Changing trend in the patterns of pretreatment diagnostic assessment for patients with cervical cancer in Japan
Changing trend in the patterns of pretreatment diagnostic assessment for patients with cervical cancer in Japan
复制标题
日本宫颈癌患者治疗前诊断评估模式的变化趋势
DOI：
10.1016/j.ygyno.2011.08.024
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发表时间：
2011
期刊：
影响因子：
4.7
通讯作者：
Kodaira T
中科院分区：
文献类型：
--
作者：
Tomita N;Toita T;Kodaira T
目的癌症分期系统应响应诊断工具的发展。国际妇产科联合会 (FIGO) 宫颈癌指南于 2009 年对治疗前评估进行了修改。我们报告了日本最近的宫颈癌治疗前检查模式。方法日本护理模式研究（PCS）工作组分析了日本两个调查期（1999-2001，324；2003-2005，285）609例接受根治性放射治疗的宫颈癌患者的治疗前诊断评估数据。采用分层两阶段整群抽样的方法，从640家机构中选取61家进行调查。结果最新FIGO指南中静脉尿路造影、膀胱镜、直肠镜等可选检查的使用逐渐减少。在这两个调查期间都很少进行手术分期。计算机断层扫描 (CT) 和磁共振成像 (MRI) 被广泛使用，即使在这两个调查期间，MRI 也变得越来越普遍。在这两项调查中，大多数患者的原发病变大小和盆腔淋巴结状况均通过 CT/MRI 进行评估。 结论 在日本，最新的 FIFAO 分期指南鼓励使用 CT/MRI 已经取代了静脉尿路造影、膀胱镜检查和直肠镜检查。日本患者获得了 CT/MRI 的潜在益处，因为通过这些方式评估了原发病变大小和盆腔淋巴结状态等预后因素。在未来的 PCS 调查中应持续监测膀胱镜和直肠镜的使用，因为只有 CT/MRI 才能导致 CT/MRI 怀疑膀胱/直肠受累的患者进行分期迁移。
OBJECTIVECancer staging systems should be responsive to the development of diagnostic tools. The International Federation of Gynecology and Obstetrics (FIGO) cervical cancer guidelines were modified in 2009 regarding the pretreatment assessment. We report the recent Japanese patterns of pretreatment workup for cervical cancer.METHODSThe Japanese Patterns of Care Study (PCS) working group analyzed the pretreatment diagnostic assessment data of 609 patients with cervical cancer treated with definitive radiotherapy in the two survey periods (1999–2001, 324; 2003–2005, 285) in Japan. Sixty-one of 640 institutions were selected for this survey using a stratified two-staged cluster sampling method.RESULTSThe use of optional examinations in the latest FIGO guidelines such as intravenous urography, cystoscopy, and proctoscopy was gradually decreasing. Surgical staging was rarely performed in either survey period. Computed tomography (CT) and magnetic resonance imaging (MRI) were widely used, and MRI has become increasingly prevalent even between the two survey periods. Primary lesion size and pelvic lymph node status was evaluated by CT/MRI for most patients in both surveys.CONCLUSIONSThe use of CT/MRI that is encouraged in the latest FIGO staging guidelines already replaced intravenous urography, cystoscopy, and proctoscopy in Japan. Japanese patients received the potential benefit of CT/MRI because prognostic factors such as primary lesion size and pelvic lymph node status were evaluated by these modalities. The use of cystoscopy and proctoscopy should be continuously monitored in the future PCS survey because only CT/MRI could lead to the stage migration for patients on suspicion of bladder/rectum involvement on CT/MRI.