Details of a Researcher - TAMATE MASATO

Papers - TAMATE MASATO

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Outcome and Surgical Technique of Robot-assisted Living Donor Hysterectomy for Uterus Transplantation.

Masato Tamate, Giuliano Testa, Laura Divine, Liza Johannesson

Journal of minimally invasive gynecology 2025.03 [International journal]

DOI PubMed

Standardization of back-table technique for uterus transplantation.

Masato Tamate, Giuliano Testa, Johanna Bayer, Liza Johannesson

Fertility and sterility 2025.02 [International journal]

OBJECTIVE: To present a standardized back-table technique for uterus transplantation (UTx). DESIGN: Step-by-step description of surgical technique and live-action narrated surgical footage showing back-table technique in UTx. SUBJECTS: Uterus transplantation has become a viable option for patients with absolute uterine factor infertility and their families. After performing 20 research cases, our institution has conducted UTx in 13 patients, and over 100 cases have been performed worldwide. Uterus transplantation is now considered technically feasible, with a high live birth rate after successful graft survival. INTERVENTION: The transplantation of a uterus involves three separate surgical components: living or deceased uterus retrieval; back-table preparation of the uterine graft; and implantation of the uterine graft in the recipient. The living donor hysterectomy and implantation of the uterus in the recipient can be seen in separate videos. The back-table process is critically important in transplant surgery. After the uterus is removed from the donor, organ perfusion, vascular preparation, and marking are essential for ensuring a smooth transition to recipient surgery. In this video, we demonstrate our standardized back-table technique. Currently, there are no articles in gynecology focused solely on back-table techniques. When selecting a potential donor, factors such as age, body mass index, general health, and obstetric and surgical history are considered. Once a candidate is deemed suitable, in-person screening includes blood tests, imaging studies, and mental health evaluations. Preoperative imaging provides valuable information on the condition of the uterine vascularity, which is crucial given the complexity and variability of pelvic vessels. Once the uterus is removed from a living or deceased donor, it is immediately placed on ice and flushed with cool preservation fluid on the back-table. Back-table procedures average 0.5-1 hours and includes the following: perfusion; preparation of the arteries; preparation of the veins; ligation of the base of the fallopian tubes; and four-point suturing of the vagina, as well as (optional) cervical cerclage. Preparing the veins is a key part of the back-table process, especially when the vessel diameters are small, necessitating conjoining. Additionally, because the uterus is a mobile organ located between the bladder and rectum, it is essential to assess the shape and positioning of the vessels that will be anastomosed to avoid torsion during the uterine-vessel anastomosis. We believe that our method will be useful for many institutions that wish to initiate UTx programs. MAIN OUTCOME MEASURES: Uterine graft viability and recipient pregnancy outcome. RESULTS: No surgical complications occurred. The postoperative course was uneventful, with early mobilization. The length of hospital stay was 5 days. The uterus was successfully implanted with successful pregnancy outcome. CONCLUSION: Our standardized back-table technique minimizes harm to the recipient. Furthermore, the technique does not compromise the uterine graft function. Further studies and more educational content using video will be key to the widespread adoption of uterine transplantation.

DOI PubMed

Standardization of recipient surgery for uterus transplantation.

Masato Tamate, Liza Johannesson, Johanna Bayer, Giuliano Testa

Fertility and sterility 2025.02 [International journal]

OBJECTIVE(S): To present a standardized surgical technique of recipient transplant surgery for uterus transplantation (UTx). DESIGN(S): Step-by-step description of surgical technique and live-action narrated surgical footage showing uterus recipient surgery in UTx. SUBJECT(S): Uterus transplantation can become a standard option for patients with absolute uterine factor infertility and their families (1, 2). Thirty-six uterus cases of UTx have been performed at Baylor University Medical Center in Dallas (January 2025). Most uterus recipients to date have a congenital absence of the uterus (Mayer-Rokitansky-Küster-Hauser syndrome [MRKH]). Our team has established standard methods for donor surgery and uterine graft back-table techniques. Because the uterus recipient surgery is typically performed using an open approach, high-quality educational videos of UTx are scarce. To aid institutions interested in initiating UTx, an educational video demonstrating our standardized recipient surgery is essential. This video shows the surgical procedure in a 39-year-old previously healthy woman with MRKH. The vascular nomenclature recommended by the United States Uterus Transplant Consortium is used in the manuscript (3). INTERVENTION(S): Uterus transplant recipient surgeries are performed via laparotomy and are significantly shorter than the living donor hysterectomies, averaging 4-5 hours (4). The operative steps performed are as follows: 1) exposure of the external iliac vessels; 2) exposure of the vaginal anastomosis site; 3) graft implantation and vascular anastomosis; 4) vaginal transection and anastomosis; and 5) fixation of the uterus and ovaries. Steps 1-2 are performed jointly by the gynecology surgeon and transplant surgeon; step 3, involving the anastomosis of blood vessels, is conducted by the transplant surgeon. Although steps 1, 2, 4, and 5 are not particularly challenging for an experienced gynecologic oncology surgeon, the vascular anastomosis in step 3 is delicate. This anastomosis involves suturing blood vessels smaller than those used in kidney and liver transplants, using 7-0 monofilament for the arterial and 8-0 monofilament for the venous anastomosis. After reperfusion of the uterine graft, the vaginal anastomosis is completed, which is where most of the bleeding occurs during surgery. For this step (step 4), we use continuous suturing from the 3 to 9 o'clock positions. The vaginal approach is preferred because of the challenging anatomy, particularly in patients with MRKH, where the foreshortened vagina lies deep in the pelvis. Continuous sutures are used for hemostasis in the posterior vaginal wall, where venous blood flow is abundant. To attempt prevention of vaginal structuring, the anterior vaginal wall is sutured interrupted. Step 5 includes fixation of the uterus and ovaries. A trained gynecology surgeon is essential, because the technique may vary depending on the condition of the patient with MRKH. Before implantation of the uterine graft in the recipient, the uterus is removed from a living or deceased donor and subsequently placed on ice and flushed with cool preservation fluid on the back table. The back table is a sterile area used in transplantation surgery where the organ is prepared for transplantation. Preparation includes trimming and potential 86 reconstructions of the vessels that will be used. The living donor hysterectomy and the back table procedure can be seen in separate videos. MAIN OUTCOME MEASURE(S): Hospital stay, perioperative, and long-term complications. Uterine graft viability and recipient pregnancy outcome. RESULT (S): No surgical complications occurred. The postoperative course was uneventful, with early mobilization. The length of hospital stay was 5 days. The uterus was successfully implanted with a successful pregnancy outcome. CONCLUSION(S): Our standardized uterus recipient surgery technique minimizes harm to the recipient. Furthermore, the technique does not compromise the uterine graft function and pregnancy outcome. Further studies and more educational content using video will be key to the widespread adoption of uterine transplantation.

DOI PubMed

Standardization of robot-assisted living donor hysterectomy for uterus transplantation.

Masato Tamate, Laura Divine, Giuliano Testa, Liza Johannesson

Fertility and sterility 2025.02 [International journal]

OBJECTIVE: To present a standardized surgical technique of robot-assisted living donor hysterectomy for uterus transplantation with preservation of the donor ovaries. DESIGN: Step-by-step description of surgical technique and live-action narrated surgical footage showing uterus donor hysterectomy. SUBJECTS: Nineteen robot-assisted living donor hysterectomies for uterus transplantation have been performed at Baylor University Medical Center at Dallas (September 2024). This video shows the surgical procedure in a 33-year-old previously healthy woman. She had a history of a unilateral laparoscopic ovarian cystectomy, and her obstetric history included three term vaginal deliveries. She independently contacted our institution expressing interest in becoming a nondirected uterus donor and underwent comprehensive evaluation by a multidisciplinary transplant team, including medical and psychological assessment for suitability to donate. She explicitly stated desire for no further children. INTERVENTION: Robot-assisted living donor hysterectomy using the da Vinci Xi robotic system. Surgery was performed with the patient in Trendelenburg position (15°), using CO2 pneumoperitoneum (<12 mm Hg), with a four robotic-arm arrangement. Ureteric stents were placed bilaterally, and indocyanine green was injected retrograde to facilitate ureter identification using firefly mode during dissection. Retraction of the uterus was performed with a uterine manipulator. The operative steps performed were as follows: ligation of the round ligaments and exposure of the retroperitoneal space; dissection of the superior uterine veins; dissection of the uterine arteries and the inferior uterine veins; dissection of the ureters, bladder, and rectum; vaginotomy and transection of the vessels; transvaginal uterine graft extraction using a Endo Catch retrieval system and closure of the vaginal cuff. Anatomical terms are used in the video and narration with reference to common gynecological practice. After removal of the uterus from the donor, the uterus was placed on ice on the back-table and flushed with cool preservation fluid. The back-table is a sterile area used in transplantation surgery where the organ is prepared for transplantation. Preparation includes trimming and potential reconstruction of the vessels that will be used. It is on the back-table where the final decision to go ahead with the transplant surgery is made by the uterus transplant team. The back-table procedure and implantation surgery can be seen in separate videos. MAIN OUTCOME MEASURES: Hospital stay, perioperative and long-term complications, uterine graft viability, and recipient pregnancy outcome. RESULTS: No surgical complications occurred. The postoperative course was uneventful, with early mobilization. The length of hospital stay was 2 days. At a 1-year follow-up, the donor reported no concerns and sexual activity without complications. The uterus was successfully implanted to a recipient with successful pregnancy outcome. CONCLUSION: Our standardized robot-assisted living donor hysterectomy technique represents a safe approach to minimize donor harm and allows for preservation of the donor ovaries. Furthermore, the technique does not compromise the uterine graft function and pregnancy outcome.

