title: Surgical principles for managing stage IB2, IIA2, and IIB uterine cervical cancer (Bulky Tumors) in Japan: a survey of the Japanese Gynecologic Oncology Group.
abstract: OBJECTIVE
  The aim of this study was to determine the current operative management of International Federation of Gynecology and Obstetrics (FIGO) stage IB2, IIA2, and IIB uterine cervical cancer (bulky tumors) in Japan by surveying the member institutions of the Japanese Gynecologic Oncology Group.
  
  
  METHODS
  We conducted a survey to assess current operative management, including indications and treatment, at all 199 active member institutions of the Japanese Gynecologic Oncology Group.
  
  
  RESULTS
  A total of 166 institutions (83.4%) responded to the survey. For patients with stage IIB squamous cell carcinoma, 35.5% (59/166) of the institutions performed surgery. For stage IIB nonsquamous cell carcinoma, surgery was performed at 88 (53.7%) of 164 institutions. Neoadjuvant chemotherapy was provided by 75 (45.5%) of 165 institutions (actively in 44 and reluctantly in 31). At 101 (61.2%) of 165 institutions, para-aortic node dissection was performed as part of radical surgery in patients with any indications. At 96 (57.9%) of 166 institutions, high-risk patients underwent chemoradiotherapy after surgery. On the other hand, adjuvant chemotherapy was given to high-risk and intermediate-risk patients at 19.9% and 33.1% institutions, respectively. More than half of the 166 institutions considered the number of metastatic nodes (91/166, 54.8%) and tumor histology (116/166, 69.9%) when selecting adjuvant therapy.
  
  
  CONCLUSIONS
  This survey provided information regarding the current surgical management of uterine cervical cancer (stages IB2, IIA2, and IIA) in Japan.
authors: *Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Kanagawa; †Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, Nishihara; ‡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, Hiroshima; #Department of Obstetrics and Gynecology, Ehime University School of Medicine, Ehime; and **Department of Obstetrics and Gynecology, Nara Prefectural Hospital, Nara, Japan.
authors: Mikio
authors: M
authors: Mikami
authors: Yoichi
authors: Y
authors: Aoki
authors: Masaru
authors: M
authors: Sakamoto
authors: Muneaki
authors: M
authors: Shimada
authors: Nobuhiro
authors: N
authors: Takeshima
authors: Hisaya
authors: H
authors: Fujiwara
authors: Takashi
authors: T
authors: Matsumoto
authors: Tunekazu
authors: T
authors: Kita
authors: Ken
authors: K
authors: Takizawa
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D059248:Chemoradiotherapy / Q000706:statistics & numerical data; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D002755:Choice Behavior; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D003625:Data Collection; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007258:Informed Consent / Q000706:statistics & numerical data; D007564:Japan / Q000453:epidemiology; D008197:Lymph Node Excision / Q000706:statistics & numerical data; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012008:Recurrence; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*