論文 - 銘苅　桂子

広汎子宮全摘出術を行った骨盤リンパ節陽性子宮頸部腺癌の治療成績

渡部 俊陽, 平良 祐介, 友寄 絵梨佳, 高江洲 朋子, 柱本 真, 下地 裕子, 新垣 精久, 仲本 朋子, 久高 亘, 銘苅 桂子, 青木 陽一

沖縄産科婦人科学会雑誌 ( 沖縄産科婦人科学会 )  44   5 - 12   2022年03月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

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子宮頸部腺癌の診断で、広汎子宮全摘出術(RH:Radical Hysterectomy)が施行された骨盤リンパ節転移陽性例の治療成績を明らかにするため、2004年4月〜2019年7月に当院でRHを行った子宮頸部腺癌(日産婦2011:IB-IIB期)で、病理組織学的に診断した骨盤リンパ節転移陽性19例と陰性49例について、診療録を後方視的に検討した。全生存率(OS)と無病生存率(DFS)に関する予後因子として、複数個のリンパ節転移のみが多変量解析で独立した予後因子と判明した。骨盤リンパ節転移陰性49例、単発転移7例、複数個転移12例の3群の患者背景に差はなく、転移陽性18例(94.7%)で術後補助療法(化学療法17例、放射線療法1例)が施行された。5年OSは100%、83.3%、40.1%(p<0.001)、5年DFSは87.1%、83.3%、10.0%(p<0.001)であった。再発は18例に認め、リンパ節転移なしでは6例(12.2%)、単発転移例では2例(28.6%)、複数個転移例では12例10例(83.3%)であった。複数個転移例の再発部位は骨盤内7例、骨盤外3例であり、骨盤内再発が高率であった。7例が放射線療法、1例が手術療法、4例が化学療法施行し、放射線療法2例と手術療法1例で無病生存が得られた。リンパ節複数個転移例に対する術後療法として、局所制御率の高い放射線療法や同時化学放射線療法の適応も検討すべきと考えられた。(著者抄録)

特集 産婦人科　働き方改革へのロードマップ 10.沖縄県における女性医師支援と働き方改革

銘苅 桂子

産婦人科の実際 ( 金原出版 )  71 ( 1 ) 63 - 68   2022年01月

掲載種別: 研究論文（学術雑誌）

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A Neonatal Case of Mild Encephalopathy/Encephalitis with a Reversible Splenial Lesion.

Oki Y, Yoshida T, Yogi A, Kurokawa S, Goya H, Tsukayama M, Nakamura S, Mekaru K, Nakanishi K

Child neurology open   9   2329048X221111716   2022年01月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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The neurological symptoms of pediatric mild encephalopathy/encephalitis with a reversible splenial lesion (MERS) are mild and have a good prognosis. However, some aspects of neonatal MERS are unclear due to a lack of clinical knowledge. We present a neonatal case of MERS with features of poor activity and prolonged poor oxygenation after birth without asphyxia. He was diagnosed with MERS by brain magnetic resonance imaging (MRI) on day10, because the diffusion restriction of the splenium of the corpus callosum (SCC) seen on diffusion-weighted MRI on day 5 was attenuating. He was discharged due to good progress on day 26, but growth issues and developmental delay were observed in the follow up from 1-10 months. In rare neonatal cases, many aspects of the clinical course and prognosis are thus unclear. MERS should be considered in newborns who show unexplained non-neural or other encephalopathic symptoms.

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Microbiome analysis in women with endometriosis: Does a microbiome exist in peritoneal fluid and ovarian cystic fluid?

Oishi S, Mekaru K, Tanaka SE, Arai W, Ashikawa K, Sakuraba Y, Nishioka M, Nakamura R, Miyagi M, Akamine K, Aoki Y

Reproductive medicine and biology ( Wiley )  21 ( 1 ) e12441   2022年01月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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PURPOSE: To investigate the relationship between the microbiome of the female genital tract and endometriosis. METHODS: This prospective cohort study included 36 women who underwent laparoscopic surgery for ovarian tumor from July 2019 to April 2020. Of them, 18 had endometriosis, and 18 did not have endometriosis. Vaginal secretions, endometrial fluid, peritoneal fluid, and ovarian cystic fluid were collected during surgery. Next-generation sequencing of bacterial 16S rRNA was performed to characterize the microbiome. RESULTS: Specific microbiomes were not detected in either peritoneal fluid or ovarian cystic fluid regardless of the presence or absence of endometriosis and the type of cyst. When the cutoff value of infectious bacterial abundance in the vagina was set as 64.3%, there were many cases more than a cutoff value in the endometriosis group significantly (p = 0.01). When the cutoff value of infectious bacterial abundance in the endometrium was set as 18.6%, there were many cases more than a cutoff level in the endometriosis cases significantly (p = 0.02). CONCLUSION: Peritoneal fluid and ovarian cystic fluid are almost sterile, although dysbiosis may occur in the vaginal and endometrial microbiome in women with endometriosis.

