Kei Ihira

Patterns and predictors of site‐specific recurrence in cervical cancer after radical hysterectomy

AbstractAimThis study examines patterns and predictors of site‐specific recurrence to explore the causes of local recurrence of cervical cancer.MethodsRadical hysterectomy was performed in 121 patients (stage IB–IIB). Nerve‐sparing was performed whenever possible. The first recurrence in local, regional, and distant areas was examined. We investigated the possibility of nerve involvement in local recurrence, focusing on paravaginal tissues containing the pelvic plexus. We provide Supporting Information on local recurrence in the paravaginal area.ResultsLocal recurrence was an independent event from regional or distant recurrence. Local recurrence was seen only in high‐risk patients, while regional and distant recurrences were not or less related to the risk category. The independent risk factors by logistic regression for local, regional, and distant recurrence were parametrial invasion, vaginal invasion, and lymph node metastasis, respectively. Local recurrence showed a comparable or more significant negative impact on survival than distant recurrence. Among seven patients with local recurrences, five had a recurrence in the paravagina. The rate of paravaginal recurrence was one in 76 early‐stage and four in 45 locally advanced diseases. Four sites of paravaginal recurrence occurred on the nerve‐sparing side and two on the non‐nerve‐sparing side. Supporting Information demonstrated histological evidence of perineural spread into the pelvic plexus and perineural invasion of the primary tumor.ConclusionsA high percentage of local recurrences are in paravaginal tissue containing the pelvic plexus. The causal association of nerve‐sparing surgery and perineural invasion with local recurrence needs to be investigated in large prospective studies.

Gut microbiome associated with PARP inhibitor efficacy in patients with ovarian cancer

To investigate an association between the gut microbiome and efficacy of poly(ADP-ribose) polymerase inhibitors (PARPi) in ovarian cancer. This study conducted fecal microbiome analysis (16S rRNA gene sequencing) and circulating tumor DNA (ctDNA) profiling for ovarian cancer patients who underwent PARPi maintenance therapy. Fecal and blood samples were collected at the baseline and the progressive disease (PD) or last follow-up. The relative abundance of gut microbes and progression-free survival (PFS) were analyzed using linear discriminant analysis of effect size and the Cox proportional hazard model according to Baseline samples were available from 23 High fecal composition of