Faculty Profiles - TAMAKOSHI, Koji

Papers - TAMAKOSHI, Koji

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Association of white blood cell count and clustered components of metabolic syndrome in Japanese men. Reviewed

Nagasawa N, Tamakoshi K, Yatsuya H, Hori Y, Ishikawa M, Murata C, Zhang H, Wada K, Otsuka R, Mabuchi T, Kondo T, Toyoshima H.

Circ J. Vol. 68 ( 10 ) page： 892-897 2004.10

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The role of inflammation in the genesis of cardiovascular disease has attracted attention and in the present study the association among metabolic syndrome (MS), white blood cell (WBC) count, and insulin concentration was investigated. METHODS AND RESULTS: A cross-sectional study of 3,594 Japanese men aged 34-69 years evaluated the MS components (high blood pressure, hypo-high density lipoprotein (HDL)-cholesterolemia, hypertriglyceridemia, hyperglycemia), as defined by the criteria given in the Third Report of the National Cholesterol Education Program Expert Panel on Detection Evaluation, and Treatment of High Blood Cholesterol in Adults, except for obesity [body mass index (BMI) >/=25 kg/m(2)]. WBC count had a positive correlation with BMI, blood pressure, triglyceride, glucose and insulin, and a negative correlation with HDL-cholesterol. The multi-adjusted means of WBC count and insulin concentration were significantly higher in MS subjects defined as having 3 or more of the components than in non-MS subjects with no more than 2 components. Both means also increased with the number of MS components (p<0.001 for trend). In the multiple linear regression analysis, BMI, HDL-cholesterol, systolic blood pressure, glucose and triglyceride had a significant and independent association with WBC count, but the insulin concentration did not. CONCLUSIONS: The cluster of MS components based on insulin resistance may cause low-grade inflammation.

Individual and joint impact of family history and Helicobacter pylori infection on the risk of stomach cancer: a nested case-control study. Reviewed

Yatsuya H, Toyoshima H, Tamakoshi A, Kikuchi S, Tamakoshi K, Kondo T, Mizoue T, Tokui N, Hoshiyama Y, Sakata K, Hayakawa N, Yoshimura T; Japan Collaborative Cohort Study Group.

Br J Cancer. Vol. 91 ( 5 ) page： 929-934 2004.8

Language：English Publishing type：Research paper (scientific journal)

We used 202 cases of stomach cancer and 394 controls nested within the Japan Collaborative Cohort Study For Evaluation of Cancer Risk (JACC study) to investigate whether family history has an independent effect on the risk of stomach cancer after controlling for the Helicobacter pylori infection. A positive history of stomach cancer in one or more first-degree relatives was associated with an increased risk of the disease in women, but not in men after controlling for H. pylori infection and other confounding variables. Women with both a family history and H. pylori infection were associated with more than five-fold increased risk of the disease (OR 5.10, 95% CI 1.58-16.5) compared to those without these factors. These results suggest the existence of inherited susceptibility to the disease in women, and that measurements of H. pylori infection together with the family history allow meaningful evaluation of risk beyond that provided by either factor alone.

A prospective study of reproductive and menstrual factors and colon cancer risk in Japanese women: findings from the JACC study. Reviewed

Tamakoshi K, Wakai K, Kojima M, Watanabe Y, Hayakawa N, Toyoshima H, Yatsuya H, Kondo T, Tokudome S, Hashimoto S, Suzuki K, Suzuki S, Kawado M, Ozasa K, Ito Y, Tamakoshi A; JACC Study Group.

