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  • 1
    Online Resource
    Online Resource
    Clinical implication of psoas muscle mass measurement for predicting death within 3 months in patients with incurable uterine cervical or corpus malignancy
    Oxford University Press (OUP) ; 2021
    In:  Japanese Journal of Clinical Oncology Vol. 51, No. 4 ( 2021-04-01), p. 577-583
    Details
    In: Japanese Journal of Clinical Oncology, Oxford University Press (OUP), Vol. 51, No. 4 ( 2021-04-01), p. 577-583
    Abstract: The aim of this study was to find a clinical marker for identifying refractory cancer cachexia. Methods We analyzed computed tomography imaging data, which included the third lumbar vertebra, from 94 patients who died of uterine cervix or corpus malignancy. The time between the date of examination and date of death was the most important attribute for this study, and the computed tomography images were classified into & gt;3 months before death and ≤ 3 months before death. Psoas muscle mass index was defined as the left–right sum of the psoas muscle areas (cm2) at the level of third lumbar vertebra, divided by height squared (m2). Results A data set of 94 computed tomography images was obtained at baseline hospital visit, and a data set of 603 images was obtained at other times. One hundred (16.6%) of the 603 non-baseline images were scanned ≤3 months before death. Mean psoas muscle mass index change rates at & gt;3 months before death and ≤3 months before death were −1.3 and −20.1%, respectively (P  & lt; 0.001). Receiver operating characteristic curve analysis yielded a cutoff value of −13.0%. The area under the curve reached a moderate accuracy level (0.777, 95% confidence interval 0.715–0.838). When we used the cutoff value to predict death within 3 months, sensitivity and specificity were 74.0 and 82.1%, respectively. Conclusions Measuring change in psoas muscle mass index might be useful for predicting cancer mortality within 3 months. It could become a potential tool for identifying refractory cancer cachexia.
    Type of Medium: Online Resource
    ISSN: 1465-3621
    URL: Article
    DOI: 10.1093/jjco/hyaa248
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 2
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    A BMI-category distribution pattern of intrinsic and treatment-related prognostic factors in endometrial cancer
    Oxford University Press (OUP) ; 2021
    In:  Japanese Journal of Clinical Oncology Vol. 51, No. 5 ( 2021-04-30), p. 722-727
    Details
    In: Japanese Journal of Clinical Oncology, Oxford University Press (OUP), Vol. 51, No. 5 ( 2021-04-30), p. 722-727
    Abstract: In patients with endometrial cancer, obesity is associated with favorable prognostic characteristics but not with prolonged survival. The aim of this study was to elucidate the reason for this clinical paradox. Methods We retrospectively reviewed 1173 patients with endometrial cancer. Patients were divided into a non-obese group [body mass index (BMI)  & lt; 30 kg/m2], class I obesity group (BMI 30–35 kg/m2) and class II obesity group (BMI ≥ 35 kg/m2). The relationship between clinicopathological factors and disease-specific survival (DSS) was analyzed by Cox regression analysis. To correct for three-time significance testing, we used the Bonferroni method, giving the level of probability at which findings were con sidered significant as P  & lt; 0.0167. Results Three disease-intrinsic variables—older age, advanced stage and high-risk histology—and three treatment-related variables—no hysterectomy, no lymphadenectomy and no chemotherapy—were independently associated with poor DSS. DSS was similar among the three groups of patients even though the proportion of patients with plural pretreatment-related unfavorable risk factors significantly decreased with increment of BMI category (40.1 vs. 27.5 vs. 17.6%, P = 0.0003). The proportion of patients with plural treatment-related unfavorable prognostic factors significantly increased with increment of BMI category (21.3 vs. 26.7 vs. 39.3%, P = 0.0072). Conclusions Poor-quality surgical staging in obese women may result in worse than expected survival outcomes.