DOI PubMed

Human papillomavirus self-sampling and urine-sampling tests and the management and short-term outcomes of cervical intraepithelial neoplasia: A prospective observational study.

Motoki Matsuura, Masato Tamate, Sachiko Nagao, Taishi Akimoto, Fukiko Kasuga, Kimihito Saito, Satoshi Shikanai, Yoko Nishimura, Mizue Teramoto, Tsuyoshi Saito

The journal of obstetrics and gynaecology research 50 ( 10 ) 1801 - 1807 2024.10 [International journal]

AIM: The importance of human papillomavirus (HPV) co-testing using physician-, self-, and urine-collected samples to predict cervical intraepithelial neoplasia (CIN) grade 1-2 prognoses has not been previously reported. Therefore, this study aimed to investigate outcomes of patients with CIN 1-2 who simultaneously underwent physician-, self-, and urine-collection sampling tests. METHODS: This study was conducted in Japan between October 2019 and November 2022 and examined the proportion of cases with CIN 1-2 progressions, the percentage of cases with persistent CIN 1-2, and the outcome differences according to the results of physician-, self-, and urine-sampling tests. RESULTS: There were 105 and 59 CIN 1 and 2 cases, respectively, with progression or persistence in 27 (29.3%) and 21 (50.0%) cases, respectively. The median follow-up was 20 and 12 months, respectively. Progression and persistence of CIN 1 were significantly associated with HPV-positive physician- and self-collected samples. No significant difference was observed between cases with CIN 2 who had HPV-positive and HPV-negative results using any sampling method. CONCLUSIONS: Physician- and self-testing for HPV are crucial for predicting disease progression risk in CIN 1 cases. Future research with an extended observation period and consideration of the progression risks is warranted.

DOI PubMed

Successful Outcome of Stage IB3 Cervical Cancer Treated With Neoadjuvant Chemotherapy Followed by Vaginal Radical Trachelectomy: A Case Report.

Masato Tamate, Motoki Matsuura, Masayuki Someya, Tasuku Mariya, Shinichi Ishioka, Tsuyoshi Saito

Cureus 16 ( 10 ) e71626 2024.10 [International journal]

Vaginal trachelectomy, which involves resecting the cervix and its parametrium, is a fertility-sparing option for the treatment of early-stage cervical cancer. Although no consensus has been reached on whether simple or radical trachelectomy is preferable, the vaginal approach is typically avoided for tumors larger than 2 cm due to concerns about recurrence. However, some evidence suggests that fertility preservation may still be viable for select patients with larger tumors. This case report describes a woman with bulky cervical cancer who wished to preserve her fertility. After undergoing neoadjuvant chemotherapy (NAC) and vaginal radical trachelectomy (VRT), she achieved a favorable oncological and perinatal outcome, successfully giving birth to a near-full-term baby. The report outlines the patient's management before, during, and after the procedure, including perinatal care. While careful selection of candidates is crucial, accumulating case reports and future trials are expected to shed more light on this treatment approach.

DOI PubMed

Risk-reducing salpingo-oophorectomy for hereditary breast and ovarian cancer patients with vaginal natural orifice transluminal endoscopic surgery (vNOTES).

Masato Tamate, Motoki Matsuura, Sachiko Nagao, Shoko Kurokawa, Taishi Akimoto, Tsuyoshi Saito

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society 2024.09 [International journal]

DOI PubMed

Step-by-step demonstration of "sciatic-nerve-preserved beyond-LEER" in a Thiel-embalmed cadaver: a novel salvage surgery for recurrent gynecologic malignancies.

Hiroyuki Kanao, Masato Tamate, Motoki Matsuura, Sachiko Nagao, Miseon Nakazawa, Shutaro Habata, Tsuyoshi Saito

Journal of gynecologic oncology 35 ( 5 ) e112 2024.09 [International journal]

OBJECTIVE: Complete resection is the curative treatment choice for recurrent gynecological malignancies. Laterally extended endopelvic resection (LEER) is an effective surgical salvage therapy for lateral recurrence. However, when a recurrent tumor occupies the ischial spine and sacrum, LEER is not indicated, and surgical salvage therapy is abandoned. Theoretically, complete resection of such a tumor is possible by additional pelvic bone resection along with the standard LEER. Nevertheless, owing to the anatomical complexities of the beyond-LEER procedure, 2 major issues should be solved: sciatic nerve injury and tumor disruption during pelvic bone amputation. To overcome these technical challenges, we applied a multidirectional beyond-LEER approach, a novel salvage surgical procedure, with an aim of demonstrating its technical feasibility. METHODS: We created a simulation model of a laterally recurrent tumor that occupied the right ischial spine and sacrum in a Thiel-embalmed cadaver. RESULTS: Multidirectional approaches, including laparoscopic, perineal, and dorsal phases, were safely applied. We laparoscopically marked the L4-L5-S1 complex and S2 nerve with different colored tapes, and by pulling them out into a dorsal surgical field, the sciatic nerve was safely preserved. The dissection lines of the multidirectional approaches were aligned using tapes as landmarks, and complete tumor clearance without tumor disruption was accomplished. By following the cadaveric training, the first laparoscopic-assisted beyond-LEER procedure was successfully performed in a patient with recurrent ovarian cancer. CONCLUSION: Using a Thiel-embalmed cadaver, we demonstrated the technical feasibility of a sciatic nerve-preserved beyond-LEER procedure, which was successfully performed in a patient with recurrent ovarian cancer.

DOI PubMed

当院における類内膜癌G3症例の細胞診・病理形態学的評価と臨床経過の検討

幅田周太朗, 齋藤晋平, 有元千紘, 野藤五沙, 長尾沙智子, 黒川晶子, 玉手雅人, 真里谷奨, 秋元太志, 松浦基樹, 岩崎雅宏, 齋藤豪

日本婦人科腫瘍学会学術講演会プログラム・抄録集 ( (公社)日本婦人科腫瘍学会 ) 66回 327 - 327 2024.07

当院における類内膜癌G3症例の細胞診・病理形態学的評価と臨床経過の検討

幅田周太朗, 齋藤晋平, 有元千紘, 野藤五沙, 長尾沙智子, 黒川晶子, 玉手雅人, 真里谷奨, 秋元太志, 松浦基樹, 岩崎雅宏, 齋藤豪

日本婦人科腫瘍学会学術講演会プログラム・抄録集 ( (公社)日本婦人科腫瘍学会 ) 66回 327 - 327 2024.07

Early outcomes of three new robotic surgical systems in patients undergoing hysterectomy.

Motoki Matsuura, Sachiko Nagao, Shoko Kurokawa, Masato Tamate, Taishi Akimoto, Tsuyoshi Saito

Updates in surgery 76 ( 5 ) 2051 - 2057 2024.05 [International journal]

New robot models, such as hinotori™, da Vinci SP™, and Hugo™, have been introduced in Japan. This study examined the surgical outcomes of these models in patients from the initial stages of their introduction to the present day.We retrospectively reviewed 36 patients with endometrial cancer or benign gynecologic disease, who underwent robotic hysterectomy using da Vinci SP™, hinotori™, or Hugo™ between March 2023 and March 2024.Robotic hysterectomy was performed using hinotori™ in 10 patients, da Vinci SP™ in 16 patients, and Hugo™ in 10 patients. No significant differences were observed in the characteristics of the patients subjected to surgery using these models. The total operative time was 123.0 min (93-144 min) for hinotori™, 95.0 min (79-165 min) for da Vinci SP™, and 98.5 min (74-177 min) for Hugo™. The total operative time of hinotori™ was significantly longer than that of the other two models (p = 0.031). No differences were observed among the robot systems with respect to complications during or after surgery and the intensity of postoperative pain.Differences in the surgical time were noted depending on the model used. It has been proven that surgeons who are already proficient in performing robotic surgery with da Vinci Xi™ can safely perform surgeries with the new models.

DOI PubMed

Surgical Outcomes of da Vinci Xi™ and da Vinci SP™ for Early-Stage Endometrial Cancer in Patients Undergoing Hysterectomy.

