Faculty Profiles - NAGAO Shoji

Papers - NAGAO Shoji

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当院におけるMSI陽性者の遺伝外来受診に関する現状と課題

原賀順子, 小川千加子, 長尾昌二, 依田尚之, 白河伸介, 入江恭平, 松岡敬典, 中村圭一郎, 平沢晃, 増山寿

日本婦人科腫瘍学会学術講演会プログラム・抄録集 65回 374 - 374 2023.7

Pure abscopal effect in a patient with advanced uterine carcinosarcoma. Reviewed International journal

Kazuhiro Okamoto, Kotaro Yoshio, Shinsuke Shirakawa, Kyohei Irie, Naoyuki Ida, Hirofumi Matsuoka, Junko Haraga, Chikako Ogawa, Keiichiro Nakamura, Shoji Nagao, Hisashi Masuyama

Radiology case reports 18 ( 7 ) 2447 - 2451 2023.7

Language：English

The abscopal effect is a rare phenomenon, in which tumor shrinkage in the nonirradiated metastatic region is observed after radiotherapy. Certainly, this response is sometimes reported with the combined use of immune-checkpoint inhibitors, but a pure abscopal effect is extremely rare, especially in endometrial cancer. We present the case of a 79-year-old woman with an advanced endometrial carcinosarcoma. She was treated with surgical reduction of the primary lesion, followed by radiotherapy of the metastatic regional lymph nodes. Distant metastases were detected in radiological imaging test 2 months after the completion of radiotherapy, and we carefully followed up without any treatment considering the patient's tolerability for further procedures. Six months after recurrence, she experienced cytoreduction in the metastatic lesions confirmed through imaging findings, which was believed to be an abscopal effect, and maintained this shrinking state for 15 months. Herein, we describe this pure abscopal effect from the perspective of imaging, pathological and molecular findings, and therapeutic strategies.

DOI： 10.1016/j.radcr.2023.04.031

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血清TFPI-2がCA125より病勢を反映した当院卵巣明細胞癌の1例

