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Miyagi S, Kawagishi N, Kashiwadate T, Fujio A, Tokodai K, Hara Y, Nakanishi C, Kamei T, Ohuchi N, Satomi S. Relationship Between Bile Duct Reconstruction and Complications in Living Donor Liver Transplantation. Transplant Proc 2017; 48:1166-9. [PMID: 27320579 DOI: 10.1016/j.transproceed.2015.10.073] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 10/03/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVES In living donor liver transplantation (LDLT), the recipient bile duct is thin and short. Bile duct complications often occur in LDLT, with persistent long-term adverse effects. Recently, we began to perform microsurgical reconstruction of the bile duct. The purpose of this study was to investigate the relationship between bile duct reconstruction methods and complications in LDLT. METHODS From 1991 to 2014, we performed 161 LDLTs (pediatric:adult = 90:71; left lobe:right lobe = 95:66). In this study, we retrospectively investigated the initial bile duct complications in LDLT and performed univariate and multivariate analyses to identify the independent risk factors for complications. RESULTS The most frequent complication was biliary stricture (9.9%), followed by biliary leakage (6.8%). On univariate and multiple logistic regression analysis, the independent risk factors for biliary stricture were bile leakage (P = .0103) and recurrent cholangitis (P = .0077). However, there were no risk factors for biliary leakage on univariate analysis in our study. The reconstruction methods (hepaticojejunostomy or duct-to-duct anastomosis) and reconstruction technique (with or without microsurgery) were not risk factors for biliary stricture and leakage. CONCLUSION In this study, the most frequent complication of LDLT was biliary stricture. The independent risk factors for biliary stricture were biliary leakage and recurrent cholangitis. Duct-to-duct anastomosis and microsurgical reconstruction of the bile duct were not risk factors for biliary stricture and leakage.
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Tokodai K, Kawagishi N, Miyagi S, Nakanishi C, Hara Y, Fujio A, Kashiwadate T, Maida K, Goto H, Kamei T, Ohuchi N. The Significance of Screening for HLA Antibodies in the Long-Term Follow-up of Pediatric Liver Transplant Recipients. Transplant Proc 2017; 48:1139-41. [PMID: 27320574 DOI: 10.1016/j.transproceed.2015.12.081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 12/07/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Post-transplant donor-specific anti-HLA antibodies (DSA) reportedly have detrimental effects on the outcomes of organ transplantation. However, the prevalence of post-transplant DSA in the long term after pediatric liver transplantation remains unclear, and the significance of post-transplant DSA is unknown. The aim of this cross-sectional study was to determine the prevalence of and characteristics of patients with post-transplant DSA. MATERIALS AND METHODS Of the 84 pediatric liver transplant recipients who were followed up in the outpatient department of our institution, 34 patients with available HLA typing data were included after they or their parent(s) provided informed consent for DSA evaluations. Luminex single-antigen bead assays were performed, and a mean fluorescence intensity of ≥1000 was used as the cut-off for a positive reaction. RESULTS No class I DSA were detected, whereas class II DSA were detected in 11 patients (32%). There were no differences in age at transplantation, immunosuppressive drugs, or follow-up period between the DSA-positive and DSA-negative patients. The rate of positive pre-transplant complement-dependent cytotoxicity crossmatch was higher with class II DSA than without, although the difference was not statistically significant. CONCLUSIONS The utility of screening for class I DSA was insignificant in the long-term follow-up of pediatric liver transplant recipients. The prevalence of class II DSA was relatively high; therefore, screening for class II DSA might be justified, although a follow-up survey of the association between post-transplant class II DSA and the long-term clinical course needs to be conducted.
