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Narui K, Satake T, Ishikawa T, Muto M, Tsunoda Y, Yamada A, Kawashima K, Uenaka N, Fujiwara Y, Oshi M, Adachi S, Suzuki C, Wada T, Yamamoto S, Tanabe M, Maegawa J, Endo I. Endoscopic mastectomy followed by immediate breast reconstruction with fat grafting for breast cancer. Breast Cancer 2024; 31:476-484. [PMID: 38512534 DOI: 10.1007/s12282-024-01561-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/24/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Although endoscopic mastectomy has been associated with good tolerance and enhanced patient satisfaction, limitations such as the implant or flap size for reconstruction with small incisions remain unresolved. Fat grafting (FG) can expand tissue volume with pinhole skin incisions. Herein, we evaluated the safety and efficacy of endoscopic mastectomy followed by immediate FG. METHODS Patients who underwent endoscopic mastectomy with immediate FG reconstruction from 2015 to 2021 were retrospectively evaluated to establish surgical outcomes and prognosis. RESULTS Twenty-three patients with clinical stage 0 or I breast cancer underwent unilateral endoscopic mastectomy with immediate FG. The median age was 45 years (41-55), and the median body mass index was 19.3 kg/m2 (15.8-26.6). Endoscopically performed procedures included skin-sparing mastectomies in 18 patients (78%) and nipple-sparing mastectomies in five patients (22%). The median procedure duration was 295 min (242-346). The median specimen weight was 133 g (71-334), and the median grafted fat volume was 200 mL (136-320). No patient required reoperation or additional procedures for complications. One patient experienced recurrence at a median follow-up of 56.1 months and underwent resection; the patient was alive without recurrence 54 months post-resection. CONCLUSION To the best of our knowledge, this is the first report of endoscopic mastectomy with immediate FG for reconstruction. When compared with other immediate autologous reconstructions, our strategy could minimize the skin incision and procedure duration, as well as limit complications. Further prospective investigations are needed to evaluate oncological safety, surgical outcomes, and patient satisfaction.
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Affiliation(s)
- Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan.
| | - Toshihiko Satake
- Department of Plastic, Reconstructive and Aesthetic Surgery, Toyama University Hospital, Toyama, Toyama, Japan
| | - Takashi Ishikawa
- Department of Breast Surgery and Oncology, Tokyo Medical University, Tokyo, Tokyo, Japan
| | - Mayu Muto
- Department of Plastic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Yui Tsunoda
- Department of Plastic Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Akimitsu Yamada
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Kei Kawashima
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Natsuki Uenaka
- Department of Breast Surgery and Oncology, Tokyo Medical University, Tokyo, Tokyo, Japan
| | - Yoshie Fujiwara
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Masanori Oshi
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | - Shoko Adachi
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Chiho Suzuki
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Tomoko Wada
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Shinya Yamamoto
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Mikiko Tanabe
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Jiro Maegawa
- Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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2
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Wang F, Numata K, Liang H, Tsuchiya H, Ruan L, Tanabe M, Bai X. Case Report: The value of contrast-enhanced ultrasound and contrast-enhanced computed tomography in the diagnosis of hepatic angiosarcoma. Front Oncol 2023; 13:1283544. [PMID: 38107062 PMCID: PMC10722152 DOI: 10.3389/fonc.2023.1283544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/10/2023] [Indexed: 12/19/2023] Open
Abstract
Background Enhanced imaging techniques have the overwhelming advantages of being noninvasive and sensitive enough to evaluate the microcirculation of lesions, thus making them accurate in the diagnosis of hepatic lesions. Unfortunately, there is very little research on and knowledge of the imaging features of a rare cancerous condition: hepatic angiosarcoma (HA). Case summary In this study, we retrospectively collected the data of six patients who underwent both contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT), and subsequently obtained a definitive histopathologic diagnosis of HA. We described the imaging appearances of HA by comparing CEUS and CECT images. Furthermore, we analyzed these imaging characteristics from the perspective of histopathology and tumorigenesis. The study included the largest number (six) of histopathologically confirmed HA patients who had received CEUS examinations to date. Conclusion By offering readers comprehensive knowledge of contrast imaging, especially CEUS, in the diagnosis of HA, our study may reduce misdiagnosis and further improve treatment options.
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Affiliation(s)
- Feiqian Wang
- Ultrasound Department, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Kazushi Numata
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Hua Liang
- Department of Pathology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Hiromi Tsuchiya
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Litao Ruan
- Ultrasound Department, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Mikiko Tanabe
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Xiaofang Bai
- Ultrasound Department, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
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3
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Suzuki C, Yamada A, Kawashima K, Sasamoto M, Fujiwara Y, Adachi S, Oshi M, Wada T, Yamamoto S, Shimada K, Ota I, Narui K, Sugae S, Shimizu D, Tanabe M, Chishima T, Ichikawa Y, Ishikawa T, Endo I. Clinicopathological Characteristics and Prognosis of Triple-Negative Apocrine Carcinoma: A Case-Control Study. World J Oncol 2023; 14:551-557. [PMID: 38022398 PMCID: PMC10681783 DOI: 10.14740/wjon1694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/12/2023] [Indexed: 12/01/2023] Open
Abstract
Background With a prevalence of only 1% among all breast cancers in Japan, apocrine carcinoma (AC) is a rare type of breast cancer, and its clinicopathological characteristics remain unclear. The aim of this study was to evaluate the characteristics and prognosis of AC, in relation to the presence or absence of androgen receptor (AR). Methods We conducted a retrospective multi-center case-control study (Yokohama Clinical Oncology Group (YCOG): YCOG1701 study) in Japan. A total of 53 patients were registered who were diagnosed with AC between 2000 and 2017 in YCOG-affiliated hospitals. Results The median age of the patients was 67 (43 - 94) years, and the median observation time was 6.1 years. Among the 53 cases, 24 had triple-negative pure AC (TN-PAC; AR-positive), whereas 29 had other types of AC (other-AC; estrogen receptor-positive and/or human epidermal growth factor receptor 2-positive or AR-negative). Tumor size was smaller (1.4 vs. 2.1 cm, P = 0.024) and metastasis occurred in fewer nodes (12.5% vs. 37.9%, P = 0.036) in the TN-PAC group than in the other-AC group. The number of patients who were administered perioperative adjuvant chemotherapy did not significantly differ between the two groups (TN-PAC/other-AC = 50.0%/55.2%, P = 0.525); however, there was no recurrence in the TN-PAC group, compared to five cases with relapse in the other-AC group. Conclusions AR-positive AC patients showed a favorable prognosis without adjuvant chemotherapy, even with the TN subtype. A clinical trial exploring the possibility of treatment de-escalation is anticipated.
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Affiliation(s)
- Chiho Suzuki
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
- Department of Breast Surgery, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa 238-8558, Japan
| | - Akimitsu Yamada
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
- Department of Breast Surgery, Chigasaki Municipal Hospital, Chigasaki, Kanagawa 253-0042, Japan
| | - Kei Kawashima
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa 232-0024, Japan
| | - Mahato Sasamoto
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Yoshie Fujiwara
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa 232-0024, Japan
| | - Shoko Adachi
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa 232-0024, Japan
| | - Masanori Oshi
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Tomoko Wada
- Department of Breast Surgery, Chigasaki Municipal Hospital, Chigasaki, Kanagawa 253-0042, Japan
- Department of Breast Surgery, Saiseikai Yokohama-shi Nanbu Hospital, Yokohama, Kanagawa 234-0054, Japan
| | - Shinya Yamamoto
- Department of Breast Surgery, Fujisawa City Hospital, Fujisawa, Kanagawa 251-8550, Japan
- Department of Breast Surgery, Yokohama Rosai Hospital, Yokohama, Kanagawa 222-0036, Japan
| | - Kazuhiro Shimada
- Department of Breast Surgery, Saiseikai Yokohama-shi Nanbu Hospital, Yokohama, Kanagawa 234-0054, Japan
- Department of Breast Surgery, Yokohama Municipal Citizen’s Hospital, Yokohama, Kanagawa 221-0855, Japan
| | - Ikuko Ota
- Department of Breast Surgery, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa 238-8558, Japan
| | - Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa 232-0024, Japan
| | - Sadatoshi Sugae
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
- Department of Breast Surgery, Fujisawa City Hospital, Fujisawa, Kanagawa 251-8550, Japan
| | - Daisuke Shimizu
- Department of Breast Surgery, Yokohama City Minato Red Cross Hospital, Yokohama, Kanagawa 231-8682, Japan
| | - Mikiko Tanabe
- Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Kanagawa 232-0024, Japan
| | - Takashi Chishima
- Department of Breast Surgery, Yokohama Rosai Hospital, Yokohama, Kanagawa 222-0036, Japan
- Department of Breast Surgery, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa 224-8503, Japan
| | - Yasushi Ichikawa
- Department of Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Takashi Ishikawa
- Department of Breast Surgery and Oncology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
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Azuma D, Kunisaki R, Yukawa T, Yaguchi K, Watanabe M, Shibui S, Nakamori Y, Toyoda J, Tanabe M, Maeda K, Inayama Y, Kimura H, Maeda S. Fulminant Amebic Enteritis in the Perinatal Period. Intern Med 2023; 62:2341-2348. [PMID: 36575014 PMCID: PMC10484775 DOI: 10.2169/internalmedicine.0839-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/15/2022] [Indexed: 12/28/2022] Open
Abstract
Pregnancy is a known risk factor for amebic enteritis, which develops into potentially fatal fulminant amebic enteritis in some cases. We describe a case of a 27-year-old non-immunosuppressed pregnant woman with fulminant amebic enteritis complicated with cytomegalovirus enteritis. She improved with intensive care and intravenous metronidazole and ganciclovir but eventually required subtotal colectomy for intestinal stenosis. It is difficult to diagnose amebic enteritis, especially in a non-endemic area. Amebic enteritis must be considered as a differential diagnosis for refractory diarrhea with bloody stools in women in the perinatal period, even those without immunosuppression.
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Affiliation(s)
- Daisuke Azuma
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Japan
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Japan
| | - Reiko Kunisaki
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Japan
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Japan
| | - Tatsu Yukawa
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Japan
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Japan
| | - Katsuki Yaguchi
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Japan
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Japan
| | - Mamoru Watanabe
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Japan
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Japan
| | - Shunsuke Shibui
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Japan
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Japan
| | - Yoshinori Nakamori
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Japan
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Japan
| | - Junya Toyoda
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Japan
| | - Mikiko Tanabe
- Department of Diagnostic Pathology, Yokohama City University Medical Center, Japan
| | - Koki Maeda
- Department of Diagnostic Pathology, Yokohama City University Medical Center, Japan
| | - Yoshiaki Inayama
- Department of Diagnostic Pathology, Yokohama City University Medical Center, Japan
| | - Hideaki Kimura
- Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Japan
| | - Shin Maeda
- Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Japan
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5
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Fujiyoshi MRA, Fujiyoshi Y, Gimpaya N, Bechara R, Jeyalingam T, Calo NC, Forbes N, Khan R, Atalla M, Toshimori A, Shimamura Y, Tanabe M, Mosko J, Inoue H, Grover S. A114 UNIFIED MAGNIFYING ENDOSCOPIC CLASSIFICATION (UMEC) FOR GASTROINTESTINAL LESIONS: A NORTH AMERICAN EDUCATION STUDY. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991233 DOI: 10.1093/jcag/gwac036.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Abstract
Background
Magnification endoscopy and magnification narrow-band imaging are image enhanced endoscopy technologies that may allow for the diagnosis of advanced neoplasia in the GI tract on the basis of imaging characteristics. Recently, the Unified Magnifying Endoscopic Classification (UMEC) has been developed, which unified the criteria for the esophagus, stomach, and colon. UMEC divides optical diagnosis into one of the three categories: non-neoplastic, intramucosal neoplasia, and deep submucosal invasive cancer.
Purpose
The objective of this study is to educate North American endoscopists on the use of the UMEC schema, and to ascertain performance of the UMEC framework among North American endoscopists.
Method
Using UMEC, five North American endoscopists (>1000 procedures) without prior training in magnifying endoscopy independently diagnosed previously collected endoscopic image set of the esophagus, stomach, and colon. The endoscopists were trained on the use of UMEC via an eleven-minute training video with exemplars of each element of UMEC from esophagus, stomach, and colon. All endoscopists were blinded to white-light and non-magnifying NBI findings as well as histopathological diagnosis. The diagnostic performance of UMEC was assessed while using the gold standard histopathology as a reference.