荒武淳一, 荻本圭祐, 市田啓佑, 成田萌, 濱崎京子, 中澤浩志, 澁谷剛志, 北井美穂, 塩崎隆也, 若橋宣, 須藤保, 長尾昌二, 山口聡

日本婦人科腫瘍学会学術講演会プログラム・抄録集 65回 370 - 370 2023.7

当院におけるcadaver surgical training(CST)を活用した,広汎子宮全摘出術の成績向上への試み

入江恭平, 白河伸介, 松岡敬典, 依田尚之, 原賀順子, 久保光太郎, 小川千加子, 中村圭一郎, 長尾昌二, 増山寿

日本婦人科腫瘍学会学術講演会プログラム・抄録集 65回 347 - 347 2023.7

卵巣癌治療中に皮膚筋炎を発症し治療に難渋した一例

徳本佑奈, 依田尚之, 兼森雅敏, 岡本和浩, 松岡敬典, 小川千加子, 中村圭一郎, 長尾昌二, 増山寿

現代産婦人科 71 ( 2 ) 261 - 265 2023.6

Language：Japanese Publisher：中国四国産科婦人科学会

今回,我々は卵巣癌治療中に急激な筋力低下,嚥下障害を伴った皮膚筋炎を経験した。全身状態不良の中で積極的な卵巣癌治療を優先的に行うことで皮膚筋炎の改善を認めたため報告する。【症例】68歳,女性。1ヵ月前に当院にて審査腹腔鏡手術を行い卵巣癌IIIC期(FIGO2014,pT3cN0M0)高異型度漿液性癌と診断した。MyChoice診断システムを提出した上で,結果開示までの間,術前化学療法としてddTC(Dose dense PTX+CBDCA)療法を開始した。1サイクル施行後,急激な筋力低下,嚥下障害が出現し,皮膚筋炎が疑われ当科入院となった。Gottron丘疹や著明な筋原性酵素の上昇を認め,抗TIF1γ抗体陽性であり,卵巣癌を契機に発症した皮膚筋炎と診断した。皮膚筋炎に対しステロイド投与を開始した。肝酵素の上昇を伴っていたが,筋原性酵素の低下に伴い改善したことから筋肉の崩壊に伴う肝酵素の上昇と診断し,第8病日に化学療法2サイクル目を施行した。卵巣癌の病状制御は良好であったが,皮膚筋炎に対する治療反応が乏しく免疫グロブリン療法も併用した。ステロイド投与と抗癌剤治療による低免疫状態のため全身管理に苦慮し,リハビリテーションも遅々としたものであった。化学療法5サイクル終了後,残存病変の完全切除による皮膚筋炎の改善を期待し,単純子宮全摘出術,両側附属器摘出術,大網切除術を施行し,肉眼的残存腫瘍なしとできた。その後も化学療法とリハビリテーションを継続し,術前に比して著明に四肢の筋力や嚥下機能の向上を認めた。【結語】皮膚筋炎と卵巣癌の治療を併用することは長期的で繊細な全身管理を要するが,化学療法だけでなく手術療法を伴った卵巣癌の標準治療を適切に敢行することが皮膚筋炎の改善に繋がった。(著者抄録)

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Neoadjuvant chemotherapy followed by interval debulking surgery for advanced epithelial ovarian cancer: GOTIC-019 study. Reviewed

Shoji Nagao, Jun Tamura, Takashi Shibutani, Maiko Miwa, Tomoyasu Kato, Ayumi Shikama, Yuji Takei, Natsuko Kamiya, Naoki Inoue, Kazuto Nakamura, Aya Inoue, Koji Yamamoto, Keiichi Fujiwara, Mitsuaki Suzuki

International journal of clinical oncology 28 ( 6 ) 804 - 815 2023.6

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: Three randomized controlled trials have resulted in extremely extensive application of the strategy of using neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS) for patients with advanced epithelial ovarian cancer in Japan. This study aimed to evaluate the status and effectiveness of treatment strategies using NAC followed by IDS in Japanese clinical practice. PATIENTS AND METHODS: We conducted a multi-institutional observational study of 940 women with Federation of Gynecology and Obstetrics (FIGO) stages III-IV epithelial ovarian cancer treated at one of nine centers between 2010 and 2015. Progression-free survival (PFS) and overall survival (OS) were compared between 486 propensity-score matched participants who underwent NAC followed by IDS and primary debulking surgery (PDS) followed by adjuvant chemotherapy. RESULTS: Patients with FIGO stage IIIC receiving NAC had a shorter OS (median OS: 48.1 vs. 68.2 months, hazard ratio [HR]: 1.34; 95% confidence interval [CI] 0.99-1.82, p = 0.06) but not PFS (median PFS: 19.7 vs. 19.4 months, HR: 1.02; 95% CI: 0.80-1.31, p = 0.88). However, patients with FIGO stage IV receiving NAC and PDS had comparable PFS (median PFS: 16.6 vs. 14.7 months, HR: 1.07 95% CI: 0.74-1.53, p = 0.73) and OS (median PFS: 45.2 vs. 35.7 months, HR: 0.98; 95% CI: 0.65-1.47, p = 0.93). CONCLUSIONS: NAC followed by IDS did not improve survival. In patients with FIGO stage IIIC, NAC may be associated with a shorter OS.

DOI： 10.1007/s10147-023-02329-7

PubMed

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Intraperitoneal Carboplatin for Ovarian Cancer — A Phase 2/3 Trial Reviewed

Shoji Nagao, Keiichi Fujiwara, Kouji Yamamoto, Hiroshi Tanabe, Aikou Okamoto, Kazuhiro Takehara, Motoaki Saito, Hiroyuki Fujiwara, David S.P. Tan, Satoshi Yamaguchi, Sosuke Adachi, Akira Kikuchi, Takeshi Hirasawa, Takeshi Yokoi, Tomonori Nagai, Toyomi Sato, Shoji Kamiura, Akira Fujishita, Wong Wai Loong, Karen Chan, Peter Syks, Alexsander Olawaye, Sang-Young Ryu, Hiroyuki Shigeta, Eiji Kondo, Yoshihito Yokoyama, Takashi Matsumoto, Kosei Hasegawa, Takayuki Enomoto