Cancer Sci. Vol. 95 ( 7 ) page： 602-607 2004.7

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

The effects of reproductive factors on the etiology of colon cancer in Asian populations remain unexplored. So we examined 38,420 Japanese women aged 40-79 years who responded to a questionnaire on reproductive and other lifestyle factors from 1988 to 1990 in the Japan Collaborative Cohort Study for Evaluation of Cancer Risk. During an average 7.6 years of follow-up, we documented 207 incident colon cancers. Multivariate analysis indicated that colon cancer risk was likely to be lower among parous women than among nulliparous. Women who had two abortions or more had a 72% higher risk of developing colon cancer [relative risk (RR) 1.72; 95% confidence interval (CI) 1.16-2.55; trend P < 0.01] compared with women who never had an abortion. The RR of colon cancer among postmenopausal women significantly decreased with increasing age at menarche (trend P = 0.01). No apparent association between colon cancer and gravida, age at first birth, age at menopause, or duration of menstruation was seen. These prospective data support the hypothesis that female reproductive events modify colon cancer risk, and suggest that reproductive factors, particularly age at menarche and having an abortion, may be of importance in the etiology of colon cancer among Japanese women.

Suppression of invasion and peritoneal carcinomatosis of ovarian cancer cells by overexpression of AP-2alpha. Reviewed

Sumigama S, Ito T, Kajiyama H, Shibata K, Tamakoshi K, Kikkawa F, Williams T, Tainsky MA, Nomura S, Mizutani S.

Oncogene. Vol. 15 ( 32 ) page： 5496-5504 2004.7

Language：English Publishing type：Research paper (scientific journal)

A previous report demonstrated that AP-2alpha favors the survival of ovarian cancer patients by clinical findings. However, the functional roles of AP-2alpha in human ovarian cancers have not been determined. To clarify the roles, we overexpressed AP-2alpha in SKOV3 human ovarian cancer cells, which originally possess little AP-2alpha. AP-2alpha overexpression changed cell morphology from spindle to epithelioid type and suppressed cell proliferation and invasion, which would be partially correlated with decreased phosphorylation levels of the erbB2, Akt and ERK pathways, increased E-cadherin and reduced pro-matrix metalloproteinase-2 levels. Moreover, nude mice intraperitoneally injected with AP-2alpha-overexpressing cells survived longer than those with neo-transfected cells. The present data represent the first direct evidence that AP-2alpha plays a tumor suppressive role in ovarian cancer.

A prospective study of body size and colon cancer mortality in Japan: The JACC Study. Reviewed

Tamakoshi K, Wakai K, Kojima M, Watanabe Y, Hayakawa N, Toyoshima H, Yatsuya H, Kondo T, Tokudome S, Hashimoto S, Suzuki K, Ito Y, Tamakoshi A; JACC Study Group.

Int J Obes Relat Metab Disord. Vol. 28 ( 4 ) page： 551-558 2004.4

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: To determine whether body size measurements are risk factors for colon cancer death among the Japanese. DESIGN AND SUBJECTS: A nationwide prospective study, the Japan Collaborative Cohort (JACC) Study from 1988 to 1999. The present analysis included 43 171 men and 58 775 women aged 40-79 y who respond to a questionnaire on current weight and height, weight around 20 y of age, and other lifestyle factors. Body mass index (BMI) at baseline and 20 y of age (B-BMI and 20-BMI, respectively) were calculated. RESULTS: We identified 127 deaths from colon cancer during the follow-up of 424 698 person-years among men and 122 deaths during the follow-up of 591 787 person-years among women. After adjustments for the lifestyle factors known to modify the risk of colon cancer, weight at baseline showed a significant positive association in women, while no such association was seen in men. There was also a significant trend of increasing risk with the increase in B-BMI among women. Women with B-BMI >/=28 kg/m(2) had a relative risk (RR) of 3.41 (95% confidence interval (CI): 1.44-8.06) compared with those with BMI of 20-<22 kg/m(2). 20-BMI also presented the same trend of increasing risk as B-BMI. Women with 20-BMI of <22 and B-BMI of >26 kg/m(2), that is, excessive BMI gain, had a high RR of 3.41 (95% CI 1.29-9.02) compared with those with 20-BMI of <22 and B-BMI of <22 kg/m(2). There were no corresponding trends of colon cancer risk for B-BMI, 20-BMI, or BMI change among men. CONCLUSIONS: These study data suggest that obesity and excessive weight gain are associated with the risk of colon cancer death in Japanese women but no such relationship was found in Japanese men.