Motoki Matsuura, Sachiko Nagao, Shoko Kurokawa, Masato Tamate, Taishi Akimoto, Tsuyoshi Saito

Journal of clinical medicine 13 ( 10 ) 2024.05 [International journal]

Objectives: This study aimed to evaluate and compare the feasibility and outcomes of two robotic hysterectomy (da Vinci Xi™ vs. da Vinci SP™) systems without lymph node dissection in patients with early-stage endometrial cancer, and assess the postoperative recurrence rate and overall survival of patients. Methods: A retrospective review of 84 patients who underwent robotic hysterectomy for endometrial cancer (stage 1A) was conducted. Surgical procedures, patient characteristics, intraoperative measures, and postoperative outcomes were statistically analyzed. A single gynecologist performed all surgeries. Results: Patient characteristics, average age, and body mass index showed no significant differences between the two models. The total operative time was significantly shorter with da Vinci SP™. Recurrence was identified in only one patient operated on with da Vinci Xi™. All patients were alive during analysis, with a median overall survival of 38 and 9 months for da Vinci Xi™ and da Vinci SP™, respectively. Conclusions: Robotic hysterectomy without lymph node dissection appears to be a safe and effective approach for patients with early-stage endometrial cancer. The da Vinci SP offers the advantage of shorter operative times than the da Vinci Xi™. These findings support the consideration of robotic surgery as a viable option for selected patients.

DOI PubMed

Current treatment strategies for ovarian cancer in the East Asian Gynecologic Oncology Trial Group (EAGOT).

Yusuke Kobayashi, Muneaki Shimada, Masato Tamate, Hyun Woong Cho, Jun Zhu, Hung-Hsueh Chou, Hiroaki Kajiyama, Aikou Okamoto, Daisuke Aoki, Sokbom Kang, Jeong-Won Lee, Jae-Weon Kim, Jae-Hoon Kim, Zhongqiu Lin, Jihong Liu, Xiaohua Wu, Hung-Cheng Lai, Ting-Chang Chang, Chyong-Huey Lai, Yong Man Kim, Takayuki Enomoto

Journal of gynecologic oncology 35 ( 3 ) e87 2024.05 [International journal]

Ovarian cancer, notable for its severe prognosis among gynecologic cancers, has seen substantial progress in treatment approaches recently. Enhanced protocols in chemotherapy and the introduction of poly (ADP-ribose) polymerase (PARP) inhibitors for maintenance therapy have markedly improved outcomes for patients with specific genetic profiles, such as those positive for BRCA mutations or exhibiting homologous recombination deficiency (HRD). Additionally, the method of intraperitoneal chemotherapy administration has emerged as a valuable alternative to traditional transvenous routes, showing promise for wider clinical adoption. The field of surgery has also evolved, with increasing exploration into the benefits and feasibility of laparoscopic methods over more invasive traditional surgeries, aiming for complete tumor removal but with reduced patient impact. The hereditary nature of ovarian cancer underscores the importance of genetic testing, which has become integral in tailoring treatment strategies, particularly in determining suitability for PARP inhibitors. The formation of the East Asian Gynecologic Oncology Trial Group (EAGOT) aims to optimize treatment across Japan, Korea, China, and Taiwan. The ovarian cancer committee of EAGOT shared the current policies, focusing on 5 topics: 1) strategies for maintenance therapy after initial surgery and chemotherapy, 2) drug regimens for platinum-sensitive and platinum-resistant recurrence, 3) intraperitoneal chemotherapy, 4) laparoscopic surgery as an alternative to laparotomy, and 5) current status of genetic testing (BRCA, HRD, and panel tests) for ovarian cancer and its prospects. EAGOT's multi-national trials aim to harmonize these evolving treatment strategies, ensuring that the latest and most effective protocols are accessible across the region, thereby significantly impacting patient outcomes in East Asia.

DOI PubMed

Hybrid Train-The-Trainer course for the Fundamental Use of Surgical Energy certificates improves self-confidence in knowledge of surgical energy and develops teaching skills: a feasibility study.

Akihiro Kondo, Masato Tamate, Yuichi Nishihara, Yusuke Watanabe

Surgical endoscopy 38 ( 1 ) 368 - 376 2024.01 [International journal]

BACKGROUND: Several well-trained expert instructors who completed the "Train-The-Trainer (TTT)" course are required to disseminate the safe use of surgical energy devices, which can be learned through the Fundamental Use of Surgical Energy (FUSE) program. This study aimed to explore whether the hybrid FUSE TTT course is feasible and effective, which can improve teaching skills of surgical energy. METHODS: The hybrid TTT course, which was designed to train FUSE-certified personnel as instructors, comprised three virtual sessions spread over 5 h in total and a 1-day in-person training, followed by a 100-min FUSE electrosurgery hands-on workshop in practice as an instructor. The participants reported on self-confidence regarding knowledge of various energy devices or adverse events before, immediately after, and 6 months after the course. Participants and experienced FUSE instructors assessed the trainees' presentation skills at the beginning of the in-person training and after the hands-on workshop. The primary outcomes were the feasibility and completion rate of the entire course. RESULTS: Seventeen participants completed the entire couse; most (94%) were satisfied with the course. Self-confidence in knowledge about various contents improved significantly: the fundamentals of electrosurgery (post, p < 0.001; 6 months, p = 0.01), mechanism and prevention of adverse events (post, p = 0.001; 6 months, p = 0.04), monopolar instruments (post, p = 0.002; 6 months, p = 0.01), bipolar instruments (post, p = 0.01; 6 months, p = 0.06), and integration with other medical devices (post, p = 0.006; 6 months, p = 0.02). The presentation skill index scores of self- and peer assessments improved after the in-person training (self-assessment [pre 44 vs. post 56, p < 0.001], peer assessment [pre 39 vs. post 68, p < 0.001]). CONCLUSIONS: The hybrid TTT course can provide FUSE-certified personnel with an improved self-confidence concerning knowledge of surgical energy and improve their presentation skills with midterm retention. This can help build trainees' self-confidence as instructors.

DOI PubMed

A Rare Case of Small Intestinal Cancer With Uterine Metastasis After Surgery for Ovarian Metastasis, Diagnosed Using Immunostaining.

Sachiko Nagao, Motoki Matsuura, Shoko Kurokawa, Masato Tamate, Taishi Akimoto, Tsuyoshi Saito

Case reports in oncological medicine 2024 8551816 - 8551816 2024 [International journal]

Uterine metastases from extragenital sites are rare. We present a case of a woman who had undergone surgery for small intestinal cancer and subsequently developed metastases in her left ovary and uterus. A nulliparous woman in her 50s underwent laparoscopic partial small bowel resection with lymph node dissection for small intestinal cancer. Five months later, computed tomography (CT) revealed a left ovarian tumor and ascites. She underwent bilateral adnexectomy and adjuvant chemotherapy, and the ovarian tumor was diagnosed as a small intestinal cancer metastasis. Two years after the small intestinal cancer surgery, a positron emission tomography (PET)-CT scan revealed a uterine accumulation. Cervical cytology was negative for intraepithelial lesion or malignancy. Endometrial histology showed an adenocarcinoma of the uterus. The patient underwent total abdominal hysterectomy followed by adjuvant chemotherapy. Histopathology and immunohistochemistry of the uterine tumor revealed that it was a metastasis of small intestinal cancer (Cytokeratin 7 [CK7] [-], Cytokeratin 20 [CK20] [+], Special AT-Rich Sequence-Binding Protein 2 [SATB2] [+], Paired Box Gene 2 [PAX2] [-], and estrogen receptor [ER] [-]). In patients with cancer, histopathology and immunohistochemistry are important for distinguishing between primary and metastatic tumors and for guiding the choice of treatment.

DOI PubMed

Diagnosis and Methods of Repair for a Uteroperitoneal Fistula (UPF) Formed After Gynecological Surgeries.

Nagisa Wada, Masato Tamate, Motoki Matsuura, Tsuyoshi Saito

Cureus 15 ( 12 ) e51064 2023.12 [International journal]

A uteroperitoneal fistula (UPF) is a rare disorder that can lead to infertility and has never been reported. UPFs can cause infertility and perinatal complications. A 34-year-old woman (gravida 0) with a history of three gynecological surgeries using a uterine manipulator was diagnosed with a UPF using hysteroscopy and hysterosalpingography. She underwent laparoscopic uterine repair as an infertility treatment. The uterine perforation may have been caused by uterine manipulator insertion or suture failure in the myometrium during her previous laparoscopic myomectomy and cystectomy procedures. The UPF disappeared after the current surgical treatment. The complications of UPFs include infection, infertility, ectopic pregnancy, and uterine rupture. We expected that the presence of a fistula would increase the risk of impaired fertilization, implantation failure, and ectopic pregnancy. This case report contributes valuable insights into the diagnosis of UPFs and their laparoscopic repair.