NEJM Evidence 2 ( 5 ) 2023.4

初回進行卵巣癌に対するPARP阻害剤維持療法の施行状況と安全性の検討

松岡敬典, 白河伸介, 入江恭平, 岡本和浩, 依田尚之, 原賀順子, 久保光太郎, 小川千加子, 中村圭一郎, 長尾昌二, 増山寿

日本産科婦人科学会雑誌 75 ( 臨増 ) S - 291 2023.2

子宮頸癌に対し放射線治療後骨盤骨折発生の多施設共同後ろ向きコホート研究

白河伸介, 長尾昌二, 入江恭平, 岡本和浩, 松岡敬典, 依田尚之, 原賀順子, 小川千加子, 中村圭一郎, 依光正枝, 児玉順一, 永坂久子, 中西美惠, 今福紀章, 山本暖, 増山寿, IPFAR

日本産科婦人科学会雑誌 75 ( 臨増 ) S - 450 2023.2

腹腔鏡下手術の適応への判断に超音波ガイド下針生検を施行した子宮腫瘤の検討

藤川淳, 久保光太郎, 兼森雅敏, 白河伸介, 岡本和浩, 依田尚之, 松岡敬典, 小川千加子, 鎌田泰彦, 中村圭一郎, 長尾昌二, 増山寿

日本産科婦人科学会雑誌 75 ( 臨増 ) S - 427 2023.2

Veliparib with frontline chemotherapy and as maintenance in Japanese women with ovarian cancer: a subanalysis of efficacy, safety, and antiemetic use in the phase 3 VELIA trial. Reviewed

Mika Mizuno, Kimihiko Ito, Hidekatsu Nakai, Hidenori Kato, Shoji Kamiura, Kimio Ushijima, Shoji Nagao, Hirokuni Takano, Masao Okadome, Munetaka Takekuma, Hideki Tokunaga, Satoru Nagase, Daisuke Aoki, Robert L Coleman, Yasuko Nishimura, Christine K Ratajczak, Hideyuki Hashiba, Hao Xiong, Noriyuki Katsumata, Takayuki Enomoto, Aikou Okamoto

International journal of clinical oncology 28 ( 1 ) 163 - 174 2022.12

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The phase 3 VELIA trial evaluated veliparib with carboplatin/paclitaxel and as maintenance in patients with high-grade serous ovarian carcinoma. METHODS: Patients with previously untreated stage III-IV high-grade serous ovarian carcinoma were randomized 1:1:1 to control (placebo with carboplatin/paclitaxel and placebo maintenance), veliparib-combination-only (veliparib with carboplatin/paclitaxel and placebo maintenance), or veliparib-throughout (veliparib with carboplatin/paclitaxel and veliparib maintenance). Randomization stratification factors included geographic region (Japan versus North America or rest of the world). Primary end point was investigator-assessed median progression-free survival. Efficacy, safety, and pharmacokinetics were evaluated in a subgroup of Japanese patients. RESULTS: Seventy-eight Japanese patients were randomized to control (n = 23), veliparib-combination-only (n = 30), and veliparib-throughout (n = 25) arms. In the Japanese subgroup, median progression-free survival for veliparib-throughout versus control was 27.4 and 19.1 months (hazard ratio, 0.46; 95% confidence interval, 0.18-1.16; p = 0.1 [not significant]). In the veliparib-throughout arm, grade 3/4 leukopenia, neutropenia, and thrombocytopenia rates were higher for Japanese (32%/88%/32%) versus non-Japanese (17%/56%/28%) patients. Grade 3/4 anemia rates were higher in non-Japanese (65%) versus Japanese (48%) patients. Early introduction of olanzapine during veliparib monotherapy maintenance phase may help prevent premature discontinuation of veliparib, via its potent antiemetic efficacy. CONCLUSIONS: Median progression-free survival was numerically longer in Japanese patients in the veliparib-throughout versus control arm, consistent with results in the overall study population. Pharmacokinetics were comparable between Japanese and non-Japanese patients. Data for the subgroup of Japanese patients were not powered to show statistical significance but to guide further investigation.

