Shogo Shigeta1, Masako Shida2, Satoru Nagase3, Masae Ikeda4, Fumiaki Takahashi5, Takeo Shibata6, Wataru Yamagami7, Hidetaka Katabuchi8, Nobuo Yaegashi9, Daisuke Aoki7, Mikio Mikami4. 1. Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan. Electronic address: s.shigeta@med.tohoku.ac.jp. 2. Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Japan. Electronic address: shida@is.icc.u-tokai.ac.jp. 3. Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine, Yamagata, Japan. 4. Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Japan. 5. Division of Medical Engineering, Department of Information Science, Iwate Medical University, Morioka, Japan. 6. Department of Health Management, Tokai University School of Health Studies, Hiratsuka, Japan. 7. Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan. 8. Department of Obstetrics and Gynecology, Kumamoto University Faculty of Life Sciences, Kumamoto, Japan. 9. Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan.
Abstract
OBJECTIVE: The Japan Society of Gynecologic Oncology published its first clinical guidelines for uterine cervical cancer in 2007 which has been revised twice in 2011 and 2017. The aim of this study was to investigate the influence of the first guideline publication on the therapeutic trend and patient outcome by analyzing uterine cervical cancer cases registered to the cancer registry organized by the Japan Society of Obstetrics and Gynecology. METHODS: Data of uterine cervical cancer cases registered to the cancer registry from 2000 to 2012 were provided. Epidemiological and clinical trend were analyzed by the Chi-squared test with subsequent standardized residual analysis. Overall survival among the patients registered between 2004 and 2009 was analyzed using the Fine and Gray competing risk model. RESULTS: 68,707 cases were registered during the study period. A trend analysis revealed that the guideline publication may have led to a decrease in neoadjuvant chemotherapy in parallel with an increase in radiation therapy mainly in stage II and III patients undergoing primary treatment. A survival analysis indicated that the introduction of the guideline may have improved overall survival among stage III uterine cervical cancer patients, even though a significant difference was not observed in all of the cases. CONCLUSIONS: This study demonstrated the potential influence of the guideline publication on the clinical trend and patient outcome. As this is the first assessment of the guideline for uterine cervical cancer in Japan, continuous evaluation is necessary to further comprehend the significance of this guideline.
OBJECTIVE: The Japan Society of Gynecologic Oncology published its first clinical guidelines for uterine cervical cancer in 2007 which has been revised twice in 2011 and 2017. The aim of this study was to investigate the influence of the first guideline publication on the therapeutic trend and patient outcome by analyzing uterine cervical cancer cases registered to the cancer registry organized by the Japan Society of Obstetrics and Gynecology. METHODS: Data of uterine cervical cancer cases registered to the cancer registry from 2000 to 2012 were provided. Epidemiological and clinical trend were analyzed by the Chi-squared test with subsequent standardized residual analysis. Overall survival among the patients registered between 2004 and 2009 was analyzed using the Fine and Gray competing risk model. RESULTS: 68,707 cases were registered during the study period. A trend analysis revealed that the guideline publication may have led to a decrease in neoadjuvant chemotherapy in parallel with an increase in radiation therapy mainly in stage II and III patients undergoing primary treatment. A survival analysis indicated that the introduction of the guideline may have improved overall survival among stage III uterine cervical cancerpatients, even though a significant difference was not observed in all of the cases. CONCLUSIONS: This study demonstrated the potential influence of the guideline publication on the clinical trend and patient outcome. As this is the first assessment of the guideline for uterine cervical cancer in Japan, continuous evaluation is necessary to further comprehend the significance of this guideline.