Bowel movement frequency and risk of colorectal cancer in a large cohort study of Japanese men and women. Reviewed

Kojima M, Wakai K, Tokudome S, Tamakoshi K, Toyoshima H, Watanabe Y, Hayakawa N, Suzuki K, Hashimoto S, Ito Y, Tamakoshi A; JACC Study Group.

Br J Cancer Vol. 90 ( 7 ) page： 1397-1401 2004.4

Language：English Publishing type：Research paper (scientific journal)

The relationship between bowel movement (BM) frequency and the risk of colorectal cancer was examined in a large cohort of 25 731 men and 37 198 women living in 24 communities in Japan. At enrolment, each participant completed a self-administrated questionnaire on BM frequency and laxative use. Incidence rate ratios (IRR) with 95% confidence intervals (CI) were estimated using Cox's proportional-hazard model. During the follow-up period (average length 7.6 years), 649 cases of colorectal cancer, including 429 cases of colon cancer, were identified. Among women, subjects who reported a BM every 2-3 days had the lowest risk of developing colorectal (IRR=0.71, 95% CI=0.52-0.97) and colon cancer (IRR=0.70, 95% CI=0.49-1.00), whereas those reporting a BM every 6 days or less had an increased risk of developing colorectal (IRR=2.47, 95% CI=1.01-6.01) and colon cancer (IRR=2.52, 95% CI=0.93-6.82) compared with those reporting >or=1 BM per day. A similar, but nonsignificant, association between the frequency of BM and cancer risk was observed in men. There was no association between colorectal or colon cancer risk and laxative use. Regulating BM frequency might therefore have a role in the prevention of colorectal cancer.

A prospective study on the possible association between having children and colon cancer risk: findings from the JACC Study. Reviewed

Tamakoshi K, Wakai K, Kojima M, Watanabe Y, Hayakawa N, Toyoshima H, Yatsuya H, Kondo T, Tokudome S, Hashimoto S, Suzuki K, Ito Y, Tamakoshi A; JACC Study Group.

Cancer Sci. Vol. 95 ( 3 ) page： 243-247 2004.3

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

If having children is regarded as an exposure in life, its effect on a host could be considered as being due to female sex hormones associated with pregnancy in women and some lifestyle factors associated with large families in both men and women. To explore the roles of having children in the etiology of colon cancer, we examined 36,629 women and 24,877 men aged 40-79 years who completed a questionnaire on the number of children and other lifestyle factors from 1988 to 1990 in the Japan Collaborative Cohort Study for Evaluation of Cancer Risk. During 291,080 and 200,648 person-years of follow-up, we documented 198 female and 202 male incident colon cancers, respectively. After adjusting for some factors known or suspected to modify the risk of colon cancer, compared with the women with no children, the multivariate-adjusted relative risks of colon cancer were 0.74 (95% confidence interval [CI]: 0.30-1.84) for one child, 1.00 (95% CI: 0.46-2.20) for two, 0.70 (95% CI: 0.31-1.55) for three, and 0.59 (95% CI: 0.26-1.33) for four or more. The risk of colon cancer showed a significantly monotonic decrease with increasing number of children (P value for trend = 0.047). There was no association between the number of children and colon cancer risk among men. From these prospective data, having children may reduce risk of colon cancer among women, but not among men, suggesting that modifications of hormone profiles secondary to pregnancies may influence female colon cancer risk.