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Two cases of polycystic ovary syndrome with onset of severe ovarian hyperstimulation syndrome following controlled ovarian stimulation with aromatase inhibitors for fertility preservation before breast cancer treatment.

Oishi S, Mekaru K, Nakamura R, Miyagi M, Akamine K, Heshiki C, Aoki Y

Taiwanese journal of obstetrics & gynecology ( Taiwanese Journal of Obstetrics and Gynecology )  60 ( 5 ) 931 - 934   2021年09月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

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OBJECTIVE: The risks of ovarian hyperstimulation syndrome (OHSS) involve high estrogen (E2) levels. We report two breast cancer patients with polycystic ovarian syndrome who underwent fertility preservation and had severe OHSS; their E2 levels were lowered using aromatase inhibitors (AI). CASE REPORTS: A 36-year-old woman underwent controlled ovarian stimulation (COS) with AI and cryopreserved 10 blastocysts. She was hospitalized with OHSS (E2 = 139.1 pg/mL). She improved with infusion alone. A 31-year-old woman underwent COS with AI and cryopreserved 8 blastocysts. She was hospitalized for OHSS (E2: 429 pg/mL). Her vascular endothelial growth factor (VEGF) levels were high (62 pg/mL) at 8 days after the procedure. She needed hospitalization for 9 days. The planned adjuvant therapy was delayed for a week in both cases. CONCLUSION: Elevated VEGF levels should be considered as a risk factor of OHSS even if E2 levels are low with AI treatment.

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Live birth outcomes from IVF treatments in younger patients with low AMH.

Miyagi M, Mekaru K, Nakamura R, Oishi S, Akamine K, Heshiki C, Aoki Y

JBRA assisted reproduction ( Jornal Brasileiro de Reproducao Assistida )  25 ( 3 ) 417 - 421   2021年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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OBJECTIVE: Anti-Müllerian hormone (AMH) is used to predict in vitro fertilization outcomes. However, predicting live birth is difficult in younger patients with low AMH. Thus, this study aimed to determine the live birth rates from younger patients with low anti-Müllerian hormone levels. METHODS: A total of 296 infertile patients with AMH measured (younger group, aged 25-38 years; older group, aged 39-42 years) were included in this study. In vitro fertilization outcomes between patients with AMH levels of <1.0ng/mL and ≥1.0ng/mL were compared. RESULTS: Younger patients with AMH levels <1.0ng/mL (younger low AMH group) exhibited lower number of oocytes retrieved than patients with AMH levels ≥1.0ng/mL (younger normal AMH group). However, there were no significant differences in cumulative pregnancy or cumulative live birth rates between groups. Older patients with AMH levels ≥1.0ng/mL (older normal AMH group) had significantly better outcomes as per mean number of oocytes, cumulative pregnancy rate, and cumulative live birth rate than older patients with AMH levels <1.0ng/mL (older low AMH group). In the younger low AMH group, the frequency of oocyte retrieval was significantly higher in patients who achieved live birth. In addition, the blastocyst transfer rate was significantly higher in individuals with live births versus subjects with non-live births. CONCLUSIONS: AMH is a predictor of live birth among older, but not younger, women. Our report suggests that younger women may become pregnant even with low AMH levels when they obtain blastocysts from frequent oocyte retrievals.

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Sex ratio of infants born through in vitro fertilization and embryo transfer: Results of a single-institution study and literature review.

