Assessing the effect of guideline introduction on clinical practice and outcome in patients with endometrial cancer in Japan: A project of the Japan society of gynecologic oncology (jsgo) guideline evaluation committee

Shogo Shigeta, Satoru Nagase, Mikio Mikami, Masae Ikeda, Masako Shida, Isao Sakaguchi, Norichika Ushioda, Fumiaki Takahashi, Wataru Yamagami, Nobuo Yaegashi, Yasuhiro Udagawa, Hidetaka Katabuchi

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: The Japan Society of Gynecologic Oncology (JSGO) published the first practice guideline for endometrial cancer in 2006. The JSGO guideline evaluation committee assessed the effect of this guideline introduction on clinical practice and patient outcome using data provided by the Japan Society of Obstetrics and Gynecology (JSOG) cancer registration system. Methods: Data of patients with endometrial cancer registered between 2000 and 2012 were analyzed, and epidemiological and clinical trends were assessed. The influence of guideline introduction on survival was determined by analyzing data of patients registered between 2004 and 2009 using competing risk model. Results: In total, 65,241 cases of endometrial cancer were registered. Total number of patients registered each year increased about 3 times in the analyzed period, and the proportion of older patients with type II endometrial cancer rapidly increased. The frequency of lymphadenectomy had decreased not only among the low-recurrence risk group but also among the intermediate- or high-recurrence risk group. Adjuvant therapy was integrated into chemotherapy (p<0.001). Overall survival did not significantly differ before and after the guideline introduction (hazard ratio [HR]=0.891; p=0.160). Additional analyses revealed patients receiving adjuvant chemotherapy showed better prognosis than those receiving adjuvant radiation therapy when limited to stage I or II (HR=0.598; p=0.003). Conclusion: It was suggested that guideline introduction influenced the management of endometrial cancer at several aspects. Better organized information and continuous evaluation are necessary to understand the causal relationship between the guideline and patient outcome.

Original languageEnglish
Article numbere76
JournalJournal of Gynecologic Oncology
Volume28
Issue number6
DOIs
Publication statusPublished - 2017 Nov 1

Fingerprint

Endometrial Neoplasms
Japan
Guidelines
Recurrence
Survival
Adjuvant Chemotherapy
Lymph Node Excision
Gynecology
Practice Guidelines
Obstetrics
Radiotherapy
Drug Therapy
Neoplasms

Keywords

  • Adjuvant
  • Chemotherapy
  • Endometrial Neoplasms
  • Lymph Node Excision
  • Practice Guideline
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

Cite this

Assessing the effect of guideline introduction on clinical practice and outcome in patients with endometrial cancer in Japan : A project of the Japan society of gynecologic oncology (jsgo) guideline evaluation committee. / Shigeta, Shogo; Nagase, Satoru; Mikami, Mikio; Ikeda, Masae; Shida, Masako; Sakaguchi, Isao; Ushioda, Norichika; Takahashi, Fumiaki; Yamagami, Wataru; Yaegashi, Nobuo; Udagawa, Yasuhiro; Katabuchi, Hidetaka.

In: Journal of Gynecologic Oncology, Vol. 28, No. 6, e76, 01.11.2017.

Research output: Contribution to journalArticle

Shigeta, Shogo ; Nagase, Satoru ; Mikami, Mikio ; Ikeda, Masae ; Shida, Masako ; Sakaguchi, Isao ; Ushioda, Norichika ; Takahashi, Fumiaki ; Yamagami, Wataru ; Yaegashi, Nobuo ; Udagawa, Yasuhiro ; Katabuchi, Hidetaka. / Assessing the effect of guideline introduction on clinical practice and outcome in patients with endometrial cancer in Japan : A project of the Japan society of gynecologic oncology (jsgo) guideline evaluation committee. In: Journal of Gynecologic Oncology. 2017 ; Vol. 28, No. 6.
@article{fc5a528173f94bc6bf23b688efa8ae47,
title = "Assessing the effect of guideline introduction on clinical practice and outcome in patients with endometrial cancer in Japan: A project of the Japan society of gynecologic oncology (jsgo) guideline evaluation committee",
abstract = "Objective: The Japan Society of Gynecologic Oncology (JSGO) published the first practice guideline for endometrial cancer in 2006. The JSGO guideline evaluation committee assessed the effect of this guideline introduction on clinical practice and patient outcome using data provided by the Japan Society of Obstetrics and Gynecology (JSOG) cancer registration system. Methods: Data of patients with endometrial cancer registered between 2000 and 2012 were analyzed, and epidemiological and clinical trends were assessed. The influence of guideline introduction on survival was determined by analyzing data of patients registered between 2004 and 2009 using competing risk model. Results: In total, 65,241 cases of endometrial cancer were registered. Total number of patients registered each year increased about 3 times in the analyzed period, and the proportion of older patients with type II endometrial cancer rapidly increased. The frequency of lymphadenectomy had decreased not only among the low-recurrence risk group but also among the intermediate- or high-recurrence risk group. Adjuvant therapy was integrated into chemotherapy (p<0.001). Overall survival did not significantly differ before and after the guideline introduction (hazard ratio [HR]=0.891; p=0.160). Additional analyses revealed patients receiving adjuvant chemotherapy showed better prognosis than those receiving adjuvant radiation therapy when limited to stage I or II (HR=0.598; p=0.003). Conclusion: It was suggested that guideline introduction influenced the management of endometrial cancer at several aspects. Better organized information and continuous evaluation are necessary to understand the causal relationship between the guideline and patient outcome.",
keywords = "Adjuvant, Chemotherapy, Endometrial Neoplasms, Lymph Node Excision, Practice Guideline, Survival",
author = "Shogo Shigeta and Satoru Nagase and Mikio Mikami and Masae Ikeda and Masako Shida and Isao Sakaguchi and Norichika Ushioda and Fumiaki Takahashi and Wataru Yamagami and Nobuo Yaegashi and Yasuhiro Udagawa and Hidetaka Katabuchi",
year = "2017",
month = "11",
day = "1",
doi = "10.3802/jgo.2017.28.e76",
language = "English",
volume = "28",
journal = "Journal of Gynecologic Oncology",
issn = "2005-0380",
publisher = "Korean Society of Gynecologic Oncology and Colposcopy",
number = "6",