Result(s)
A total of 299 gastrointestinal lesions (77 esophagus, 92 stomach, and 130 colon) were assessed using UMEC. For esophageal squamous cell carcinoma, the sensitivity, specificity, and accuracy for all 5 endoscopists ranged from 65.2% (95% CI: 50.9–77.9) to 87.0% (95% CI: 75.3–94.6), 77.4% (95% CI: 60.9–89.6) to 96.8% (95% CI: 86.8–99.8), and 75.3% to 87.0%, respectively. For gastric adenocarcinoma, the sensitivity, specificity, and accuracy for all 5 endoscopists ranged from 94.9% (95% CI: 85.0–99.1) to 100%, 52.9% (95% CI: 39.4–66.2) to 92.2% (95% CI: 82.7–97.5), and 73.3% to 93.3%, respectively. For colorectal adenocarcinoma, the sensitivity, specificity, and accuracy for all 5 endoscopists ranged from 76.2% (95% CI: 62.0–87.3) to 83.3% (95% CI: 70.3–92.5), 89.7% (95% CI: 82.1–94.9) to 97.7% (95% CI: 93.1–99.6), and 86.8% to 90.7%, respectively.
Image
Conclusion(s)
UMEC is a simple and practical classification that can be used to introduce and educate endoscopists to magnification narrow-band imaging and optical diagnosis.
Please acknowledge all funding agencies by checking the applicable boxes below
CAG
Disclosure of Interest
M. R. A. Fujiyoshi Grant / Research support from: 2022 CAG/AbbVie Education Research Grant, Y. Fujiyoshi: None Declared, N. Gimpaya: None Declared, R. Bechara: None Declared, T. Jeyalingam: None Declared, N. Calo: None Declared, N. Forbes: None Declared, R. Khan: None Declared, M. Atalla: None Declared, A. Toshimori: None Declared, Y. Shimamura: None Declared, M. Tanabe: None Declared, J. Mosko: None Declared, H. Inoue: None Declared, S. Grover: None Declared
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Affiliation(s)
- M R A Fujiyoshi
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto , Toronto , Canada
- Digestive Diseases Center, Showa University Koto Toyosu Hospital , Tokyo , Japan
| | - Y Fujiyoshi
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto , Toronto , Canada
- Digestive Diseases Center, Showa University Koto Toyosu Hospital , Tokyo , Japan
| | - N Gimpaya
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto , Toronto , Canada
| | - R Bechara
- Division of Gastroenterology, Kingston General and Hotel Dieu Hospital, Queen's University , Kingston
| | - T Jeyalingam
- Division of Gastroenterology, University Health Network, University of Toronto , Toronto
| | - N C Calo
- Division of Gastroenterology, University of Ottawa , Ottawa
| | - N Forbes
- Division of Gastroenterology, University of Calgary , Calgary , Canada
| | - R Khan
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto , Toronto , Canada
| | - M Atalla
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto , Toronto , Canada
| | - A Toshimori
- Digestive Diseases Center, Showa University Koto Toyosu Hospital , Tokyo , Japan
| | - Y Shimamura
- Digestive Diseases Center, Showa University Koto Toyosu Hospital , Tokyo , Japan
| | - M Tanabe
- Digestive Diseases Center, Showa University Koto Toyosu Hospital , Tokyo , Japan
| | - J Mosko
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto , Toronto , Canada
| | - H Inoue
- Digestive Diseases Center, Showa University Koto Toyosu Hospital , Tokyo , Japan
| | - S Grover
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto , Toronto , Canada
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Yoshida T, Ogura G, Tanabe M, Hayashi T, Ohbayashi C, Azuma M, Kunisaki C, Akazawa Y, Ozawa S, Matsumoto S, Suzuki T, Mitoro A, Fukunaga T, Shimizu A, Fujimoto G, Yao T. Clinicopathological features of PD-L1 protein expression, EBV positivity, and MSI status in patients with advanced gastric and esophagogastric junction adenocarcinoma in Japan. Cancer Biol Ther 2022; 23:191-200. [PMID: 35220884 PMCID: PMC8890430 DOI: 10.1080/15384047.2022.2038002] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
This real-world study examined the prevalence of programmed death ligand-1 (PD-L1) expression and assessed the frequency of microsatellite instability-high (MSI-H) status and Epstein-Barr virus (EBV) positivity in Japanese patients with advanced gastric and gastroesophageal junction (GEJ) adenocarcinoma. This multicenter (5 sites), retrospective, observational study (November 2018–March 2019) evaluated Japanese patients with advanced gastric and GEJ adenocarcinoma after surgical resection (Stage II/III at initial diagnosis) or unresectable advanced cancer (Stage IV). The primary objectives were prevalence of PD-L1 expression (combined positive score [CPS] ≥1), MSI status, and EBV positivity. Tumor specimens of 389/391 patients were analyzed (male, 67.1%; mean age, 67.6 ± 12.2 years); 241/389 (62%) were PD-L1 positive, 24/379 (6.3%) had MSI-H tumors, and 13/389 (3.3%) were EBV positive. PD-L1 expression was higher in tumor-infiltrating immune cells than in tumor cells for lower CPS cutoffs. Among patients with MSI-H tumors and EBV-positive tumors, 19/24 (79.2%) and 9/13 (69.2%), respectively, were PD-L1 positive. A greater proportion of patients with MSI-H tumors (83.3% [20/24]) were PD-L1 positive than those with MSI-low/stable tumors (60.8% [216/355]; p = .0297); similarly, an association was observed between history of H pylori infection and PD-L1 expression. A higher proportion of patients with MSI-H tumors demonstrated PD-L1 expression with a CPS ≥10 (66.7% [16/24]) vs those with MSI-low/stable tumors (24.8% [88/355]; p < .0001). The prevalence of PD-L1 positivity among Japanese patients was comparable to that in previous pembrolizumab clinical trials and studies in gastric cancer. Particularly, higher PD-L1 expression was observed in MSI-H tumors.
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Affiliation(s)
- Tsutomu Yoshida
- Department of Pathology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Go Ogura
- Department of Pathology, Tokai University School of Medicine, Isehara, Japan
| | - Mikiko Tanabe
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Takuo Hayashi
- Department of Diagnostic Pathology, Main Hospital, Juntendo University, Tokyo, Japan
| | - Chiho Ohbayashi
- Department of Diagnostic Pathology, Nara Medical University, Kashihara, Japan
| | - Mizutomo Azuma
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Chikara Kunisaki
- Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Yoichi Akazawa
- Department of Gastroenterology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Soji Ozawa
- Department of Gastroenterological Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Sohei Matsumoto
- Department of Surgery, Nara Medical University, Kashihara, Japan
| | - Takayoshi Suzuki
- Division of Gastroenterology and Hepatology, Tokai University School of Medicine, Tokai University, Isehara, Japan
| | - Akira Mitoro
- Department of Gastroenterology, Nara Medical University, Kashihara, Japan
| | - Tetsu Fukunaga
- Department of Gastroenterology and Minimally Invasive Surgery, School of Medicine, Juntendo University, Tokyo, Japan
| | | | | | - Takashi Yao
- Department of Human Pathology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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7
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Takasaki A, Kurita T, Yanagisawa M, Ino A, Hiramatsu D, Ikmi A, Ito H, Kato T, Fukuoka S, Sugimoto T, Nakata T, Masuda J, Tanabe M, Kakimoto H, Dohi K. Impact of in-hospital medical management for COVID-19 pandemic on door-to-balloon time in patients with ST-elevation myocardial infarction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Delayed door-to-balloon (DTB) time and deterioration of in-hospital mortality during the coronavirus disease 2019 (COVID-19) pandemic have been reported. Little is known about the impact of changes in in-hospital medical management before primary percutaneous coronary intervention (PCI) for COVID-19 such as screening test (antigen or polymerase chain reaction (PCR) tests, chest CT for excluding the pneumoniae) and primary PCI under full personal protective equipment (PPE) on DTB time and in-hospital mortality.
Purpose
The purpose of this study was to evaluate the impact of in-hospital medical management for COVID-19 on DTB time and in-hospital mortality during COVID-19 pandemic period.
Methods
We compared DTB time and in-hospital mortality of 502 ST-elevation myocardial infarction (STEMI) patients during COVID-19 pandemic (February 2020 and January 2021) with 2035 STEMI patients before pandemic (February 2016 and January 2020) using date from Mie ACS registry, a retrospective and multicenter registry.
Results
The COVID-19 screening tests before primary PCI and/or primary PCI under full PPE was performed on 173/502 (34.5%) patients (antigen or PCR tests; 39 (7.8%), chest CT; 156 (31.3%), full PPE; 11 (2.2%)). These patients had lower rate of achievement of DTB time ≤90 min compared with others (Figure 1A). Moreover, In-hospital management of COVID-19 screening tests and/or primary PCI under full PPE was an independent factor of DTB time>90 min with odds ratio of 1.94 (95% confidential interval: 1.37–2.76, p<0.001). In addition, in-hospital mortality of those patients was higher compared with others (Figure 1B).
Conclusion
In-hospital medical management for COVID-19 screening tests before primary PCI and/or primary PCI under full PPE was the independent factor of DTB time>90 min. This study reinforces the need to focus efforts on shortening DTB time, while controlling the epidemic of infection.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - T Kurita
- Mie University Hospital , Tsu , Japan
| | | | - A Ino
- Ise City Red Cross Hospital, cardiology , Ise , Japan
| | - D Hiramatsu
- Matsusaka chuo general hospital , matsusaka , Japan
| | - A Ikmi
- Suzuka chuo general hospital , Suzuka , Japan
| | - H Ito
- Mie University Hospital , Tsu , Japan
| | - T Kato
- Mie prefectural general medical center , yokkaichi , Japan
| | - S Fukuoka
- mie chuo medical center , tsu , Japan
| | | | | | - J Masuda
- Mie prefectural general medical center , yokkaichi , Japan
| | - M Tanabe
- Mie University Hospital , Tsu , Japan
| | - H Kakimoto
- saiseikai matsusaka general hospital , matsusaka , Japan
| | - K Dohi
- Mie University Hospital , Tsu , Japan
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8
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Yazawa K, Takeda K, Sawada Y, Watanabe J, Sato T, Yamaguchi T, Sekikawa Z, Tanabe M, Kunisaki C, Endo I. [Long-Term Survival after Surgical Resection for Small Cell Neuroendocrine Carcinoma of the Gallbladder]. Gan To Kagaku Ryoho 2022; 49:473-477. [PMID: 35444140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A 60-year-old woman was not accompanied by any symptom. She had a gallstone which was identified 20 years prior. Ultrasonography performed by a local doctor revealed that the gallbladder was filled with small stones, and the patient was referred to our department for further examination and treatment for gallbladder stone. Tumor markers are elevated. Contrast- enhanced CT revealed gallbladder stones and thickening in the gallbladder body. PET-CT showed abnormal accumulation of FDG-PET with SUVmax 3.6 in the body of the gallbladder. With a diagnosis of gallbladder cancer, extended cholecystectomy and gallbladder bed resection with regional lymph node dissection were performed. The tumor was diagnosed histologically as small cell type neuroendocrine carcinoma of the gallbladder(pT2a[SS], pN0, pStage ⅡA; Japanese society of hepato-biliary-pancreatic surgery, the 7th edition). The postoperative course was uneventful. This patient has been followed up for 8 years without obvious signs of recurrence. R0 resection and lack of lymph node metastasis can allow long- term survival.
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Affiliation(s)
- Keiichi Yazawa
- Dept. of Surgery, Gastroenterological Center, Yokohama City University Medical Center
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9
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Suzuki C, Yamada A, Adachi S, Shima H, Kida K, Oshi M, Sugae S, Yamamoto S, Narui K, Tanabe M, Takabe K, Ichikawa Y, Ishikawa T, Endo I. Bromodomain-containing Protein 4 Is a Favourable Prognostic Factor in Breast Cancer Patients. Anticancer Res 2021; 41:3597-3606. [PMID: 34230156 DOI: 10.21873/anticanres.15148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 11/10/2022]
Abstract
AIM To evaluate the association between bromodomain-containing protein 4 (BRD4) expression and clinicopathological factors and prognosis in human breast cancer specimens. PATIENTS AND METHODS We used tissue microarrays constructed from samples of patients (n=183) who underwent surgery. We validated the association between BRD4 expression and prognosis in solid tumours, including breast cancer, using The Cancer Genome Atlas (TCGA) database. RESULTS Immunohistochemical staining showed that BRD4 was widely distributed in breast cancer tissues. BRD4 was strongly expressed in 19.7% of patients but BRD4 staining intensity was not correlated with other clinicopathological factors. Most importantly, patients with a strong BRD4 expression had a significantly longer disease-specific survival than those with a weak BRD4 expression (100.0% vs. 91.3% at 5 years, p=0.027). mRNA expression analysis showed similar results (91.2% vs. 80.2% at 6 years, p=0.047). CONCLUSION Strong BRD4 expression was associated with a significantly better prognosis in breast cancer tumours.