DOI PubMed

婦人科内視鏡技術認定医が不在である当院でのTLHの取り組み

西森貢隆, 嶋田浩志, 藤部佑哉, 鈴木美紀, 玉手雅人, 松浦基樹, 岩崎雅宏, 齋藤豪

北海道産科婦人科学会会誌 ( 北海道産科婦人科学会 ) 67 ( 1 ) 91 - 91 2023.12

Identification of cancer driver mutations in liquid-based cytology samples for the screening of endometrial diseases

Motoki Matsuura, Kiyoko Takane, Kiyoshi Yamaguchi, Tsuneo Ikenoue, Seira Hatakeyama, Shoko Kurokawa, Masato Tamate, Taishi Akimoto, Masahiro Iwasaki, Shintaro Sugita, Tadashi Hasegawa, Yasunori Ota, Tsuyoshi Saito, Yoichi Furukawa

BJC Reports ( Springer Science and Business Media LLC ) 1 ( 1 ) 18 - 18 2023.11 [International journal]

Abstract Background Endometrial cancer (EC) is one of the leading causes of cancer death among women and early detection is crucial for its successful treatment. We previously showed that cytological examination combined with genetic analysis using liquid-based cytology (LBC) samples improved the diagnostic sensitivity of EC. Methods Among 218 individuals who underwent endometrial screening by LBC, 208 samples were analysed by cancer-panel sequencing. Excluding 13 samples with low sequence coverage, we further analysed 195 samples. Results Among the 195 women analysed, 39 and 15 were eventually shown to suffer from malignant endometrial and non-endometrial neoplasms, respectively. Driver mutation(s) were found in nine of the 15 cytology-negative patients with endometrial malignancy, corroborating that combination of cytological and genetic analyses should increase the sensitivity of the diagnosis of malignant endometrial neoplasms. Importantly, driver alterations were found in 32 of 125 women without malignant or premalignant diseases, which raises caution for the interpretation of genetic alterations detected in the endometrial samples. Comparison between the driver mutations in the 32 subjects and those in the 29 endometrial malignancies unveiled that the number of mutations and mutations in PTEN, CTNNB1, and TP53 may be applied for the assessment and prediction of development of EC. Conclusions The genetic analysis combined with liquid-based cytology is useful to improve the diagnostic sensitivity of endometrial neoplasms. However, caution must be taken when cancer-associated mutation(s) are detected in the genetic analysis. Further investigation may clarify the risk of malignant endometrial neoplasms in women with driver mutation(s).

DOI PubMed

【婦人科悪性腫瘍手術-トラブルシューティングとその予防法-】単純外陰切除術

齋藤豪, 松浦基樹, 玉手雅人, 真里谷奨

産婦人科の実際 ( 金原出版(株) ) 72 ( 12 ) 1397 - 1401 2023.11

Clinical characteristics and prognostic factors of endometrial stromal sarcoma and undifferentiated uterine sarcoma confirmed by central pathologic review: A multi-institutional retrospective study from the Japanese Clinical Oncology Group.

Akira Kikuchi, Hiroshi Yoshida, Hitoshi Tsuda, Shin Nishio, Shiro Suzuki, Kazuhiro Takehara, Nao Kino, Toshiyuki Sumi, Kazuyoshi Kato, Masatoshi Yokoyama, Kazuto Nakamura, Masashi Takano, Shinya Sato, Hisamori Kato, Masato Tamate, Koji Horie, Tomoyasu Kato, Atsuhiko Sakamoto, Masaharu Fukunaga, Tsunehisa Kaku, Masayuki Yoshida, Nobuo Yaegashi, Toyomi Satoh

Gynecologic oncology 176 82 - 89 2023.09 [International journal]

OBJECTIVES: Low-grade and high-grade endometrial stromal sarcomas (LGESS and HGESS) and undifferentiated uterine sarcomas (UUS) are rare tumors whose pathological classification and staging system have changed recently. These tumors are reported to contain fusion genes. We aimed to clarify the genetic background, clinical features, prognostic factors, and optimal therapy of these tumors using a new classification and staging system. METHODS: We analyzed the clinical features and prognostic information of 72 patients with LGESS, 25 with HGESS, and 16 with UUS using central pathological review. Estrogen and progesterone receptors (PgRs) were examined by immunohistochemistry. JAZF1-SUZ12 and YWHAE-NUTM2A/B gene fusions were tested using real-time polymerase chain reaction. RESULTS: The 5-year overall survival (OS) rates of LGESS, HGESS, and UUS were 94%, 53%, and 25%, respectively. In LGESS, stage IV, incomplete surgery, and absence of PgR were associated with poor OS. The presence of JAZF1-SUZ12 fusion gene was not associated with OS. In HGESS, the relationship between stage and prognosis was unclear. None of the 3 patients with YWHAE-NUTM2A/B fusion gene died during follow-up. Adjuvant chemotherapy was associated with a favorable OS. Incomplete resection of UUS was associated with poor OS; however, residual tumors frequently occurred. Although most patients underwent adjuvant chemotherapy, their prognosis was extremely poor even in stage I disease. CONCLUSIONS: Prognosis of LGESS is generally good; however, stage IV, incomplete surgery, and PgR-negative tumors are associated with poor prognosis. Adjuvant chemotherapy may be useful for HGESS. Prognosis of UUS is extremely poor, even with adjuvant chemotherapy.

DOI PubMed

子宮原発骨肉腫の1例

南香穂, 嶋田浩志, 今沙織, 鈴木美紀, 玉手雅人, 幅田周太朗, 松浦基樹, 岩崎雅宏, 齋藤豪

北日本産科婦人科学会総会・学術講演会プログラム・抄録集 ( 東北連合産科婦人科学会・北日本産科婦人科学会 ) 70回 65 - 65 2023.09

Laparoscopic retrovesical lower uterine segment bypass for hysterectomy with previous caesarean section: Hung Up the Bladder Bypass (HUBB) technique.

Masato Tamate, Motoki Matsuura, Nagisa Wada, Takaki Adachi, Kazuma Yorozu, Chihiro Arimoto, Tsuyoshi Saito

Journal of gynecology obstetrics and human reproduction 52 ( 8 ) 102629 - 102629 2023.07 [International journal]

Patients with a history of cesarean section and a highly adherent bladder may have difficulty in bladder dissection and may suffer damage. It may also be difficult to orient the patient for repair in the event of damage. In such cases, dissection from the side between the bladder and cervix is a good way to avoid complication. This video reviews the steps of the HUBB technique procedure, provides tips and tricks for performing a successful adhesiolysis, and illustrates the procedure's adaptability. The first is the identification of the uterine artery and its position. Step2, a Laparoscopic retrovesical lower uterine segment bypass is created. Step3 a Hung Up the Bladder Bypass is created, the bladder is completely dissected. Step4, an adhesiolysis and leak test is performed. In this report, we would like to introduce a technique for creating a retrovesical lower uterine segment bypass using a laparoscope and traction on the bypass to dissect the bladder.

DOI PubMed

Cervical conization with endoCUT mode applying gastrointestinal endoscopic polypectomy technique.

Masato Tamate, Motoki Matsuura, Tsuyoshi Saito

Obstetrics & gynecology science 66 ( 6 ) 584 - 586 2023.06 [International journal]

OBJECTIVE: To show how endoCUT (COMPANY, CITY, STATE, COUNTRY) mode can be safely managed with cervical conization. METHODS: Demonstration of the technique and explanation of endoCUT and soft coagulation mode with narrated video footage. Cervical conization is a therapeutic and diagnostic procedure performed for the diagnosis of cervical intraepithelial lesions and cervical cancer. Specific methods include cold scalpel, ultrasonically activated device and laser, and loop electrosurgical excision procedure (LEEP), which involves transpiration and partial excision. The endoCUT mode and soft coagulation in VIO3 (COMPANY, CITY, STATE, COUNTRY) were used to perform cervical conical resection safely and at low cost (Fig. 1). The endoCUT mode was originally developed for polypectomy in gastrointestinal endoscopy, where no counter traction can be applied [1,2]. RESULTS: The endoCUT mode approach to cervical conization with several key strategies to minimize blood loss and ensure safety: 1) incisions can be made in close contact; 2) resection can be performed with minimal contact with the lesion; 3) control of bleeding from the resected transection by soft coagulation; and 4) low running cost of endoCUT mode. CONCLUSION: Conventionally, cervical conical resection has been performed by using a device capable of making a close incision (cold scalpel, ultrasonically activated device and laser, and LEEP etc.), but there have been issues with bleeding control and cost. Here, we present a new technique using the endoCUT mode and several strategies for safe and effective resection.

DOI PubMed

Therapeutic efficacy of a four-year treatment with eribulin in a patient with uterine leiomyosarcoma: A case report.

