| Project/Area Number |
18K09218
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 56040:Obstetrics and gynecology-related
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| Research Institution | University of Tsukuba |
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Principal Investigator |
Satoh Toyomi 筑波大学, 医学医療系, 教授 (80344886)
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| Project Period (FY) |
2018-04-01 – 2023-03-31
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| Project Status |
Completed (Fiscal Year 2022)
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| Budget Amount *help |
¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000)
Fiscal Year 2022: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2021: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2020: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
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| Keywords | 婦人科悪性腫瘍 / 卵巣がん / 子宮体がん / 子宮頸がん / 静脈血栓塞栓症(VTE) / 深部静脈血栓症(DVT) / 肺塞栓症(PE) / 予防 / 深部静脈血栓症（DVT) / 静脈血栓塞栓症（VTE） / 深部静脈血栓症（DVT） / 肺塞栓症（PE） |
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| Outline of Final Research Achievements |
The aim of this study is to establish methods of postoperative symptomatic venous thromboembolism (VTE) prophylaxis for patients with gynecological carcinoma. Before treatment, VTE screening was conducted including asymptomatic for them. When VTE was discovered in them, anticoagulant therapy was started and review of the therapy for these patients were performed. After surgery, anticoagulant therapy was performed on following patients with: ① undergoing surgery with lymph node dissection, ② BMI> 28, ③ a history of VTE, ④ thrombotic predisposition, ⑤ VTE discovered before onset of treatment. Patients other than ① to ⑤ received standard treatment. Patients who developed symptomatic VTE after surgery were repeatedly investigated and the prevention methods were improved based on the results. Recently the rate of patients who developed postoperative symptomatic VTE was decreased to about 0.3% (about 3% at the start of the study).
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| Academic Significance and Societal Importance of the Research Achievements |
本研究により、治療開始前のVTE併発割合は、卵巣がんでは27.0%、子宮体がんでは11.5%、子宮頸がんでは7.3%で、その98.2%が無症候性であった事を英文誌に報告した。無症候性VTEに気がつかずに侵襲性が大きい標準治療を施した場合、医原性に無症候性VTEを症候性にする可能性につき警鐘を鳴らした。発見されたVTEへの適切な対応に加え、術後に患者を選択し薬剤による抗凝固療法を行うことで術後のVTEひいては致命的合併症である肺塞栓症（PE）発症率も有意に減少させることができ、臨床的に意義がある結果を報告することができた（英文論文のacceptは2023年5月）。
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