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Kamei T, Okuma Y, Sone R, Nagamata M, Hosomi Y. 535P High flow nasal cannula oxygen for respiratory failure in patients with airway obstruction due to primary lung cancer. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00693-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Kamei T, Okuma Y, Sone R, Nagamata M, Hosomi Y. 535P High flow nasal cannula oxygen for respiratory failure in patients with airway obstruction due to primary lung cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw599.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Miyagi S, Fujio A, Tokodai K, Hara Y, Nakanishi C, Goto H, Kamei T, Kawagishi N, Ohuchi N, Satomi S. Successful Case of Somatostatin Analog Stopping Gastrointestinal Bleeding, One of the Most Frequent Complications After Simultaneous Pancreas-kidney Transplantation: A Case Report. Transplant Proc 2016; 48:985-7. [PMID: 27234785 DOI: 10.1016/j.transproceed.2015.10.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 10/03/2015] [Indexed: 10/21/2022]
Abstract
OBJECT Pancreas transplantation has the highest surgical complication rate of all routinely performed organ transplantation procedures. The complications are not only caused by the pancreas itself but also occur due to issues with the transplant recipient. We report the case of a patient who experienced massive gastrointestinal bleeding after simultaneous pancreas-kidney transplantation (SPK), which was stopped successfully using somatostatin analog. PATIENTS AND METHODS The patient was a 45-year-old woman with diabetes mellitus type 1 who underwent SPK with enteric drainage. She had melena 5 days after SPK. RESULTS At first, we suspected that the melena was caused by the transplanted duodenum because of rejection and ischemic changes. The patient experienced severe bleeding 9 days after SPK. We quickly performed open surgery and inserted an endoscope from the recipient's ileum to investigate the transplanted duodenum. However, no bleeding source was found, including in the transplanted duodenum and the recipient's ileum end. We determined that the bleeding source was the recipient's ascending colon. We attempted to perform endovascular treatment but could not detect the source of the bleeding; therefore, we used somatostatin analog to let the blood vessels shrink and reduce pancreatic output. Thereafter, the function of the transplanted pancreas and kidney gradually recovered, and the recipient was discharged 154 days after SPK. CONCLUSION Gastrointestinal bleeding is a lethal complication and has several different causes, such as mucosal rejection, ischemic changes, and exocrine output of the pancreas graft. Somatostatin analog is one of the most acceptable treatments for patients who have gastrointestinal bleeding after SPK.
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Tokodai K, Kawagishi N, Miyagi S, Nakanishi C, Hara Y, Fujio A, Kashiwadate T, Maida K, Goto H, Kamei T, Ohuchi N. Poor Long-Term Outcomes of Adult Liver Transplantation Involving Elderly Living Donors. Transplant Proc 2016; 48:1130-3. [DOI: 10.1016/j.transproceed.2016.01.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 01/05/2016] [Accepted: 01/21/2016] [Indexed: 12/21/2022]
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Hjerpe A, Ascoli V, Bedrossian CWM, Boon ME, Creaney J, Davidson B, Dejmek A, Dobra K, Fassina A, Field A, Firat P, Kamei T, Kobayashi T, Michael CW, Önder S, Segal A, Vielh P. Guidelines for the Cytopathologic Diagnosis of Epithelioid and Mixed-Type Malignant Mesothelioma: a secondary publication. Cytopathology 2016; 26:142-56. [PMID: 26052757 DOI: 10.1111/cyt.12250] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2015] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To provide practical guidelines for the cytopathologic diagnosis of malignant mesothelioma. DATA SOURCES Cytopathologists with an interest in the field involved in the International Mesothelioma Interest Group (IMIG) and the International Academy of Cytology (IAC) contributed to this update. Reference material includes peer-reviewed publications and textbooks. RATIONALE This article is the result of discussions during and after the IMIG 2012 conference in Boston, followed by thorough discussions during the 2013 IAC meeting in Paris. Additional contributions have been obtained from cytopathologists and scientists who could not attend these meetings, with final discussions and input during the IMIG 2014 conference in Cape Town.
