1.Prognostic impact of peritoneal cytology on treating endometrial cancer using data from the Japan Society of Obstetrics and Gynecology cancer registry
Kensuke SAKAI ; Wataru YAMAGAMI ; Fumiaki TAKAHASHI ; Hideki TOKUNAGA ; Eiko YAMAMOTO ; Yoshihito YOKOYAMA ; Kiyoshi YOSHINO ; Kei KAWANA ; Satoru NAGASE
Journal of Gynecologic Oncology 2025;36(3):e41-
Objective:
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.
Methods:
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.
Results:
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.
Conclusion
Positive peritoneal cytology was a prognostic factor for endometrial cancer for the JSOG gynecological tumor registry.
2.Revision of quality indicators for cervical cancer and trend analysis of existing indicators in Japan
Tamaki KAKUWA ; Ryoko RIKITAKE ; Satoru NAGASE ; Mikio MIKAMI ; Tsukasa BABA ; Masanori KANEUCHI ; Hideki TOKUNAGA ; Manabu SEINO ; Toshinari MURAMATSU ; Wataru YAMAGAMI ; Kazuhiro TAKEHARA ; Hitoshi NIIKURA ; Yasuyuki HIRASHIMA ; Kiyoshi YOSHINO ; Yuichi ICHINOSE ; Akira KAWATA ; Takahiro HIGASHI
Journal of Gynecologic Oncology 2025;36(5):e78-
Objective:
Cervical cancer rates in Japan (16.0/100,000) exceed the global average rate (11.3/100,000, according to the High/Very-High Human Development Index in 2020). This necessitates the evaluation of care quality and the quality indicators (QIs) for cervical cancer that were developed in 2013 to serve this purpose. This study updated these indicators using current evidence and consensus while longitudinally examining trends in practice patterns.
Methods:
The revision involved reviewing existing QIs and patterns of care indicators and incorporating new indicators using the modified Delphi method. Adherence to these indicators was assessed using a linked hospital-based cancer registry-based diagnostic procedure combination database covering approximately 70% of patients with cancer in Japan. The longitudinal trends of the existing indicators were evaluated using the linear probability model.
Results:
Seven new indicators were added to the existing twelve. Two of the new indicators mainly focused on early-stage surgical intervention, while one focused on advanced-stage bevacizumab combination therapy, with adherence rates of 81.7%, 0.8%, and 45.9%.Longitudinal analyses revealed significant improvements with the use of cisplatin in concurrent chemoradiotherapy for advanced-stage cervical cancer (+1%/year), oral anticancer agents as maintenance therapy after primary treatment for early-stage cervical cancer (−0.8%/ year), and hysterectomy for adenocarcinoma in situ in patients above 44 years old (−2%/year).
Conclusion
The QIs for cervical cancer in Japan have been revised based on 2022 evidence.The existing and new indicators should be continually evaluated to correspond to the latest knowledge. This will facilitate the standardization and promotion of bottom-up improvements in cervical cancer care.
3.Japan Society of Gynecologic Oncology 2022 guidelines for uterine cervical neoplasm treatment
Manabu SEINO ; Satoru NAGASE ; Hideki TOKUNAGA ; Wataru YAMAGAMI ; Yoichi KOBAYASHI ; Tsutomu TABATA ; Masanori KANEUCHI ; Yasuyuki HIRASHIMA ; Hitoshi NIIKURA ; Kiyoshi YOSHINO ; Kazuhiro TAKEHARA ; Tsukasa BABA ; Hidetaka KATABUCHI ; Mikio MIKAMI
Journal of Gynecologic Oncology 2024;35(1):e15-
The Japan Society of Gynecologic Oncology (JSGO) Guidelines 2022 for the Treatment of Uterine Cervical Cancer are revised from the 2017 guideline. This guideline aimed to provide standard care for cervical cancer, indicate appropriate current treatment methods for cervical cancer, minimize variances in treatment methods among institutions, improve disease prognosis and treatment safety, reduce the economic and psychosomatic burden of patients by promoting the performance of appropriate treatment, and enhance mutual understanding between patients and healthcare professionals. The guidelines were prepared through the consensus of the JSGO Guideline Committee, based on a careful review of evidence gathered through the literature searches and the medical health insurance system and actual clinical practice situations in Japan. The guidelines comprise seven chapters and 5 algorithms.The main features of the 2022 revision are as follows: 1) added discussed points at the final consensus meeting; 2) revised the treatment methods based on the International Federation of Gynecology and Obstetrics 2018 staging system; 3) examined minimally invasive surgery based on Laparoscopic Approach to Cervical Cancer trial; 4) added clinical question (CQ) for treatments of rare histological types, gastric type, and small-cell neuroendocrine carcinoma; 5) added CQ for intensity-modulated radiation therapy; 6) added CQ for cancer genomic profiling test; and 7) added CQ for cancer survivorship. Each recommendation is accompanied by a classification of recommendation categories based on the consensus reached by the Guideline Committee members. Here, we present the English version of the JSGO Guidelines 2022 for the Treatment of Uterine Cervical Cancer.