    Type of Medium: Online Resource
    ISSN: 1465-3621
    URL: Article
    DOI: 10.1093/jjco/hyaa274
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 3
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    Online Resource
    Clinical relevance of addition of conventional treatment to concurrent chemoradiotherapy in patients with FIGO stage III–IV cervical cancer: a retrospective analysis of a Japanese cohort
    Oxford University Press (OUP) ; 2022
    In:  Japanese Journal of Clinical Oncology Vol. 52, No. 3 ( 2022-03-03), p. 244-250
    Details
    In: Japanese Journal of Clinical Oncology, Oxford University Press (OUP), Vol. 52, No. 3 ( 2022-03-03), p. 244-250
    Abstract: Concurrent chemoradiotherapy has limited therapeutic efficacy for stage III–IV cervical cancer. We aimed to identify a subgroup of patients with stage III–IV cervical cancer who benefit from concurrent chemoradiotherapy with additional treatment. Methods We retrospectively reviewed 120 patients with stage III–IV cervical cancer who were treated with concurrent chemoradiotherapy from 2002 to 2018. We compared overall survival between patients treated with concurrent chemoradiotherapy alone and those who received concurrent chemoradiotherapy with additional conventional treatments (systemic chemotherapy before and/or after concurrent chemoradiotherapy and/or extended-field radiation). Prognostic factors were statistically analysed. Results Overall, 44 (36.7%) and 21 (17.5%) patients were radiologically diagnosed with pelvic and para-aortic lymph node enlargement, respectively. The median tumour diameter was 5.7 cm. A total of 69 (57.5%) patients received no additional treatment, and 51 (42.5%) received additional treatment. Cox regression analysis identified the following prognostic factors: histological non-squamous cell carcinoma (hazard ratio, 3.9; 95% confidence interval, 1.8–8.2), tumour diameter of ≥6 cm (hazard ratio, 2.1; 95% confidence interval, 1.2–3.7), radiological pelvic lymph node enlargement (hazard ratio, 2.1; 95% confidence interval, 1.1–4.0) and radiological para-aortic lymph node enlargement (hazard ratio, 2.1; 95% confidence interval, 1.1–4.1). Even in the lowest risk group (no risk factors), the 5-year overall survival rate was lower in the additional treatment group than in the concurrent chemoradiotherapy alone group (78.7% vs. 80.9%, respectively; log-rank test, P = 0.79). Conclusions Addition of conventional treatments to concurrent chemoradiotherapy might not improve survival in patients with advanced cervical cancer. Novel treatment strategies including immune checkpoint inhibitors should be considered for such patients.
    Type of Medium: Online Resource
    ISSN: 1465-3621
    URL: Article
    DOI: 10.1093/jjco/hyab191
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
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  • 4
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    Validity of skeletal muscle mass index measurements for assessing sarcopenia in patients with gynecological cancer
    Oxford University Press (OUP) ; 2021
    In:  Japanese Journal of Clinical Oncology Vol. 51, No. 10 ( 2021-10-05), p. 1534-1540
    Details
    In: Japanese Journal of Clinical Oncology, Oxford University Press (OUP), Vol. 51, No. 10 ( 2021-10-05), p. 1534-1540
    Abstract: The current study investigated an optimal method for using CT scan in detection of low skeletal muscle mass quantity (SMQ). Methods In total, 82 consecutive patients with gynecological cancers were examined using computed tomography (CT) and dual-energy X-ray absorptiometry (DEXA) before treatment. Low SMQ was defined as a DEXA-based skeletal muscle mass index (SMI) of & lt;5.40 kg/m2. Furthermore, CT-based SMI values were measured by six evaluators, and each evaluator measured SMI values two times for each subject. The first SMI value and the average SMI value were used for analyses. Receiver operating characteristic (ROC) analyses were performed to evaluate the performance of CT-based SMI measurements for detecting low SMQ. Interobserver agreement was assessed using the intraclass correlation coefficient (ICC). Results In total, 23 patients (28.0%) were diagnosed with low skeletal muscle mass. All areas under the curve (AUC) values from twelve (six evaluators × two measurements) ROC curves were within the range of 0.8–0.9. AUC values based on a single measurement and those based on two measurements were almost the same. The ICC was 0.828 (95% CI 0.777–0.874, P  & lt; 0.001) when using a single measurement value and increased to 0.959 (95% CI 0.944–0.971, P  & lt; 0.001) when using the average of the two measurements. Conclusions A single measurement CT-based SMI efficiently identified patients with low SMQ in a daily clinical setting. The reliability of SMI measurements might be further improved by using a mean value of two measurements compared with the use of a single measurement value.
