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Article History

Received: 7 March 2026

Accepted: 1 June 2026

First Online: 8 June 2026

Declarations

:

: This study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Institutional Review Board of Hakodate Municipal Hospital (Approval No. 2025-319). The requirement for informed consent was waived due to the retrospective design with institutional opt-out.

: The requirement for consent to publish was waived due to the retrospective design, use of de-identified data, and institutional opt-out.

: The requirement for informed consent to participate was waived due to the retrospective design with institutional opt-out.

: During the preparation of this work, the authors used ChatGPT (OpenAI) in order to improve the English language expression, assist in structuring the manuscript, and generate Python scripts for statistical analysis. After using this tool/service, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.

: KH, KY, and IY have received honoraria for lectures and chairing from Mitsubishi Tanabe Pharma Corporation and Eisai Co., Ltd. IY has also received honoraria for lectures and chairing from Sanofi. The other authors report no relevant financial or non-financial competing interests to declare.