Faculty Profiles - NAGAO Shoji

Feasibility of extraperitoneal laparoscopic para-aortic and common iliac lymphadenectomy

Shoji Nagao, Keiichi Fujiwara, Reina Kagawa, Yoshiaki Kozuka, Takashi Oda, Kenichiro Maehata, Hiroyasu Ishikawa, Hirofumi Koike, Ichiro Kohno

GYNECOLOGIC ONCOLOGY 103 ( 2 ) 732 - 735 2006.11

Language：English Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

DOI： 10.1016/j.ygyno.2006.04.026

婦人科癌診療の新たな潮流卵巣癌に対する腹腔内化学療法の再評価

藤原恵一, 長尾昌二

産科と婦人科 9 ( 19 ) 1091 - 7 2006.9

Hormonal function after ovarian transposition to the abdominal subcutaneous fat tissue

S. Nagao, K. Fujiwara, H. Ishikawa, T. Oda, K. Tanaka, E. Aotani, I. Kohno

International Journal of Gynecological Cancer 16 ( 1 ) 121 - 124 2006.1

Language：English

We previously reported a new technique for ovarian transposition to the abdominal subcutaneous fat tissue (OTAFT) following hysterectomy. The purpose of this study is to assess the hormonal function after OTAFT. From 1993 to 2000, OTAFT was performed in 27 patients (group A). Forty-two women underwent hysterectomy and retained ovaries without transposition (group B). In 19 cases, bilateral oophorectomy with hysterectomy was performed, and they received a hormone replacement therapy (HRT) (group C). Serum follicle-stimulating hormone (FSH) level of patients was monitored every 2-12 months, and the time of menopause (defined as FSH &gt
40 mIU/mL two times consecutively) was determined in groups A and B. After a median follow-up of 65 months, cumulative ovarian survival did not show significant difference between group A and group B (HR = 0.52, 95% CI = 0.17-1.16
P= 0.10). In patients who were 40 years old or younger, ovarian function declined significantly in group A compared to group B (HR = 0.29, 95% CI = 0.02-0.91
P= 0.04). However, FSH level of postmenopausal patients in group A was not different from FSH level of patients in group C, but FSH level of postmenopausal patients in group B was significantly higher than FSH level of patients in group C (P= 0.002). Although the procedure of OTAFT may somewhat affect the ovarian function, the transposed ovary in postmenopausal women presumably still secrete a small amount of estrogen which is equivalent to an estrogen level by HRT. © 2006, IGCS.

DOI： 10.1111/j.1525-1438.2006.00280.x

Scopus

P1-39 長期経過観察を行ったCIN1(cervical intraepithelial lesion 1)症例における予後解析 : 高リスク型Human Papillomavirus(HPV)感染とHPV-DNAタイプ別の検討(Group 5 子宮頸部腫瘍V,一般演題,講演要旨,第58回日本産科婦人科学会学術講演会)

小田隆司, 藤原恵一, 小塚良哲, 香川玲奈, 長尾昌二, 前畑賢一郎, 石川博康, 小池浩文, 河野一郎

日本産科婦人科學會雜誌 58 ( 2 ) 383 - 383 2006

P2-139 後腹膜鏡下傍大動脈リンパ節生検のFeasibility Study(Group 131 悪性腫瘍全般I,一般演題,講演要旨,第58回日本産科婦人科学会学術講演会)

長尾昌二, 香川玲奈, 小塚良哲, 小田隆司, 前畑賢一郎, 石川博康, 小池浩文, 藤原恵一, 河野一郎

日本産科婦人科學會雜誌 58 ( 2 ) 638 - 638 2006

Intraperitoneal carboplatin infusion may be a pharmacologically more reasonable route than intravenous administration as a systemic chemotherapy. A comparative pharmacokinetic analysis of platinum using a new mathematical model after intraperitoneal vs. intravenous infusion of carboplatin - A Sankai Gynecology Study Group (SGSG) study

Y Miyagi, K Fujiwara, J Kigawa, H Itamochi, S Nagao, E Aotani, N Terakawa, Kohno, I