    Type of Medium: Online Resource
    ISSN: 1465-3621
    URL: Article
    DOI: 10.1093/jjco/hyab116
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 5
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    Online Resource
    Diagnostic criteria of sentinel lymph node micrometastasis or macrometastasis based on tissue rinse liquid-based cytology in gynecological cancer
    Springer Science and Business Media LLC ; 2020
    In:  International Journal of Clinical Oncology Vol. 25, No. 12 ( 2020-12), p. 2138-2143
    Details
    In: International Journal of Clinical Oncology, Springer Science and Business Media LLC, Vol. 25, No. 12 ( 2020-12), p. 2138-2143
    Type of Medium: Online Resource
    ISSN: 1341-9625 , 1437-7772
    URL: Article
    DOI: 10.1007/s10147-020-01774-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 1481773-1
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  • 6
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    IA1期の子宮頸癌患者に対する腹腔鏡下子宮全摘術の有用性：後方視的コホート研究
    Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy ; 2020
    In:  JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY Vol. 36, No. 1 ( 2020), p. 55-59
    Details
    In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY, Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy, Vol. 36, No. 1 ( 2020), p. 55-59
    Type of Medium: Online Resource
    ISSN: 1884-5746 , 1884-9938
    URL: Article
    DOI: 10.5180/jsgoe.36.1_55
    Language: English
    Publisher: Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy
    Publication Date: 2020
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  • 7
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    Imaging-based definition of lower uterine segment carcinoma to improve the detection sensitivity of probable Lynch syndrome
    Oxford University Press (OUP) ; 2020
    In:  Japanese Journal of Clinical Oncology Vol. 50, No. 3 ( 2020-03-09), p. 270-275
    Details
    In: Japanese Journal of Clinical Oncology, Oxford University Press (OUP), Vol. 50, No. 3 ( 2020-03-09), p. 270-275
    Abstract: The aim of this study was to investigate a magnetic resonance imaging-based definition of lower uterine segment carcinoma. Methods We retrospectively reviewed 587 consecutive patients with endometrial cancer who underwent hysterectomy. Lower uterine segment carcinoma was determined through pathological examination and magnetic resonance imaging assessment. For imaging assessment, the location of the inner lining of the uterus was classified into four equal parts on a sagittal section image. A tumor was defined as lower uterine segment carcinoma when its thickest part was located in the second or the third part from the uterine fundus. Lower uterine segment carcinoma was further divided into lower uterine segment in a narrow sense, upon which diagnosis was exclusively based on pathological findings, and lower uterine segment in a broad sense that were the remaining lower uterine segment carcinomas except lower uterine segment carcinomas in a narrow sense. The relationship between lower uterine segment carcinoma and probable Lynch syndrome was investigated. Patients with loss of MSH2, MSH6, and PMS2 expression or those with tumors with loss of MLH1 and absence of MLH1 promoter methylation were diagnosed as probable Lynch syndrome. Results Lower uterine segment carcinoma was identified in 59 (10.2%) patients. Twenty-eight (47.5%) patients were categorized as lower uterine segment in a narrow sense and 31 (52.5%) as lower uterine segment in a broad sense. Among them, probable Lynch syndrome was identified in 12 (20.3%) cases. There was no difference in clinical profiles, including the prevalence of probable Lynch syndrome between the two categories. Conclusions A magnetic resonance imaging-based expanded definition of lower uterine segment carcinoma is likely to secure characteristics equivalent to a conventional pathology-based definition of lower uterine segment carcinoma. The novel definition of lower uterine segment carcinoma might improve the detection of probable Lynch syndrome.