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Affiliation(s)
- Chiho Suzuki
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Akimitsu Yamada
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan;
| | - Shoko Adachi
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hidetaka Shima
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kumiko Kida
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masanori Oshi
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Division of Breast Surgery, Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, U.S.A
| | - Sadatoshi Sugae
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shinya Yamamoto
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Mikiko Tanabe
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kazuaki Takabe
- Division of Breast Surgery, Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, U.S.A
| | - Yasushi Ichikawa
- Department of Oncology, Yokohama City University Hospital, Yokohama, Japan
| | - Takashi Ishikawa
- Department of Breast Surgery and Oncology, Tokyo Medical University Hospital, Tokyo, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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10
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Uenaka N, Yamamoto S, Sato S, Kudo T, Adachi S, Narui K, Tanabe M, Yamada A, Ishikawa T, Endo I. Primary breast lymphoma initially diagnosed as invasive ductal carcinoma: A case report. Clin Case Rep 2021; 9:e04189. [PMID: 34194774 PMCID: PMC8222742 DOI: 10.1002/ccr3.4189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 01/23/2023] Open
Abstract
A malignant tumor in the breast may not be conclusive of breast cancer. It is important to keep the possibility of primary breast lymphoma in rare scenarios. For the diagnosis of primary breast lymphoma, immunohistochemical staining is necessary.
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Affiliation(s)
- Natsuki Uenaka
- Department of Breast and Thyroid SurgeryYokohama City University Medical CenterYokohamaJapan
- Department of Breast Surgery and OncologyTokyo Medical UniversityShinjuku‐kuJapan
| | - Shinya Yamamoto
- Department of Breast and Thyroid SurgeryYokohama City University Medical CenterYokohamaJapan
| | - Seiya Sato
- Department of Breast and Thyroid SurgeryYokohama City University Medical CenterYokohamaJapan
| | - Takamichi Kudo
- Department of Breast and Thyroid SurgeryYokohama City University Medical CenterYokohamaJapan
| | - Shoko Adachi
- Department of Breast and Thyroid SurgeryYokohama City University Medical CenterYokohamaJapan
| | - Kazutaka Narui
- Department of Breast and Thyroid SurgeryYokohama City University Medical CenterYokohamaJapan
| | - Mikiko Tanabe
- Department of PathologyYokohama City University Medical CenterYokohamaJapan
| | - Akimitsu Yamada
- Department of Gastroenterological SurgeryYokohama City University Graduate School of MedicineYokohamaJapan
| | - Takashi Ishikawa
- Department of Breast Surgery and OncologyTokyo Medical UniversityShinjuku‐kuJapan
| | - Itaru Endo
- Department of Gastroenterological SurgeryYokohama City University Graduate School of MedicineYokohamaJapan
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11
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Konishi T, Fujiogi M, Michihata N, Tanaka-Mizutani H, Morita K, Matsui H, Fushimi K, Tanabe M, Seto Y, Yasunaga H. Breast cancer surgery in patients with schizophrenia: short-term outcomes from a nationwide cohort. Br J Surg 2021; 108:168-173. [PMID: 33711128 DOI: 10.1093/bjs/znaa070] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/04/2020] [Accepted: 09/30/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Although patients with schizophrenia have a higher risk of developing breast cancer than the general population, studies that have investigated postoperative complications after breast cancer surgery in patients with schizophrenia are scarce. This study examined associations between schizophrenia and short-term outcomes following breast cancer surgery. METHODS Patients who underwent surgery for stage 0-III breast cancer between July 2010 and March 2017 were identified from a Japanese nationwide inpatient database. Multivariable analyses were conducted to compare postoperative complications and hospitalization costs between patients with schizophrenia and those without any psychiatric disorder. Three sensitivity analyses were performed: a 1 : 4 matched-pair cohort analysis with matching for age, institution, and fiscal year at admission; analyses excluding patients with schizophrenia who were not taking antipsychotic medication; and analyses excluding patients with schizophrenia who were admitted to hospital involuntarily. RESULTS The study included 3660 patients with schizophrenia and 350 860 without any psychiatric disorder. Patients with schizophrenia had a higher in-hospital morbidity (odds ratio (OR) 1.37, 95 per cent c.i. 1.21 to 1.55), with more postoperative bleeding (OR 1.34, 1.05 to 1.71) surgical-site infections (OR 1.22, 1.04 to 1.43), and sepsis (OR 1.20, 1.03 to 1.41). The total cost of hospitalization (coefficient €743, 95 per cent c.i. 680 to 806) was higher than that for patients without any psychiatric disorder. All sensitivity analyses showed similar results to the main analyses. CONCLUSION Although causal inferences remain premature, multivariable regression analyses showed that schizophrenia was associated with greater in-hospital morbidity and higher total cost of hospitalization after breast cancer surgery than in the general population.
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Affiliation(s)
- T Konishi
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.,Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - M Fujiogi
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - N Michihata
- Department of Health Services Research, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - H Tanaka-Mizutani
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - K Morita
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan.,Department of Health Services, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - H Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - K Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - M Tanabe
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Y Seto
- Department of Breast and Endocrine Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.,Department of Gastrointestinal Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - H Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
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12
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Yamamoto S, Narui K, Ishikawa T, Adachi S, Shimada K, Shimizu D, Yamada A, Sugae S, Tanabe M, Oba M, Morita S, Doi T, Hasegawa S, Morita T, Kito A, Chishima T, Ichikawa Y, Endo I. First-line Gemcitabine Versus Treatment of Physician's Choice for Metastatic Breast Cancer: A Prospective Cohort Study. Anticancer Res 2021; 41:1671-1676. [PMID: 33788764 DOI: 10.21873/anticanres.14930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM This study aimed to investigate the efficacy of first-line gemcitabine monotherapy for metastatic breast cancer (MBC) and its effect on health-related quality of life (HRQoL) compared with treatment of physician's choice (TPC). PATIENTS AND METHODS We enrolled 96 patients into the first-line gemcitabine group (n=47) or other treatment of physician's choice (TPC) group (n=49) from May 2010 to April 2013. HRQoL was evaluated every 4 weeks. RESULTS There was no significant difference in the median time to treatment failure (5.3 vs. 4.6 months, hazard ratio=0.87, p=0.546) and the incidence rates of grade 3/4 haematological toxicity (10.6% vs. 8.1%, p=0.677) and grade 3/4 non-haematological toxicity (4.2% vs. 8.1%, p=0.429) between the gemcitabine and TPC groups. Changes in HRQoL from baseline to 12 weeks were not significantly different. CONCLUSION Gemcitabine achieves similar efficacy and HRQoL benefit to other chemotherapy and can be used as first-line treatment for MBC.
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Affiliation(s)
- Shinya Yamamoto
- Yokohama City University Medical Center, Department of Breast and Thyroid Surgery, Yokohama, Japan
| | - Kazutaka Narui
- Yokohama City University Medical Center, Department of Breast and Thyroid Surgery, Yokohama, Japan;
| | - Takashi Ishikawa
- Yokohama City University Medical Center, Department of Breast and Thyroid Surgery, Yokohama, Japan
| | - Shoko Adachi
- Yokohama City University Medical Center, Department of Breast and Thyroid Surgery, Yokohama, Japan
| | - Kazuhiro Shimada
- Yokohama City University Medical Center, Department of Breast and Thyroid Surgery, Yokohama, Japan
| | - Daisuke Shimizu
- Yokohama City University Medical Center, Department of Breast and Thyroid Surgery, Yokohama, Japan
| | - Akimitsu Yamada
- Yokohama City University Graduate School of Medicine, Department of Gastroenterological Surgery, Yokohama, Japan
| | - Sadatoshi Sugae
- Yokohama City University Graduate School of Medicine, Department of Gastroenterological Surgery, Yokohama, Japan
| | - Mikiko Tanabe
- Yokohama City University Medical Center, Department of Pathology, Yokohama, Japan
| | - Mari Oba
- Yokohama City University Medical Center, Department of Biostatics and Epidemiology, Yokohama, Japan
| | - Satoshi Morita
- Kyoto University Graduate School of Medicine, Department of Biomedical Statistics and Bioinformatics, Kyoto, Japan
| | - Takako Doi
- Shonan Kinen Hospital, Breast Center, Kamakura, Japan
| | - Satoshi Hasegawa
- Saiseikai Yokohama-shi Nanbu Hospital, Department of Surgery, Yokohama, Japan
| | - Tomoyuki Morita
- Yokosuka Kyosai Hospital, Department of Surgery, Yokosuka, Japan
| | - Ayako Kito
- Yokohama Municipal Citizen's Hospital, Department of Breast Surgery, Yokohama, Japan
| | - Takashi Chishima
- Yokohama Rosai Hospital, Department of Breast Surgery, Yokohama, Japan
| | - Yasushi Ichikawa
- Yokohama City University Graduate School of Medicine, Department of Clinical Oncology, Yokohama, Japan
| | - Itaru Endo
- Yokohama City University Graduate School of Medicine, Department of Gastroenterological Surgery, Yokohama, Japan
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13
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Yamada A, Suzuki C, Shima H, Kida K, Adachi S, Yamamoto S, Narui K, Tanabe M, Shimizu D, Taniguchi R, Oshi M, Takabe K, Miyagi Y, Ichikawa Y, Ishikawa T, Endo I. Aldehyde Dehydrogenase 1-related Genes in Triple-negative Breast Cancer Investigated Using Network Analysis. Anticancer Res 2020; 40:6733-6742. [PMID: 33288566 DOI: 10.21873/anticanres.14696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/03/2020] [Accepted: 11/13/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Aldehyde dehydrogenase 1 (ALDH1) is known as a breast cancer stem cell (CSC) marker. This study aimed to identify genes associated with ALDH1. MATERIALS AND METHODS ALDH1-positive and -negative breast cancer cells were isolated using laser capture microdissection from five tissue samples of ALDH1-positive breast cancer patients. Messenger RNA expression levels were compared between ALDH1-positive and -negative cells. RESULTS We found 104 differentially expressed genes between ALDH1-positive and -negative cells. Gene ontology and pathway analysis revealed that these genes were correlated with CSC functions and pathways. Network analyses identified 10 genes that were closely associated with ALDH1. We validated these 10 genes utilizing The Cancer Genome Atlas and the Molecular Taxonomy of Breast Cancer International Consortium cohort, and found that they were associated with ALDH1 expression and correlated with Wnt pathway signaling. CONCLUSION The 10 genes we identified could be potential targets for CSC therapy of breast cancer.
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Affiliation(s)
- Akimitsu Yamada
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Kanagawa, Japan;
| | - Chiho Suzuki
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Hidetaka Shima
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Kumiko Kida
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Kanagawa, Japan
| | - Shoko Adachi
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Kanagawa, Japan
| | - Shinya Yamamoto
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Kanagawa, Japan
| | - Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Kanagawa, Japan
| | - Mikiko Tanabe
- Department of Pathology, Yokohama City University Medical Center, Kanagawa, Japan
| | - Daisuke Shimizu
- Department of Breast Surgery, Yokohama City Minato Red Cross Hospital, Kanagawa, Japan
| | | | - Masanori Oshi
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Kanagawa, Japan.,Division of Breast Surgery, Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, U.S.A
| | - Kazuaki Takabe
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Kanagawa, Japan.,Division of Breast Surgery, Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, U.S.A.,Department of Breast Disease, Tokyo Medical University Hospital, Tokyo, Japan
| | - Yohei Miyagi
- Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, Kanagawa, Japan
| | - Yasushi Ichikawa
- Department of Oncology, Yokohama City University, Kanagawa, Japan
| | - Takashi Ishikawa
- Department of Breast Disease, Tokyo Medical University Hospital, Tokyo, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
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14
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Narui K, Ishikawa T, Oba MS, Hasegawa Y, Kaise H, Kawate T, Yamada A, Yamada K, Suzuki Y, Niikura N, Kohno N, Kimoto T, Sugae S, Kosaka Y, Miyashita M, Okamura T, Shimizu D, Tanino H, Tanabe M, Morita S, Endo I, Tokuda Y. Prediction of pathological complete response after neoadjuvant chemotherapy in breast cancer by combining magnetic resonance imaging and core needle biopsy. Surg Oncol 2020; 35:447-452. [PMID: 33045629 DOI: 10.1016/j.suronc.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/22/2020] [Accepted: 10/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Pathological complete response (pCR) is often achieved by neoadjuvant chemotherapy (NAC), particularly in hormone receptor-negative breast cancer. Contrast-enhanced magnetic resonance imaging (cMRI) is the most reliable imaging modality to evaluate the pathological effect of NAC. Ultrasonography is indispensable to collect representative specimens from the target lesion by core needle biopsy (CNB). This study aimed to evaluate the accuracy of predicting pCR by adding CNB after NAC, in cases with complete clinical response (cCR) diagnosed by cMRI. METHODS In this prospective multicentre study, we evaluated patients diagnosed with cCR by cMRI after NAC. Ultrasound-guided CNB (uCNB) using a 14G needle was performed without clip markers under general anaesthesia as planned surgery. Specimens collected by uCNB were compared to those resected surgically and were categorized as (i) no carcinoma (ypT0), (ii) no invasive carcinoma and only residual carcinoma in situ (ypTis) and (iii) residual invasive carcinoma. The concordance of pathological results between the uCNB and surgical specimens was evaluated. RESULTS Of the 83 patients evaluated, 41 (49.4%) and 17 (20.5%) of them had ypT0 and ypTis, respectively. The false negative rates (FNR), sensitivity and specificity for predicting ypT0 by uCNB were 50.0%, 50.0%, 100%, respectively, and those for predicting ypT0+ypTis were 28.0%, 72.0% and 98.3%, respectively. The concordance rates were 74.7% (62/83) for ypT0 and 90.4% (75/83) for ypT0+ypTis. CONCLUSION In cCR cases diagnosed by cMRI, uCNB was not accurate enough to predict pCR. Additional modalities like clip placements and/or thicker core needles may be required for better prediction.