Nagata C, Mekaru K, Gibo K, Nakamura R, Oishi S, Miyagi M, Akamine K, Aoki Y

JBRA assisted reproduction ( Jornal Brasileiro de Reproducao Assistida )  25 ( 3 ) 337 - 340   2021年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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OBJECTIVE: The possible effects of Assisted Reproductive Technology (ART) on sex ratio at birth are extremely significant. This study aimed to determine whether ART affects the sex ratio of infants born through in vitro fertilization and embryo transfer (IVF-ET). MATERIALS AND METHODS: We ran this retrospective study on 290 singleton infants born following IVF-ET from February 2014 to August 2018 at a single institution. We compared the sex ratios of these infants with respect to insemination versus intracytoplasmic sperm injection (ICSI), early-cleavage embryo versus blastocyst transfer, fresh versus frozen-thawed embryo transfer and normal sperm versus asthenospermia. RESULTS: There were no significant differences in the sex ratio with respect to the fertilization method, transfer time, fresh embryo or frozen-thawed embryo transfer. In addition, the multiple logistic regression analysis revealed that these factors did not significantly affect the sex ratio. CONCLUSIONS: Our study indicated that the differences in the fertilization method transfer time and sperm motility rate did not affect the sex ratio of IVF live births. However, with increasing numbers of ICSI and blastocyst transfer cycles, factors possibly affecting the sex ratio need to be further investigated.

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Transabdominal cerclage in early pregnancy for cervical shortening after radical trachelectomy: A case report.

Kinjyo Y, Nana Y, Chinen Y, Kinjo T, Mekaru K, Aoki Y

Case reports in women's health ( Case Reports in Women's Health )  31   e00323   2021年07月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

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Radical trachelectomy (RT) is a method of fertility preservation for patients with early invasive uterine cervical cancer stage IA2 or IB1 with a tumor diameter of ≤2 cm. However, women who have undergone RT have high risks of abortion and premature birth. To prevent premature birth, cervical cerclage is performed in patients with an ultra-short cervix, but the portio vaginalis is not visible in these patients, and transvaginal uterine cervical cerclage is almost impossible. In such cases, transabdominal cerclage (TAC) is considered. The patient reported here was a 39-year-old Japanese woman, gravida 2, para 0. At 37 years, she was diagnosed with cervical cancer, stage IB1 (according to the International Federation of Gynecology and Obstetrics [FIGO] classification), so abdominal modified RT was performed. One year after the operation, she became pregnant through in vitro fertilization and embryo transfer. The cervical length was 17 mm at 13 weeks of gestation but was shortened to 5 mm at 16 weeks of gestation, so TAC was performed. An emergency cesarean section was performed because of increased genital bleeding at 34 weeks of gestation and a live baby was delivered.

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A high-risk gestational trophoblastic neoplasia derived from a complete hydatidiform mole with coexisting fetus identified by short tandem repeats analysis: A case report.

Taira Y, Shimoji Y, Nakasone T, Arakaki Y, Nakamoto T, Kinjo T, Kudaka W, Mekaru K, Aoki Y

Case reports in women's health ( Case Reports in Women's Health )  31   e00336   2021年07月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

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A complete hydatidiform mole coexisting with a fetus (CHMCF) is a rare form of twin pregnancy. High-risk gestational trophoblastic neoplasia (GTN) can occur after a CHMCF pregnancy, although the frequency is low. In cases of GTN, the clinical diagnosis and that based on the International Federation of Gynecology and Obstetrics (FIGO) scoring system can differ. This case report concerns a patient with a choriocarcinoma that was initially diagnosed and treated as a low-risk stage III GTN following a live birth from a CHMCF pregnancy. We used short tandem repeat (STR) analysis to identify the causative pregnancy as the patient's earlier complete hydatidiform mole. Clinicians should anticipate a high-risk GTN when treating persistent trophoblastic disease (PTD) in patients with a non-typical course.

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Critical respiratory failure in pregnancy complicated with COVID-19: A case report.

Chinen Y, Kinjyo Y, Mekaru K, Kinjo T, Higure Y, Kinjo T, Miyagi K, Yamada H, Masamoto H, Goya H, Yoshida T, Maeshiro S, Nakamatsu M, Fujita J, Aoki Y

Case reports in women's health ( Case Reports in Women's Health )  30   e00309   2021年04月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

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The case is presented of a 29-year-old primiparous woman who was COVID-19-positive at 34 weeks of gestation and who developed severe acute respiratory distress syndrome. After a four-day history of fever and mild dyspnea, she was referred to hospital. Ciclesonide, dexamethasone, heparin sodium, and sulbactam/ampicillin were initiated, followed by remdesivir and tocilizumab. On the fourth day after admission (at 34 weeks 5 days of gestation), respiratory failure required ventilator management. An emergency cesarean section was performed and a 2565-g male infant was delivered with an Apgar score of 8/8 and negative COVID-19 status. However, on the following day the patient's respiratory condition deteriorated and mechanical ventilation was initiated. Subsequently, her respiratory condition quickly improved and mechanical ventilation was terminated 4 days after intubation. She was discharged 12 days after cesarean delivery. Our case provides additional evidence that raises concerns regarding the unfavorable maternal consequences of COVID-19 infection during pregnancy.