    Type of Medium: Online Resource
    ISSN: 1465-3621
    URL: Article
    DOI: 10.1093/jjco/hyz162
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 8
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    Online Resource
    Initial screening by immunohistochemistry is effective in universal screening for Lynch syndrome in endometrial cancer patients: a prospective observational study
    Oxford University Press (OUP) ; 2022
    In:  Japanese Journal of Clinical Oncology Vol. 52, No. 7 ( 2022-07-08), p. 752-758
    Details
    In: Japanese Journal of Clinical Oncology, Oxford University Press (OUP), Vol. 52, No. 7 ( 2022-07-08), p. 752-758
    Abstract: Few prospective reports of universal screening for Lynch syndrome exist for patients with endometrial cancer. In this study, we performed immunohistochemical staining for DNA mismatch repair-related genes (MLH1, MSH2, MSH6 and PMS2), to determine the extent to which Lynch syndrome can be diagnosed in endometrial cancer patients through universal screening. Methods We recruited 116 consecutive patients assumed to have uterine corpus malignancy from October 2019 to February 2021 in a prospective observational study. We performed immunohistochemical for mismatch repair-related proteins on samples from 100 patients who had surgicopathologically confirmed diagnoses of endometrial cancer. Samples with missing immunohistochemical results for any of the proteins had subsequent universal screening tests for microsatellite instability, DNA methylation of the MLH1 promoter region and mismatch repair genetics. Results We identified 19 (19.0%) patients with lost results for any of the proteins. All 19 patient samples had subsequent screening tests. We identified the microsatellite instability-high phenotype in 84.2% (16/19) of these patients and MLH1 methylation in 57.9% (11/19). Mismatch repair genetic testing detected two pathological variants, in MSH2 and MSH6, which indicated that the prevalence of Lynch syndrome was 2.0% in our cohort. Two cases of unclassified variant (MSH6) and one case of benign variant (PMS2) were also detected. Conclusions Initial screening by immunohistochemical is an effective method in universal screening for Lynch syndrome in endometrial cancer patients.
    Type of Medium: Online Resource
    ISSN: 1465-3621
    URL: Article
    DOI: 10.1093/jjco/hyac058
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
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  • 9
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    Validity of measuring psoas muscle mass index for assessing sarcopenia in patients with gynecological cancer
    Oxford University Press (OUP) ; 2021
    In:  Japanese Journal of Clinical Oncology Vol. 51, No. 3 ( 2021-03-03), p. 393-399
    Details
    In: Japanese Journal of Clinical Oncology, Oxford University Press (OUP), Vol. 51, No. 3 ( 2021-03-03), p. 393-399
    Abstract: The current study evaluated the performance of psoas muscle mass measurement for detecting low skeletal muscle mass quantity. Methods A sample of 82 consecutive patients with gynecological cancers was examined using computed tomography and dual energy X-ray absorptiometric scan before treatment. Skeletal muscle mass index was measured by dual energy X-ray absorptiometric scan and its cut-off value was set at 5.40 kg/m2 for detecting low skeletal muscle mass. Psoas muscle mass index was manually measured with cross-sectional computed tomography imaging at the level of L3 by six evaluators. Results Low skeletal muscle mass index was identified in 23 (28.0%) patients. Two-way analysis of variance confirmed a significant main effect of skeletal muscle mass index on mean psoas muscle mass index values (P  & lt; 0.0001). A receiver operating characteristic curve obtained from a total of 492 psoas muscle mass index data points gathered from six evaluators produced an area under the curve value of 0.697 (95% confidence interval 0.649–0.744) and a cut-off value of 3.52 cm2/m2, with sensitivity of 79.0% and specificity of 59.6%. Using the cut-off value, the kappa coefficient for evaluating diagnostic agreement between skeletal muscle mass index (low vs. normal) and psoas muscle mass index (low vs. normal) was 0.308 (95% confidence interval 0.225–0.392), suggesting poor agreement. Fleiss’ kappa produced a coefficient of 0.418 (95% confidence interval 0.362–0.473), suggesting moderate agreement. Conclusions Although relevance between skeletal muscle mass index and psoas muscle mass index was confirmed, intensity of relevance between them was weak. Psoas muscle mass index measurement should be subordinated to skeletal muscle mass index measurement for detection of low skeletal muscle mass.
    Type of Medium: Online Resource
    ISSN: 1465-3621
    URL: Article
    DOI: 10.1093/jjco/hyaa218
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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