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Affiliation(s)
- Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Takashi Ishikawa
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan.
| | - Mari S Oba
- Department of Medical Statistics, Toho University, Tokyo, Japan
| | - Yoshie Hasegawa
- Department of Breast Surgery, Hirosaki Municipal Hospital, Hirosaki, Japan
| | - Hiroshi Kaise
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Takahiko Kawate
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Akimitsu Yamada
- Department of Gastroenterological Surgery, Yokohama City University, Yokohama, Japan
| | - Kimito Yamada
- Department of Breast Oncology and Surgery, Tokyo Medical University, Tokyo, Japan
| | - Yasuhiro Suzuki
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Naoki Niikura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Norio Kohno
- Department of Breast Surgery, Kobe Kaisei Hospital, Kobe, Japan
| | - Takeo Kimoto
- Department of Breast Surgery, Kobe Kaisei Hospital, Kobe, Japan
| | - Sadatoshi Sugae
- Department of Gastroenterological Surgery, Yokohama City University, Yokohama, Japan
| | - Yoshimasa Kosaka
- Department of Breast and Endocrine Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | | | - Takuho Okamura
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Daisuke Shimizu
- Department of Breast Surgery, Yokohama City Minato Red Cross Hospital, Yokohama, Japan
| | - Hirokazu Tanino
- Department of Breast and Endocrine Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Mikiko Tanabe
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University, Yokohama, Japan
| | - Yutaka Tokuda
- Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Isehara, Japan
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15
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Sato A, Tanabe M, Tsuboi Y, Ito Y, Akiyama F, Takahashi S, Murakami Y, Seto Y. PIK3CA mutations and predicting the therapeutic effects of neoadjuvant chemotherapy in primary breast cancer. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30720-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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16
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Wakabayashi T, Tanaka K, Shiozawa T, Takahashi Y, Tanabe M, Matsuo K. Liver regeneration after performing associating liver partition and portal vein occlusion for staged hepatectomy (ALPPS) is histologically similar to that occurring after liver transplantation using a small-for-size graft. Surg Today 2020; 51:374-383. [PMID: 32772152 DOI: 10.1007/s00595-020-02097-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can achieve marked future liver remnant (FLR) hypertrophy but this procedure is associated with a risk of mortality due to liver failure because of an insufficient FLR functional increase, a situation comparable to small-for-size syndrome (SFSS) after living-donor liver transplantation (LDLT). METHODS The clinical data, morphologic volume changes, and histopathologic and immunohistochemical findings in hepatocytes and bile ductules were compared between ALPPS (n = 10) and LDLT with a risk for SFSS (n = 12). RESULTS Although the patient characteristics and short-term outcome differed between the groups, the mean hypertrophy ratios with respect to liver volume for the FLR after performing the first-stage ALPPS procedures resembled those in small-for-size grafts after similar time intervals: 1.702 ± 0.407 in ALPPS vs. 1.948 ± 0.252 in LDLT (P = 0.205). The histologic grades for sinusoidal dilation (P = 0.896), congestion (P = 0.922), vacuolar change (P = 0.964), hepatocanalicular cholestasis (P = 0.969), and ductular reaction (P = 0.728) within the FLR at the second-stage operation during ALPPS or implanted graft were all similar between the groups. CONCLUSIONS The hepatic regenerative process may be similar in ALPPS and LDLT using a small-for-size graft. Reducing the hepatic vascular inflow that may be excessive for the FLR volume during the first stage of ALPPS might enhance the functional recovery since measures with a similar effect appear to lessen the likelihood of SFSS.
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Affiliation(s)
- Tetsuji Wakabayashi
- Department of General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, 227-8501, Japan
| | - Kuniya Tanaka
- Department of General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, 227-8501, Japan. .,Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Teikyo University Chiba Medical Center, Chiba, Japan. .,Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan.
| | - Toshimitsu Shiozawa
- Department of General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, 227-8501, Japan
| | - Yuki Takahashi
- Department of General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, 227-8501, Japan
| | - Mikiko Tanabe
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kenichi Matsuo
- Department of General and Gastroenterological Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, 227-8501, Japan.,Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Teikyo University Chiba Medical Center, Chiba, Japan.,Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
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Kimura M, Narui K, Shima H, Ikejima S, Muto M, Satake T, Tanabe M, Inayama Y, Adachi S, Yamada A, Shimada K, Sugae S, Ichikawa Y, Ishikawa T, Endo I. Development of an invasive ductal carcinoma in a contralateral composite nipple graft after an autologous breast reconstruction: a case report. Surg Case Rep 2020; 6:203. [PMID: 32770432 PMCID: PMC7415053 DOI: 10.1186/s40792-020-00962-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nipple-areola complex (NAC) reconstruction is a technique used in breast reconstructive surgery, which is performed during the final stage of breast reconstruction after total mastectomy of primary breast cancer. Composite nipple grafts utilizing the contralateral NAC are common; however, to our knowledge, there are no reports of new primary invasive ductal carcinoma development within the graft. Here, we describe one such case for the first time. CASE PRESENTATION A 54-year-old woman was referred to us by the Department of Plastic and Reconstructive Surgery in our medical center for further evaluation of right nipple erosion. She had undergone total mastectomy of the right breast following a breast cancer diagnosis 15 years ago, at which time tumor biological profiling revealed the following: estrogen receptor (ER), positive; progesterone receptor (PgR), negative; and human epidermal growth factor receptor 2 (HER2), undetermined. She received adjuvant chemotherapy and endocrine therapy. She defaulted endocrine therapy for a few years, and 7 years after surgery, she underwent autologous breast reconstruction with a deep inferior epigastric perforator (DIEP) flap. In the following year, NAC reconstruction was performed using a composite graft technique. Seven years after the NAC reconstruction, erosion appeared on the nipple grafted from its contralateral counterpart; scrape cytology revealed malignancy. The skin on the right side of her chest around the NAC and subcutaneous fat tissue consisted of transferred tissue from the abdomen, as the DIEP flap and grafted nipple were located on the graft skin. The right nipple carcinoma arose from the tissue taken from the left nipple. Magnetic resonance imaging (MRI) or computed tomography showed no malignant findings in the left breast. As the malignant lesion seemed limited to the area around the grafted right nipple on MRI, surgical resection with sufficient lateral and deep margins was performed around the right nipple. Pathological findings revealed invasive ductal carcinoma with comedo ductal components infiltrating the graft skin and underlying adipose tissue. Immunohistochemistry revealed positive for ER, PgR, and HER2. CONCLUSIONS To our knowledge, this is the first case involving the development of invasive ductal carcinoma in a nipple graft constructed on the skin of a DIEP flap, with the origin from the contralateral breast's nipple.
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Affiliation(s)
- Mariko Kimura
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan. .,Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | - Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Hidetaka Shima
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Shizune Ikejima
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Mayu Muto
- Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Toshihiko Satake
- Plastic and Reconstructive Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Mikiko Tanabe
- Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yoshiaki Inayama
- Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Shoko Adachi
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Akimitsu Yamada
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Kazuhiro Shimada
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan
| | - Sadatoshi Sugae
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yasushi Ichikawa
- Department of Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takashi Ishikawa
- Department of Breast Oncology and Surgery, Tokyo Medical University, Shinjuku, Tokyo, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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18
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Yamada A, Narui K, Satake T, Adachi S, Tanabe M, Shimizu D, Ishikawa T, Endo I. Long-Term Outcomes of Immediate Autologous Breast Reconstruction for Breast Cancer Patients. J Surg Res 2020; 251:78-84. [PMID: 32113041 DOI: 10.1016/j.jss.2020.01.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 01/08/2020] [Accepted: 01/16/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND There is limited information on the oncological outcomes of immediate autologous breast reconstruction in the Asian population. This study aimed to evaluate the oncological outcomes of immediate one-stage autologous breast reconstruction using a free perforator flap for breast cancer patients at a single institution in Japan. METHODS We retrospectively reviewed 239 patients who underwent immediate one-stage autologous breast reconstruction using a free perforator flap after skin- or nipple-sparing mastectomy. The whole breast was pathologically analyzed in 5-mm sections. Clinical and pathological data were collected from medical records. RESULTS For tumor stage among the 239 patients, 101 (42.3%) had stage 0, 127 (53.1%) had stage I and II, and 11 (4.6%) had stage III. Twenty-three patients (9.6%) had margin involvement in the surgical specimen. Adjuvant chemotherapy was performed in 75 patients (30%), and endocrine therapy was administered in 153 patients (64%). Radiation therapy was performed in 15 patients (6.3%) because of multiple lymph node metastases or margin involvement. With a median follow-up time of 73 mo, local recurrence was found in 3.3%, distant metastases in 2.5%, and contralateral breast cancer in 3.7%. All patients with local recurrence did not receive radiation therapy as adjuvant treatment. CONCLUSIONS Among the patients who underwent immediate one-stage autologous reconstruction after breast surgery, 3.3% had local recurrence. For patients with margin involvement, radiation therapy is a promising option.
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Affiliation(s)
- Akimitsu Yamada
- Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Kanazawa, Yokohama, Kanagawa, Japan; Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Minami, Yokohama, Kanagawa, Japan
| | - Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Minami, Yokohama, Kanagawa, Japan.
| | - Toshihiko Satake
- Department of Plastic Surgery, Yokohama City University Medical Center, Minami, Yokohama, Kanagawa, Japan
| | - Shoko Adachi
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Minami, Yokohama, Kanagawa, Japan
| | - Mikiko Tanabe
- Department of Pathology, Yokohama City University Medical Center, Minami, Yokohama, Kanagawa, Japan
| | - Daisuke Shimizu
- Department of Breast Surgery, Yokohama City Minato Red Cross Hospital, Naka, Yokohama, Kanagawa, Japan
| | - Takashi Ishikawa
- Department of Breast Surgery and Oncology, Tokyo Medical University, Shinjuku, Tokyo, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Kanazawa, Yokohama, Kanagawa, Japan
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19
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Morise Z, Aldrighetti L, Belli G, Ratti F, Belli A, Cherqui D, Tanabe M, Wakabayashi G. Laparoscopic repeat liver resection for hepatocellular carcinoma: a multicentre propensity score-based study. Br J Surg 2020; 107:889-895. [PMID: 31994182 DOI: 10.1002/bjs.11436] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/08/2019] [Accepted: 10/28/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND In the absence of randomized controlled data and even propensity-matched data, indications for, and outcomes of, laparoscopic repeat liver resection for hepatocellular carcinoma (HCC) remain uncertain. This study aimed to clarify the current indications for laparoscopic repeat liver resection for HCC, and to evaluate outcomes. METHODS Forty-two liver surgery centres around the world registered patients who underwent repeat liver resection for HCC. Patient characteristics, preoperative liver function, tumour characteristics, surgical method, and short- and long-term outcomes were recorded. RESULTS Analyses showed that the laparoscopic procedure was generally used in patients with relatively poor performance status and liver function, but favourable tumour characteristics. Intraoperative blood loss (mean(s.d.) 254(551) versus 748(1128) ml; P < 0·001), duration of operation (248(156) versus 285(167) min; P < 0·001), morbidity (12·7 versus 18·1 per cent; P = 0·006) and duration of postoperative hospital stay (10·1(14·3) versus 11·8(11·8) days; P = 0·013) were significantly reduced for laparoscopic compared with open procedures, whereas survival time was comparable (median 10·04 versus 8·94 years; P = 0·297). Propensity score matching showed that laparoscopic repeat liver resection for HCC resulted in less intraoperative blood loss (268(730) versus 497(784) ml; P = 0·001) and a longer operation time (272(187) versus 232(129); P = 0·007) than the open approach, and similar survival time (12·55 versus 8·94 years; P = 0·086). CONCLUSION Laparoscopic repeat liver resection is feasible in selected patients with recurrent HCC.