Motoki Matsuura, Kazuma Yorozu, Sachiko Nagao, Shoko Kurokawa, Masato Tamate, Taishi Akimoto, Tsuyoshi Saito

Gynecologic oncology reports 47 101205 - 101205 2023.06 [International journal]

Uterine leiomyosarcoma (LMS) is a gynecological malignancy with an extremely poor prognosis. Multiple new therapeutic agents, including pazopanib, trabectedin, and eribulin, have been clinically applied to treat uterine LMS, and their therapeutic effects are expected. We encountered one patient with advanced recurrent uterine LMS who achieved a partial response to a four-year treatment with eribulin. A 31-year-old woman was diagnosed with stage 2B LMS. After the first recurrence, Gemcitabine, Docetaxel (GD) therapy was administered, and complete response (CR) was achieved. However, 2 years and 10 months later, recurrence occurred at the vaginal cuff, and GD therapy and doxorubicin hydrochloride were administered, resulting in CR. Five months later, she experienced another recurrence at the same location and was treated with eribulin. To date, 53 courses of eribulin have been administered and are currently ongoing. Maintaining low neutrophil-to-lymphocyte ratio and low platelet-to lymphocyte ratio in this manner is considered to be one of the reasons why eribulin continues to be effective. We encountered a rare case in which eribulin was administered for the longest period of time, and produced an observable effect in uterine LMS.

DOI PubMed

「助手力」の教育助手力を構成する要素とは何か,どのように教育するのか

梅本美菜, 松浦基樹, 足立岳貴, 有本千紘, 黒川晶子, 西村庸子, 玉手雅人, 秋元太志, 幅田周太朗, 岩崎雅弘, 齋藤豪

産婦人科手術 ( (株)メジカルビュー社 ) ( 34 ) 162 - 162 2023.06

Mailing human papillomavirus self-sampling kits to women under-screened for cervical cancer improved detection in cervical cancer screening in a general population study in Japan.

Yoko Nishimura, Motoki Matsuura, Noriko Terada, Sachiko Nagao, Hiroshi Shimada, Kyoko Isoyama, Masato Tamate, Masahiro Iwasaki, Tsuyoshi Saito

BMC public health 23 ( 1 ) 473 - 473 2023.03 [International journal]

BACKGROUND: One cause of the increase in cervical cancer rates in Japan is the long-term stagnation in the cervical cancer screening consultation rate. Therefore, improving the screening consultation rate is of urgent concern to reduce cervical cancer incidence. Self-collected human papilloma virus (HPV) tests have been successfully adopted in several countries, such as the Netherlands and Australia, as a measure of individuals who have not undergone cervical cancer screening in national programs. This study aimed to verify whether self-collected HPV tests presented an effective countermeasure for individuals who had not undergone the recommended cervical cancer screenings. METHODS: This study was conducted from December 2020 to September 2022 in Muroran City, Japan. The primary evaluated endpoint was the percentage of citizens who underwent cervical cancer screening at a hospital with positive self-collected HPV test results. The secondary endpoint was the percentage of included participants who were diagnosed with cervical intraepithelial neoplasia (CIN) or higher among those who visited a hospital and underwent cervical cancer screening. RESULTS: The included study participants were 7,653 individuals aged 20-50 years with no record of previous cervical cancer examination in the past 5 years. We mailed these participants information on self-administered HPV tests as an alternative screening procedure and sent the kit to 1,674 women who requested the test. Among them, 953 returned the kit. Among the 89 HPV-positive individuals (positive rate, 9.3%), 71 (79.8%) visited the designated hospital for an examination. A closer examination revealed that 13 women (18.3% of hospital visits) had a CIN finding of CIN2 or higher, among whom one each had cervical cancer and vulvar cancer, eight presented with CIN3, and three presented with CIN2; two cases of invasive gynecologic cancer were also identified. CONCLUSIONS: We conclude that the self-collected HPV tests showed a certain efficacy as a measure of individuals who had not undergone the recommended cervical cancer screening. We devised ways to have the unexamined patients undergo HPV testing and ensure that HPV-positive individuals visited the hospital. Despite a few limitations, our findings suggest the effectiveness of this public health intervention.

DOI PubMed

Graft Failure after Uterus Transplantation in 16 Recipients: A Review

Iori Kisu, Risa Matsuda, Tetsuro Shiraishi, Ryoma Hayashi, Yusuke Matoba, Masato Tamate, Kouji Banno

Journal of Clinical Medicine 12 ( 5 ) 2023.03 [International journal]

Uterus transplantation (UTx) is now an alternative to surrogacy and adoption for women with uterine factor infertility to have children; however, there are still unresolved clinical and technical issues. One of these is that the graft failure rate after transplantation is somewhat higher than that of other life-saving organ transplants, which is a critical concern. Herein, we summarize the details of 16 graft failures after UTx with living or deceased donors using the published literature in order to learn from these negative outcomes. To date, the main causes of graft failure are vascular factors (arterial and/or venous thrombosis, atherosclerosis, and poor perfusion). Many recipients with thrombosis develop graft failure within one month of surgery. Therefore, it is necessary to devise a safe and stable surgical technique with higher success rates for further development in the UTx field.

DOI PubMed

Pathological classification of desmoplastic reaction is prognostic factor in cervical adenocarcinoma.

Taishi Akimoto, Akira Takasawa, Kumi Takasawa, Tomoyuki Aoyama, Motoki Matsuura, Masato Tamate, Masahiro Iwasaki, Shutaro Habata, Taro Murakami, Makoto Osanai, Tsuyoshi Saito

Medical molecular morphology 55 ( 4 ) 275 - 282 2022.12 [Domestic journal]

Desmoplastic reaction (DR) and inflammation are significant pathological manifestations of tumorigenesis in several cancers. However, the correlation between these stromal reactions and cervical adenocarcinoma has been poorly documented. This investigation elucidated whether DR is a prognostic indicator in early cervical adenocarcinoma patients. Fifty-nine patients with early stage cervical adenocarcinoma (stages I/II) were included in the study. DR was divided into three groups, mature, intermediate, and immature, based on the presence of myxoid stroma and hyalinized keloid-like collagen. Inflammatory cell responses were classified as mild, moderate, and severe. Those stromal reactions were separately evaluated in the invasion front stroma and intratumoral stroma. In both the intratumor and invasion front stroma, intermediate/immature DR was correlated with tumor size, T stage, N stage, lymphovascular invasion, and parametrial infiltration (p < 0.001 to p < 0.05). In addition, in the intratumoral stroma, intermediate/immature DR led to short relapse-free survival and overall survival (p < 0.001). In the invasion front stroma, inflammatory cell responses were associated with DR immaturity and FIGO stage (p < 0.01). These results suggest that the classification of DR maturity is a potential prognostic biomarker in early stage cervical adenocarcinoma patients. DR can be evaluated by routine H&E staining without immunohistochemistry, making it convenient and economical in clinical practice.

DOI PubMed

A mixed-method evaluation of cadaver surgery training for gynecologic oncology.

Masato Tamate, Motoki Matsuura, Hiroyuki Kanao, Tsuyoshi Saito

The journal of obstetrics and gynaecology research 48 ( 12 ) 3252 - 3261 2022.12 [International journal]

AIM: Traditional surgical training techniques with using patients, and new advances with live animals, artificial models, and simulation methods have several shortcomings. There are a few reports on the usefulness of cadaver surgery training (CST) in gynecology. Herein, we used a mixed-method evaluation to qualitatively and quantitatively explore the educational efficacy of CST by conducting CST programs at the Sapporo Medical University, Japan. METHODS: In 2020, we conducted two CST programs with 45 participants-13 residents, 8 specialists recognized by Japan Society of Obstetrics and Gynecology, 23 certified endoscopists recognized by Japan Society of Gynecology and Obstetrics Endoscopy and Minimally Invasive Therapy, 15 specialists recognized by Japan Society of Gynecologic Oncology, and 14 certified endoscopists cum oncology. Three participants observed the procedure virtually and 42 were physically present. Laparoscopic radical hysterectomy and pelvic exenteration were performed on five Thiel-embalmed cadavers. Participants were asked to complete pre- and post-training surveys that included qualitative questions, concerning the purpose and cost of CST, and quantitative questions, testing anatomical knowledge. RESULTS: We observed that the rate of score improvement to the quantitative questions increased from 58.6% pre-CST to 75.6% post-CST. Furthermore, oncology specialists and those who performed more surgeries and faced more complications during surgeries recorded high percentage of correct answers. Multiple regression analysis statistically confirmed these results. CONCLUSIONS: This study confirmed the educational efficacy of CST.

DOI PubMed

Human papillomavirus testing and cytology using physician-collected uterine cervical samples vs. self-collected vaginal samples and urine samples.