DOI： 10.1007/s10147-022-02258-x

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分葉状頸管腺過形成の診断で腹腔鏡下子宮全摘出術を施行し,子宮頸部上皮内胃型腺癌が判明した1例 Reviewed

依田尚之, 久保光太郎, 田中佑衣, 兼森雅敏, 白河伸介, 岡本和浩, 松岡敬典, 小川千加子, 中村圭一郎, 長尾昌二, 増山寿

現代産婦人科 71 ( 1 ) 99 - 103 2022.12

Language：Japanese Publisher：中国四国産科婦人科学会

子宮頸部に胃型粘液を産生する多嚢胞性病変を認めた場合に分葉状頸管腺過形成(Lobular endocervical glandular hyperplasia:LEGH)と最小偏倚腺癌(minimal deviation adenocarcinoma:MDA)を含む胃型粘液性癌(mucinous carcinoma,gastric type:GAS)とを鑑別することは非常に困難である。LEGHと診断し,腹腔鏡下子宮全摘出術を行い子宮頸部上皮内胃型腺癌と診断した1例を経験したので報告する。症例は56歳女性,4妊2産。前医の子宮頸管細胞診にてatypical glandular cells(AGC)を認めた。その後の子宮頸管細胞診の再検や頸管内掻爬組織診では異常所見を認めないが,子宮頸部多発嚢胞がありLEGH疑いにて精査加療目的に当科紹介となった。頸管内掻爬組織診の再検にて,子宮頸管線上皮はMUC5AC陽性,MUC6陽性,HIK1083一部陽性を示し,Endocervical epithelium with gastric type mucinであり,LEGHと診断した。画像所見や子宮頸管細胞診・組織診から悪性を強く疑わず,経過観察又は,子宮摘出を提示したところ,患者は子宮摘出を希望した。腹腔鏡下子宮全摘出術,両側付属器摘出術を施行し,術後病理学的診断はAdenocarcinoma in situ(gastric type)associated with LEGHであった。その後,外来にて定期検診を施行しているが明らかな再発を認めない。MRI所見,子宮頸管細胞診異常,gastric type mucinから術前診断し,LEGHの治療戦略を立てるべきだが,腹腔鏡下子宮摘出術を選択する場合には,AISやMDAの合併している可能性に留意した術式を工夫すべきかもしれない。(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J05038&link_issn=&doc_id=20221221480017&doc_link_id=%2Fcv0mtrob%2F2022%2F007101%2F017%2F0099-0103%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcv0mtrob%2F2022%2F007101%2F017%2F0099-0103%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

腫瘍の自然脱落により診断に至った子宮腺肉腫の一例

田中佑衣, 依田尚之, 兼森雅敏, 白河伸介, 岡本和浩, 松岡敬典, 原賀順子, 小川千加子, 中村圭一郎, 長尾昌二, 増山寿

現代産婦人科 71 ( Suppl. ) S62 - S63 2022.9

Tumor size before image-guided brachytherapy is an important factor of local control after radiotherapy for cervical squamous cell carcinoma: analysis in cases using central shielding. Reviewed International journal

Kotaro Yoshio, Hiroki Ihara, Kazuhiro Okamoto, Etsuji Suzuki, Takeshi Ogata, Soichi Sugiyama, Keiichiro Nakamura, Shoji Nagao, Hisashi Masuyama, Takao Hiraki

Journal of radiation research 2022.7

Language：English Publishing type：Research paper (scientific journal)

We analyzed the local control (LC) of cervical squamous cell carcinoma treated by computed tomography (CT)-based image-guided brachytherapy (IGBT) using central shielding (CS). We also examined the value of tumor diameter before brachytherapy (BT) as a factor of LC. In total, 97 patients were analyzed between April 2016 and March 2020. Whole-pelvic (WP) radiotherapy (RT) with CS was performed, and the total pelvic sidewall dose was 50 or 50.4 Gy; IGBT was delivered in 3-4 fractions. The total dose was calculated as the biologically equivalent dose in 2 Gy fractions, and distribution was modified manually by graphical optimization. The median follow-up period was 31.8 months (6.3-63.2 months). The 1- and 2-year LC rates were 89% and 87%, respectively. The hazard ratio was 10.11 (95% confidence interval: 1.48-68.99) for local recurrence in those with a horizontal tumor diameter ≥ 4 cm compared to those with < 4 cm before BT. In CT-based IGBT for squamous cell carcinoma, favorable LC can be obtained in patients with a tumor diameter < 4 cm before BT. However, if the tumor diameter is ≥ 4 cm, different treatment strategies such as employing interstitial-BT for dose escalation may be necessary.

