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  1. Article: Reconsideration of Sharp Dissection in Gynecological Surgery.

    Tanase, Yasuhito / Shimada, Muneaki / Kato, Mayumi Kobayashi / Uno, Masaya / Ishikawa, Mitsuya / Kato, Tomoyasu

    Gynecology and minimally invasive therapy

    2023  Volume 12, Issue 2, Page(s) 96–98

    Abstract: In surgical fields, sharp dissection is a basic surgical technique, and the prognosis and oncological outcomes are known to be affected by the technique of dissection. Even in gynecologic surgery, we believe that the basic surgical technique is sharp ... ...

    Abstract In surgical fields, sharp dissection is a basic surgical technique, and the prognosis and oncological outcomes are known to be affected by the technique of dissection. Even in gynecologic surgery, we believe that the basic surgical technique is sharp dissection. We herein present our technique and discuss its significance. Sharp dissection should entail the removal of a single thin line between the residual tissue and the excised tissue. If this line becomes multiple or thicker, it is not sharp dissection but blunt dissection. The accumulation of this thin line of sharp dissection can form surgical layers. What is important is moderate tissue tension and how to use monopolar. One can sharply cut the loose connective tissue assisted by moderate tissue tension. With regard to the use of monopolar, it is essential that it not be applied directly to the tissue, but rather be used with or without touching the tissue. Inadvertent blunt dissection should be minimized, as most surgical procedures can be performed with sharp dissection. We usually perform sharp dissection for open surgery as well as minimally invasive surgery. We obstetricians and gynecologists should reconsider the significance of sharp dissection and practice it in gynecological surgery.
    Language English
    Publishing date 2023-04-25
    Publishing country India
    Document type Journal Article
    ZDB-ID 2696587-2
    ISSN 2213-3070
    ISSN 2213-3070
    DOI 10.4103/gmit.gmit_3_23
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Variations in Procedures for Ureterolysis with Sharp Dissection in Minimally Invasive Hysterectomy.

    Tanase, Yasuhito / Kato, Mayumi Kobayashi / Uno, Masaya / Ishikawa, Mitsuya / Kato, Tomoyasu

    Gynecology and minimally invasive therapy

    2022  Volume 11, Issue 3, Page(s) 171–173

    Abstract: To safely perform minimally invasive hysterectomy (MIH), including laparoscopic hysterectomy and robot-assisted hysterectomy, partial ureterolysis, or visualizing only the ureter without dissection is often inadequate. Moreover, careless blunt dissection ...

    Abstract To safely perform minimally invasive hysterectomy (MIH), including laparoscopic hysterectomy and robot-assisted hysterectomy, partial ureterolysis, or visualizing only the ureter without dissection is often inadequate. Moreover, careless blunt dissection could injure the blood vessels. We present our surgical method for ureterolysis using sharp dissection during MIH. First, the outer portion of the ureter is dissected. Dissecting between the pelvic sidewall and the posterior leaf of the broad ligament creates a pararectal space outside the ureter, enabling the easy identification of the ureter running on the posterior leaf. Second, the inner portion of the ureter is dissected. After determining the location of the ureter, a better partial dissection of the ureter can be performed from the posterior leaf, instead of dissecting along the entire circumference. If fine surgery has to be performed, the ureter can be dissected by enclosing it within its sheath. We primarily perform dissections using a monopolar device, which allows a sharp dissection. Furthermore, in our method, we often include the dissection of the ureteral tunnel. It is important to understand the anatomy and membrane structure of the ureter in each patient and adjust the extent of ureterolysis based on individual differences.
    Language English
    Publishing date 2022-08-05
    Publishing country India
    Document type Journal Article
    ZDB-ID 2696587-2
    ISSN 2213-3070
    ISSN 2213-3070
    DOI 10.4103/gmit.gmit_129_21
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Surgically treated cervical cancer in a high-risk group in the era of the 2018 FIGO staging schema: a nationwide study.

    Shigeta, Shogo / Shimada, Muneaki / Tsuji, Keita / Watanabe, Zen / Tanase, Yasuhito / Matsuo, Koji / Nakanishi, Toru / Saito, Toshiaki / Aoki, Daisuke / Mikami, Mikio

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 12020

    Abstract: The 2018 International Federation of Gynecology and Obstetrics (FIGO) revision to the staging criteria for uterine cervical cancer adopted pathological staging for patients who underwent surgery. We investigated the correlation between ... ...