GYNECOLOGIC ONCOLOGY 99 ( 3 ) 591 - 596 2005.12

Language：English Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Objective. To clarify the pharmacological advantage of carboplatin-based intraperitoneal chemotherapy using the three-compartment mathematical model. Methods. Eleven consecutive patients in one institution underwent intraperitoneal administration of carboplatin, and 11 consecutive patients in another institution received intravenous administration. Carboplatin (AUC = 6 mg x min/ml) was diluted in 500 ml 5% glucose and administered either as an intraperitoneal bolus infusion or intravenous drip infusion during I h. Patients undergoing intravenous injection also received an infusion of 500 ml 5% glucose to obtain intraperitoneal samples. Intraperitoneal fluid and blood samples were obtained, immediately and 1, 2, 4, 8 12, and 24 h after administration. The mathematical model consisting of a three-compartment model was applied to analyze the pharmacokinetics. The model was created with simultaneous differential equations and was solved by the Runge-Kutta method. Results. The rate constants of platinum diffusion from the peritoneal cavity to serum, serum to peritoneal cavity, serum to peripheral space, peripheral space to serum, and elimination were 0.94 +/- 0.79 (mean +/- SD), 1.28 +/- 2.50, 16.50 +/- 9.26, 0.99 +/- 0.62, and 4.14 +/- 1.45 (h(-1)), respectively. When the theoretical pharmacological concentration of platinum was calculated using this mathematical model, 24-h platinum AUC in the serum was exactly the same regardless of intraperitoneal or intravenous administration of carboplatin. However, the 24-h platinum AUC in the peritoneal cavity was approximately 17 times higher when carboplatin was administered by the intraperitoneal route. Conclusion. The present pharmacological analysis suggests that intraperitoneal infusion of carboplatin is feasible not only as an intraperitoneal regional therapy but also as a more reasonable route for systemic chemotherapy. (c) 2005 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.ygyno.2005.06.055

Y Miyagi, K Fujiwara, J Kigawa, H Itamochi, S Nagao, E Aotani, N Terakawa, Kohno, I

GYNECOLOGIC ONCOLOGY 99 ( 3 ) 591 - 596 2005.12

Language：English Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

DOI： 10.1016/j.ygyno.2005.06.055

Difference of carboplatin clearance estimated by the Cockroft-Gault, Jelliffe, Modified-Jelliffe, Wright or Chatelut formula

S Nagao, K Fujiwara, N Imafuku, R Kagawa, Y Kozuka, T Oda, K Maehata, H Ishikawa, H Koike, E Aotani, Kohno, I

GYNECOLOGIC ONCOLOGY 99 ( 2 ) 327 - 333 2005.11

Language：English Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Objective. Although the Calvert Formula is the standard method to calculate the dose of carboplatin, there is no consensus how to determine the glomerular filtration rate (GFR) without Using [Cr-51]-ethylenediamine tetraacetic acid (Cr-51-EDTA). Creatinine clearance (Ccr), calculated using the Cockroft-Gault, Jelliffe, Modified-Jelliffe or Wright formulae, has been used as a substitute for the GFR. In addition to these four formulae, the Chatelut formula has been proposed as a way to calculate carboplatin clearance. Among these formulae, Jelliffe formula does not include body surface area (BSA) or body weight, it to adjust the body size and thus may have greater bias than the other four formulae ill estimating carboplatin clearance. The Purpose of this Study is to evaluate if these five formulae could equally estimate the carboplatin clearance.
Methods. Carboplatin clearance was estimated in 253 patients with gynecologic cancer who received carboplatin-based chemotherapy between January 1996 and August 2004. Ccr was estimated using the Cockroft-Gault, Jelliffe, Modified-Jelliffie or Wright formulae. Carboplatin clearance was also calculated directly by using the Chatelut formula. The five estimations of carboplatin clearance were compared with each other using the post-hoc Wilcoxon signed rank test. The median percent en-or (MPE) and the median absolute percent error (MAPE) were evaluated by comparing carboplatin clearance. The relationships between BSA and ratios of estimated carboplatin clearance (Jelliffe/Cockroft-Gault, Jelliffe/Modified-Jelliffe, Jelliffe/Wright, Jelliffe/Chatelut) were evaluated by using simple regression.
Results. The estimated carboplatin clearances were: Cockroft-Gault formula, 109.8 +/- 28.4; Jelliffe formula, 128.5 +/- 28.2; Modified-Jelliffe formula, 110.8 +/- 25.7; Wright formula, 112.2 +/- 24.3; Chatelut formula, 114.1 +/- 33.0. A statistically significant difference was observed between carboplatin clearance Calculated using Jelliffe formula and that given by each of the other four formulae. Comparing the results of the Cockroft-Gault formula with the Jellife, Modified-Jelliffe, Wright and Chatelut formulae yielded MPEs of +19%, +2%, +3% and +3% and MAPEs of 27%, 5%, 6% and 6%, respectively. There was a significant correlation between BSA and ratio of estimated carboplatin clearance (Jellife/Cockroft-Gault, Jelliffe/Modified-Jellife, Jelliffe/Wright, Jelliffe/Chatelut), with Pearson correlation coefficients of 0.928, 0.847, 0.965 and 0.839 respectively. As the BSA of patient became smaller, the differences between the carboplatin clearance calculated by the Jelliffe formula from other four formulas became larger.
Conclusions. Estimates of carboplatin clearance calculated by the Jelliffe formula tend to have greater positive bias compared to the other four formulae, particularly when the BSA of the patient is small. Ill order to conduct collaborative international Studies, it may be necessary to standardize the formula used to estimate carboplatin clearance to perforin international collaboration Studies. (c) 2005 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.ygyno.2005.06.003