Noriko Terada, Motoki Matsuura, Shoko Kurokawa, Yoko Nishimura, Masato Tamate, Kyoko Isoyama, Satoko Yamazaki, Hiroshi Shimada, Masahiro Suzuki, Yuta Tabuchi, Mizue Teramoto, Tsuyoshi Saito

International journal of clinical oncology 27 ( 11 ) 1742 - 1749 2022.11 [Domestic journal]

BACKGROUND: Human papillomavirus (HPV) testing using self-collected vaginal samples and urine samples is convenient and effective for improving the screening rate. But, to serve as an alternative cervical cancer screening technique, such tests must offer sensitivity equivalent to the HPV testing of physician-collected cervical samples. To examine the effectiveness of HPV testing using self-collected samples and urine samples, we compared the results of HPV testing using these samples with those of HPV testing using physician-collected samples and cytological examinations. METHODS: The study population included 300 women (age: 20-50 years) with abnormal cervical cytology. The results of HPV testing using self-collected samples and urine samples and physician-collected samples and cervical cytology were compared. RESULTS: For all HPV types, the κ-value was 0.773 for physician- and self-collected samples and 0.575 for physician-collected and urine samples. The κ-value for HPV type 16-positive samples was 0.988 for physician- and self-collected samples and 0.896 for physician-collected and urine samples. The κ-value for HPV type 18-positive samples was 0.856 for physician- and self-collected samples and 0.831 for physician-collected and urine samples. For other HPV types, the value was 0.809 for physician- and self-collected samples and 0.617 for physician-collected and urine samples. CONCLUSIONS: The obtained results were consistent between physician- and self-collected samples as well as between physician-collected and urine samples. Considering that the agreement rate was particularly high for the high-risk HPV types 16 and 18, HPV testing using physician-collected samples, self-collected samples, and urine samples was equally effective for the types with high carcinogenicity.

DOI PubMed

巨大嚢胞化し、子宮留膿腫を繰り返した帝王切開瘢痕部症候群の1例

仁木舜一, 嶋田浩志, 玉手雅人, 杉山芽, 今沙織, 鈴木美紀, 松浦基樹, 齋藤豪

北日本産科婦人科学会総会・学術講演会プログラム・抄録集 ( 東北連合産科婦人科学会・北日本産科婦人科学会 ) 69回 112 - 112 2022.10

帝王切開創のケロイド予防とその修復の取り組み

杉山芽, 嶋田浩志, 玉手雅人, 仁木舜一, 今沙織, 鈴木美紀, 石岡伸一, 斎藤豪

北日本産科婦人科学会総会・学術講演会プログラム・抄録集 ( 東北連合産科婦人科学会・北日本産科婦人科学会 ) 69回 66 - 66 2022.10

Radical Vaginal Trachelectomy.

Tsuyoshi Saito, Motoki Matsuura, Masato Tamate, Masahiro Iwasaki, Tasuku Mariya

Surgery journal (New York, N.Y.) 7 ( Suppl 2 ) S103-S107 2021.12 [International journal]

Recently, radical vaginal hysterectomy (RVH) has developed into laparoscopically assisted radical vaginal hysterectomy (LARVH), which is associated with the laparoscopical procedure, and it is applied as radical vaginal trachelectomy and semi-radical vaginal hysterectomy. LARVH is indicated for patients with stage IB1 and IIA1 cervical carcinoma, especially those with a tumor size of less than 2 cm, because the cardinal ligaments cannot be resected widely. Although RVH that is associated with laparoscopic pelvic lymphadenectomy is the most used surgical procedure, radical trachelectomy may be performed either abdominally or vaginally (laparoscopic or robotic). One report found that the pregnancy rate was higher in patients who underwent minimally invasive or radical vaginal trachelectomy than in those who underwent radical abdominal trachelectomy.

DOI PubMed

子宮温存している若年発症子宮体部腺肉腫の2例

寺田倫子, 松浦基樹, 野藤五沙, 西村庸子, 真里谷奨, 玉手雅人, 岩崎雅宏, 齋藤豪

日本婦人科腫瘍学会学術講演会プログラム・抄録集 ( (公社)日本婦人科腫瘍学会 ) 63回 292 - 292 2021.07

Study of laparoscopic monopolar devices and its thermal effects

Motoki Matsuura, Masato Tamate, Sachiko Nagao, Muna Nishio, Tadahi Okada, Yoko Nishimura, Kyoko Isoyama, Noriko Terada, Tsuyoshi Saito

European Journal of Gynaecological Oncology ( IMR Press Limited ) 42 ( 1 ) 118 - 121 2021.02

Objective: Energy devices are frequently used in minimally invasive surgeries (MIS). For MIS involving gynecologic malignancies, energy devices should be used cautiously to prevent thermal injuries to nearby organs. We evaluated monopolar electrosurgery devices and measured increases in temperature in the tissue and device. Methods: Briefly, the surface of a porcine tissue was incised using short and long activation times. Subsequently, the maximum temperature at the tip of the monopolar device, the cooling time required to reach a temperature of 60 ◦C, and the maximum tissue temperature were recorded. Results: Longer activation time was correlated with a higher tip temperature. With all activation times, there was an increase in the tip temperature that exceeded 100 ◦C. The cooling time to reach 60 ◦C was faster with the short activation times than with the long activation times. Even with the same output, the temperature decreased faster in the coagulation mode, suggesting that the cooling times were shorter with lower outputs. The tissue temperature dropped to 60 ◦C or less within 1 s in the cut mode but required approximately 2 s in the coagulation mode at 40 W. The temperature of the dissected tissue increased to 60 ◦C or higher the cooling time was longer with high output and in the coagulation mode. Conclusions: We revealed that the activation of the monopolar device under routine use conditions exceeded a temperature of 100 ◦C. Additionally, the temperatures of the tip and tissue were significantly higher in proportion to the output and time. For MIS involving gynecologic malignancies, careful attention is necessary to avoid thermal injury.

DOI

骨盤解剖学をCadaver Surgery Trainingで理解する混合研究の試み

玉手雅人, 松浦基樹, 阿部秀悦, 西村庸子, 常松梨沙, 寺田倫子, 真里谷奨, 岩崎雅宏, 金尾祐之, 齋藤豪

日本婦人科腫瘍学会雑誌 ( (公社)日本婦人科腫瘍学会 ) 39 ( 1 ) 311 - 311 2021.01

ERα increases endometrial cancer cell resistance to cisplatin via upregulation of BAG3.

Shuetsu Abe, Masahiro Iwasaki, Shutaro Habata, Tasuku Mariya, Masato Tamate, Motoki Matsuura, Seiro Satohisa, Tsuyoshi Saito

Oncology letters 21 ( 1 ) 20 - 20 2021.01 [International journal]

Endometrial cancer is a leading cause of cancer-associated mortality in women and has a poor prognosis in advanced stages. Our previous study revealed that BCL-2-associated athanogene 3 (BAG3) may contribute to enhancing cell viability through downregulation of microRNA (miR)-29b in endometrial cancer cell lines. In addition, a relationship between estrogen receptor α (ERα) and BAG3 was recently reported in several cancer cell types. The present study investigated the relationship between ERα and BAG3 in endometrial cancer cell lines. The results demonstrated that exogenous ERα overexpression enhanced BAG3 expression in the EMTOKA endometrial cancer cell line, which does not endogenously express ERα, but had no effect on BAG3 expression levels in the Ishikawa cell line, which does endogenously express ERα. In addition, ERα overexpression suppressed miR-29b expression and enhanced the expression of Mcl-1, a mediator situated downstream of BAG3, in EMTOKA cells, but not Ishikawa cells. ERα overexpression also enhanced EMTOKA, but not Ishikawa, endometrial cancer cell viability in the presence of cisplatin. These findings suggested that ERα may contribute to enhancing endometrial cancer cell resistance to anticancer agents through BAG3 overexpression.

DOI PubMed

腹腔鏡下子宮筋腫核出術後に発生したparasitic myomaの1例

岩崎雅宏, 真里谷奨, 阿部秀悦, 松浦基樹, 玉手雅人, 齋藤豪

日本産科婦人科内視鏡学会雑誌 ( (一社)日本産科婦人科内視鏡学会 ) 36 ( Suppl.I ) [O - 196] 2020.11

Mucinous carcinoma originating in the peritoneum diagnosed by an ascites cell block: a case report.

