reflux, suggesting that only 7.1% (13 of 184) of nighttime refluxes were symptomatic. Nighttime reflux was observed in 48 (11%) of 425 awakening episodes during sleep. Different reflux patterns at each phase during nighttime might explain the pathogenesis of GERD and its related sleep disturbances.
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Affiliation(s)
- Y Fujiwara
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Y Kohata
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Nakahara
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Tanigawa
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - H Yamagami
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Shiba
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Watanabe
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - K Tominaga
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Watanabe
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Arakawa
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
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