Difference of carboplatin clearance estimated by the Cockroft-Gault, Jelliffe, Modified-Jelliffe, Wright or Chatelut formula International journal

S Nagao, K Fujiwara, N Imafuku, R Kagawa, Y Kozuka, T Oda, K Maehata, H Ishikawa, H Koike, E Aotani, Kohno, I

GYNECOLOGIC ONCOLOGY 99 ( 2 ) 327 - 333 2005.11

Language：English Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

DOI： 10.1016/j.ygyno.2005.06.003

Combination chemotherapy of docetaxel and carboplatin in advanced or recurrent cervix cancer. A pilot study International journal

S Nagao, K Fujiwara, T Oda, H Ishikawa, H Koike, H Tanaka, Kohno, I

GYNECOLOGIC ONCOLOGY 96 ( 3 ) 805 - 809 2005.3

Language：English Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Objectives. This is a pilot study for a future trial to assess the efficacy and safety of combination chemotherapy with docetaxel and carboplatin in advanced or recurrent uterine cervix cancer.
Methods. The patients eligible for this study had histologically confirmed, advanced (stage IB2-IV) or recurrent uterine cervix cancer. Eligible patients had measurable lesions and must have sufficient bone marrow, renal, and liver functions. Docetaxel was administered intravenously (IV) at 60 mg/m(2) followed by IV carboplatin administration based on AUC = 6. Chemotherapy was repeated in 1-6 courses depending on the purpose of the therapy. The response was evaluated based on RECIST criteria. The toxicity grade was determined by NCI-CTC version 2.
Results. During January 2001 and April 2004, 17 patients were entered in this study. The distribution of stage was IB2, 3; IIB, 8; IIIB, 3; IVB, 1; recurrent, 2. There were 9 squamous cell carcinomas, 6 adenocarcinomas, 1 adenosquamous cell carcinoma, and 1 small cell carcinoma. The overall response rate was 76% (2 CR, 11 PR, and 4 SD). No progression of disease was observed. All 5 adenocarcinoma patients in the neoadjuvant chemotherapy group responded including 1 pathological CR. The incidences of grade 3/4 toxicities were 76% for neutrocytopenia, 12% for thrombocytopenia, and 6% for anemia. No grade 3/4 neurotoxicity was observed.
Conclusions. The combination of docetaxel and carboplatin is an effective and safe treatment for uterine cervix cancer. Further evaluation particularly targeted on cervical adenocarcinoma is warranted. (c) 2004 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.ygyno.2004.11.044

Combination chemotherapy of docetaxel and carboplatin in advanced or recurrent cervix cancer. A pilot study

S Nagao, K Fujiwara, T Oda, H Ishikawa, H Koike, H Tanaka, Kohno, I

GYNECOLOGIC ONCOLOGY 96 ( 3 ) 805 - 809 2005.3

Language：English Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

DOI： 10.1016/j.ygyno.2004.11.044