DOI： 10.1093/jrr/rrac040

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卵巣未熟奇形種に併発した抗NMDA受容体脳炎の一例

松岡敬典, 白河伸介, 岡本和浩, 依田尚之, 久保光太郎, 小川千加子, 中村圭一郎, 長尾昌二, 増山寿

日本婦人科腫瘍学会学術講演会プログラム・抄録集 64回 285 - 285 2022.7

当院で施行した婦人科癌のがんゲノム医療の現況と課題

依田尚之, 小川千加子, 入江恭平, 岡本和浩, 松岡敬典, 久保光太郎, 中村圭一郎, 長尾昌二, 増山寿, 平沢晃

日本婦人科腫瘍学会学術講演会プログラム・抄録集 64回 205 - 205 2022.7

肥満を伴う子宮体癌患者に対して腹腔鏡下手術を施行した2症例

久保光太郎, 岡本和浩, 依田尚之, 松岡敬典, 小川千加子, 中村圭一郎, 長尾昌二, 増山寿

日本婦人科腫瘍学会学術講演会プログラム・抄録集 64回 244 - 244 2022.7

当院で施行した婦人科癌のがんゲノム医療の現況と課題

依田尚之, 小川千加子, 入江恭平, 岡本和浩, 松岡敬典, 久保光太郎, 中村圭一郎, 長尾昌二, 増山寿, 平沢晃

日本婦人科腫瘍学会学術講演会プログラム・抄録集 64回 205 - 205 2022.7

Abscopal effectによる遠隔転移の消失と考えられた子宮癌肉腫の一例

岡本和浩, 入江恭平, 松岡敬典, 依田尚之, 小川千加子, 中村圭一郎, 長尾昌二, 増山寿

日本婦人科腫瘍学会学術講演会プログラム・抄録集 64回 237 - 237 2022.7

Effect of prior olaparib maintenance therapy for platinum sensitive recurrent ovarian cancer on response to subsequent platinum-based chemotherapy. Reviewed International journal

Hiroshi Nakazawa, Shoji Nagao, Moyu Narita, Takashi Shibutani, Tomoatsu Jimi, Hiroko Yano, Miho Kitai, Takaya Shiozaki, Satoshi Yamaguchi

The journal of obstetrics and gynaecology research 2022.2

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

AIM: Several years have passed since olaparib maintenance therapy was approved in patients with platinum sensitive recurrent ovarian cancer (PSROC). We speculated that the response to platinum-based chemotherapy (PBC) would be impaired at the time of recurrence after olaparib maintenance therapy. We conducted a noninterventional retrospective study to clarify this clinical question in a single institution. METHODS: We included all patients with PSROC who received olaparib after second or later line of PBC between April 18, 2018, and August 31, 2021. We evaluated the effect of olaparib maintenance therapy on PBC after progression. RESULTS: We identified 42 patients who received olaparib maintenance therapy after second or later line of PBC. Twenty-four patients relapsed after olaparib maintenance therapy, and 17 patients received PBC again. Four of 17 patients (complete response 2, partial response 2) responded to the PBC. The median progression-free survival was longer in patients with platinum-free interval ≥12 months than platinum-free interval of 6-12 months (9.7 vs 2.6 months, hazard ratio, 0.20: 95% confidence interval, 0.04-0.90; p = 0.04). CONCLUSIONS: In the patients with PSROC who experienced disease progression after olaparib maintenance therapy, especially in those with platinum-free interval of 6-12 months, the response to subsequent PBC was extremely poor. The efficiency of re-administration of PBC for PSROC patients with a short-term recurrence after olaparib treatment may need to be reconsidered.

DOI： 10.1111/jog.15184

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