Serum phospholipid transfer protein mass as a possible protective factor for coronary heart diseases. Reviewed

Yatsuya H, Tamakoshi K, Hattori H, Otsuka R, Wada K, Zhang H, Mabuchi T, Ishikawa M, Murata C, Yoshida T, Kondo T, Toyoshima H

Circ J Vol. 68 ( 1 ) page： 11-16 2004.1

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Phospholipid transfer protein (PLTP) can generate pre-beta high-density lipoprotein (HDL), an efficient acceptor of peripheral cholesterol, by mediating a process called HDL conversion. The transfer of phospholipids to immature HDL is also essential in maintaining reverse cholesterol transport. The phospholipid transfer activity of PLTP has been associated with various patho-physiological conditions; however, little information is available concerning the relationship between PLTP mass and disease. METHODS AND RESULTS: Using a sandwich enzyme-linked immunosorbent assay, PLTP concentration was measured and related to the risk of developing cardiovascular disease in a worksite-based cohort of Japanese men (n=2,567). Multiple linear regression analysis showed significant associations between PLTP and HDL cholesterol, triglycerides, low-density lipoprotein cholesterol, and body mass index (standardized beta=0.395, -0.191, -0.064, and -0.064, respectively; R(2)=0.31). During the follow-up period, there were 10 cases of coronary heart disease (CHD) and 7 of stroke. The multivariate adjusted relative risk of CHD was 0.46 (95% confidence interval, 0.20-1.07) for an increase of 1 standard deviation in the PLTP value (p=0.071). PLTP concentration was not related to the risk of stroke. CONCLUSIONS: The results of this prospective study indicate that the serum PLTP concentration would serve as a predictor of CHD, independent of HDL cholesterol, triglycerides and other established risk factors.

Diet and colorectal cancer mortality: results from the Japan Collaborative Cohort Study. Reviewed

Kojima M, Wakai K, Tamakoshi K, Tokudome S, Toyoshima H, Watanabe Y, Hayakawa N, Suzuki K, Hashimoto S, Ito Y, Tamakoshi A; Japan Collaborative Cohort Study Group.

Nutr Cancer. Vol. 50 ( 1 ) page： 23-32 2004

Language：English Publishing type：Research paper (scientific journal)

The relationship between diet and colorectal cancer mortality was analyzed in a prospective study of 45,181 men and 62,643 women aged 40-79 yr enrolled in the Japan Collaborative Cohort Study. Between 1988 and 1990, subjects completed a self-administered questionnaire on their sociodemographic characteristics, diet, and other lifestyle habits. During the follow-up period (average 9.9 yr), 284 colon cancer deaths (138 men and 146 women) and 173 rectal cancer deaths (116 men and 57 women) were confirmed. The only significant association of colorectal cancer mortality with vegetable intake was observed between male rectal cancer mortality and green leafy vegetable consumption [hazard ratio (HR) using Cox proportional hazard models = 0.6; 95% confidence interval (CI) = 0.3-0.9; P for trend = 0.02]. Yogurt intake was also inversely associated with male rectal cancer mortality (HR = 0.5; 95% CI = 0.2-1.0; P for trend = 0.04). Egg consumption was positively associated with male colon cancer mortality (P for trend = 0.04). Women with high fruit consumption had increased colon cancer mortality (HR = 1.6; 95% CI = 1.0-2.6; P for trend = 0.04). It should be noted that this study lacked statistical power due to small sample size and measurement error in the food-frequency questionnaire. Further investigation is therefore necessary to confirm the association between diet and colorectal cancer, especially by subsites and gender.

肥満者における心血管疾患発症の過剰リスクを説明する新しい軸　血清レプチン値と白血球数の関連

八谷寛, 間淵智子, 大塚礼, 和田恵子, 長澤伸江, 張恵明, 村田千代栄, 石川美由紀, 堀容子, 近藤高明, 玉腰浩司, 豊嶋英明

Vol. 20 page： 19-25 2004

人間ドックの有効性と限界

玉腰浩司、八谷寛、豊嶋英明

総合臨床 Vol. 53 page： 2435-2338 2004

日本人男性における血清レプチン濃度と5年間追跡後の体重変化

八谷寛, 玉腰浩司, 大塚礼, 間淵智子, 和田恵子, 張恵明, 村田千代栄, 石川美由紀, 近藤高明, 豊嶋英明

健康医科学研究助成論文集 Vol. 19 page： 110-117 2004

肥満を伴った高脂血症患者に対する運動療法の効果に関する研究　行動医学的アプローチを用いた運動習慣の定着による動脈硬化促進要因の改善に関する研究

下光輝一, 井上茂, 小田切優子, 高波嘉一, 豊嶋英明, 八谷寛, 玉腰浩司, 近藤高明, 井口ちよ

医科学応用研究財団研究報告 Vol. 21 page： 215-223 2004

Long-term body weight variability is associated with elevated C-reactive protein independent of current body mass index among Japanese men. Reviewed

