Aim: This study aimed to validate a simplified method of quantifying chemotherapy-induced peripheral neuropathy using the PainVision PS-2100 R (PV) electrical perception system. Methods:We assessed patients diagnosed with epithelial ovarian cancer, fallopian tube cancer, or peritoneal cancer and were about to undergo first-time paclitaxel and carboplatin chemotherapy.Peripheral neuropathy was assessed before and after chemotherapy administration in all patients according to the National Cancer Institute-Common Terminology Criteria for Adverse Events Version 4.0 (NCI-CTCAE4.0), using a conventional assessment in combination with the PV system.The PV device comprises electrodes attached to the ulnar side of the forearm and the first joint of index fingers on both the left and right sides to measure the electrical perceptual threshold. The average of three threshold measurements was recorded for each patient.Results: Thirty female patients (age 51.6 ± 12.2 [mean ± SD]) were included, and median number of chemotherapy drug treatments was 5 (first quartile: 4, second quartile: 5, and third quartile: 5). Twenty-seven patients (90%) reported posttreatment numbness; NCI-CTCAE4.0 perceptual anomaly grades were as follows: G1, 57 (40%); G2, 19 (13%); and G3, 7 (5%). A positive correlation was identified between right medial side PV threshold score and perceptual anomaly grade on measurements of the inner right-hand side only. Conclusion:Our preliminary results suggest that peripheral neuropathy may be quantified using PV. As CIPN often lowers QOL, it needs to be appropriately evaluated. Future studies with a larger patient cohort and methodological refinements to improve accuracy are warranted.

Background/Aim: Tumour biopsy using laparoscopy before neoadjuvant chemotherapy for advanced ovarian cancer has been widely accepted. However, there are few reports about its operative outcome compared to biopsy with laparotomy. We investigated the advantage of laparoscopic biopsy for advanced ovarian cancer. Patients and Methods: We included 23 patients who underwent laparoscopy and 27 who underwent exploratory laparotomy before neoadjuvant chemotherapy between January 2012 and August 2020. We reviewed their medical records and evaluated their operative outcomes. Results: Blood loss was significantly lower in the laparoscopy group (5 ml vs. 320 ml, p<0.05). The period until the initiation of neoadjuvant chemotherapy was significantly shorter in the laparoscopy group (12 days vs. 16 days, p<0.05). Overall survival did not differ significantly between the two groups (25.4 months vs. 24.7 months, p=0.53). Conclusion: Laparoscopic tumour biopsy is useful and safe for histological diagnosis, thereby allowing for early introduction to neoadjuvant chemotherapy.Epithelial ovarian cancer (EOC) is the gynaecological malignancy with the highest mortality rate. At the time of diagnosis, most patients have stage III or IV disease classified according to the International Federation of Gynecology and Obstetrics (FIGO) staging system, indicating that the tumour has disseminated into the peritoneal cavity and/or metastasized to organs outside the pelvis. Adequate surgical cytoreduction is the most important independent prognostic factor, and the standard treatment for advanced EOC is primary debulking surgery (PDS) followed by platinum-based chemotherapy. On the other hand, it is generally supported that massive ascites, poor performance status, malnutrition, and pleural effusion are often associated with extensive disease spread, and in those cases, neoadjuvant chemotherapy (NAC) with interval debulking surgery (IDS) could be a good alternative treatment. Previous randomized clinical trials (EORTC, CHROUS, JCOG0602) reported no difference in survival outcomes in stage IIIC/IV ovarian cancer patients who were treated with NAC plus IDS compared with PDS, and the surgically-related morbidity rate (such as haemorrhagic, infective, and thromboembolic adverse events) was higher in PDS (1-3). However, the problem has been often discussed that these trials resulted in low rate of complete/optimal surgery in both PDS and IDS and median operative time in these trials was shorter than other studies (4-6). The SCORPION trial showed relatively higher rates of complete/optimal surgery in PDS and IDS, 91% and 81% respectively, possibly due to introduction of scoring peritoneal dissemination by laparoscopic surgery (7). There was no difference in prognosis between PDS and IDS groups, in spite of improvement in surgical outcome. The SCORPION trial showed that PDS also resulted in significantly higher incidence of perioperative complication than IDS. Diagnostic laparoscopic surgery for advanced EOC is gaining popularity because it is minimally...