}

TY - JOUR

T1 - Assessing the effect of guideline introduction on clinical practice and outcome in patients with endometrial cancer in Japan

T2 - A project of the Japan society of gynecologic oncology (jsgo) guideline evaluation committee

AU - Shigeta, Shogo

AU - Nagase, Satoru

AU - Mikami, Mikio

AU - Ikeda, Masae

AU - Shida, Masako

AU - Sakaguchi, Isao

AU - Ushioda, Norichika

AU - Takahashi, Fumiaki

AU - Yamagami, Wataru

AU - Yaegashi, Nobuo

AU - Udagawa, Yasuhiro

AU - Katabuchi, Hidetaka

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Objective: The Japan Society of Gynecologic Oncology (JSGO) published the first practice guideline for endometrial cancer in 2006. The JSGO guideline evaluation committee assessed the effect of this guideline introduction on clinical practice and patient outcome using data provided by the Japan Society of Obstetrics and Gynecology (JSOG) cancer registration system. Methods: Data of patients with endometrial cancer registered between 2000 and 2012 were analyzed, and epidemiological and clinical trends were assessed. The influence of guideline introduction on survival was determined by analyzing data of patients registered between 2004 and 2009 using competing risk model. Results: In total, 65,241 cases of endometrial cancer were registered. Total number of patients registered each year increased about 3 times in the analyzed period, and the proportion of older patients with type II endometrial cancer rapidly increased. The frequency of lymphadenectomy had decreased not only among the low-recurrence risk group but also among the intermediate- or high-recurrence risk group. Adjuvant therapy was integrated into chemotherapy (p<0.001). Overall survival did not significantly differ before and after the guideline introduction (hazard ratio [HR]=0.891; p=0.160). Additional analyses revealed patients receiving adjuvant chemotherapy showed better prognosis than those receiving adjuvant radiation therapy when limited to stage I or II (HR=0.598; p=0.003). Conclusion: It was suggested that guideline introduction influenced the management of endometrial cancer at several aspects. Better organized information and continuous evaluation are necessary to understand the causal relationship between the guideline and patient outcome.

AB - Objective: The Japan Society of Gynecologic Oncology (JSGO) published the first practice guideline for endometrial cancer in 2006. The JSGO guideline evaluation committee assessed the effect of this guideline introduction on clinical practice and patient outcome using data provided by the Japan Society of Obstetrics and Gynecology (JSOG) cancer registration system. Methods: Data of patients with endometrial cancer registered between 2000 and 2012 were analyzed, and epidemiological and clinical trends were assessed. The influence of guideline introduction on survival was determined by analyzing data of patients registered between 2004 and 2009 using competing risk model. Results: In total, 65,241 cases of endometrial cancer were registered. Total number of patients registered each year increased about 3 times in the analyzed period, and the proportion of older patients with type II endometrial cancer rapidly increased. The frequency of lymphadenectomy had decreased not only among the low-recurrence risk group but also among the intermediate- or high-recurrence risk group. Adjuvant therapy was integrated into chemotherapy (p<0.001). Overall survival did not significantly differ before and after the guideline introduction (hazard ratio [HR]=0.891; p=0.160). Additional analyses revealed patients receiving adjuvant chemotherapy showed better prognosis than those receiving adjuvant radiation therapy when limited to stage I or II (HR=0.598; p=0.003). Conclusion: It was suggested that guideline introduction influenced the management of endometrial cancer at several aspects. Better organized information and continuous evaluation are necessary to understand the causal relationship between the guideline and patient outcome.

KW - Adjuvant

KW - Chemotherapy

KW - Endometrial Neoplasms

KW - Lymph Node Excision

KW - Practice Guideline

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=85031501892&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85031501892&partnerID=8YFLogxK

U2 - 10.3802/jgo.2017.28.e76

DO - 10.3802/jgo.2017.28.e76

M3 - Article

C2 - 29027394

AN - SCOPUS:85031501892

VL - 28

JO - Journal of Gynecologic Oncology

JF - Journal of Gynecologic Oncology

SN - 2005-0380

IS - 6

M1 - e76

ER -