Eiko Yamamoto

Prognostic impact of peritoneal cytology on treating endometrial cancer using data from the Japan Society of Obstetrics and Gynecology cancer registry

The prognostic value and clinical usage of peritoneal cytology in endometrial cancer are uncertain. This study aimed to determine whether positive cytology is associated with the prognosis for endometrial cancer. A Japanese nationwide retrospective registry study was conducted between 2012 and 2019. Clinicopathological data were analyzed for patients who were registered in the Japan Society of Obstetrics and Gynecology (JSOG) gynecological tumor registry and underwent initial treatment for endometrial cancer. In total, 83,027 patients who met the inclusion criteria were identified. Data on peritoneal cytology status and overall survival (OS) were available for 74,984 and 36,995 patients, respectively. Positive peritoneal cytology was found in 11,536 (15.4%) patients. A higher proportion of patients who had positive peritoneal cytology were related to advanced stages, high-grade histology, deep myometrial invasion, lymph node (LN) metastasis, and poor risk of recurrence. After controlling for age, stage, myometrial invasion, LN metastasis, distant metastasis, and risk of recurrence, positive peritoneal cytology was associated with poor prognosis (p<0.001). Multivariate Cox regression analysis revealed that clinicopathological factors (i.e., age, International Federation of Gynecology and Obstetrics stage, histological type, myometrial invasion, LN metastasis, distant metastasis, and peritoneal cytology), including positive peritoneal cytology, were also significant prognostic factors for OS. Positive peritoneal cytology was a prognostic factor for endometrial cancer for the JSOG gynecological tumor registry.

Detailed report on the clinicopathological factors of patients with endometrial cancer in Japan: a JSOG gynecologic tumor registry-based study

In this study, we collected data over 8 years (2012-2019) from the Japan Society of Obstetrics and Gynecology (JSOG) tumor registry to determine the status of endometrial cancer in Japan, and analyzed detailed clinicopathological factors. The JSOG maintains a tumor registry that gathers information on endometrial cancer treated at the JSOG-registered institutions. Data from the patients whose endometrial cancer treatment was initiated from 2012 to 2019 were analyzed retrospectively. A total of 82,969 patients with endometrial cancer underwent treatment from 2012 to 2019. Chemotherapy alone or in combination with hormonal therapy is more common among endometrial cancer patients under 40 years compared with those over 40 years. The number of patients with endometrial cancer, treated with laparoscopic or robot-assisted surgery was observed to have increased yearly. Small cell carcinomas and undifferentiated carcinomas were more likely to be diagnosed at an advanced stage. Lymphadenectomy was most commonly performed for stage IIIC2 disease, whereas positive peritoneal washing cytology was most common for stage IVB and serous carcinoma. Multi-year summary reports provided detailed clinicopathological information regarding endometrial cancer that could not be obtained in a single year. These reports were useful in understanding treatment strategies and trends over time based on age, histology, and stage.

Outcomes of cases with complete hydatidiform mole coexisting with a fetus: a single-center study

Abstract Background Complete hydatidiform moles coexisting with a fetus (CHMCF) are uncommon. Although CHMCF is associated with perinatal complications and post-molar gestational trophoblastic neoplasia (GTN), necessitating post-delivery chemotherapy, live birth remains feasible. This report presents 14 cases of CHMCF in Japan. Methods  We reviewed medical records of patients with CHMCF treated at our hospital from 2000 to 2020 and summarized clinical data, including maternal age, pregnancy details, delivery outcomes, fertility treatments, serum human chorionic gonadotropin (hCG) levels, and ultrasonography findings. Results Fourteen cases of CHMCF were diagnosed. The average age of the mothers was 30.6 years, with the majority conceiving following fertility treatment. The mean gestational age at diagnosis was 12 weeks. Six patients maintained their pregnancies, leading to two live births through emergency cesarean section. Eight patients exhibited spontaneous regression following treatment and pregnancy interruption, achieving negative serum hCG levels within 17.4 weeks. Six patients experienced post-molar GTN, including the two who had live births. One patient presented with FIGO stage I disease, while five patients had stage III lung metastases. All patients received chemotherapy, averaging nine courses, achieving remission within 13.7 weeks. Conclusion  The occurrence of GTN was higher after CHMCF than after typical complete hydatidiform moles. Despite the heightened risk of premature birth, some patients with CHMCF who maintain their pregnancies can successfully deliver live babies. Informed consent is essential for patients with CHMCF when considering pregnancy continuation. A team approach involving gynecological oncologists, obstetricians, and neonatologists is essential for effective diagnosis and treatment.

Utility of manual vacuum aspiration followed by curettage in the treating hydatidiform mole: A retrospective analysis

AbstractAimWhile manual vacuum aspiration (MVA) is commonly employed for early first‐trimester abortions, its effectiveness in treating hydatidiform mole is still unclear. This study sought to evaluate the efficacy and safety of MVA in comparison to dilation and curettage (D&amp;C) for managing hydatidiform mole.MethodsWe conducted a retrospective review of medical records for 198 patients with hydatidiform mole treated at Nagoya University Hospital between 2004 and 2023. After excluding cases with incomplete data, we compared 106 patients who underwent D&amp;C with 60 patients treated with MVA followed by curettage. We evaluated the surgical duration, intraoperative blood loss, and the occurrence of post‐molar gestational trophoblastic neoplasia (GTN) in both groups.ResultsThe surgical duration and blood loss were similar between the MVA and D&amp;C groups. The average surgical time was 13.2 min for D&amp;C and 11.8 min for MVA (p = 0.145). Most cases in both groups experienced blood loss of less than 10 mL, with no significant difference (p = 0.066). Over a median follow‐up period of 33.4 months, 25 cases developed post‐molar GTN. All GTN cases originated from complete hydatidiform mole (25 of 132 cases, 18.9%), and none were from partial hydatidiform mole. Kaplan–Meier analysis, focusing only on patients with complete hydatidiform mole, indicated no significant difference in the time to onset of GTN between the D&amp;C and MVA groups (p = 0.632).ConclusionsMVA followed by curettage is a viable approach for treating molar pregnancy.