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特集 画像!-エキスパート直伝　産婦人科画像診断- (第2章)生殖内分泌　子宮内膜

赤嶺 こずえ, 銘苅 桂子

産科と婦人科 ( (株)診断と治療社 )  88 ( 13 ) 246 - 249   2021年03月

掲載種別: 研究論文（学術雑誌）

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Sigmoid Volvulus in Pregnancy Assessed by Contrast-Enhanced Computed Tomography Scanning.

Watanabe T, Kinjo T, Kinjyo Y, Nitta H, Masamoto H, Mekaru K, Aoki Y

Case reports in obstetrics and gynecology ( Case Reports in Obstetrics and Gynecology )  2021   6692483 - 6692483   2021年 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

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Sigmoid volvulus requires urgent treatment, and it is particularly rare among pregnant women without a history of laparotomy. A delay in diagnosis may lead to serious consequences for the mother and fetus, and a rapid diagnosis and treatment in this setting is essential. The patient was a 19-year-old primiparous woman. She complained of repeated exacerbations and remissions of abrupt lower abdominal pain for the past 2 days and was transported to our hospital at 33 weeks of gestation. Ultrasonography revealed no placental thickening, and maternal bowel dilation was difficult to identify. Plain abdominal X-ray showed a dilated colon on the left side of the abdomen. Contrast-enhanced CT scan of the abdomen revealed a volvulus on the dorsal side of the uterus. The proximal end of the transverse to sigmoid colon was markedly dilated, and the distal end was collapsed. The elevated lactate level on blood gas analysis suggested intestinal ischemia. She was suspected of having a sigmoid volvulus at 33 weeks and 3 days of gestation. We decided to perform a cesarean section to secure the operative field for an intestinal resection following delivery. A male weighing 1840 g with Apgar scores 8/8 was delivered. The sigmoid colon was approximately 80 cm in length. A 360-degree clockwise rotation of was observed with a very distended but viable sigmoid loop. Following reduction of the volvulus, the sigmoid colon was fixed to the left side of the peritoneum. The mother had an uneventful postoperative course, and the infant was discharged without any sequelae. This case demonstrates two important lessons. First, sigmoid volvulus can occur in pregnant women even if they never had a laparotomy. Second, abdominal contrast-enhanced CT is useful for rapid diagnostic and treatment decisions relative to this pathology.

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Hyperbaric Oxygen Therapy for Suburethral Vaginal Mucosal Necrosis after Interstitial Irradiation for Recurrent Cervical Cancer.

Arakaki Y, Shimoji Y, Nakasone T, Taira Y, Nakamoto T, Kudaka W, Mekaru K, Aoki Y

Case reports in obstetrics and gynecology ( Case Reports in Obstetrics and Gynecology )  2021   1737975 - 1737975   2021年 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

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Patients with gynecological malignancies can develop radiation injuries, such as cystitis, proctitis, and soft tissue necrosis which have approved indications for hyperbaric oxygen therapy (HBOT). A 76-year-old Japanese woman with vaginal recurrence of cervical cancer was treated with the high-dose rate interstitial brachytherapy. Twenty-one months after the irradiation, she developed radiation necrosis on the external urethral opening. Two cycles of HBOT were performed. HBOT consisted of delivering 100% oxygen for 60 minutes at 2.4 atmospheres absolute. Pressure exposure was performed once daily, 5 days a week for 6 weeks. Eventually, the necrotic mucosa was completely replaced by the normal mucosa. No adverse effects were observed. We successfully treated a case of late adverse events of radiation therapy with HBOT. It was noninvasive and appears to be a useful treatment option which should be considered standard treatment practice.

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Threatened uterine rupture following laparoscopic surgery in interstitial tubal pregnancy.