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Affiliation(s)
- Z Morise
- Department of General Surgery, Fujita Health University School of Medicine, Bantane Hospital, Aichi, Japan
| | - L Aldrighetti
- Hepatobiliary Division, Department of Surgery, San Raffaele Hospital, Milan, Italy
| | - G Belli
- Department of General and Hepatopancreatobiliary Surgery, Loreto Nuovo Hospital, Naples, Italy
| | - F Ratti
- Hepatobiliary Division, Department of Surgery, San Raffaele Hospital, Milan, Italy
| | - A Belli
- Department of Abdominal Surgical Oncology, Fondazione G. Pascale-Istituto di Ricovero e Cura a Carattere Scientifico, National Cancer Institute of Naples, Naples, Italy
| | - D Cherqui
- Hepatobiliary Centre, Paul Brousse Hospital, Villejuif, France
| | - M Tanabe
- Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - G Wakabayashi
- Department of Surgery, Ageo Central General Hospital, Ageo, Japan
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20
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Narui K, Ishikawa T, Shimizu D, Yamada A, Tanabe M, Sasaki T, Oba MS, Morita S, Nawata S, Kida K, Mogaki M, Doi T, Tsugawa K, Ogata H, Ota T, Kosaka Y, Sengoku N, Kuranami M, Niikura N, Saito Y, Suzuki Y, Suto A, Arioka H, Chishima T, Ichikawa Y, Endo I, Tokuda Y. Anthracycline could be essential for triple-negative breast cancer: A randomised phase II study by the Kanagawa Breast Oncology Group (KBOG) 1101. Breast 2019; 47:1-9. [DOI: 10.1016/j.breast.2019.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 05/25/2019] [Accepted: 06/10/2019] [Indexed: 01/16/2023] Open
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21
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Kawahara T, Takeshima T, Miyoshi Y, Nakaigawa N, Yao M, Tanabe M, Uemura H. Long-Term Control of Metastatic Renal Cell Carcinoma Using Pazopanib. Case Rep Oncol 2019; 12:543-547. [PMID: 31427949 PMCID: PMC6696783 DOI: 10.1159/000501716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 11/21/2022] Open
Abstract
COMPARZ study revealed no marked differences in terms of the progression free survival and overall survival between sunitinib and pazopanib treatment. Regarding the quality of life and early tumor shrinkage, pazopanib showed more favorable results than sunitinib treatment. A 70-year-old man underwent right nephrectomy in 2015. In 2017, iliac bone metastasis was found and consequently lung metastasis was developed. Pazopanib (200 mg × 4 tablets) was introduced. He showed no abnormal liver function markers during pazopanib treatment for more than two years and the size and number of lung metastases decreased. We herein report a case of successful control of metastatic renal cell carcinoma for more than two years using pazopanib treatment.
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Affiliation(s)
- Takashi Kawahara
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Tappei Takeshima
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Yasuhide Miyoshi
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Noboru Nakaigawa
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masahiro Yao
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Mikiko Tanabe
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Hiroji Uemura
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
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22
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Kawahara T, Mochizuki T, Sugimura R, Izumi K, Kuroda S, Miyoshi Y, Nakaigawa N, Yao M, Tanabe M, Uemura H. Successful Resection of Cisplatin-Resistant Renal Pelvic Cancer after the Administration of Pembrolizumab as Second-Line Therapy. Case Rep Oncol 2019; 12:548-553. [PMID: 31427950 PMCID: PMC6696768 DOI: 10.1159/000501715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 12/26/2022] Open
Abstract
Pembrolizumab has been used as a second-line systemic therapy for urothelial carcinoma. We herein report a case of cisplatin-resistant renal-pelvic urothelial carcinoma that was successfully resected after pembrolizumab treatment. A 74-year-old woman was referred to our hospital for further examination for gross hematuria and a renal-pelvis tumor. Retrograde pyelography showed a defect lesion in her renal pelvis and urinary cytology of the renal pelvis showed class V. Because staging CT could not deny lung metastasis, we planned to perform nephro-ureterectomy after evaluating the response to neoadjuvant chemotherapy. After three courses of gemcitabine and cisplatin chemotherapy, the original site showed progression; thus, nephro-ureterectomy was cancelled. We introduced pembrolizumab as a second-line therapy. After four courses of pembrolizumab treatment, the size of the original lesion was significantly decreased. During these therapies the lung tumor size was unchanged; thus, we determined that the lung tumor was not metastatic and performed nephro-ureterectomy. A pathological examination demonstrated that the tumor was completely resected with a negative surgical margin. We described the first case in which cisplatin-resistant renal pelvic tumor was successfully resected after pembrolizumab treatment.
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Affiliation(s)
- Takashi Kawahara
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Taku Mochizuki
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Rumiko Sugimura
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Koji Izumi
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Shinnosuke Kuroda
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Yasuhide Miyoshi
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Noboru Nakaigawa
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masahiro Yao
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Mikiko Tanabe
- Division of Diagnostic pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Hiroji Uemura
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
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23
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Kojima Y, Tanabe M, Kato I, Motoi T, Kimura M, Sawazumi T, Tanaka R, Chiba S, Otani M, Inayama Y. Myoepithelioma-like tumor of the vulvar region showing infiltrative growth and harboring only a few estrogen receptor-positive cells: A case report. Pathol Int 2019; 69:172-176. [PMID: 30737997 DOI: 10.1111/pin.12765] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 12/19/2018] [Indexed: 11/26/2022]
Abstract
Recently, a new entity "myoepithelioma-like tumor of the vulvar region (MELTVR)" was proposed as a rare mesenchymal neoplasm arising in vulvar regions of adult women. While MELTVRs morphologically resemble soft tissue myoepitheliomas and extraskeletal myxoid chondrosarcomas, they have a unique immunohistochemical profile (positive for epithelial membrane antigen and estrogen receptor, negative for S100 protein and glial fibrillary acidic protein, and loss of INI1/SMARCB1 expression), and lack EWSR1 and NR4A3 gene rearrangement, as seen by fluorescence in situ hybridization. MELTVRs are usually well-demarcated tumors, with no reports of extensive infiltrative growth. In the current report, we present an unusual case of MELTVR showing infiltrative growth and harboring only a few estrogen receptor-positive cells, which might indicate a variation in this rare tumor.
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Affiliation(s)
- Yui Kojima
- Department of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Mikiko Tanabe
- Department of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Ikuma Kato
- Department of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Toru Motoi
- Department of Pathology, Tokyo Metropolitan Cancer & Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Mariko Kimura
- Department of Breast & Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Tomoe Sawazumi
- Department of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Reiko Tanaka
- Department of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Sawako Chiba
- Department of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Masako Otani
- Department of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yoshiaki Inayama
- Department of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
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24
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Sugimura R, Kawahara T, Noguchi G, Takamoto D, Izumi K, Miyoshi Y, Kishida T, Yao M, Tanabe M, Uemura H. Clear cell adenocarcinoma of the prostatic urethra: A case report. IJU Case Rep 2018; 2:19-22. [PMID: 32743364 PMCID: PMC7292196 DOI: 10.1002/iju5.12028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 11/03/2018] [Indexed: 12/01/2022] Open
Abstract
Introduction Clear cell adenocarcinoma of the prostatic urethra in men is an extremely rare disease, with only eight case reports published. Case presentation A 56‐year‐old man visited our hospital for gross hematuria. Urinary cytology detected class V, cystoscopy showed no abnormal findings, and contrast‐enhanced computed tomography also showed no abnormal findings in his upper urinary tract except for a low‐enhancement lesion on his left prostate lobe. Magnetic resonance imaging revealed a cystic lesion surrounding the prostate that was suspected of being urethral or prostate cancer, so transurethral resection was performed. A papillary tumor was detected at the prostatic urethra, and after resecting this tumor, a cavity showing multiple tumors was observed. The final pathological diagnosis was clear cell adenocarcinoma. Laparoscopic radical cystectomy and urethrectomy were thus performed. The pathological diagnosis was the same as at the primary tumor site. Conclusion We herein report a case of clear cell adenocarcinoma of the prostatic urethra.
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Affiliation(s)
- Rumiko Sugimura
- Departments of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan
| | - Takashi Kawahara
- Departments of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan.,Department of Urology Yokohama City University Graduate School of Medicine Yokohama Japan
| | - Go Noguchi
- Department of Urology Kanagawa Cancer Center Yokohama Japan
| | - Daiji Takamoto
- Departments of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan
| | - Koji Izumi
- Departments of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan
| | - Yasuhide Miyoshi
- Departments of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan
| | | | - Masahiro Yao
- Department of Urology Yokohama City University Graduate School of Medicine Yokohama Japan
| | - Mikiko Tanabe
- Division of Diagnostic Pathology Yokohama City University Medical Center Yokohama Kanagawa Japan
| | - Hiroji Uemura
- Departments of Urology and Renal Transplantation Yokohama City University Medical Center Yokohama Japan
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25
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Uemura K, Kawahara T, Ishida H, Nakaigawa N, Tanabe M, Yao M, Uemura H. Sarcomatoid Variant of Bladder Carcinoma: A Case Report. Case Rep Oncol 2018; 11:633-637. [PMID: 30323753 PMCID: PMC6180258 DOI: 10.1159/000492779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 07/30/2018] [Indexed: 11/22/2022] Open
Abstract
A 59-year-old man was referred to our hospital complaining of asymptomatic gross hematuria. Cystoscopy revealed a papillary tumor 8 cm in diameter filling the bladder. The patient underwent transurethral resection of the bladder tumor. The pathological findings revealed the sarcomatoid variant of urothelial carcinoma with a heterologous osteosarcomatous element. He had no metastasis according to our imaging analyses; thus, we planned radical cystectomy after two courses of neoadjuvant chemotherapy (gemcitabine and cisplatin). Following chemotherapy, enlarged pelvic lymph nodes were noted, and extremely aggressive local progression of the bladder tumor was confirmed. The patient ultimately died 6 months after his initial visit to our hospital.
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Affiliation(s)
- Koichi Uemura
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Takashi Kawahara
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan.,Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroaki Ishida
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Noboru Nakaigawa
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Mikiko Tanabe
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Masahiro Yao
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroji Uemura
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
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26
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Horimoto Y, Terao T, Tsutsumi Y, Tanabe M, Mogushi K, Arakawa A, Sonoue H, Saito M. Elucidation of frequent HER2 overexpression in ductal carcinoma in situ. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30618-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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27
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Iwamoto G, Kawahara T, Tanabe M, Ninomiya S, Takamoto D, Mochizuki T, Kuroda S, Takeshima T, Izumi K, Hattori Y, Teranishi JI, Yumura Y, Miyoshi Y, Uemura H. Paraganglioma in the bladder: a case report. J Med Case Rep 2017; 11:306. [PMID: 29084607 PMCID: PMC5663097 DOI: 10.1186/s13256-017-1473-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 09/24/2017] [Indexed: 11/23/2022] Open
Abstract
Background Paraganglioma is an extra site of pheochromocytoma. Paraganglioma in the bladder is a very rare disease accounting for 0.06% of all bladder tumors. Case presentation A 77-year-old Japanese man was referred to our department for the further examination of a bladder tumor detected on preoperative computed tomography of his gastric cancer. Cystoscopy revealed a submucosal tumor in the upper area of his bladder, so transurethral resection of the bladder tumor was performed. During transurethral resection of the bladder tumor, his blood pressure sharply increased, and a pathological examination showed paraganglioma in his bladder. Postoperative I-123-metaiodobenzylguanidine scintigraphy detected a higher intake of his bladder tumor. Laboratory examinations showed a slightly increased noradrenaline level of 530 pg/ml and reduced platelet count at 167,000/μL. Based on the progression of his gastric cancer, no additional therapy was performed on his bladder tumor. Eight months after surgery, he died from aspiration pneumonitis. Conclusions Here we report a rare case of paraganglioma in the bladder. We discuss paraganglioma based on previous studies.
