Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Miyagi, Japan.
Advisor, Matsue City Hospital, Matsue, Shimane, Japan.
J Obstet Gynaecol Res. 2022 Mar;48(3):576-586. doi: 10.1111/jog.15112. Epub 2021 Dec 14.
Treatment strategies based on histological subtypes are unestablished.
Rethinking the significance of surgery for uterine cervical cancer.
Using the database of cervical cancer stages IB-IIB with extensive hysterectomy (Federation of Gynecology and Obstetrics [FIGO] 2008) established by the Japanese Gynecologic Oncology Group network, we conducted a clinicopathological study of cervical cancer cases reclassified according to the FIGO 2018 staging. In stage IB (FIGO 2018) cervical cancer patients, there was no significant difference in treatment outcome according to histological type, but in stages IIA, IIB, and IIIC1 (FIGO 2018), the treatment outcome of nonsquamous cell carcinoma was significantly worse than that of squamous cell carcinoma. Considering post-treatment health care, it is important to consider ovarian preservation in young patients with cervical cancer, up to stage IIA (FIGO 2018) for squamous cell carcinoma and stage IB1 (FIGO 2018) for nonsquamous cell carcinoma, after careful evaluation of clinicopathological factors before surgery.
Locally advanced adenocarcinoma of the cervix is a rare and refractory cancer that has been shown to have low radiosensitivity, and its treatment outcome is still unsatisfactory. A new therapeutic strategy involving multidisciplinary treatment in combination with perioperative chemotherapy at a facility that can provide highly curative surgical treatment is desired.
Minimally invasive surgery is being introduced for the treatment of early-stage cervical cancer. However, the number of eligible cases should be expanded in a phased manner, based on an objective evaluation of surgical outcomes at the facilities. Omics analysis may be useful to develop a new treatment for human papillomavirus nonrelated cervical cancer, represented by gastric mucinous carcinoma.
基于组织学亚型的治疗策略尚未确定。
重新思考宫颈癌手术的意义。
利用日本妇科肿瘤学团体网络建立的广泛子宫切除术（FIGO 2008）的宫颈癌分期 IB-IIB 数据库，我们对根据 FIGO 2018 分期重新分类的宫颈癌病例进行了临床病理研究。在 IB 期（FIGO 2018）宫颈癌患者中，组织学类型与治疗结果无显著差异，但在 IIA、IIB 和 IIIC1 期（FIGO 2018），非鳞状细胞癌的治疗结果明显差于鳞状细胞癌。考虑到治疗后的保健，对于宫颈癌的年轻患者，考虑到卵巢保存很重要，可达 IIA 期（FIGO 2018）的鳞状细胞癌和 IIB1 期（FIGO 2018）的非鳞状细胞癌，在手术前仔细评估临床病理因素后。
宫颈局部晚期腺癌是一种罕见且难治的癌症，其放射敏感性较低，其治疗结果仍不理想。需要一种新的治疗策略，包括多学科治疗，结合围手术期化疗，在能够提供高治愈率手术治疗的机构中进行。
微创外科手术正在被引入治疗早期宫颈癌。然而，应根据各医疗机构手术结果的客观评估，分阶段扩大合格病例数量。组学分析可能有助于为非 HPV 相关宫颈癌（以胃粘液腺癌为代表）开发新的治疗方法。