Sachiko Nagao, Motoki Matsuura, Masato Tamate, Shintaro Sugita, Tsuyoshi Saito

Journal of medical case reports 14 ( 1 ) 99 - 99 2020.07 [International journal]

BACKGROUND: Peritoneal carcinoma is a rare disease that is diagnosed and treated in a manner similar to ovarian cancer. In most cases, the histological type is serous carcinoma, and chemotherapy is effective. However, there are a few case reports of mucinous peritoneal carcinoma. We inferred the histological type before surgery using an ascites cell block sample, which was useful for determining the treatment plan. CASE PRESENTATION: Our patient was a 60-year-old Japanese woman. She presented with a feeling of fullness in the abdomen. A computed tomographic scan showed a large quantity of ascitic fluid and thickening of the greater omentum, as well as thickening of the peritoneum at the pouch of Douglas and diaphragm. Hence, peritoneal carcinoma was suspected. The tumor markers carcinoembryonic antigen, cancer antigen 19-9, and cancer antigen 125 were all increased, and no malignant findings were observed in the uterus or ovaries. Cells suggestive of carcinoma were found in the ascitic fluid, and immunostaining by the cell block method suggested the possibility of mucinous carcinoma. The preoperative chemotherapy strategy was changed to short courses, and tumor reduction surgery was planned. Similar to the suspicion before surgery, the pathology results indicated mucinous carcinoma, and the therapeutic effect of chemotherapy was grade 0. CONCLUSIONS: Determining whether peritoneal carcinoma is serous carcinoma is important for therapy and prognostic prediction. In this case, we encountered a patient for whom surgery was chosen because of drug therapy resistance inferred through histological type estimation using the cell block method. Inferring the histological type by cell block preparation is useful for diagnosis and treatment selection.

DOI PubMed

子宮筋腫に対して腹腔鏡手術後,異型細胞・核分裂像の増加を認めた症例の特徴と傾向

神未央奈, 玉手雅人, 明石祐史, 杉尾明香, 足立英文, 松浦基樹, 森下美幸, 齋藤豪

北海道産科婦人科学会会誌 ( 北海道産科婦人科学会 ) 64 ( 1 ) 104 - 104 2020.03

Three-Dimensional Peripheral Bloodstream Model of the Uterus for Laparoscopic Radical Hysterectomy.

Shin Takenaka, Kenro Chikazawa, Eri Yoshiizumi, Yusuke Hirose, Masato Tamate, Ken Nakayama, Miki Morioka, Akihiko Sekizawa, Koji Matsumoto

Journal of minimally invasive gynecology 27 ( 5 ) 1196 - 1202 2020 [International journal]

Trainees require extensive experience to perform radical hysterectomy. Before starting training during an actual operation, trainees should be familiar with the pelvic anatomy and should simulate surgical procedures. Many simulators are available for virtual reality training of laparoscopic operations, but they are very expensive. The materials required to construct our model included sponges and colored wires sold in home improvement stores that allowed for superior cost effectiveness. The model represented almost all peripheral vessels and nerves around the uterus, including the minor vessels. Attaching and detaching the vessels was easy, facilitating reconstruction of the dissected vessels. The wires were easy to bend, ensuring high operability. This model allows for the simulation of laparoscopic radical hysterectomy in a dry box. Our model was superior to a 2-dimensional picture for the memorization of branching and positional relationships of the blood vessels. Comparison of our model with actual operative videos showed that the dry box provided an identical surgical view of an actual laparoscopic radical hysterectomy. We developed a peripheral bloodstream model of the uterus for repeated simulation of laparoscopic radical hysterectomy with an actual surgical view using a dry box.

DOI PubMed

手術に応用できるドライボックス練習を目指してロングテールの長さ、ショートテールの長さは、何cmが適切か?

青木美帆子, 鈴木幸雄, 仙波恵樹, 平賀裕章, 長尾沙智子, 吉泉絵理, 遠山篤史, 山本さやか, 吉野育典, 天雲千晶, 友野勝幸, 矢田大輔, 角暢浩, 玉手雅人, 竹中慎, 松浦基樹, 林茂徳, 宮城悦子

日本産科婦人科内視鏡学会雑誌 ( (一社)日本産科婦人科内視鏡学会 ) 35 ( Suppl.I ) 119 - 119 2019.08 [Refereed]

Efficacy of liquid-based genetic diagnosis of endometrial cancer.

Motoki Matsuura, Kiyoshi Yamaguchi, Masato Tamate, Seiro Satohisa, Mizue Teramoto, Masahiro Iwasaki, Shintaro Sugita, Tadashi Hasegawa, Rika Koubo, Kiyoko Takane, Tsuneo Ikenoue, Yoichi Furukawa, Tsuyoshi Saito

Cancer science 109 ( 12 ) 4025 - 4032 2018.12 [International journal]

Although liquid-based cytology (LBC) has increased the sensitivity of cytological diagnosis of endometrial cancer (EC) compared with conventional smear cytology, the sensitivity of LBC for the detection of EC is between 70% and 96% and remains unsatisfactory. In the present study, we compared the efficacy of LBC with liquid-based genetic diagnosis (LBGDx) by amplicon sequencing of five genes including PTEN, PIK3CA, CTNNB1, KRAS, and TP53 in 48 LBC subjects who underwent endometrial screening. Consequently, LBC classified 15 samples as "positive or suspicious for malignancy" and the 15 were later confirmed as EC. However, LBC failed to identify five cases who were diagnosed as EC by additional transvaginal ultrasound and endometrial curettage, indicating that the sensitivity of cytology alone was 75% (15/20). LBGDx identified 11 pathogenic PTEN variants in 10 subjects, six PIK3CA variants in nine, three CTNNB1 variants in five, two KRAS variants in four, and three TP53 variants in three. Collectively, at least one pathogenic variant was identified in 19 subjects, which included 17 EC (15 endometrioid carcinoma and 2 endometrial carcinosarcomas), and one cervical adenocarcinoma. However, LBGDx did not identify any pathogenic mutations in three of the 20 EC, indicating that the sensitivity of LBGDx alone was 85% (17/20). Although five EC were negative for malignancy by LBC and three were negative for pathogenic mutations by LBGDx, the combination of LBC and LBGDx would successfully diagnose all 20 EC. These data suggested that LBGDx is a useful strategy to improve the sensitivity of screening of EC by LBC.

DOI PubMed

Treatment and prognosis of recurrent uterine leiomyosarcomas in last 5 years

Saito Tsuyoshi, Tanaka Rhoichi, Satohisa Seiro, Abe Shuetsu, Iwasaki Masahiro, Teramoto Mizue, Matsuura Motoki, Tamate Masato

INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER 28 50 2018.10 [Refereed]

Recurrence after total laparoscopic hysterectomy without morcellation for smooth muscle tumors of uncertain malignant potential: A rare case report

Satohisa Seiro, Abe Shuetsu, Iwasaki Masahiro, Akimoto Taishi, Shikanai Satoshi, Tamate Masato, Matsuura Motoki, Teramoto Mizue, Saito Tsuyoshi

INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER 28 84 2018.10 [Refereed]

The role of claudin-2 on the malignancy of human endometrioid carcinoma tissues

Satohisa Seiro, Shimada Hiroshi, Kohno Takayuki, Konno Takumi, Tamate Masato, Matsuura Motoki, Teramoto Mizue, Akimoto Taishi, Iwasaki Masahiro, Kojima Takashi, Saito Tsuyoshi

INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER ( BMJ PUBLISHING GROUP ) 28 109 - 109 2018.10 [Refereed]

Rap1GAP inhibits tumor progression in endometrial cancer.

Masato Tamate, Ryoichi Tanaka, Hiroyuki Osogami, Motoki Matsuura, Seiro Satohisa, Masahiro Iwasaki, Tsuyoshi Saito

Biochemical and biophysical research communications 485 ( 2 ) 476 - 483 2017.04 [International journal]

OBJECTIVE: Endometrioid adenocarcinoma (EAC) is a common endometrial cancer with recent dramatic increases in incidence. Previous findings indicate that Rap1GAP acts as a tumor suppressor inhibiting Ras superfamily protein Rap1 in multiple aggressive carcinomas; however, Rap1GAP expression in EAC has not been investigated. In this study, the tumor suppressing activity of Rap1GAP in EAC was explored. METHODS: EAC cell lines were used to examine Rap1GAP levels by real-time RT-PCR and western blotting and the effects of Rap1GAP on cancer cell invasion and migration. Rap1GAP expression was analyzed by immunohistochemical staining for Rap1GAP, E-cadherin in surgically resected tumors of 114 EAC patients scored according to EAC differentiation grade. Prognostic variables such as age, stage, grade, tumor size, and immunostaining for Rap1GAP, E-cadherin were evaluated using Cox regression multivariate analysis. RESULTS: Low Rap1GAP expression was detected in poorly differentiated EAC cells. Rap1GAP deficiency significantly accelerated while Rap1 deficiency decreased cancer cell migration and invasion. Patients with higher Rap1GAP, E-cadherin, and especially combined Rap1GAP/E-cadherin levels had better overall survival than EAC patients with no or weak expression. In addition, Rap1GAP expression was an independent prognostic factor in EAC. CONCLUSIONS: Inhibition of Rap1GAP expression increases EAC cell migration and invasion through upregulation of Rap1. Low expression of Rap1GAP correlates with poor EAC differentiation. Our findings suggest that Rap1GAP is an important tumor suppressor with high prognostic value in EAC.