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Affiliation(s)
- Genta Iwamoto
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Takashi Kawahara
- Departments of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan.
| | - Mikiko Tanabe
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Sahoko Ninomiya
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Daiji Takamoto
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Taku Mochizuki
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Shinnosuke Kuroda
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Teppei Takeshima
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Koji Izumi
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yusuke Hattori
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Jun-Ichi Teranishi
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yasushi Yumura
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yasuhide Miyoshi
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Hiroji Uemura
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
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Sakuta K, Sato T, Tanabe M, Higa H, Ikeda M, Matsuno H, Komatsu T, Sakai K, Terasawa Y, Omoto S, Mitsumura H, Toyoda C, Iguchi Y. The NAG scale: A noble predictive scale for hematoma expansion in non-severe intracerebral hemorrhage patients. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Matsuno S, Yamane M, Muramatsu T, Okamura A, Kashima Y, Sakurada M, Kijima M, Tanabe M, Mutoh M, Habara M. P4220Feasibility of contemporary percutaneous coronary intervention for chronic total occlusion in chronic kidney disease patients: sub-analysis of Japanese multicenter registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S. Matsuno
- Cardiovascular Institute, Dept. of Cardiovascular Medicine, Tokyo, Japan
| | - M. Yamane
- Saitama Sekishinkai Hospital, Cardiology Department, Saitama, Japan
| | - T. Muramatsu
- Tokyo General Hospital, Cardiovascular Center, Tokyo, Japan
| | - A. Okamura
- Sakurabashi-Watanabe Hospital, Division of Cardiology, Osaka, Japan
| | - Y. Kashima
- Sapporo CardioVascular Clinic, Division of Cardiology, Hokkaido, Japan
| | - M. Sakurada
- Tokorozawa Heart Center, Dept. of Cardiology, Saitama, Japan
| | - M. Kijima
- Hoshi General Hospital, Cardiology and Vascular Medicine, Fukushima, Japan
| | - M. Tanabe
- Kyoto Okamoto Memorial Hospital, Dept. of Cardiology, Kyoto, Japan
| | - M. Mutoh
- Saitama Prefecture Cardiovascular and Respiratory Center, Division of Cardiology, Saitama, Japan
| | - M. Habara
- Toyohashi Heart Center, Dept. of Cardiology, Aichi, Japan
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Katoh H, Yamane M, Muramatsu T, Okamura A, Kashima Y, Matsuno S, Sakurada M, Kijima M, Tanabe M, Habara M. P4222Examination of chronic total occlusion cases who were switched to antegrade approach after failure of retrograde procedure from the Japanese Retrograde Summit Registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ishikawa T, Narui K, Oba MS, Yamada A, Kida K, Tanabe M, Ichikawa Y. Abstract 1767: Analysis of biomarkers and anthracycline benefit for hormone receptor-negative breast cancer: results from a randomized phase 2 neoadjuvant study (KBOG 1101 Study). Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-1767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
AIM: We compared 6 cycles of docetaxel and cyclophosphamide (TC6) with 3 cycles of 5-fluorouracil and epirubicin and cyclophosphamide followed by 3 cycles of docetaxel (FEC-D) as neoadjuvant chemotherapy for patients with hormone receptor (HR)-negative breast cancer (BC) to identify biomarkers requiring anthracycline treatment.
Methods: In total, 103 patients with operable HR-negative BC were administered TC6 or FEC-D. Triple-negative BC was subdivided by CK5/6 and EGFR into basal- and non-basal BCs. The primary endpoint was pathological complete response (pCR). Secondary endpoints were safety, breast-conserving surgery ratio, disease-free survival, overall survival, and predictive factors (Ki-67, P-53, ALDH1 and TOP2A by IHC and TOP2A by FISH) for each regimen.
Results: Of the 103 patients, 97 completed the study. Overall pCR was higher for patients treated with FEC-D (36%) than for those treated with TC6 (25.5%) (P=0.265). FEC-D was significantly superior to TC6 in basal BC (42.9% vs 13.6%; P=0.033), while no differences in HER2 and non-basal BCs. Aldehyde dehydrogenase 1 (ALDH1) positivity was inversely associated with pCR for both regimens, significantly for FEC-D (FEC-D: p=0.047, TC6: p=0.085). Patients who achieved pCR tended to have longer DFS (P = 0.287) and OS (P = 0.069). Patients with basal and non-basal BC treated with FEC-D had significantly better DFS (P = 0.016) and OS (P = 0.034) than those with TC6.
Conclusion: We found TC6 was less effective than FEC-D for HR-negative BC because it was not sufficient to treat basal-BC. This suggests that DNA damaging agents like anthracyclines are required for treating basal-BC. Additionally, ALDH1 could be a marker for resistance to conventional chemotherapy.
Citation Format: Takashi Ishikawa, Kazutaka Narui, Mari S. Oba, Akimitsu Yamada, Kumiko Kida, Mikiko Tanabe, Yasushi Ichikawa. Analysis of biomarkers and anthracycline benefit for hormone receptor-negative breast cancer: results from a randomized phase 2 neoadjuvant study (KBOG 1101 Study) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 1767. doi:10.1158/1538-7445.AM2017-1767
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Affiliation(s)
| | - Kazutaka Narui
- 2Yokohama City University Medical Center, Yokohama, Japan
| | - Mari S. Oba
- 2Yokohama City University Medical Center, Yokohama, Japan
| | | | - Kumiko Kida
- 2Yokohama City University Medical Center, Yokohama, Japan
| | - Mikiko Tanabe
- 2Yokohama City University Medical Center, Yokohama, Japan
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Shimazu M, Kato Y, Kawachi S, Tanabe M, Hoshino K, Wakabayashi G, Kitagawa Y, Kitajima M. Impact of Portal Hemodynamic Changes in Partial Liver Grafts on Short-Term Graft Regeneration in Living Donor Liver Transplantation. Transplant Proc 2017; 48:2747-2755. [PMID: 27788812 DOI: 10.1016/j.transproceed.2016.06.053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 05/20/2016] [Accepted: 06/22/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Regeneration of partial liver grafts is critical for successful living donor liver transplantation (LDLT), especially in adult recipients. The purpose of this study was to investigate the intraoperative hemodynamic changes in partial liver grafts and characterize their potential impact on post-transplant liver regeneration in LDLT. METHODS We examined the portal venous flow (PVF) and hepatic arterial flow (HAF) to partial liver grafts by means of ultrasonic transit time flowmeter of donors immediately before graft retrieval and of the corresponding recipients after vascular reconstruction in 48 LDLT cases. We evaluated post-transplant liver regeneration according to the changes in graft liver volume between the time of transplantation and the 7th post-transplant day. RESULTS There was a significant increase in PVF to the partial liver grafts in recipients (rPVF) compared with that in donors. In contrast, graft HAF in recipients significantly decreased compared with that in donors. The rPVF inversely correlated with graft weight (GW)-recipient body weight ratio (GRWR), whereas HAF volume showed no significant correlation. The rPVF/GW positively correlated with the rate of liver regeneration (GRR), which inversely correlated with GRWR. The rPVF/GW was significantly higher, and GRR tended to be larger in the small graft group than in the non-small graft group. CONCLUSIONS Intraoperative portal hemodynamic changes in partial liver grafts strongly affect their post-transplant regeneration. In particular, in small liver grafts, an immediate and remarkable increase in graft PVF may contribute to rapid liver regeneration after LDLT if the increased PVF remains within a safe range.
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Affiliation(s)
- M Shimazu
- Department of Surgery, School of Medicine, Keio University, Tokyo, Japan; Department of Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
| | - Y Kato
- Department of Surgery, Fujita Health University, Aichi, Japan
| | - S Kawachi
- Department of Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - M Tanabe
- Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - K Hoshino
- Department of Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - G Wakabayashi
- Department of Surgery, Ageo Central General Hospital, Saitama, Japan
| | - Y Kitagawa
- Department of Surgery, School of Medicine, Keio University, Tokyo, Japan
| | - M Kitajima
- International University of Health and Welfare, Tokyo, Japan
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Tanabe M, Niwa K, Kinoshita K. Absolute optical responsivity down to the photon counting level with a photomultiplier tube. Rev Sci Instrum 2017; 88:043104. [PMID: 28456233 DOI: 10.1063/1.4979812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A novel method is presented for evaluation of the absolute optical responsivity of a photomultiplier tube (PMT) at optical powers down to the photon counting level under visible light. This method is based on a combination of the calibrated responsivity and nonlinearity corrections using a silicon photodiode and a PMT. The evaluation results with the PMT enable accurate determination of the absolute optical responsivity over a wide power range of 10-11 W to 10-16 W under visible light. This method provides validation of both the photon counting efficiency of a PMT and of accurate optical measurement with attenuators at the photon counting level.
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Affiliation(s)
- M Tanabe
- National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology, Umesono 1-1-1, Tsukuba, Ibaraki 3058563, Japan
| | - K Niwa
- National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology, Umesono 1-1-1, Tsukuba, Ibaraki 3058563, Japan
| | - K Kinoshita
- National Metrology Institute of Japan, National Institute of Advanced Industrial Science and Technology, Umesono 1-1-1, Tsukuba, Ibaraki 3058563, Japan
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Narui K, Ishikawa T, Shimizu D, Tanabe M, Sasaki T, Oba MS, Morita S, Nawata S, Kida K, Mogaki M, Doi T, Tsugawa K, Ogata H, Ota T, Kosaka Y, Sengoku N, Kuranami M, Saito Y, Suzuki Y, Suto A, Arioka H, Chishima T, Ichikawa Y, Endo I, Tokuda Y. Abstract P5-16-04: A randomized phase II neoadjuvant study comparing docetaxel and cyclophosphamide (TC) with 5-fluorouracil, epirubicin, and cyclophosphamide followed by docetaxel (FEC-D) for hormone receptor-negative breast cancer: The Kanagawa breast oncology group (KBOG) 1101 study. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-16-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: This study aimed to evaluate response to neoadjuvant chemotherapy (NAC) for patients with hormone receptor-negative (HR-negative) breast cancer (BC) to identify subtypes that require anthracycline treatment.
Methods: In total, 103 patients with operable HR-negative BC were registered. They were randomely assigned to administration of 6 cycles of docetaxel (75mg/m2) and cyclophosphamide (600 mg/m2) (TC6) or 3 cycles of 5-fluorouracil (500 mg/m2), epirubicin (100mg/m2), and cyclophosphamide (500mg/m2) followed by 3 cycles of docetaxel (100mg/m2) (FEC-D). Cytokeratin (CK) 5/6 and EGFR expression were used to identify basal and non-basal triple-negative (TN) BC. The primary endpoint was pathological complete response (pCR); secondary endpoints were safety, breast-conserving surgery, disease-free survival, and overall survival. Predictive factors of pCR for each regimen were also evaluated.
Results:
The pCR rate was 36% for FEC-D and 25.5% for TC6, which did not differ significantly (P=0.265). When TN BC was subdivided into basal and non-basal subtypes, the pCR rate in the basal subtype was significantly lower for TC6 (13.6%) than for FEC-D (42.9%) (P=0.033), but did not significantly differ in the non-basal (TC6, 36.4%; FEC-D, 25.0%) and HER2-positive (TC6, 41.7%; FEC-D, 35.7%) cases.
The relative dose intensities of epirubicin and docetaxel in FEC-D and docetaxel in TC6 were 96.3±13.0%, 93.5±14.6%, and 93.9±16.3% (mean±SD), respectively. Occurrence of grade ≥2 adverse events was significant in FEC-D-treated patients. Poor appetite (P<0.001), nausea (P<0.001), vomiting (P<0.001), dysgeusia (P=0.03), and fatigue (P=0.05) were significantly more common for FEC-D than TC6. Patients treated with FEC-D experienced significantly more febrile neutropenia and anemia (P=0.016 and 0.017, respectively).
The rates of breast-conserving surgery were 68.0 and 72.3% for FEC-D and TC6, respectively (P=0.641).
Patients achieved pCR had better DFS (log rank test, P = 0.287) and OS (log rank test, P = 0.069), though not significant. Patients treated with FEC-D had better DFS (log rank test, P = 0.107) and OS (log rank test, P = 0.159), though not significant. Among patients with TN BC, those treated with FEC-D had significantly better DFS (log rank test, P = 0.016) and OS (log rank test, P = 0.034) than treated with TC6.
Low ALDH1 expression and high topo IIα protein expression were strongly correlated with pCR in FEC-D, with odds ratios (ORs) of 4.33 [95% CI, 1.02–18.38] and 4.08 [0.97–17.2], respectively. ALDH1 was also associated with pCR in TC, OR=3.50 [0.84–14.6]. Other factors, including age, tumor size, nodal status, tumor grade, Ki67, p53, and TOP 2A status were not associated with pCR in either regimen.
Conclusions:We found that TC6 was less effective than FEC-D for treating HR-negative BC because it was insufficient for TNBC, particularly for basal BC. This suggests that anthracycline is more important than taxane for basal BC. Additionally, ALDH1 could be a marker for resistance to conventional chemotherapy.