Arakaki Y, Mekaru K, Shimoji Y, Nakamura R, Miyagi M, Aoki Y

The journal of obstetrics and gynaecology research ( Journal of Obstetrics and Gynaecology Research )  47 ( 2 ) 818 - 821   2020年11月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Contraception is recommended for a certain period following a hysterotomy; however, no consensus exists on the required duration of contraception. A 21-year-old female was brought to the emergency room in a state of shock due to intraperitoneal bleeding. An emergency laparoscopic cornuostomy indicated for ruptured interstitial pregnancy was performed. Despite contraception, the patient got pregnant 1.5 months after surgery. At 16 weeks of gestation, threatened uterine rupture was suspected, as magnetic resonance imaging (MRI) revealed hematogenous amniotic fluid and a subchorionic hematoma near the interstitial portion of the fallopian tube. An MRI at 21 weeks showed hematoma shrinkage and disappearance of the hematogenous amniotic fluid. At 37 weeks, an elective cesarean section was performed, which resulted in a live birth. Pregnancy shortly after surgery is a risk factor for uterine rupture. In such cases, MRI could be useful in the evaluation of threatened uterine ruptures.

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Evaluation of neonatal withdrawal syndrome in neonates delivered by women taking psychotropic or anticonvulsant drugs: A retrospective chart review of the effects of multiple medications and breastfeeding.

Kanemura A, Masamoto H, Kinjo T, Mekaru K, Yoshida T, Goya H, Aoki Y

European journal of obstetrics, gynecology, and reproductive biology ( European Journal of Obstetrics and Gynecology and Reproductive Biology )  254   226 - 230   2020年11月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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OBJECTIVES: Neonates delivered by women who were taking psychotropic or anticonvulsant drugs during pregnancy are at increased risk of developing neonatal withdrawal syndrome. We investigated the incidence of neonatal withdrawal symptoms and the effects of multiple maternal medications and breastfeeding on neonatal withdrawal symptoms. STUDY DESIGN: This study examined the overall incidence of neonatal withdrawal symptoms in neonates delivered from 2004 to 2016 by women who were taking oral antipsychotics, antidepressants, anxiolytics, sedatives, or anticonvulsant drugs during pregnancy. Moreover, we compared the incidence of neonatal symptoms between mothers taking single drugs and multiple drugs, and between breastfed and formula-fed neonates. We scored the neonates according to the neonatal withdrawal syndrome checklist created by Isobe et al., which is widely used in Japan. RESULTS: We examined 131 mothers and their 134 neonates. Withdrawal symptoms were found in 54.5 % of neonates. Symptoms were found in 32.4 % of neonates delivered by mothers taking single drugs and 62.9 % of neonates delivered by mothers taking two or more drugs (p = 0.0019). One or more withdrawal symptoms developed in 46.4 % of breastfed neonates and 66.1 % of formula-fed neonates (p = 0.034). Five infants had a score of 8 or more points on the withdrawal checklist, which is an indication to consider treatment with pharmacotherapy. All five of these neonates were mainly formula-fed, and their mothers were taking two or more drugs. CONCLUSIONS: The incidence of withdrawal symptoms was high in neonates delivered by women taking psychotropic or anticonvulsant drugs; however, there were few serious cases. The risk increased when a mother was taking multiple drugs. Breastfeeding appeared to protect against withdrawal symptoms.

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Relative dose intensity and overall treatment time in older patients with cervical cancer treated with concurrent chemoradiotherapy.

Nakamura R, Shimoji Y, Nakasone T, Taira Y, Arakaki Y, Nakamoto T, Ooyama T, Kudaka W, Mekaru K, Aoki Y

Journal of geriatric oncology ( Journal of Geriatric Oncology )  12 ( 2 ) 332 - 334   2020年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Long-term Outcomes of Cervical Adenocarcinoma Treated With Concurrent Chemoradiotherapy Using Paclitaxel and Cisplatin.