Tamakoshi K, Yatsuya H, Kondo T, Ishikawa M, Zhang H, Murata C, Otsuka R, Mabuchi T, Hori Y, Zhu S, Yoshida T, Toyoshima H.

Int J Obes Relat Metab Disord. Vol. 27 ( 9 ) page： 1059-1065 2003.9

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: To elucidate the effect of long-term weight variability on C-reactive protein (CRP) levels. DESIGN: Cross-sectional study of the circulating CRP. SUBJECTS: A total of 637 Japanese men aged 40-49 y in1997. MEASUREMENTS: Serum CRP levels, body mass index in 1997 (current BMI), the slope of weight on age (weight-slope) representing an individual's weight trend of direction and magnitude, and the root mean square error around the slope of weight on age (weight-RMSE) representing the weight fluctuation magnitude, as calculated by a simple linear regression model in which each value of the subject's five actual weights (aged 20, 25, 30 y, five years ago, and current) was a dependent variable and the subject's ages independent variables. RESULTS: After adjustment for age and confounders, including smoking and health status, the odds ratios of elevated CRP (> or =0.06 mg/dl) were 1.83 (95% CI: 1.25-2.69), 2.63 (1.69-4.11), and 10.31 (2.17-48.98) for upper normal-weight (BMI: 22-<25 kg/m(2)), overweight (25-<30), and obese (> or =30) persons, respectively, compared with lower normal-weight persons (18.5-<22). Adjusting for age, confounders, and current BMI, weight-slope was positively associated with CRP level especially among subjects with BMI> or =25 kg/m(2) (trend P<0.01), and weight-RMSE was positively associated with CRP level particularly among subjects with BMI <25 kg/m(2) (trend P<0.05). CONCLUSION: Our results suggest a state of low-grade systemic inflammation not only in overweight and obese persons, but also in normal-weight persons with large weight fluctuation, possibly explaining in part the positive association between weight fluctuation and CVD.

Association between weight fluctuation and fasting insulin concentration in Japanese men. Reviewed

Yatsuya H, Tamakoshi K, Yoshida T, Hori Y, Zhang H, Ishikawa M, Zhu S, Kondo T, Toyoshima H.

Int J Obes Relat Metab Disord. Vol. 27 ( 4 ) page： 478-483 2003.4

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: To investigate whether long-term weight fluctuation is associated with the fasting serum insulin concentration. DESIGN AND SUBJECTS: Weight histories of 1932 male Japanese workers aged 40-59 y were analyzed in relation to their current fasting serum insulin concentration. MEASUREMENTS: Individual weight fluctuation was calculated by root mean square error (RMSE) along the linear regression line of weight measured at five to six different ages. RESULTS: The mean RMSE and fasting insulin concentration were 1.22 kg and 4.5 microU/ml, respectively. The multivariate adjusted insulin level became higher with the increase in weight fluctuation. Subanalysis stratified by current body mass index (BMI) showed that the multivariate adjusted insulin level in individuals in the top quartile of fluctuation was 4.3 microU/ml, against 3.9 microU/ml in those in the bottom quartile (P=0.018, analysis of covariance (ANCOVA)) in the normal weight subgroup with current BMI below 25 kg/m(2). In the overweight subgroup with BMI 25 kg/m(2) or above, the level was 6.9 microU/ml in individuals in the top quartile and 6.2 microU/ml in those in the bottom quartile (P=0.054, ANCOVA). CONCLUSION: The results suggest that weight fluctuation increases the risk of developing hyperinsulinemia. Prospective observations together with measurement of changes in adiposity are needed for confirmation.