Citation Format: Narui K, Ishikawa T, Shimizu D, Tanabe M, Sasaki T, Oba MS, Morita S, Nawata S, Kida K, Mogaki M, Doi T, Tsugawa K, Ogata H, Ota T, Kosaka Y, Sengoku N, Kuranami M, Saito Y, Suzuki Y, Suto A, Arioka H, Chishima T, Ichikawa Y, Endo I, Tokuda Y. A randomized phase II neoadjuvant study comparing docetaxel and cyclophosphamide (TC) with 5-fluorouracil, epirubicin, and cyclophosphamide followed by docetaxel (FEC-D) for hormone receptor-negative breast cancer: The Kanagawa breast oncology group (KBOG) 1101 study [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-16-04.
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Affiliation(s)
- K Narui
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Ishikawa
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - D Shimizu
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - M Tanabe
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Sasaki
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - MS Oba
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - S Morita
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - S Nawata
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - K Kida
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - M Mogaki
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Doi
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - K Tsugawa
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - H Ogata
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Ota
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Kosaka
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - N Sengoku
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - M Kuranami
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Saito
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Suzuki
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - A Suto
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - H Arioka
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - T Chishima
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Ichikawa
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - I Endo
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
| | - Y Tokuda
- Yokohama City University Medical Center, Yokohama, Japan; Tokyo Medical Univercity, Tokyo, Japan; Yokosuka Kyosai Hospital, Yokosuka, Japan; Shonan Kinen Hospital, Kamakura, Japan; St. Marianna Univercity School of Medicine, Kawasaki, Japan; Kitasato University, Sagamihara, Japan; Tokai University, Isehara, Japan; Yokohama Rosai Hospital, Yokohama, Japan; Yokohama City University, Yokohama, Japan
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Soeda E, Hoshino K, Izawa Y, Takaoka C, Isobe C, Takahashi A, Takahashi N, Yamada Y, Shimojima N, Fujino A, Shinoda M, Kitagawa Y, Tanabe M, Nakamaru S, Taki N, Sekiguchi A, Nakazawa Y, Turukawa T, Kuroda T. A Report on the Positive Response to an Outdoor Nature Challenge of a Snow Camp for Young Liver Transplant Patients. Transplant Proc 2017; 49:115-120. [PMID: 28104117 DOI: 10.1016/j.transproceed.2016.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES More than two decades have passed since the first living donor liver transplantation was performed in Japan in 1989. There are many reports about problems in adherence to taking medication and medical follow-ups in children who received liver transplants, because there is no transition strategy for those children and parents or guardians. The objective of this study is to measure the effect of nature and outdoor activity to improve children's medical adherence. METHODS We recruited participants from 9-year-old children who are attending the outpatient liver transplant clinic in a stable condition (no event such as rejection or surgical procedure within 6 months). We took participants to a snow camp and measured its effect by using the IKIRU CHIKARA (IKR) tool, which contain 28 items divided into 3 categories: psychosocial ability, moral fitness, and physical ability. Children were tested on three occasions, before, just after, and 1 month after the camp. RESULTS Eight patients participated in the snow camp and 7 patients were eligible for the study. The average age was 12.6 with a range 10 to 17 years. There were 3 girls and 4 boys. The average IKR scores before, just after, and 1 month after the camp were 127.9, 131.5, and 126.6, respectively. CONCLUSION An outdoor activity such as a snow camp can be safely conducted, and it is an acceptable option to incorporate within a pediatric liver transplant program. There were no significant changes in IKR scores during this short observation. Longer observation is needed to measure the effect of nature and outdoor activities.
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Affiliation(s)
- E Soeda
- Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan.
| | - K Hoshino
- School of Medicine, Keio University, Tokyo, Japan
| | - Y Izawa
- Department of Nursing, Keio University Hospital, Tokyo, Japan
| | - C Takaoka
- Department of Nursing, Keio University Hospital, Tokyo, Japan
| | - C Isobe
- School of Nursing, Shibuya Medical Association, Tokyo, Japan
| | | | - N Takahashi
- School of Medicine, Keio University, Tokyo, Japan
| | - Y Yamada
- School of Medicine, Keio University, Tokyo, Japan
| | - N Shimojima
- School of Medicine, Keio University, Tokyo, Japan
| | - A Fujino
- School of Medicine, Keio University, Tokyo, Japan
| | - M Shinoda
- School of Medicine, Keio University, Tokyo, Japan
| | - Y Kitagawa
- School of Medicine, Keio University, Tokyo, Japan
| | - M Tanabe
- Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - S Nakamaru
- Faculty of Health and Sports Science, Juntendo University, Chiba, Japan
| | - N Taki
- Faculty of Educatoin, Shinshu University, Nagano, Japan
| | - A Sekiguchi
- Japanese Center for Research on Women in Sports, Juntendo University, Tokyo, Japan
| | | | | | - T Kuroda
- School of Medicine, Keio University, Tokyo, Japan
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Suzuki T, Zeng Z, Zhao B, Wei Z, Tanabe M, Shimbo T, Kajio H, Kato N, Naruse M. Comparison of coronary heart disease risk among four diagnostic definitions of metabolic syndrome. J Endocrinol Invest 2016; 39:1337-1346. [PMID: 27572249 DOI: 10.1007/s40618-016-0538-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 08/19/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Metabolic syndrome (MetS) is now well known as one of the major risk factors for coronary heart disease (CHD). Currently, there are several methods used to define MetS. The aim of this study was to determine to what extent current MetS definition reflects CHD risk using the probability of CHD in 10 years based on Framingham risk score algorithms. METHODS A total of 7575 adults, aged 16-93 years (2532 men and 5043 women), were recruited. We conducted a cross-sectional health survey in China using MetS criteria from four different definitions: modified National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF), Chinese and Japanese. RESULTS Differences in the prevalence of MetS by each definition were small in males (22.9-25.9 %), whereas in females, MetS was three times more prevalent using the IDF definition (29.1 %) versus the Japanese definition (9.7 %). Framingham risk scores in participants with MetS were significantly higher than in those without MetS by all definition criteria (p < 0.001). The CHD risk scores for participants with MetS by each definition showed similar values in males (range 11.5-12.1 %) with no significant differences among definitions. Conversely, in females with MetS the risk score for CHD was low (range 3.5-4.3 %) by each MetS definition. CONCLUSIONS These findings suggest that further studies are required to establish appropriate criteria of MetS in females.
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Affiliation(s)
- T Suzuki
- Department of Clinical Study and Informatics, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan.
- Department of Public Health, Kitasato University School of Medicine, 1-15-1, Minami-ku, Kitasato Sagamihara, Kanagawa, 252-0374, Japan.
| | - Z Zeng
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - B Zhao
- Taiyuan Center for Disease Control and Prevention, Taiyuan, 030000, China
| | - Z Wei
- Taiyuan People Hospital, Taiyuan, 030000, China
| | - M Tanabe
- Department of Endocrinology and Diabetes Mellitus, Fukuoka University Hospital, Fukuoka, 814-0180, Japan
| | - T Shimbo
- Department of Clinical Study and Informatics, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
| | - H Kajio
- Department of Diabetes and Metabolic Medicine, Center Hospital, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
| | - N Kato
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Center for Global Health and Medicine, Tokyo, 162-8655, Japan
| | - M Naruse
- Department of Endocrinology, Metabolism and Hypertension, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan.
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Patel P, Dahab M, Tanabe M, Murphy A, Ettema L, Guy S, Roberts B. Tracking official development assistance for reproductive health in conflict-affected countries: 2002-2011. BJOG 2016; 123:1693-704. [PMID: 26817807 PMCID: PMC5066640 DOI: 10.1111/1471-0528.13851] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To provide information on trends on official development assistance (ODA) disbursement patterns for reproductive health activities in 18 conflict-affected countries. DESIGN Secondary data analysis. SAMPLE 18 conflict-affected countries and 36 non-conflict-affected countries. METHODS The Creditor Reporting System (CRS) database was analyzed for ODA disbursement for direct and indirect reproductive health activities to 18 conflict-affected countries (2002-2011). A comparative analysis was also made with 36 non-conflict-affected counties in the same 'least-developed' income category. Multivariate regression analyses examined associations between conflict status and reproductive health ODA and between reproductive needs and ODA disbursements. MAIN OUTCOME MEASURES Patterns of ODA disbursements (constant U.S. dollars) for reproductive health activities. RESULTS The average annual ODA disbursed for reproductive health to 18 conflict-affected countries from 2002 to 2011 was US$ 1.93 per person per year. There was an increase of 298% in ODA for reproductive health activities to the conflict-affected countries between 2002 and 2011; 56% of this increase was due to increases in HIV/AIDS funding. The average annual per capita reproductive health ODA disbursed to least-developed non-conflict-affected countries was 57% higher than to least-developed conflict-affected countries. Regression analyses confirmed disparities in ODA to and between conflict-affected countries. CONCLUSIONS Despite increases in ODA for reproductive health for conflict-affected countries (albeit largely for HIV/AIDS activities), considerable disparities remains. TWEETABLE ABSTRACT Study tracking 10 years of aid for reproductive aid shows major disparities for conflict-affected countries.
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Affiliation(s)
- P Patel
- Global Health and SecurityDepartment of War StudiesKing's College LondonLondonUK
| | - M Dahab
- United Nations High Commissioner for RefugeesLondonUK
| | - M Tanabe
- Reproductive Health ProgramWomen's Refugee CommissionNew YorkNYUSA
| | - A Murphy
- London School of Hygiene & Tropical MedicineLondonUK
| | - L Ettema
- Marie Stopes InternationalBrusselsBelgium
| | - S Guy
- Marie Stopes InternationalLondonUK
| | - B Roberts
- London School of Hygiene & Tropical MedicineLondonUK
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Asano F, Watanabe K, Shinkai M, Tei Y, Mishina K, Tanabe M, Ishii H, Shinoda M, Shimokawaji T, Kudo M, Kaneko T. Relapse of both small cell lung cancer and Lambert-Eaton myasthenic syndrome after a 13-year disease-free survival period. Chin J Cancer 2016; 35:63. [PMID: 27370896 PMCID: PMC4930592 DOI: 10.1186/s40880-016-0127-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 03/10/2016] [Indexed: 08/30/2023]
Abstract
Lambert–Eaton myasthenic syndrome (LEMS) is a paraneoplastic syndrome and only 3% of small cell lung carcinoma (SCLC) patients have LEMS. Moreover, the recurrence of SCLC after a disease-free survival (DFS) of more than 10 years is rare. We report a patient who had a recurrence of both SCLC and LEMS after a 13-year DFS period. A 69-year-old man was diagnosed with LEMS and SCLC (cT0N2M0, stage IIIA) 13 years ago. Chemoradiotherapy was performed and a complete response was achieved. With anticancer treatment, the LEMS symptoms was alleviated. At the age of 82 years, gait disturbance appeared followed by left supraclavicular lymphadenopathy and further examination revealed the recurrence of SCLC. Careful screening for the recurrence of SCLC might be needed when the patient has recurrent or secondary paraneoplastic neurological syndrome even after a long DFS period.
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Affiliation(s)
- Fumio Asano
- Respiratory Disease Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Keisuke Watanabe
- Respiratory Disease Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan. .,Department of Medicine, McMaster University, Hamilton, ON, Canada.
| | - Masaharu Shinkai
- Respiratory Disease Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Yoshitaka Tei
- Respiratory Disease Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Kei Mishina
- Respiratory Disease Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Mikiko Tanabe
- Department of Pathology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Hiroshi Ishii
- Respiratory Disease Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Masahiro Shinoda
- Respiratory Disease Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Tadasuke Shimokawaji
- Comprehensive Cancer Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Makoto Kudo
- Respiratory Disease Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Takeshi Kaneko
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
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Tanabe M, Kelly R, de Lahunta A, Duffy MS, Wade SE, Divers TJ. Verminous Encephalitis in a Horse Produced by Nematodes in the Family Protostrongylidae. Vet Pathol 2016; 44:119-22. [PMID: 17197637 DOI: 10.1354/vp.44-1-119] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Parasitic granulomatous eosinophilic inflammation was observed in the central nervous system (CNS) of a 6-month-old Arabian colt from New York state. Inflammation was associated with eggs, larvae, and adult nematodes in the cerebellum. Nematodes had histological characteristics of the superfamily Metastrongyloidea. The presence of dorsal-spined larvae in the CNS was further indicative of infection with a nematode in the family Protostrongylidae. Infections were most compatible with Parelaphostrongylus tenuis but specific diagnosis was not possible. This is the first definitive report of a protostrongylid nematode infection in a horse.
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Affiliation(s)
- M Tanabe
- Antech Diagnostics, 17672-B Cowan Avenue, Irvine, CA 92614, USA.