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Ito H, Kamei T, Odake S, Nakano M, Okeda R, Kohriki S, Kawachi J, Onders RP, Yoshii F. An Autopsy Case of Amyotrophic Lateral Sclerosis with Diaphragm Pacing. Intern Med 2016; 55:3511-3513. [PMID: 27904119 PMCID: PMC5216153 DOI: 10.2169/internalmedicine.55.7130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Respiratory insufficiency is a critical problem in amyotrophic lateral sclerosis (ALS) patients. We herein present the case of an autopsied patient with sporadic ALS who underwent diaphragm pacing (DP). The pathology showed several localized adhesions with a markedly atrophied diaphragm. A marked loss of motor neurons with Bunina bodies and phosphorylated TDP-43 positive inclusions was found in the spinal cord and primary motor cortex. Mild hyalinization and a few multinucleated giant cells were present around the electrode tracks in the diaphragm. However, no infiltration of inflammatory cells was detected. Our findings suggest that full-time DP might not cause severe damage to adjacent diaphragm tissue.
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Ariga H, Jingu K, Kamei T, Umezawa R, Nemoto K, Miyazaki S, Yoshioka T. Chemoradiation Therapy for Esophageal Cancer Did Not Decrease Survival During the Later Period Compared With Surgery Alone at More Than 10 Year Follow-up. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Shimizu M, Ohe M, Ono A, Nam Y, Takei S, Tsuda H, Irie T, Hibino M, Kamei T. [Case report: A case of diabetic chorea associated hyperviscosity without abnormal findings of magnetic resonance imaging]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2014; 103:3103-3105. [PMID: 25812343 DOI: 10.2169/naika.103.3103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Nonaka M, Okita Y, Kanemura Y, Goto H, Kamei T, Iwata R, Takeda J, Oshige H, Yoshimura K, Asai A. NT-27 * SURGICAL RESECTION OF THALAMIC MALIGNANT GLIOMA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou265.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Miyata G, Kato T, Kamei T, Nakano T, Abe S, Katsura K, Taniyama Y, Teshima J, Naoshima K, Takaya K, Nakagawa T, Zuguchi M, Yamada M, Sato A, Ohuchi N. LB019-SUN NUMERICAL BENCHMARKS TO QUANTIFY A PATIENT'S PHYSICAL RECOVERY AFTER SURGERY. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60597-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Nakano T, Miyata G, Kamei T, Naoshima K, Abe S, Katsura K, Taniyama Y, Teshima J, Ohuchi N. LB018-SUN EFFECTS OF LOW-CARBOHYDRATE ENTERAL NUTRITION ON STABILIZATION OF BLOOD SUGAR LEVELS AFTER ESOPHAGEAL SURGERY: A RANDOMIZED CONTROLLED TRIAL. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60596-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Khanitchaidecha W, Koshy P, Kamei T, Shakya M, Kazama F. Investigation of the effects of hydrogenotrophic denitrification and anammox on the improvement of the quality of the drinking water supply system. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2013; 48:1533-1542. [PMID: 23802162 DOI: 10.1080/10934529.2013.797249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A drinking water supply system operates at Chyasal (in the Kathmandu Valley, Nepal) for purifying the groundwater that has high levels of ammonium nitrogen (NH4-N). However, high NO3-N concentrations were seen in the water after treatment. To further improve the quality of the drinking water, two types of attached growth reactors were developed for the purification system: (i) a hydrogenotrophic denitrification (HD reactor) and (ii) a concurrent reactor with anammox and hydrogenotrophic denitrification (AnHD reactor). For the HD reactor fed by water containing NO3-N, the denitrification efficiency was high (95-98%) for all NO3-N feed rates (20-40 mg/L). The nitrite-nitrogen (NO2-N) and nitrate-nitrogen (NO3-N) concentrations in the effluent were ∼0.5 mg/L. On the other hand, the AnHD reactor fed with water containing NH4-N and NO2-N was operated under varying flow rates of H2(30-70 mL/min) and intermittent supply periods (1-2 h). The efficiency of the anammox process was found to increase with decreasing H2flow rates or with increasing intermittency of the H2supply, while the efficiency of denitrification decreased under these conditions. For the optimal condition of 1.5 h intermittent H2supply, the anammox and denitrification efficiencies of the AnHD reactor reached 80% and 42%, respectively, while the concentrations of both NH4-N and NO2-N in the effluent were <1.0 mg/L, and no NO3-N was detected. From the experimental results, it is clear that both HD and AnHD reactors can function as efficient and critical units of the water purification system.
