Synopsis: Although cervical cancer treatment guidelines recommend conization for cervical intraepithelial neoplasia 3 (CIN3), considering perinatal risks, laser vaporization may be selected. <Objective>To retrospectively examine the treatment outcome and recurrence risk factors of laser vaporization. <Method>In total, 338 patients with CIN3 who underwent laser vaporization during the initial treatment at our hospital from 2014 to 2018 were enrolled. Recurrence rate and risk factors were examined using JMP version 17. <Results>The median patient age was 35 (20-89) years, and median body mass index (BMI) was 20.7 (14.7-34.7) kg/m2. In total, 175 and 153 patients had histories of childbirth and smoking, respectively. Eleven patients (4.7%) exhibited intraoperative blood loss of >50ml. The median follow-up period was 34 (0-83) months. Thirty-two cases recurred, and the 1-, 2-, and 3-year recurrence rates were 2.8%, 6.3%, and 9.1%, respectively. Age, BMI, childbirth history, smoking history, pre-treatment human papilloma virus infection status, and intraoperative bleeding were analyzed for recurrence risk factors; however, no statistically significant differences were observed. <Conclusion>No recurrence risk factors were identified after laser vaporization; however, long-term follow-up is warranted because recurrence rate increases over time.

Synopsis: In this study, we analyzed how the molecular-targeted drugs and related companion diagnosis system were selected in patients newly diagnosis or recurrent ovarian cancer treated at the participating institution in Chugoku and Shikoku region between January 1, 2021 and December 31, 2021.

For newly diagnosed patients, PAOLA-1 regimen (combining maintenance olaparib and bevacizumab) was the most frequently used for HRD (58%), whereas for HRP cases, 55% were treated with bevacizumab and 45% with niraparib. Bevacizumab and niraparib were also used for patients who had not undergone companion diagnosis.

Recurrent cases were divided according to the presence or absence of platinum sensitivity. PARP inhibitors were used in 80% of platinum sensitive relapses, while the majority (78%) of the resistant cases were treated with bevacizumab.

Genetic counseling or testing was performed in 25 of 27 patients with tumor BRCA variant identified by HRD testing. It was revealed that most of the facilities which participated in this research have performed genetic intervention for patients with somatic variant identified by HRD testing, which could be an inducement for HBOC treatment.

Synopsis: Recurrence of carcinoma in situ (CIS) of uterine cervix in the form of invasive cancer is extremely rare. We report a case of repeated recurrence after total hysterectomy for CIS. The patient underwent cervical conization for CIS at 48-years-old. At 57-years-old, the patient had a recurrence of CIS and underwent extended hysterectomy. At 59-years-old, the patient had an abnormal vaginal stump cytological diagnosis and the histological diagnosis was CIS. The patient was referred to our hospital because a recurrent tumor was found on the vaginal stump. A recurrent lesion was found on the vaginal wall and a 2 cm-sized tumor was palpated on the left side of the vaginal stump. The vaginal wall histology showed SCC and the lesion disappeared after CCRT. 9 months after, a recurrence was found in the vaginal stump, and radiotherapy was performed again, but 4 months later, a recurrence in the vaginal stump and metastasis in the external iliac lymph node were found and chemotherapy was performed. 3 months later, a recurrence in the external iliac and obturator lymph node was found, and the patient underwent resection of the recurrent tumor and pelvic lymph node dissection. 15 months after surgery, the patient underwent resection of recurrent tumor and vagina and colostomy. 17 months after surgery, para-aortic lymph node metastasis was detected and radiotherapy was administered. She has had recurrences and repeated chemotherapy since then and is still undergoing chemotherapy.

Synopsis: Ovarian granulosa cell tumors (GCTs) account for about 5% of malignant ovarian tumors. Surgery is the mainstay of treatment, but recurrent cases are not uncommon. Surgery, chemotherapy, and radiotherapy have limitations, and optimal treatment for recurrent cases has not been established. Here we present two cases of inoperable recurrent GCT that responded to combination therapy with an aromatase inhibitor and a GnRH agonist. Case 1 was a 56-year-old woman who had undergone two surgeries for recurrent GCT, which resulted in intestinal injury due to severe intraperitoneal adhesions. The tumor recurred, and she received hormonal therapy with an aromatase inhibitor alone, followed by combination with TC therapy and bevacizumab, both of which were unsuccessful. She received combination therapy with an aromatase inhibitor and a GnRH agonist, which has brought into complete response. Case 2 was an 84-year-old woman who had undergone two surgeries for recurrent GCT, with chemotherapy between them. Both a single aromatase inhibitor and following weekly TC therapy for subsequent recurrence were not effective. So, a combination therapy of an aromatase inhibitor and a GnRH agonist was performed again, which has brought into partial response. Both patients are continuing hormonal therapy with two agents.