    Abstract The 2018 International Federation of Gynecology and Obstetrics (FIGO) revision to the staging criteria for uterine cervical cancer adopted pathological staging for patients who underwent surgery. We investigated the correlation between clinicopathological factors and prognosis in patients with high-risk factors in accordance with the FIGO 2018 staging criteria by analyzing a real-world database of 6,192 patients who underwent radical hysterectomy at 116 institutions belonging to the Japan Gynecologic Oncology Group. A total of 1,392 patients were categorized into the high-risk group. Non-squamous cell carcinoma histology, regional lymph node metastasis, pT2 classification, and ovarian metastasis were identified as independent risk factors for mortality. Based on pathological findings, 313, 1003, and 76 patients were re-classified into FIGO 2018 stages IIB, IIIC1p, and IIIC2p, respectively. Patients with stage IIIC2p disease showed worse prognoses than those with stage IIB or IIIC1p disease. In patients with stage IIIC1p disease, overall survival was significantly better if their tumors were localized in the uterine cervix, except for single lymph node metastasis, with a 5-year overall survival rate of 91.8%. This study clarified the heterogeneity of the high-risk group and provided insights into the feasibility of upfront radical hysterectomy for a limited number of patients harboring high-risk factors.
    MeSH term(s) Humans ; Female ; Uterine Cervical Neoplasms/pathology ; Neoplasm Staging ; Lymphatic Metastasis ; Prognosis ; Hysterectomy ; Retrospective Studies
    Language English
    Publishing date 2023-07-25
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-023-39014-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Endometrioid Endometrial Carcinoma With NKX3.1 Expression in a Transgender Man: A Case Report.

    Yoshida, Hiroshi / Uno, Masaya / Ogimoto, Keisuke / Kobayashi-Kato, Mayumi / Tanase, Yasuhito / Ishikawa, Mitsuya / Kato, Tomoyasu

    International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists

    2023  Volume 42, Issue 3, Page(s) 308–314

    Abstract: Endometrial cancer in transgender men is rare, and its histopathologic features remain unknown. A 30-yr-old transgender man with an intrauterine tumor, an ovarian mass, and a 2-yr history of testosterone use was referred to us for treatment. The presence ...

    Abstract Endometrial cancer in transgender men is rare, and its histopathologic features remain unknown. A 30-yr-old transgender man with an intrauterine tumor, an ovarian mass, and a 2-yr history of testosterone use was referred to us for treatment. The presence of the tumors was confirmed via imaging, and the intrauterine tumor was identified as an endometrial endometrioid carcinoma via endometrial biopsy. The patient underwent hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and lymph node dissection. Pathologic examination revealed grade 3 endometrioid endometrial carcinoma, and the synchronous endometrial and ovarian tumors were collectively characterized as primary endometrial carcinoma. Metastatic carcinomas were discovered in both ovaries and the omentum, pelvic peritoneum, and a para-aortic lymph node. On immunohistochemistry, the tumor cells diffusely expressed p53, retained expression of PTEN, ARID1A, PMS2, and MSH6, and focally expressed estrogen receptors, androgen receptors, and NKX3.1. NKX3.1 was also expressed in glandular structures within the exocervical squamous epithelium. Prostate-specific antigen and prostatic acid phosphatase were focally positive. In conclusion, we describe a transgender man with NKX3.1-expressing endometrioid endometrial carcinoma who provides valuable suggestions regarding the effects of testosterone on endometrial cancer and appropriate gynecological care for transgender men.
    MeSH term(s) Female ; Humans ; Carcinoma, Endometrioid/pathology ; Transgender Persons ; Endometrial Neoplasms/pathology ; Ovarian Neoplasms/pathology ; Endometrium/pathology
    Language English
    Publishing date 2023-02-21
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 604859-6
    ISSN 1538-7151 ; 0277-1691
    ISSN (online) 1538-7151
    ISSN 0277-1691
    DOI 10.1097/PGP.0000000000000869
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Ovarian Mucinous Tumor Presenting Atypical Lobular Endocervical Glandular Hyperplasia-Like Appearance in a Patient With Germline