*The metabolic syndrome is associated with elevated circulating C-reactive protein in healthy reference range, a systemic low-grade inflammatory state. Reviewed

Tamakoshi K, Yatsuya H, Kondo T, Hori Y, Ishikawa M, Zhang H, Murata C, Otsuka R, Zhu S, Toyoshima H.

Int J Obes Relat Metab Disord. Vol. 27 ( 4 ) page： 443-449 2003.4

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: To elucidate the underlying mechanisms between C-reactive protein (CRP) and cardiovascular disease, we examined the association of circulating CRP in healthy reference range (< or =1.0 mg/dl) measured by high-sensitive CRP assay with the metabolic syndrome (MS). DESIGN: Cross-sectional study of circulating CRP in adult men. SUBJECTS: A total of 3692 Japanese men aged 34-69 y. MEASUREMENTS: Serum CRP, total cholesterol, triglycerides, LDL-cholesterol, fasting glucose, fasting insulin, uric acid, systolic blood pressure, diastolic blood pressure, and body mass index (BMI). RESULTS: There was a statistically significant positive correlation between CRP and BMI (r=0.25), total cholesterol (r=0.096), triglycerides (r=0.22), LDL-cholesterol (r=0.12), fasting glucose (r=0.088), fasting insulin (r=0.17), uric acid (r=0.13), systolic blood pressure (r=0.12), and diastolic blood pressure (r=0.11), and a significant negative correlation of CRP with HDL-cholesterol (r=0.24). After adjusting for age, smoking, and all other components of MS, obesity, hypertriglyceridemia, hyper-LDL-cholesterolemia, diabetes, hyperinsulinemia, and hyperuricemia were significantly associated with both mildly (> or =0.06 mg/dl) and moderately (> or =0.11 mg/dl) elevated CRP. Compared with men who had no such components of the MS, those who had one, two, three, four, and five or more components were, respectively, 1.48, 1.84, 1.92, 3.42, and 4.17 times more likely to have mildly elevated CRP levels (trend P<0.001). As for moderately elevated CRP, the same association was observed. CONCLUSIONS: These results indicate that a variety of components of the MS are associated with elevated CRP levels in a systemic low-grade inflammatory state.

U-shaped association between white blood cell count and fasting plasma glucose level. Reviewed

Tamakoshi K, Yatsuya H, Kondo T, Hori Y, Zhang H, Ishikawa M, Murata C, Otsuka R, Zhu S, Toyoshima H.

Diabetes Care. Vol. 26 ( 3 ) page： 950 2003.3

The accuracy of long-term recall of past body weight in Japanese adult men. Reviewed

Tamakoshi K, Yatsuya H, Kondo T, Hirano T, Hori Y, Yoshida T, Toyoshima H.

Int J Obes Relat Metab Disord. Vol. 27 ( 2 ) page： 247-252 2003.2

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: To examine the influences of recall period, current body weight, weight gain and loss, and weight variability on the accuracy of long-term recall of past weight. DESIGN AND SUBJECTS: Comparison of recalled weights around 25 y old with weights measured at age 25y in health checkup records among 2453 Japanese men (age: 34-61 y). MEASUREMENTS: Deviations between reported and measured weights were examined as to the three indexes: actual error (reported-measured), percent error (actual error/measured x 100), and absolute value of the percent error. Weight variability was defined as (1) the coefficient of variation of weight (CV) and (2) the root mean square error around the slope of weight on age (RMSE). RESULTS: Recalled weight strongly correlated with measured weight (r=0.849). Correlation coefficients decreased as age or the elapsed time since age 25y increased. Recalled weight (mean=58.3 kg) was slightly greater than measured weight at age 25y (mean=57.0 kg, mean actual error=1.28 kg). Subjects with a current body mass index (BMI) of less than 28.6 kg/m(2) overestimated their past weights, whereas those with BM1 of 28.6 kg/m(2) or over underestimated it. Subjects with weight loss since age 25y underestimated their past weights, whereas those with stable weight or gain overestimated it. There were monotonic increases in the three indexes of deviation across the CV quartile categories. Concerning the effect RMSE, a similar trend was observed. CONCLUSION: These results indicate that past body weights over a long period seem to be recalled with good accuracy. However, it should be kept in mind when using recalled weight in an epidemiologic study that accuracy of recall is influenced by age or elapsed time, current BMI, weight gain and loss, and weight variability.

