1.Advantages of the Central Supply System of Medical Instruments.
Tsuneyuki ATOBE ; Shigeru KOBAYASHI ; Fumiaki MATSUO
Journal of the Japanese Association of Rural Medicine 2001;50(1):45-48
Recently, varieties of medical instruments have been developed and improved upon rapidly along with the progress of medicine. However, the advent of many types of new devices sometimes creates confusion on the clinical scene. The central supply system of medical instruments may be effective in reducing medical troubles and accidents, through centralized maintenance, check and repair stuff education and enlightenment.
In our hospital, the central supply room of medical instruments was established in April 1993 to try to reduce the costs and troubles. We have somehow managed our system by trail and error for eight years. Recently, many people who have any relationship with us have come to rate our system highly. We will try to make a further effort to establish a better supply system.
2.Significance of histology and nodal status on the survival of women with early-stage cervical cancer: validation of the 2018 FIGO cervical cancer staging system
Hiroko MACHIDA ; Koji MATSUO ; Yoichi KOBAYASHI ; Mai MOMOMURA ; Fumiaki TAKAHASHI ; Tsutomu TABATA ; Eiji KONDO ; Wataru YAMAGAMI ; Yasuhiko EBINA ; Masanori KANEUCHI ; Satoru NAGASE ; Mikio MIKAMI
Journal of Gynecologic Oncology 2022;33(3):e26-
Objective:
To assess the efficacy of the FIGO 2018 classification system for nodal-specific classifications for early-stage cervical cancer; specifically, to examine the impact of nodal metastasis on survival and the effect of postoperative treatments, according to histological subtypes.
Methods:
This society-based retrospective observational study in Japan examined 16,539 women with the 2009 FIGO stage IB1 cervical cancer who underwent primary surgical treatment from 2004 to 2015. Associations of cause-specific survival (CSS) with nodal metastasis and postoperative adjuvant therapy were examined according to histology type (squamous cell carcinoma [SCC], n=10,315; and non-SCC, n=6,224).
Results:
The nodal metastasis rate for SCC was higher than that for non-SCC (10.7% vs. 8.3%, p<0.001). In multivariable analysis, the impact of nodal metastasis on CSS was greater for non-SCC tumors (adjusted-hazard ratio [HR], 3.11; 95% confidence interval [CI], 2.40–4.02) than for SCC tumors (adjusted-HR, 2.20; 95% CI, 1.70–2.84; p<0.001). Propensity score matching analysis showed significantly lower CSS rates for women with pelvic nodal metastasis from non-SCC tumors than from SCC tumors (5-year CSS rate, 75.4% vs. 90.3%, p<0.001). The CSS rates for women with nodal metastasis in SCC histology were similar between the postoperative concurrent chemoradiotherapy/radiotherapy and chemotherapy groups (89.2% vs. 86.1%, p=0.42), whereas those in non-SCC histology who received postoperative chemotherapy improved the CSS (74.1% vs. 67.7%, p=0.043).
Conclusion
The node-specific staging system in the 2018 FIGO cervical cancer classification is applicable to both non-SCC tumors and SCC tumors; however, the prognostic significance of nodal metastases and efficacy of postoperative therapies vary according to histology.