    Yoshida, Hiroshi / Hiranuma, Kengo / Nakahara, Mariko / Kobayashi-Kato, Mayumi / Tanase, Yasuhito / Uno, Masaya / Shiraishi, Kouya / Ishikawa, Mitsuya / Kato, Tomoyasu

    International journal of surgical pathology

    2023  Volume 32, Issue 2, Page(s) 394–400

    Abstract: Peutz-Jeghers syndrome (PJS) is associated with female genital lesions, such as cervical gastric-type adenocarcinoma and lobular endocervical glandular hyperplasia (LEGH). However, ovarian mucinous borderline tumors (OMBT) with atypical LEGH-like ... ...

    Abstract Peutz-Jeghers syndrome (PJS) is associated with female genital lesions, such as cervical gastric-type adenocarcinoma and lobular endocervical glandular hyperplasia (LEGH). However, ovarian mucinous borderline tumors (OMBT) with atypical LEGH-like histology have not been described. The patient was a 60-year-old female with PJS clinically diagnosed at 23 years old with gastrointestinal polyposis. Abdominal distension was noted, and computed tomography scan revealed bilateral breast masses, multiple lung nodules, and a multicystic ovarian tumor. A needle biopsy revealed invasive ductal carcinoma of the breast. For the ovarian tumor, simple hysterectomy and bilateral salpingo-oophorectomy were performed. The left ovarian tumor was 25 × 20 × 12 cm in size and a multicystic tumor containing yellowish mucus without a solid part. Histologically, the cyst wall was covered with mucus cells with focal mild-to-moderate cellular atypia, forming LEGH-like architectures. The glandular cells were immunohistochemically positive for MUC5AC, MUC6 (focal), HIK1083 (focal), and HNF4α. Stromal invasion was not observed. Cervical lesions were not observed. The final pathological diagnosis was OMBT showing atypical LEGH morphology. Targeted sequencing of nontumor tissues revealed the germline
    MeSH term(s) Humans ; Female ; Middle Aged ; Young Adult ; Adult ; Hyperplasia ; Ovarian Neoplasms/diagnosis ; Adenocarcinoma ; Biopsy, Needle ; Germ Cells ; AMP-Activated Protein Kinase Kinases
    Chemical Substances STK11 protein, human (EC 2.7.11.1) ; AMP-Activated Protein Kinase Kinases (EC 2.7.11.3)
    Language English
    Publishing date 2023-05-24
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 1336393-1
    ISSN 1940-2465 ; 1066-8969
    ISSN (online) 1940-2465
    ISSN 1066-8969
    DOI 10.1177/10668969231177256
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Ovarian Mesonephric-Like Adenocarcinoma With Recurrent Liver Metastases: A Case Report with Analysis of Therapeutic Molecular Targets.

    Sugitani, Ayumi / Ogawa, Ayako / Yoshida, Hiroshi / Kobayashi-Kato, Mayumi / Kikkawa, Nao / Tanase, Yasuhito / Uno, Masaya / Ishikawa, Mitsuya / Kato, Tomoyasu

    International journal of surgical pathology

    2023  Volume 32, Issue 3, Page(s) 578–585

    Abstract: Ovarian mesonephric-like adenocarcinoma (MLA) is a rare cancer subtype. We describe a patient with ovarian MLA wherein liver metastases developed 1 month after surgery. A phenotypic analysis of the tumor was performed to identify molecular therapeutic ... ...