Trends in the mortality (1950-1997) and incidence (1975-1993) of malignant ovarian neoplasm among Japanese women: analyses by age, time, and birth cohort. Reviewed

Tamakoshi K, Kondo T, Yatsuya H, Hori Y, Kikkawa F, Toyoshima H.

Gynecol Oncol. Vol. 83 ( 1 ) page： 64-71 2001.10

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: The purpose of this study was to explore epidemiological features of malignant ovarian neoplasm in Japan. METHODS: The number of deaths from malignant ovarian neoplasm was obtained from the national vital statistics. Estimated incidence rates, based on several cancer registries, were also used for analyses. We divided the subjects into two age groups (0-29 and 30+ years) and examined secular trends in mortality (1950-1997) and incidence (1975-1993) by age, time, and birth cohort. RESULTS: The age-adjusted mortality rate has increased approximately 4-fold (from 0.9 to 3.6 per 100,000 women) from 1950 to 1997. Age-specific mortality rates showed a rising pattern in the elderly, whereas mortality in the younger people tended to increase in the 1950s and 1960s, but then decreased in the 1970s and afterward. In analyses using a mathematical model, the time effect in the population aged 0-29 years increased with advancing period up to 1970, and then decreased. The cohort effects had positive values, which indicate higher than additive influence from age/time effect, for birth cohorts from 1900 to 1935. The age-adjusted incidence rate increased approximately 1.5-fold (from 3.6 to 5.7) from 1975 to 1993. The rate increased in the early 1980s, but has remained stable since the late 1980s. Age-specific incidence rates in older age groups increased steadily up to 1985, and have remained stable since, while the rates in younger women have remained almost unchanged. CONCLUSION: The major effects on malignant ovarian neoplasm in Japan are supposed to be due to declining parity and therapeutic improvements.

Clinical behavior of borderline ovarian tumors: a study of 150 cases. Reviewed

Tamakoshi K, Kikkawa F, Nakashima N, Tamakoshi A, Kawai M, Furuhashi Y, Hattori SE, Kuzuya K, Arii Y, Suganuma N, Tomoda Y.

J Surg Oncol. Vol. 64 ( 2 ) page： 147-152 1997.2

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: We evaluated the clinical features, treatment, and survival status of the patients with borderline ovarian tumors. METHODS: A retrospective review of the charts of 150 patients with borderline ovarian tumor registered at the Tokai Ovarian Tumor Study Group from January 1, 1980, to December 31, 1994, was conducted to obtain clinical and pathological information. RESULTS: In stage II and III disease, the numbers of patients with no residual tumor, residual tumor of <2 cm, 2-5 cm, and >5 cm were 9, 10, 3, and 3, respectively. The sizes of residual tumors and corresponding clinical response to chemotherapy were as follows: residual tumor of <2 cm, complete response (CR), 6 patients; no change (NC), 2; progressive disease (PD), 2; tumors 2-5 cm, NC, 1 patient, PD, 2; tumors >5 cm, PD, 3 patients. The survival for patients with residual tumor <2 cm was significantly better than for those with residual tumor from 2-5 cm and of >5 cm (P < 0.05). The survival for patients with stage II and III serous tumor was significantly longer than that for patients with stage II and III mucinous tumor (P < 0.05). CONCLUSION: In advanced borderline ovarian tumor, the prognosis of patients with gross residual tumor after initial surgery, and especially with mucinous tumor, was poor.

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Papers - TAMAKOSHI, Koji