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1.
Journal of Gynecologic Oncology ; : e25-2021.
Artigo em Inglês | WPRIM | ID: wpr-915078

RESUMO

Objectives@#This review aims to introduce preoperative scoring systems to predict lymph node metastasis (LNM) and ongoing clinical trials to investigate the therapeutic role of lymphadenectomy for endometrial cancer. @*Methods@#We summarized previous reports on the preoperative prediction models for LNM and evaluated their validity to omit lymphadenectomy in our recent cohorts. Next, we compared characteristics of two ongoing lymphadenectomy trials (JCOG1412, ECLAT) to examine the survival benefit of lymphadenectomy in endometrial cancer, and described the details of JCOG1412. @*Results@#Lymphadenectomy has been omitted for 64 endometrial cancer patients who met lowrisk criteria to omit lymphadenectomy using our scoring system (LNM score) and no lymphatic failure has been observed. Other two models also produced comparable results. Two randomized phase III trials to evaluate survival benefit of lymphadenectomy are ongoing for endometrial cancer. JCOG1412 compares pelvic lymphadenectomy alone with pelvic and para-aortic lymphadenectomy to evaluate the therapeutic role of para-aortic lymphadenectomy for patients at risk of LNM. For quality assurance of lymphadenectomy, we defined several regulations, including lower limit of the number of resected nodes, and submission of photos of dissected area to evaluate thoroughness of lymphadenectomy in the protocol. The latest monitoring report showed that the quality of lymphadenectomy has been well-controlled in JCOG1412. @*Conclusion@#Our strategy seems reasonable to omit lymphadenectomy and could be generalized in clinical practice. JCOG1412 is a high-quality lymphadenectomy trial in terms of the quality of surgical procedures, which would draw the bona-fide conclusions regarding the therapeutic role of lymphadenectomy for endometrial cancer.

2.
Kampo Medicine ; : 371-377, 2020.
Artigo em Japonês | WPRIM | ID: wpr-924515

RESUMO

We report a case of a 57-year-old woman with radiation proctitis (RP) treated by shiunko (SK) enema with promising outcomes. The patient underwent interstitial brachytherapy for anterior vaginal vault recurrence of uterine cancer. Nine months after the treatment, she had anal pain and was diagnosed with RP by clinical course and colonoscopy. The rectal ulcer was so severe that a surgeon proposed permanent stoma formation as one option, given eventual risk of rectovaginal fistula. The patient rejected stoma formation and opted for Kampo medicine. Though she took keishibukuryogankayokuinin for blood stasis at first, her anal pain and rectal bleeding gradually worsened. Thereafter, she mainly used SK enema, kyukikyogaito and magnesium oxide. Anal pain and rectal bleeding decreased after applying SK to the rectal wall per rectum. Magnetic resonance imaging (MRI) and colonoscopy findings of the rectal ulcer also improved. SK effectively reduced anal pain and rectal bleeding as well as stimulated tissue repair in our patient, and therefore SK is worth considering in the treatment of RP.

3.
Experimental & Molecular Medicine ; : 1-10, 2006.
Artigo em Inglês | WPRIM | ID: wpr-77907

RESUMO

The Wnt signaling pathway is conserved in various species from worms to mammals, and plays important roles in cellular proliferation, differentiation, and migration. Wnt stabilizes cytoplasmic beta-catenin and then the accumulated beta-catenin is translocated into the nucleus, where it activates the transcriptional factor T-cell factor (Tcf)/lymphoid enhancer factor (Lef), and thereby stimulates the expression of genes including c-myc, c-jun, fra-1, and cyclin D1. Tight regulation of this response involves post-translational modifications of the components of the Wnt signaling pathway. Phosphorylation, ubiquitination, and sumoylation have been shown to affect the half-life of beta-catenin and the transcriptional activity of Tcf/Lef. The precise spatio-temporal patterns of these multiple modifications determine the driving force of various cellular responses.


Assuntos
Animais , Humanos , Sítios de Ligação , Regulação da Expressão Gênica , Modelos Biológicos , Ligação Proteica , Processamento de Proteína Pós-Traducional , Transdução de Sinais , Fatores de Transcrição TCF , Transativadores , Proteínas Wnt/classificação , beta Catenina
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