    Abstract Ovarian mesonephric-like adenocarcinoma (MLA) is a rare cancer subtype. We describe a patient with ovarian MLA wherein liver metastases developed 1 month after surgery. A phenotypic analysis of the tumor was performed to identify molecular therapeutic targets. A 53-year-old woman, without any symptoms, underwent uterine cancer screening. Transvaginal ultrasonography revealed an ovarian mass, and subsequent pelvic magnetic resonance imaging showed a 13 × 10 cm multicystic ovarian lesion with a solid part. No extra ovarian lesions were observed and a staging laparotomy was performed. Pathological examination revealed an MLA of the left ovary (stage IC1). The tumor comprised tumor cells in a tubular pattern with intraluminal eosinophilic material, as well as mixed glandular and papillary, cord-like, and solid patterns. Endometriosis was also observed. Immunohistochemically, the tumor cells were positive for PAX8, GATA3 (focal), TTF1 (focal), and CD10 (luminal) and negative for the estrogen receptor, progesterone receptor, and WT1. One month after surgery, computed tomography revealed multiple liver metastases. Additional immunohistochemistry for therapeutic targets revealed that the tumor cells were weakly positive for human epidermal growth factor receptor 2 (focal; score 1+), pan-tropomyosin receptor kinase-negative, programmed death-ligand 1-negative, and PMS2 and MSH6 intact. The companion homologous recombination deficiency test (MyChoice
    MeSH term(s) Female ; Humans ; Middle Aged ; Ovarian Cysts ; Ovarian Neoplasms/diagnosis ; Ovarian Neoplasms/surgery ; Ovarian Neoplasms/pathology ; Adenocarcinoma/pathology ; Liver Neoplasms/diagnosis ; Liver Neoplasms/surgery
    Language English
    Publishing date 2023-06-21
    Publishing country United States
    Document type Case Reports ; Review ; Journal Article
    ZDB-ID 1336393-1
    ISSN 1940-2465 ; 1066-8969
    ISSN (online) 1940-2465
    ISSN 1066-8969
    DOI 10.1177/10668969231183631
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Long-Term Follow-Up after Surgical Management for Atypical Endometriosis: A Series of Nine Cases.

    Tanase, Yasuhito / Kawaguchi, Ryuji / Uchiyama, Tomoko / Kobayashi, Hiroshi

    Case reports in oncology

    2019  Volume 12, Issue 1, Page(s) 76–83

    Abstract: Background and objective: Atypical endometriosis is reported to possess a precancerous potential attributed to premalignant changes characterized by cytological atypia and architecture proliferation. Although the coexistence of atypical endometriosis ... ...

    Abstract Background and objective: Atypical endometriosis is reported to possess a precancerous potential attributed to premalignant changes characterized by cytological atypia and architecture proliferation. Although the coexistence of atypical endometriosis and neoplasms has been reported, cases of atypical endometriosis transformation to carcinoma are rarely reported. The purpose of this case series was to evaluate the prognosis of atypical endometriosis.
    Subjects and methods: Data from nine women who underwent surgical treatment including cystectomy and salpingo-oophorectomy with or without hysterectomy and diagnosed with atypical endometriosis was analyzed. Between January 2006 and January 2018, the clinical characteristics and prognosis of atypical endometriosis were evaluated.
    Results: During the follow-up period, eight of nine patients with atypical endometriosis did not develop malignant epithelial tumors, although one patient developed endometrioid carcinoma, grade 1, 48 months after her right laparoscopic cystectomy. The median overall survival period for all patients was 68 (range 13-131) months.
    Conclusion: When we encounter the cases of atypical endometriosis, it is necessary to consider the possibility of ovarian cancer and carefully follow those cases for long periods.
    Language English
    Publishing date 2019-01-21
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2458961-5
    ISSN 1662-6575
    ISSN 1662-6575
    DOI 10.1159/000496178
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Brain Metastases from Uterine Cervical and Endometrial Cancer.

    Kato, Mayumi Kobayashi / Tanase, Yasuhito / Uno, Masaya / Ishikawa, Mitsuya / Kato, Tomoyasu

    Cancers

    2021  Volume 13, Issue 3

    Abstract: Reports on brain metastases (BMs) from uterine cervical carcinoma (CC) and uterine endometrial carcinoma (EC) have recently increased due to the development of massive databases and improvements in diagnostic procedures. This review separately ... ...