4.Detailed report on the clinicopathological factors of patients with endometrial cancer in Japan: a JSOG gynecologic tumor registry-based study
Takeshi MAKABE ; Wataru YAMAGAMI ; Fumiaki TAKAHASHI ; Hideki TOKUNAGA ; Eiko YAMAMOTO ; Yoshihito YOKOYAMA ; Kiyoshi YOSHINO ; Kei KAWANA ; Satoru NAGASE
Journal of Gynecologic Oncology 2024;35(4):e54-
Objective:
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.
Methods:
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.
Results:
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.
Conclusion
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.
5.Japan Society of Gynecologic Oncology 2022 guidelines for uterine cervical neoplasm treatment
Manabu SEINO ; Satoru NAGASE ; Hideki TOKUNAGA ; Wataru YAMAGAMI ; Yoichi KOBAYASHI ; Tsutomu TABATA ; Masanori KANEUCHI ; Yasuyuki HIRASHIMA ; Hitoshi NIIKURA ; Kiyoshi YOSHINO ; Kazuhiro TAKEHARA ; Tsukasa BABA ; Hidetaka KATABUCHI ; Mikio MIKAMI
Journal of Gynecologic Oncology 2024;35(1):e15-
The Japan Society of Gynecologic Oncology (JSGO) Guidelines 2022 for the Treatment of Uterine Cervical Cancer are revised from the 2017 guideline. This guideline aimed to provide standard care for cervical cancer, indicate appropriate current treatment methods for cervical cancer, minimize variances in treatment methods among institutions, improve disease prognosis and treatment safety, reduce the economic and psychosomatic burden of patients by promoting the performance of appropriate treatment, and enhance mutual understanding between patients and healthcare professionals. The guidelines were prepared through the consensus of the JSGO Guideline Committee, based on a careful review of evidence gathered through the literature searches and the medical health insurance system and actual clinical practice situations in Japan. The guidelines comprise seven chapters and 5 algorithms.The main features of the 2022 revision are as follows: 1) added discussed points at the final consensus meeting; 2) revised the treatment methods based on the International Federation of Gynecology and Obstetrics 2018 staging system; 3) examined minimally invasive surgery based on Laparoscopic Approach to Cervical Cancer trial; 4) added clinical question (CQ) for treatments of rare histological types, gastric type, and small-cell neuroendocrine carcinoma; 5) added CQ for intensity-modulated radiation therapy; 6) added CQ for cancer genomic profiling test; and 7) added CQ for cancer survivorship. Each recommendation is accompanied by a classification of recommendation categories based on the consensus reached by the Guideline Committee members. Here, we present the English version of the JSGO Guidelines 2022 for the Treatment of Uterine Cervical Cancer.
6.Detailed report on the clinicopathological factors of patients with endometrial cancer in Japan: a JSOG gynecologic tumor registry-based study
Takeshi MAKABE ; Wataru YAMAGAMI ; Fumiaki TAKAHASHI ; Hideki TOKUNAGA ; Eiko YAMAMOTO ; Yoshihito YOKOYAMA ; Kiyoshi YOSHINO ; Kei KAWANA ; Satoru NAGASE
Journal of Gynecologic Oncology 2024;35(4):e54-
Objective:
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.
Methods:
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.
Results:
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.
Conclusion
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.