Background/Aim: We investigated the predictive value of scoring systems of peritoneal disseminations for complete surgery (CS) at primary debulking surgery (PDS) in advanced ovarian cancer. Patients and Methods: We retrospectively enrolled eligible patients with clinical stages III or IVA selected for PDS from January 2015 to December 2019. Concern variables were predictive index value (PIV) and peritoneal cancer index (PCI) from operative and pathological reports. Primary endpoints were cutoffs to predict operative completeness using the receiver operating characteristic curve. Results: Among 111 patients, PIV ≥8 and PCI ≥13 were the best predictors of incomplete PDS, including optimal and suboptimal surgeries (AUC=0.821 and 0.855, respectively). CS rates in PIV ≤6 and PCI ≤12 were significantly higher than in PIV ≥8 (89.3% vs. 47.2%; p<0.05) and PCI ≥13 (90.9% vs. 41.2%: p<0.05). Conclusion: PIV and PCI are potential predictors for CS at PDS. Every year, numerous patients suffer from ovarian cancer, the seventh most prevalent malignant tumor in women, with almost 240,000 newly diagnosed cases annually, as well as the eighth most common cause of female cancer death, with almost 150,000 deaths annually worldwide (1). In Japan, the incidence of ovarian cancer has been increasing up to 15.0 per 100,000 women, almost half of whom were newly diagnosed as advanced ovarian cancer (AOC) with International Federation of Gynecology and Obstetrics (FIGO) stage III and IV (36.2% and 10.0%, respectively) (2).Complete resection in primary debulking surgery (PDS) is considered the most favorable therapeutic option for AOC (3). Recently, several randomized control trials (RCTs) compared the postoperative prognosis between PDS and interval debulking surgery (IDS) after neoadjuvant chemotherapy (NAC) (4-7). Of these trials, the EORTC and CHORUS studies showed non-inferiority of IDS to PDS (4, 5). In the SCORPION trial, NAC + IDS was not superior to PDS in improving prognosis, but the authors considered NAC + IDS as an acceptable strategy for patients with large dissemination burdens because the incidence of operative complications was less than that for PDS (7). Although other RCTs are ongoing to clarify therapeutic superiority of PDS to overcome the limitations in previous studies, such as the low rate of complete surgery (8, 9), gynecologists need to pursue complete surgery in PDS (complete PDS), and if it seems difficult, consider NAC + IDS. Therefore, in deciding on operative options for AOC, a reliable predictive model for operative completeness in PDS based on preoperative examinations should be established.Recently, diagnostic laparoscopy has been indicated as the safest method for tumor biopsy in AOC cases, and it has been also established as a potential strategy for detecting cases with large disseminations likely to result in suboptimal surgery in PDS (10). Furthermore, some quantitative scoring systems for abdominal disseminations, such as predictive index value (PIV) and Peritoneal Cancer Index (PCI), have been used ...

At the 73rd Annual Congress of the Japan Society of Obstetrics and Gynecology, young doctors from Japan and South Korea made presentations on the present condition of risk‐reducing surgery for hereditary breast and ovarian cancer (RRSO) in their respective country. RRSO was insured in Japan in April 2020, whereas in South Korea, it was insured 7 years earlier in 2013. In Japan, certification criteria have been set for facilities that perform RRSO, and the number of facilities is increasing, but regional disparities still exist in its distribution. The number of gBRCA1/2 testing facilities is larger, and the cost is more affordable in South Korea than in Japan. Additionally, South Korea provides genetic counseling to a wider range of relatives compared to Japan. In the future, as the indications for the gBRCA1/2 test have expanded as a companion diagnostic for the use of PARP inhibitors, it is expected that the number of candidates for the gBRCA1/2 mutation test and RRSO will increase in Japan. It is important to increase the number of BRCA tests while maintaining the quality of genetic counseling in order to provide adequate information on BRCA mutations and RRSO for patients to support their decision. For the development of hereditary breast and ovarian cancer (HBOC) medical care, it is necessary to publish a nationwide database in Japan and continue to analyze and discuss the data based on the results.