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Kasahata N, Uchihara T, Nakamura A, Miyazawa Y, Kamei T. A 71-year-old woman with PSP-like symptoms. Brain Pathol 2012; 22:733-6. [PMID: 22925084 DOI: 10.1111/j.1750-3639.2012.00621.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Iida A, Hosono N, Sano M, Kamei T, Oshima S, Tokuda T, Nakajima M, Kubo M, Nakamura Y, Ikegawa S. Novel deletion mutations of OPTN in amyotrophic lateral sclerosis in Japanese. Neurobiol Aging 2012; 33:1843.e19-24. [DOI: 10.1016/j.neurobiolaging.2011.12.037] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 12/10/2011] [Accepted: 12/28/2011] [Indexed: 12/29/2022]
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Iida A, Hosono N, Sano M, Kamei T, Oshima S, Tokuda T, Kubo M, Nakamura Y, Ikegawa S. Optineurin mutations in Japanese amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2012; 83:233-5. [PMID: 21217154 DOI: 10.1136/jnnp.2010.234963] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Iida A, Takahashi A, Kubo M, Saito S, Hosono N, Ohnishi Y, Kiyotani K, Mushiroda T, Nakajima M, Ozaki K, Tanaka T, Tsunoda T, Oshima S, Sano M, Kamei T, Tokuda T, Aoki M, Hasegawa K, Mizoguchi K, Morita M, Takahashi Y, Katsuno M, Atsuta N, Watanabe H, Tanaka F, Kaji R, Nakano I, Kamatani N, Tsuji S, Sobue G, Nakamura Y, Ikegawa S. A functional variant in ZNF512B is associated with susceptibility to amyotrophic lateral sclerosis in Japanese. Hum Mol Genet 2011; 20:3684-92. [DOI: 10.1093/hmg/ddr268] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Iida A, Takahashi A, Deng M, Zhang Y, Wang J, Atsuta N, Tanaka F, Kamei T, Sano M, Oshima S, Tokuda T, Morita M, Akimoto C, Nakajima M, Kubo M, Kamatani N, Nakano I, Sobue G, Nakamura Y, Fan D, Ikegawa S. Replication analysis of SNPs on 9p21.2 and 19p13.3 with amyotrophic lateral sclerosis in East Asians. Neurobiol Aging 2011; 32:757.e13-4. [DOI: 10.1016/j.neurobiolaging.2010.12.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Revised: 12/11/2010] [Accepted: 12/21/2010] [Indexed: 11/29/2022]
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Kamei T, Hoshino G, Murata K, Toriumi Y. Antitumour effect of Phellinus baumii: three post-operative cases with cancer. ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.2042-7166.2003.tb04016.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ishigami H, Kitayama J, Kaisaki S, Kato M, Yamaguchi H, Otani K, Kamei T, Nagawa H. Gastrectomy in combination with S-1, intravenous, and intraperitoneal paclitaxel: A novel multidisciplinary treatment strategy for gastric cancer with peritoneal metastasis. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kamei T. [Is PAM an effective antidote for organophosphate poisoning? Pros: PAM (pralidoxime) is effective for acute poisoning of organophosphorus]. CHUDOKU KENKYU : CHUDOKU KENKYUKAI JUN KIKANSHI = THE JAPANESE JOURNAL OF TOXICOLOGY 2010; 23:31-35. [PMID: 20380319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Ishigami H, Kitayama J, Kaisaki S, Hidemura A, Kato M, Otani K, Kamei T, Soma D, Miyato H, Nagawa H. 6520 Weekly intravenous and intraperitoneal paclitaxel combined with S-1 for advanced gastric cancer with peritoneal metastasis. