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Objective: The Japan Society of Gynecologic Oncology published its first clinical guidelines for uterine cervical cancer in 2007 which has been revised twice in 2011 and 2017. The aim of this study was to investigate the influence of the first guideline publication on the therapeutic trend and patient outcome by analyzing uterine cervical cancer cases registered to the cancer registry organized by the Japan Society of Obstetrics and Gynecology., Methods: Data of uterine cervical cancer cases registered to the cancer registry from 2000 to 2012 were provided. Epidemiological and clinical trend were analyzed by the Chi-squared test with subsequent standardized residual analysis. Overall survival among the patients registered between 2004 and 2009 was analyzed using the Fine and Gray competing risk model., Results: 68,707 cases were registered during the study period. A trend analysis revealed that the guideline publication may have led to a decrease in neoadjuvant chemotherapy in parallel with an increase in radiation therapy mainly in stage II and III patients undergoing primary treatment. A survival analysis indicated that the introduction of the guideline may have improved overall survival among stage III uterine cervical cancer patients, even though a significant difference was not observed in all of the cases., Conclusions: This study demonstrated the potential influence of the guideline publication on the clinical trend and patient outcome. As this is the first assessment of the guideline for uterine cervical cancer in Japan, continuous evaluation is necessary to further comprehend the significance of this guideline., Competing Interests: Declaration of Competing Interest The authors have no conflict of interest to disclose regarding to this study., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Aim: We modified the antimicrobial prophylaxis of surgical site infection (SSI) according to the guidelines of the Japanese Society of Chemotherapy and Japan Society of Infectious Diseases (hereinafter referred to as optimization) and measured outcomes., Methods: From April 2016 to March 2017, we performed cesarean section and open hysterectomy with optimization, and compared the outcome to that of surgery performed without optimization between April 2014 and March 2016. We measured the rates of antibiotic discontinuation, appropriate antibiotic selection, SSI incidence, resumption of antibiotic therapy and fever incidence, as well as the length of postoperative hospital stay and medical expenses for antibiotics to evaluate the appropriateness and outcomes of antibiotic prophylaxis., Results: Optimization resulted in a change in the method of selecting antibiotics for cesarean section, but there was no change in SSI incidence rate (0.74% vs 0.0%, P = 0.36). Optimization reduced the use of antibiotics and medical expenses of hysterectomy (median reduction of 50% and 78% for hysterectomy without or with lymphadenectomy, respectively). However, there was no change in outcome regarding SSI incidence (5.7% vs 0.0%, P = 0.11 and 7.8% vs 9.5%, P = 0.77, respectively)., Conclusion: Appropriate use of antibiotics according to guidelines reduced antibiotic dose and medical expenses, but there was no change in outcome regarding SSI incidence rate. These findings suggested that implementation of dosing regimens according to the guidelines would be useful to reduce antibiotic medicine costs and prevent resistant bacteria and complications associated with antibiotics., (© 2018 Japan Society of Obstetrics and Gynecology.)

Objective: We investigated the current status of surgical procedures for endometrial carcinoma in Japan by surveying members of the Japan Gynecologic Oncology Group (JGOG)., Methods: A mail survey focusing on hysterectomy procedures, indications for radical hysterectomy, methods for detecting pelvic (PEN) and para-aortic lymph node (PAN) status, and indications for PAN dissection/biopsy, was sent to all 215 authorized JGOG member institutions., Results: A total of 139 (57.2%) members responded to the survey. Abdominal total hysterectomy (TAH) was utilized by 35.3% of institutions and Piver class II extended hysterectomy by 30.2%. In 35.5% of institutions, hysterectomy procedures were selectively employed based on tumor-related factors. Radical hysterectomy (RH) was utilized by 29.5% of institutions; TAH was used significantly more frequently by specialist hospitals while RH was significantly less commonly utilized by specialist hospitals compared with university hospitals and general hospitals. PEN dissection was routinely utilized by 97.8% of institutions. In 93.5% of institutions, PAN dissection/biopsy was used either routinely (12.2%) or selectively based on tumor-related factors (81.2%). In 6.5% of institutions, PAN dissection/biopsy has never been employed., Conclusion: The status of surgical procedures for the treatment of endometrial cancer is still not standardized. However, TAH, bilateral salpingo-oophorectomy, PEN dissection, and PAN dissection/biopsy in selected cases are recent surgical procedures used for the treatment of endometrial cancer in Japan. Clinical trials to determine the survival benefit of the different surgical procedures should be developed to determine the standard surgical procedures to be used for the treatment of endometrial cancer.