DOI PubMed

BAG3-mediated Mcl-1 stabilization contributes to drug resistance via interaction with USP9X in ovarian cancer.

Shutaro Habata, Masahiro Iwasaki, Asuka Sugio, Miwa Suzuki, Masato Tamate, Seiro Satohisa, Ryoichi Tanaka, Tsuyoshi Saito

International journal of oncology 49 ( 1 ) 402 - 10 2016.07 [International journal]

Paclitaxel in combination with carboplatin improves survival among patients with susceptible ovarian cancers, but no strategy has been established against resistant ovarian cancers. BAG3 (Bcl-2-associated athanogene 3) is one of six BAG family proteins, which are involved in such cellular processes as proliferation, migration and apoptosis. In addition, expression of BAG3 with Mcl-1, a Bcl-2 family protein, reportedly associates with resistance to chemotherapy. Our aim in this study was to evaluate the functional role of BAG3 and Mcl-1 in ovarian cancer chemoresistance and explore possible new targets for treatment. We found that combined expression of BAG3 and Mcl-1 was significantly associated with a poor prognosis in ovarian cancer patients. In vitro, BAG3 knockdown in ES2 clear ovarian cancer cells significantly increased the efficacy of paclitaxel in combination with the Mcl-1 antagonist MIM1, with or without the Bcl-2 family antagonist ABT737. Moreover, BAG3 was found to positively regulate Mcl-1 levels by binding to and inhibiting USP9X. Our data show that BAG3 and Mcl-1 are key mediators of resistance to chemotherapy in ovarian cancer. In BAG3 knockdown ES2 clear ovarian cancer cells, combination with ABT737 and MIM1 enhanced the efficacy of paclitaxel. These results suggest that inhibiting BAG3 in addition to anti-apoptotic Bcl-2 family proteins may be a useful therapeutic strategy for the treatment of chemoresistant ovarian cancers.

DOI PubMed

Preservation of fertility and subsequent childbirth after methotrexate treatment of placenta percreta: a case report.

Masato Tamate, Motoki Matsuura, Shutaro Habata, Yushi Akashi, Ryoichi Tanaka, Shinichi Ishioka, Toshiaki Endo, Tsuyoshi Saito

Journal of medical case reports 9 232 - 232 2015.10 [International journal]

INTRODUCTION: Placenta percreta is associated with maternal morbidity and mortality. A hysterectomy is often needed to control the bleeding in such cases. However, it has been advocated that placenta percreta be managed conservatively to avoid massive pelvic bleeding and to preserve the patient's fertility. Here, we present a case of placenta percreta diagnosed by magnetic resonance imaging, and treated with systemic administration of methotrexate. CASE PRESENTATION: A 27-year-old nulliparous Japanese woman at 39 gestational weeks had an uncomplicated vaginal delivery of a 3244-g infant. However, her placenta was not delivered, and we could not remove it manually. Contrast-enhanced magnetic resonance imaging indicated deep myometrial invasion by placental tissue and the whole placenta was strongly enhanced. Seven days post-partum, her serum human chorionic gonadotropin level was 12,656IU/L. Our patient hoped to preserve her uterus for a future pregnancy. She therefore received 13 courses of methotrexate (50mg/week, intravenous injection). Her serum human chorionic gonadotropin level was undetectable 97 days after the first methotrexate injection. At 117 days post-partum, she had a labor-like pain every three minutes and delivered the placenta. Our patient regained normal menses and at follow-up remained in good health. Two years later, she delivered a healthy daughter. CONCLUSION: We should try to detect placenta percreta in high-risk patients by any means. For low-risk patients, we should give a diagnosis swiftly and control any intrauterine infection and massive bleeding.

DOI PubMed

BAG3 increases the invasiveness of uterine corpus carcinoma cells by suppressing miR-29b and enhancing MMP2 expression.

Shutaro Habata, Masahiro Iwasaki, Asuka Sugio, Miwa Suzuki, Masato Tamate, Seiro Satohisa, Ryoichi Tanaka, Tsuyoshi Saito

Oncology reports 33 ( 5 ) 2613 - 21 2015.05 [International journal]

Approximately 30% of uterine corpus carcinomas are diagnosed at an advanced stage and have a poor prognosis. Our previous study indicated that BCL2-associated athanogene 3 (BAG3) enhances matrix metalloproteinase-2 (MMP2) expression and binds to MMP2 to positively regulate the process of cell invasion in ovarian cancer cells. Recently, altered miRNA expression patterns were observed in several groups of patients with endometrial cancers. One of the altered miRNAs, miR-29b, reportedly reduces tumor invasiveness by suppressing MMP2 expression. Our aim in the present study was to examine the relationships among BAG3, miR-29b and MMP2 in endometrioid adenocarcinoma cells. We found that BAG3 suppresses miR-29b expression and enhances MMP2 expression, which in turn increases cell motility and invasiveness. Moreover, restoration of miR-29b through BAG3 knockdown reduced MMP2 expression, as well as cell motility and invasiveness. Collectively, our findings indicate that BAG3 enhances MMP2 expression by suppressing miR-29b, thereby increasing the metastatic potential of endometrioid adenocarcinomas.

DOI PubMed

BAG3 upregulates Mcl-1 through downregulation of miR-29b to induce anticancer drug resistance in ovarian cancer.

Asuka Sugio, Masahiro Iwasaki, Shutaro Habata, Tasuku Mariya, Miwa Suzuki, Hiroyuki Osogami, Masato Tamate, Ryoichi Tanaka, Tsuyoshi Saito

Gynecologic oncology 134 ( 3 ) 615 - 23 2014.09 [International journal]

OBJECTIVE: Ovarian cancer is the leading cause of death from gynecologic cancer, reflecting its often late diagnosis and its chemoresistance. We identified a set of microRNAs whose expression is altered upon BAG3 knockdown. Our primary objective was to examine the relationships between BAG3, miR-29b and Mcl-1, an antiapoptotic Bcl-2 family protein, in ovarian cancer cells. METHODS: Ovarian cancer cells were cultured and their responsiveness to paclitaxel was tested. Microarray analysis was performed to identify microRNAs differentially expressed in ES2 BAG3 knockdown ovarian cancer cells and their control cells. Primary ovarian cancer tissues were obtained from 56 patients operated on for ovarian cancer. The patients' clinical and pathological data were obtained from their medical records. RESULTS: BAG3 knockdown increased the chemosensitivity to paclitaxel of ES2 ovarian clear cell carcinoma cells to a greater degree than AMOC2 serous adenocarcinoma cells. qRT-PCR analysis showed that miR-29b expression was significantly upregulated in primary cancer tissue expressing low levels of BAG3, as compared to tissue expressing high levels. Moreover, levels of miR-29b correlated significantly with progression-free survival. Upregulation of miR-29b also reduced levels of Mcl-1 and sensitized ES2 cells to low-dose paclitaxel. CONCLUSIONS: BAG3 knockdown appears to downregulate expression of Mcl-1 through upregulation of miR-29b, thereby increasing the chemosensitivity of ovarian clear cell carcinoma cells. This suggests that BAG3 is a key determinant of the responsiveness of ovarian cancer cells, especially clear cell carcinoma, to paclitaxel and that BAG3 may be a useful therapeutic target for the treatment of ovarian cancer.

DOI PubMed

Prediction of the therapeutic effect of dienogest in ovarian endometrial cysts using the apparent diffusion coefficient.

Motoki Matsuura, Masato Tamate, Yuta Tabuchi, Sakura Takada, Ryoichi Tanaka, Masahiro Iwasaki, Tsuyoshi Saito

Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology 30 ( 8 ) 597 - 9 2014.08 [International journal]

The purpose of this study was to investigate whether apparent diffusion coefficient (ADC) mean values can be used for predicting the treatment response in ovarian endometrial cyst patients with dienogest (DNG) administration. Eighteen patients received DNG (2 mg/day, orally) for 60 days, among whom 26 ovarian endometrial cysts were retrospectively identified. Mean ADC values of individual ovarian endometrial cysts were obtained by ADC maps inside the tumor. There was a significant correlation between ADC values and reduction ratio. When calculating the mean ADC values for three groups; more than 50%, 50-25% and less than 25%, ADC values significantly increased with increasing reduction ratio; 2.05 × 10(-3)mm(2)/s, 1.28 × 10(-3)mm(2)/s and 0.94 × 10(-3)mm(2)/s, respectively (p = 0.0180). Multiple regression analysis by reduction ratio (%), ADC mean values (× 10(-3)mm(2)/s), tumor longest diameter (cm) and CA125 (U/ml) revealed that tumor reduction ratio by DNG administration could be predicted by the following equation; R = 19.3 + 24.0x - 0.4y + 0.1z (R: Reduction ratio, x: ADC mean, y: Longest diameter, z: CA125). In conclusion, the ADC mean value is useful for the prediction of the treatment response in ovarian endometrial cyst patients with DNG administration.

DOI PubMed

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