Arakaki Y, Ariga T, Heianna J, Shimoji Y, Nakasone T, Taira Y, Nakamoto T, Ooyama T, Kudaka W, Kaneshima I, Nishihira K, Mekaru K, Aoki Y

In vivo (Athens, Greece) ( In vivo (Athens, Greece) )  34 ( 5 ) 2739 - 2743   2020年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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© 2020 International Institute of Anticancer Research. All rights reserved. Background/Aim: We retrospectively analyzed the locally advanced adenocarcinoma (AC)/adenosquamous carcinoma (ASC) of the uterine cervix treated with concurrent chemoradiotherapy using cisplatin plus paclitaxel (TP-CCRT). Patients and Methods: Thirty patients with stage IB-IVA AC/ASC were treated with whole pelvis external beam radiotherapy. A high-dose-rate intracavitary brachytherapy was delivered once per week at a fractional dose of 6 Gy. For TP-CCRT, the patients received cisplatin and paclitaxel. Results: A complete response was achieved in 17 patients (77.3%) in the TP-CCRT group and 4 patients (50.0%) in the P-CCRT group. The 5-year OS rate in the TPCCRT and P-CCRT groups was 74.2% and 25.0% (p=0.0094), the central DFS rate was 58.0% and 12.5% (p=0.0267), and the distant DFS rate was 63.6% and 12.5% (p=0.0042), respectively. Conclusion: TP-CCRT achieves a considerably better disease control for AC of the cervix, leading to a better OS.

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Malignant bowel obstruction in recurrent gynecologic cancers: who will benefit from palliative surgical intervention?

Nakamura R.

European Journal of Gynaecological Oncology ( European Journal of Gynaecological Oncology )  41 ( 4 ) 513 - 516   2020年08月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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©2020 Nakamura et al. Purpose of Investigation: To define factors that assist in the selection of patients with gynecologic cancer who have malignant bowel obstruction (MBO) for those who are most likely to benefit from palliative bowel surgery. Materials and Methods: Between 2004 and 2014, 11 women who underwent surgery for bowel obstruction after a discharge for the treatment of gynecologic cancer were included. The diagnosis of MBO was confirmed by symptoms and signs of intestinal obstruction along with abdominal X-ray, or a computed tomography (CT) scan. Results: The median age of women was 58 years and the median time to surgery was six days. Colostomy was performed in seven of eleven patients, ileostomy in three, and bowel resection and anastomosis in two. Postoperative oral intake was achieved in ten of eleven cases, with a median period of 77 (range, 27–224) days. The progression free interval (PFI) of the primary cancer was < 6 months in six patients and ≥ 6 months in five. The median duration of post-operative oral intake in patients with PFI of < 6 and ≥ 6 months was 34.5 (range, 0–65), and 120 (range, 89–224) days, respectively (p = 0.0014). The median survival time after surgery in patients with PFI of < 6 and ≥ 6 months was 43 (range, 11–111), and 156 (range 94–253) days, respectively (p = 0.0206). Conclusion: PFI of primary gynecologic cancer is a good indicator that could help select for those patients who would most likely benefit from palliative bowel surgery. Surgery for MBO should be considered for patients without serious contraindications.

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特集 異所性妊娠の最新診療 異所性妊娠のMRI診断

伊良波 裕子, 石神 康生, 銘苅 桂子

産科と婦人科 ( (株)診断と治療社 )  87 ( 7 ) 771 - 775   2020年07月

掲載種別: 研究論文（学術雑誌）

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Hysterectomy for Recurrent/Residual Cervical Cancer Following Definitive Radiotherapy.

Nakasone T, Taira Y, Shimoji Y, Arakaki Y, Nakamoto T, Ooyama T, Kudaka W, Kaneshima I, Nishihira K, Mekaru K, Aoki Y

In vivo (Athens, Greece) ( In Vivo )  34 ( 4 ) 2173 - 2177   2020年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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© 2020 International Institute of Anticancer Research. All rights reserved. Background/Aim: Radical hysterectomy has been used for local recurrent or persistent (LR) cervical cancer after radiotherapy (RT), but the rate of serious complications is high and tolerance is low. This study determined the efficacy, safety, and prognostic factors of adjuvant simple hysterectomy in LR cervical cancer post-RT. Patients and Methods: A total of 21 patients who underwent hysterectomy for LR cervical cancer post-RT in our Department between May 2007 and September 2018 were included in the study. Primary, definitive RT was performed. Histological response by definitive RT in the extirpated uterus was classified on the basis of histological response criteria: effect (Ef) 0-3. Results: The 5-year overall survival (OS) and disease-free survival (DFS) rates were 51.9% and 50.1%, respectively. Ef 1 was significantly associated with poorer prognosis compared to Ef 2 or Ef 3. Conclusion: Adjuvant hysterectomy could be a treatment of choice for LR cervical cancer post-RT.

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