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Current Surgical Principle for Uterine Cervical Cancer of Stages Ia2, Ib1, and IIa1 in Japan: A Survey of the Japanese Gynecologic Oncology Group

Mikami, Mikio MD, PhD*; Aoki, Yoichi MD, PhD; Sakamoto, Masaru MD, PhD; Shimada, Muneaki MD, PhD§; Takeshima, Nobuhiro MD, PhD; Fujiwara, Hisaya MD, PhD; Matsumoto, Takashi MD, PhD#; Kita, Tunekazu MD, PhD**; Takizawa, Ken MD, PhDDisease Committee of Uterine Cervical and Vulvar Cancer, Japanese Gynecologic Oncology Group

International Journal of Gynecological Cancer: November 2013 - Volume 23 - Issue 9 - p 1655–1662
doi: 10.1097/IGC.0000000000000005
Cervical Cancer

Objective The objective of this study was to determine the current operative principle of uterine cervical cancer of stages Ia2, Ib1, and IIa1 (International Federation of Gynecology and Obstetrics) in Japan by surveying member institutions of the Japanese Gynecologic Oncology Group (JGOG).

Methods We conducted a survey to assess the current operative principle, including indications and treatment, at all 199 active member institutions of the JGOG.

Results A total of 166 institutions (83.4%) responded to the survey. For Ia2 squamous cell carcinoma without the need to preserve fertility, modified radical hysterectomy was performed, and lymph node dissection was done in about 85%. At 60% of JGOG institutions, it was considered that less invasive procedures might be suitable. At the majority of JGOG institutions, radical surgery and lymph node dissection were considered necessary for stages Ib1 and IIa1 squamous cell carcinoma, with 70% considering that less invasive procedures might not be suitable.

Conclusions This survey provides information regarding the current status of surgical principle for uterine cervical cancer (stages Ia2, Ib1, and IIa1) in Japan.

*Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa; †Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ryukyu, Ryukyu; ‡Department of Gynecology, Sasaki Foundation Kyoundo Hospital, Tokyo; §Department of Obstetrics and Gynecology, Tottori University School of Medicine, Tottori; ∥Departments of Gynecology, Cancer Institute Hospital, Tokyo; ¶Department of Obstetrics and Gynecology, Hiroshima University Graduate School of Medicine; #Department of Gynecology, Sikoku Cancer Center, Ehime; and **Department of Obstetrics and Gynecology, Nara Prefectural Hospital, Nara, Japan.

Address correspondence and reprint requests to Mikio Mikami, MD, PhD, Department of Obstetrics and Gynecology, Tokai University School of Medicine, Shimokasuya 143, Isehara, Kanagawa 259-1193, Japan. E-mail:

This work was supported in part by a grant-in-aid for scientific research from MEXT (no. 23592465), MEXT (Ministry of Education, Culture, Sports, Science and Technology)–Supported Program for the Strategic Research Foundation at Private Universities 2012-2014, and a grant from Tokai University Research Aid.

The authors declare no conflicts of interest.

Received March 26, 2013

Accepted August 20, 2013

© 2013 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.