7.Japan Society of Gynecologic Oncology 2022 guidelines for uterine cervical neoplasm treatment
Manabu SEINO ; Satoru NAGASE ; Hideki TOKUNAGA ; Wataru YAMAGAMI ; Yoichi KOBAYASHI ; Tsutomu TABATA ; Masanori KANEUCHI ; Yasuyuki HIRASHIMA ; Hitoshi NIIKURA ; Kiyoshi YOSHINO ; Kazuhiro TAKEHARA ; Tsukasa BABA ; Hidetaka KATABUCHI ; Mikio MIKAMI
Journal of Gynecologic Oncology 2024;35(1):e15-
The Japan Society of Gynecologic Oncology (JSGO) Guidelines 2022 for the Treatment of Uterine Cervical Cancer are revised from the 2017 guideline. This guideline aimed to provide standard care for cervical cancer, indicate appropriate current treatment methods for cervical cancer, minimize variances in treatment methods among institutions, improve disease prognosis and treatment safety, reduce the economic and psychosomatic burden of patients by promoting the performance of appropriate treatment, and enhance mutual understanding between patients and healthcare professionals. The guidelines were prepared through the consensus of the JSGO Guideline Committee, based on a careful review of evidence gathered through the literature searches and the medical health insurance system and actual clinical practice situations in Japan. The guidelines comprise seven chapters and 5 algorithms.The main features of the 2022 revision are as follows: 1) added discussed points at the final consensus meeting; 2) revised the treatment methods based on the International Federation of Gynecology and Obstetrics 2018 staging system; 3) examined minimally invasive surgery based on Laparoscopic Approach to Cervical Cancer trial; 4) added clinical question (CQ) for treatments of rare histological types, gastric type, and small-cell neuroendocrine carcinoma; 5) added CQ for intensity-modulated radiation therapy; 6) added CQ for cancer genomic profiling test; and 7) added CQ for cancer survivorship. Each recommendation is accompanied by a classification of recommendation categories based on the consensus reached by the Guideline Committee members. Here, we present the English version of the JSGO Guidelines 2022 for the Treatment of Uterine Cervical Cancer.
8.Detailed report on the clinicopathological factors of patients with endometrial cancer in Japan: a JSOG gynecologic tumor registry-based study
Takeshi MAKABE ; Wataru YAMAGAMI ; Fumiaki TAKAHASHI ; Hideki TOKUNAGA ; Eiko YAMAMOTO ; Yoshihito YOKOYAMA ; Kiyoshi YOSHINO ; Kei KAWANA ; Satoru NAGASE
Journal of Gynecologic Oncology 2024;35(4):e54-
Objective:
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.
Methods:
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.
Results:
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.
Conclusion
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.
9.Japan Society of Gynecologic Oncology 2018 guidelines for treatment of uterine body neoplasms
Wataru YAMAGAMI ; Mikio MIKAMI ; Satoru NAGASE ; Tsutomu TABATA ; Yoichi KOBAYASHI ; Masanori KANEUCHI ; Hiroaki KOBAYASHI ; Hidekazu YAMADA ; Kiyoshi HASEGAWA ; Hiroyuki FUJIWARA ; Hidetaka KATABUCHI ; Daisuke AOKI
Journal of Gynecologic Oncology 2020;31(1):18-
10.Japan Society of Gynecologic Oncology 2018 guidelines for treatment of uterine body neoplasms
Wataru YAMAGAMI ; Mikio MIKAMI ; Satoru NAGASE ; Tsutomu TABATA ; Yoichi KOBAYASHI ; Masanori KANEUCHI ; Hiroaki KOBAYASHI ; Hidekazu YAMADA ; Kiyoshi HASEGAWA ; Hiroyuki FUJIWARA ; Hidetaka KATABUCHI ; Daisuke AOKI
Journal of Gynecologic Oncology 2020;31(1):e18-
The Fourth Edition of the Guidelines for Treatment of Uterine Body Neoplasm was published in 2018. These guidelines include 9 chapters: 1. Overview of the guidelines, 2. Initial treatment for endometrial cancer, 3. Postoperative adjuvant therapy for endometrial cancer, 4. Post-treatment surveillance for endometrial cancer, 5. Treatment for advanced or recurrent endometrial cancer, 6. Fertility-sparing therapy, 7. Treatment of uterine carcinosarcoma and uterine sarcoma, 8. Treatment of trophoblastic disease, 9. Document collection; and nine algorithms: 1-3. Initial treatment of endometrial cancer, 4. Postoperative adjuvant treatment for endometrial cancer, 5. Treatment of recurrent endometrial cancer, 6. Fertility-sparing therapy, 7. Treatment for uterine carcinosarcoma, 8. Treatment for uterine sarcoma, 9. Treatment for choriocarcinoma. Each chapter includes overviews and clinical questions, and recommendations, objectives, explanation, and references are provided for each clinical question. This revision has no major changes compared to the 3rd edition, but does have some differences: 1) an explanation of the recommendation decision process and conflict of interest considerations have been added in the overview, 2) nurses, pharmacists and patients participated in creation of the guidelines, in addition to physicians, 3) the approach to evidence collection is listed at the end of the guidelines, and 4) for clinical questions that lack evidence or clinical validation, the opinion of the Guidelines Committee is given as a “Recommendations for tomorrowâ€.

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