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71242-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ishigami H, Kitayama J, Kaisaki S, Hidemura A, Kato M, Otani K, Kamei T, Soma D, Miyato H, Yamashita H, Nagawa H. Phase II study of weekly intravenous and intraperitoneal paclitaxel combined with S-1 for advanced gastric cancer with peritoneal metastasis. Ann Oncol 2009; 21:67-70. [PMID: 19605503 DOI: 10.1093/annonc/mdp260] [Citation(s) in RCA: 173] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A phase II study to evaluate the efficacy and tolerability of weekly i.v. and i.p. paclitaxel (PTX) combined with S-1 was carried out in gastric cancer patients with peritoneal metastasis. PATIENTS AND METHODS Gastric cancer patients with peritoneal dissemination and/or cancer cells on peritoneal cytology were enrolled. PTX was administered i.v. at 50 mg/m(2) and i.p. at 20 mg/m(2) on days 1 and 8. S-1 was administered at 80 mg/m(2)/day for 14 consecutive days, followed by 7 days rest. The primary end point was the 1-year overall survival (OS) rate. Secondary end points were the response rate, efficacy against malignant ascites and safety. RESULTS Forty patients were enrolled, including 21 with primary tumors with peritoneal dissemination, 13 with peritoneal recurrence and six with positive peritoneal cytology only. The median number of courses was 7 (range 1-23). The 1-year OS rate was 78% (95% confidence interval 65% to 90%). The overall response rate was 56% in 18 patients with target lesions. Malignant ascites disappeared or decreased in 13 of 21 (62%) patients. The frequent grade 3/4 toxic effects included neutropenia (38%), leukopenia (18%) and anemia (10%). CONCLUSION Combination chemotherapy of i.v. and i.p. PTX with S-1 is well tolerated and active in gastric cancer patients with peritoneal metastasis.
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Ishigami H, Kitayama J, Kaisaki S, Hidemura A, Kato M, Otani K, Kamei T, Soma D, Miyato H, Yamashita H, Nagawa H. Phase II study of weekly intravenous and intraperitoneal paclitaxel combined with S-1 for advanced gastric cancer with peritoneal metastasis. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4542 Background: A phase II study to evaluate the efficacy and tolerability of weekly intravenous and intraperitoneal paclitaxel combined with S-1 was performed in gastric cancer patients with peritoneal metastasis. Methods: Gastric cancer patients with peritoneal dissemination and/or cancer cells on peritoneal cytology were enrolled. Paclitaxel was administered intravenously at 50 mg/m2 and intraperitoneally at 20 mg/m2 on days 1 and 8. S-1 was administered at 80 mg/m2/day for 14 consecutive days, followed by 7 days rest. The primary endpoint was the 1-year overall survival rate. Secondary endpoints were the response rate, efficacy against malignant ascites and safety. Results: Forty patients were enrolled, including 21 with primary tumors with peritoneal dissemination confirmed by staging laparoscopy, 13 with peritoneal recurrence, and 6 with positive peritoneal cytology only. The median number of courses administered was 7 (range 1–23). The 1-year overall survival rate was 78% (95% CI, 65–90%). The overall response rate was 56% (95% CI, 32–79%) in 18 patients with target lesions. Malignant ascites disappeared or decreased in 13 of 21 (62%) patients. The incidences of grade 3/4 hematological and non- hematological toxicities were 40% and 15%, respectively. The frequent grade 3/4 toxicities included neutropenia (38%), leukopenia (18%), anemia (10%), and nausea (8%). Catheter obstruction observed in one patient was the only complication related to the peritoneal access device or intraperitoneal infusion. There were no treatment-related deaths. Conclusions: Combination chemotherapy of intravenous and intraperitoneal paclitaxel with S-1 is well tolerated and active in gastric cancer patients with peritoneal metastasis. No significant financial relationships to disclose.
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