    Abstract Reports on brain metastases (BMs) from uterine cervical carcinoma (CC) and uterine endometrial carcinoma (EC) have recently increased due to the development of massive databases and improvements in diagnostic procedures. This review separately investigates the prevalence, clinical characteristics, clinical presentation, diagnosis, treatment, and prognosis of BMs from CC and uterine endometrial carcinoma EC. For patients with CC, early-stage disease and poorly differentiated carcinoma lead to BMs, and elderly age, poor performance status, and multiple BMs are listed as poor prognostic factors. Advanced-stage disease and high-grade carcinoma are high-risk factors for BMs from EC, and multiple metastases and extracranial metastases, or unimodal therapies, are possibly factors indicating poor prognosis. There is no "most effective" therapy that has gained consensus for the treatment of BMs. Treatment decisions are based on clinical status, number of the metastases, tumor size, and metastases at distant organs. Surgical resection followed by adjuvant radiotherapy appears to be the best treatment approach to date. Stereotactic ablative radiation therapy has been increasingly associated with good outcomes in preserving cognitive functions. Despite treatment, patients died within 1 year after the BM diagnosis. BMs from uterine cancer remain quite rare, and the current evidence is limited; thus, further studies are needed.
    Language English
    Publishing date 2021-01-29
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers13030519
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Loss of ARID1A Expression as a Favorable Prognostic Factor in Early-Stage Grade 3 Endometrioid Endometrial Carcinoma Patients.

    Kato, Mayumi Kobayashi / Yoshida, Hiroshi / Tanase, Yasuhito / Uno, Masaya / Ishikawa, Mitsuya / Kato, Tomoyasu

    Pathology oncology research : POR

    2021  Volume 27, Page(s) 598550

    Abstract: Introduction: ...

    Abstract Introduction:
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor/metabolism ; Carcinoma, Endometrioid/metabolism ; Carcinoma, Endometrioid/mortality ; Carcinoma, Endometrioid/pathology ; Carcinoma, Endometrioid/surgery ; DNA-Binding Proteins/metabolism ; Endometrial Neoplasms/metabolism ; Endometrial Neoplasms/mortality ; Endometrial Neoplasms/pathology ; Endometrial Neoplasms/surgery ; Female ; Follow-Up Studies ; Gene Expression Regulation, Neoplastic ; Humans ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Rate ; Transcription Factors/metabolism
    Chemical Substances ARID1A protein, human ; Biomarkers, Tumor ; DNA-Binding Proteins ; Transcription Factors
    Language English
    Publishing date 2021-03-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 1375979-6
    ISSN 1532-2807 ; 1219-4956
    ISSN (online) 1532-2807
    ISSN 1219-4956
    DOI 10.3389/pore.2021.598550
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Analysis of Risk Factors for Lymphatic Metastasis in Endometrial Carcinoma and Utility of Three-Dimensional Magnetic Resonance Imaging in Gynecology.

    Tanase, Yasuhito / Takahama, Junko / Kawaguchi, Ryuji / Kobayashi, Hiroshi

    World journal of oncology

    2018  Volume 9, Issue 3, Page(s) 74–79

    Abstract: Background: The aim of our study was to evaluate the utility of three-dimensional magnetic resonance imaging (3D-MRI) in gynecologic fields. We examined the relation between tumor volume measured with 3D-MRI and lymph node metastasis in patients with ... ...

    Abstract Background: The aim of our study was to evaluate the utility of three-dimensional magnetic resonance imaging (3D-MRI) in gynecologic fields. We examined the relation between tumor volume measured with 3D-MRI and lymph node metastasis in patients with endometrial carcinoma.
    Methods: A retrospective analysis of 84 patients with endometrial carcinoma who underwent hysterectomy, bilateral salpingo-oophorectomy with pelvic/para-aortic lymphadenectomy at our institute was performed. Of these, the tumor volume of 59 patients could be calculated using 3D-MRI. Age, serum CA125 level, histologic type and grade, volume of tumors were examined in relation to pelvic/para-aortic lymph node metastasis as preoperative risk factors. Tumor volume measurements were calculated using 3D-MRI with AqariusNET Server 4G software. Univariate and multivariate associations between the preoperative risk factors and pelvic/para-aortic lymph node metastasis were analyzed. Receiver operating characteristic (ROC) curves were used to determine the best cut-off points for CA125 levels and tumor volume to predict lymph metastasis.
    Results: The mean age, CA125 value and tumor volume were 61.6 years, 51.6 (IU/L) and 11.6 (cm
    Conclusions: Our results suggest that tumor volume calculated with 3D-MRI correlates with lymph node metastasis in endometrial carcinoma.
    Language English
    Publishing date 2018-06-26
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2548989-6
    ISSN 1920-454X ; 1920-454X
    ISSN (online) 1920-454X
    ISSN 1920-454X
    DOI 10.14740/wjon1106w
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