Search

Aims: To investigate the oncologic and obstetric outcomes of radical trachelectomy (RT) in patients with early‐stage cervical cancer and to evaluate the potential role of fertility‐preserving treatments in improving pregnancy outcomes while oncologic status is stable. Methods: In this single‐institution study, we analyzed the oncologic and obstetric outcomes of 67 patients with early‐stage cervical cancer who underwent RT at Nagoya University Hospital. Results: The cancer recurrence rate (6.0%) and the mortality rate (1.5%) were comparable with those of previous studies. Of the 46 patients who attempted to conceive after RT, 19 (41.3%) became pregnant, and 16 gave birth. Of these 37.5% delivered at term, and delivery at less than 28 weeks of gestation occurred in 31.3% of pregnancies. Conclusions: RT is a viable treatment option for selected patients with early‐stage cervical cancer. However, the use of less invasive techniques, such as conization/simple trachelectomy and pelvic lymph node dissection, may improve pregnancy outcomes while oncologic status is stable. [ABSTRACT FROM AUTHOR]

Objectives: To carry out a comparison of upper urinary tract urothelial carcinoma characteristics and behavior between patients in Taiwan and Japan. Methods: A Taiwan urinary tract urothelial carcinoma cohort was obtained from Kaohsiung Chang Gung Memorial Hospital, and a Japan urinary tract urothelial carcinoma cohort from Hirosaki University Hospital. The inclusion criteria were urinary tract urothelial carcinoma patients who underwent radical nephroureterectomy. Those who received perioperative chemotherapy were excluded. Finally, 765 patients in the Taiwan cohort and 325 in the Japan cohort were analyzed. The end‐point of this study was to study the natural course of urinary tract urothelial carcinoma within 5 years between these two groups. Results: The main finding was that urinary tract urothelial carcinoma patients in Taiwan were younger (P < 0.001), more were women (P < 0.001), with low‐stage disease (P < 0.001), with more chronic kidney disease (P < 0.001), with less smoking history (P < 0.001), with more bladder cancer history (P = 0.002), with more multifocal (P < 0.001) and less high‐grade disease (P = 0.015), as well as less lymphovascular invasion (P < 0.001) and more squamous differentiation (P < 0.001). However, the multivariate Cox regression analysis showed no racial difference in oncologic outcome, such as intravesical recurrence, systemic recurrence or cancer‐specific death in primary and propensity‐matched cohorts. Bladder cancer history was found to be the most important factor predicting intravesical recurrences, whereas stage was strongly associated with systemic recurrence and cancer specific mortality. Conclusions: The clinical characteristics of urinary tract urothelial carcinoma in Taiwan are significantly different from those of urinary tract urothelial carcinoma in Japan. However, there is no racial difference in stage‐specific oncologic outcome after standard nephroureterectomy. [ABSTRACT FROM AUTHOR]

The history of prostate brachytherapy has passed one century. In 1983, modern low‐dose‐rate prostate brachytherapy using a transrectal ultrasound‐guided procedure was introduced. In the early 1990s, low‐dose‐rate brachytherapy was introduced and rapidly spread across the USA due to its excellent oncological control, cost‐effectiveness and technically easy procedure. Since low‐dose‐rate brachytherapy was introduced in Japan (2003), over 15 years have passed. More than 43 000 patients have undergone low‐dose‐rate brachytherapy. Japanese urologists and radiation oncologists are on course with leading brachytherapists in the USA. A nationwide prospective cohort study, J‐POPS, was initiated in 2005. The J‐POPS group also provides educational programs including an annual novel training course in low‐dose‐rate brachytherapy to familiarize urologists, radiation oncologists and pathologists with the procedure. Important information on Japanese patients has accumulated, especially by the J‐POPS study group. The Japanese investigators reported excellent oncological outcomes of low‐dose‐rate brachytherapy, showing equivalent or superior efficacy to surgery in low‐ to intermediate‐risk patients, and superior efficacy in high‐risk patients using the surgery biochemical recurrence definition (prostate‐specific antigen cut‐off value of 0.2 ng/mL). Two randomized controlled studies (SHIP study: intermediate risk, and TRIP study: high risk) carried out by the J‐POPS group are ongoing, and an additional follow‐up study (J‐POPS 2 study) has been started to evaluate survival outcomes over longer follow‐up periods. Low‐dose‐rate brachytherapy is expected to provide a survival benefit, which must be confirmed by further studies with longer follow‐up periods in the future. [ABSTRACT FROM AUTHOR]