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Tanabe M, Iwase T, Okumura Y, Yoshida A, Masuda N, Nakatsukasa K, Shien T, Tanaka S, Komoike Y, Taguchi T, Arima N, Nishimura R, Inaji H, Ishitobi M. Local recurrence risk after previous salvage mastectomy. Eur J Surg Oncol 2016; 42:980-5. [PMID: 27055945 DOI: 10.1016/j.ejso.2016.03.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/02/2016] [Accepted: 03/04/2016] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Breast-conserving surgery is a standard treatment for early breast cancer. For ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery, salvage mastectomy is the current standard surgical procedure. However, it is not rare for patients with IBTR who have received salvage mastectomy to develop local recurrence. In this study, we examined the risk factors of local recurrence after salvage mastectomy for IBTR. PATIENTS AND METHODS A total of 118 consecutive patients who had histologically confirmed IBTR without distant metastases and underwent salvage mastectomy without irradiation for IBTR between 1989 and 2008 were included from eight institutions in Japan. The risk factors of local recurrence were assessed. RESULTS The median follow-up period from salvage mastectomy for IBTR was 4.6 years. Patients with pN2 or higher on diagnosis of the primary tumor showed significantly poorer local recurrence-free survival than those with pN0 or pN1 at primary tumor (p < 0.001). Multivariate analysis showed that the lymph node status of the primary tumor was a significantly independent predictive factor of local recurrence-free survival (p = 0.02). CONCLUSION The lymph node status of the primary tumor might be a predictive factor of local recurrence-free survival after salvage mastectomy for IBTR. Further research and validation studies are needed. (UMIN-CTR number UMIN000008136).
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Affiliation(s)
- M Tanabe
- Dept. of Breast Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - T Iwase
- Dept. of Breast Surgical Oncology, Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Y Okumura
- Dept. of Breast & Endocrine Surgery, Kumamoto City Hospital, Kumamoto, Japan
| | - A Yoshida
- Dept. of Breast Surgery, St. Luke's International Hospital, Tokyo, Japan
| | - N Masuda
- Dept. of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - K Nakatsukasa
- Dept. of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - T Shien
- Dept. of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - S Tanaka
- Section of Breast and Endocrine Surgery, Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan
| | - Y Komoike
- Dept. of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - T Taguchi
- Dept. of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - N Arima
- Dept. of Pathology, Kumamoto City Hospital, Kumamoto, Japan
| | - R Nishimura
- Dept. of Breast & Endocrine Surgery, Kumamoto City Hospital, Kumamoto, Japan
| | - H Inaji
- Dept. of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - M Ishitobi
- Dept. of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
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Kida K, Ishikawa T, Yamada A, Shimada K, Narui K, Sugae S, Shimizu D, Tanabe M, Sasaki T, Ichikawa Y, Endo I. Effect of ALDH1 on prognosis and chemoresistance by breast cancer subtype. Breast Cancer Res Treat 2016; 156:261-9. [PMID: 26975188 DOI: 10.1007/s10549-016-3738-7] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 02/27/2016] [Indexed: 01/08/2023]
Abstract
Aldehyde dehydrogenase 1 (ALDH1) has been identified as a breast cancer stem cell marker, but its value as a predictor of prognosis and chemoresistance is controversial. This study investigated the effect of ALDH1 on prognosis and chemoresponse by breast cancer subtype. We immunohistochemically analyzed 653 invasive breast cancer specimens and evaluated correlations among clinicopathological factors, survival status, response to neoadjuvant chemotherapy, and ALDH1 expression. Of 653 specimens, 139 (21.3 %) expressed ALDH1 in tumor cells. ALDH1 expression was correlated significantly with larger tumor size, node metastasis, higher nuclear grade, and with HER2(+) and progesterone/estrogen receptor (HR)(-) subtypes. ALDH1 expression was significantly observed in HER2 type and triple-negative breast cancer (TNBC). Patients with ALDH1(+) cancers had significantly shorter disease-free survival (P < 0001) and overall survival (P = 0.044). ALDH1 expression significantly affected prognosis of luminal types, but not TNBC and HER2-enriched types. For the 234 patients treated with neoadjuvant chemotherapy, pathological complete response (pCR) rate was significantly lower in ALDH1(+) cases (13.5 vs. 30.3 %, P = 0.003). pCR and ALDH1 expression were significantly correlated in TNBC patients (P = 0.003). ALDH1(+) breast cancers tended to be aggressive, with poor prognoses. Although ALDH1(+) TNBC showed higher chemoresistance, ALDH1 had significant impact on prognosis in the luminal type but not in TNBC.
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Affiliation(s)
- Kumiko Kida
- Department of Gastroenterological Surgery and Surgical Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takashi Ishikawa
- Department of Breast Surgery, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, Japan.
| | - Akimitsu Yamada
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Kazuhiro Shimada
- Department of Gastroenterological Surgery and Surgical Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Sadatoshi Sugae
- Department of Gastroenterological Surgery and Surgical Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Daisuke Shimizu
- Department of Gastroenterological Surgery and Surgical Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Mikiko Tanabe
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Takeshi Sasaki
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yasushi Ichikawa
- Department of Gastroenterological Surgery and Surgical Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery and Surgical Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Ishikawa T, Narui K, Tanabe M, Kida K, Oba MS, Yamada A, Ichikawa Y, Endo I. BRCAness is beneficial for indicating triple negative breast cancer patients resistant to taxane. Eur J Surg Oncol 2016; 42:999-1001. [PMID: 27041672 DOI: 10.1016/j.ejso.2016.02.246] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 02/11/2016] [Accepted: 02/12/2016] [Indexed: 01/16/2023] Open
Abstract
AIM Triple negative breast cancer (TNBC) is a heterogeneous disease and is associated with the cancer stem cell (CSC), basal-like, and BRCA1 function deficient (BRCAness) subtypes. We examined these 3 subtypes in TNBC and compared their chemosensitivity against anthracycline or taxane with a special attention to BRCAness. METHODS Sixty-six TNBC cases were obtained from a randomized phase II trial comparing TCx6 (TC6) with FEC-Docetaxel (FEC-D) as neoadjuvant chemotherapy. The core needle specimens before chemotherapy were used for subtyping. The basal-like and CSC subtypes were identified by immunohistochemistry; CK5/6 and EGFR staining for the basal-like subtype and ALDH1 staining for the CSC subtype. The BRCAness subtype was examined by Multiplex Ligation-dependent Probe Amplification (MLPA). Correlations between subgroups and pCR rates according to each regimen and subtype were examined. RESULTS The basal-like and BRCAness subtypes were significantly associated (p = 0.010) with the other subtypes, but not the CSC subtype. The pCR rates were higher with FEC-D than with TC6 in the basal-like (54.5% vs 14.3%, p = 0.081) and BRCAness (56.2% vs 16.7%, p = 0.030) subtypes. Both were not effective in the CSC subtype (18.2% vs 11.8%, p = 1.00). CONCLUSION BRCAness identified by MLPA was practically useful for treatment selection for avoiding taxane. ALDH1 may be considered as a marker for the CSC subtype requiring novel agents.
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Affiliation(s)
- T Ishikawa
- Department of Breast Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku, Tokyo 160-0023, Japan.
| | - K Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - M Tanabe
- Department of Pathology, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - K Kida
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - M S Oba
- Department of Bioinformatics, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - A Yamada
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - Y Ichikawa
- Department of Clinical Oncology and Gastrointestinal Surgery, School of Medicine, Yokohama City University, Yokohama 232-0024, Japan
| | - I Endo
- Department of Clinical Oncology and Gastrointestinal Surgery, School of Medicine, Yokohama City University, Yokohama 232-0024, Japan
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Maeda Y, Kawahara T, Tanabe M, Kumano Y, Ohtaka M, Kondo T, Mochizuki T, Hattori Y, Teranishi JI, Miyoshi Y, Yumura Y, Inayama Y, Yao M, Uemura H. Ureteroscopy-Assisted Biopsy for a Retroperitoneal Tumor: A Case Report. Case Rep Oncol 2015; 8:279-84. [PMID: 26351434 PMCID: PMC4560321 DOI: 10.1159/000437049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction Retroperitoneal tumor is often seen in urology clinical practice. To diagnose the tumor, tumor specimens must be obtained. However, in some cases, the tumor is penetrated by vessels around the ureter, and it may be difficult to detect the optimal spot for obtaining a specimen, even when performing open surgery. Case Presentation A 53-year-old male patient was referred to our hospital for further examination of left back pain due to hydronephrosis. Enhanced computed tomography demonstrated ureter stenosis in front of the ilium, which was surrounded by a retroperitoneal tumor. The tumor was penetrated by blood vessels; therefore, we performed an open surgical biopsy on the suspicion of a retroperitoneal tumor using ureteroscopic assistance. The diagnosis of idiopathic retroperitoneal fibrosis was made according to the biopsy. Conclusion We herein report the first case of a ureteroscopy-assisted biopsy for the pathological diagnosis of a retroperitoneal tumor.
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Affiliation(s)
- Yoko Maeda
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Takashi Kawahara
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan ; Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Mikiko Tanabe
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yohei Kumano
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Mari Ohtaka
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Takuya Kondo
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Taku Mochizuki
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Yusuke Hattori
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Jun-Ichi Teranishi
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Yasuhide Miyoshi
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Yasushi Yumura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
| | - Yoshiaki Inayama
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Masahiro Yao
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroji Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Japan
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Ishikawa T, Narui K, Shimada K, Kida K, Oba MS, Tanabe M, Ichikawa Y, Sugae S, Endo I. Abstract P3-06-27: BRCAness is important to identify TNBC subtype resistant to taxanes. Cancer Res 2015. [DOI: 10.1158/1538-7445.sabcs14-p3-06-27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: Triple negative breast cancer (TNBC) is heterogeneous and consists of tumors associated with basal like, BRCA related and cancer stem cell (CSC) phenotypes. Although anti-cancer agents are substantial for treating TNBC, existing ones do not work in some subpopulation in TNBC at all. However, it has not been reported that subdivision of TNBC is useful for choosing ant-cancer agents.
AIM: To examine whether subdividing TNBC is beneficial for tailored chemotherapy and to identify predictive factors for existing anti-cancer agents in TNBC.
METHODS: Sixty-six TNBC cases from a randomized phase II trial comparing TCx6 (TC6) with FEC followed by docetaxel (FEC-D) as neoadjuvant chemotherapy for hormone receptor-negative breast cancer (Kanagawa Breast Oncology Group 1101 Study). TNBC was subdivided by 1) IHC of CK 5/6 and EGFR into basal- and non-basal subtypes, and 2) MLPA of BRCA1 into BRCA1 and non-BRCA1 subtypes. The pCR rates were examined according to each regimen and subtype. 3) The association of grade 3 pCR was examined with Ki-67, p53, aldehyde dehydrogenase (ALDH) 1 and topoisomerase 2A (topoIIα) by IHC and TOP2A by FISH for each regimen.
RESULTS: 1) In basal subtype, the pCR rate was significantly higher for FEC-D (42.9%) compared with TC6 (13.6%) (p=0.033), but it was equivalent in non-basal subtype (FEC-D vs TC: 25.0% vs 36.4%, p=0.554). 2) In BRCA1 subtype, it was more significant (FEC-D vs TC: 53.8 % vs 13.3%, p=0.022). 3) An association between pCR and low ALDH1 expression was found in both FEC-D and TC6 (OR: 3.75 and 2.73). High topo IIα protein expression was associated with pCR in FEC-D (OR: 3.5).
DISCUSSION: TC6 was less effective than FEC-D in basal subtype and BRCA1 subtype, showing that taxanes cannot exert their anticancer role in tumors with BRCA1 dysfunction. Although basal subtype may contain more BRCA1-defective tumors than non-basal subtype, MLPA of BRCA1 was better to identify subtype resistant to taxanes than CK5/6 and EGFR. ALDH1 predicted treatment efficacy, and could therefore represent a marker of resistance to conventional chemotherapy.
Citation Format: Takashi Ishikawa, Kazutaka Narui, Kazuhiro Shimada, Kumiko Kida, Mari S Oba, Mikiko Tanabe, Yasushi Ichikawa, Sadatoshi Sugae, Itaru Endo. BRCAness is important to identify TNBC subtype resistant to taxanes [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-06-27.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Itaru Endo
- 3Yokohama City University, School of Medicine
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Kimura A, Tanabe M, Tajima M, Yamazaki K. The examination of the quantification method of the physical activity of the cerebrovascular handicapped person by wearable camera. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kida K, Ishikawa T, Yamada A, Narui K, Sugae S, Tanabe M, Ichikawa Y, Endo I. Abstract P2-06-16: The impact of ALDH1 on chemo-resistance and prognosis according to intrinsic subtype in breast cancers. Cancer Res 2015. [DOI: 10.1158/1538-7445.sabcs14-p2-06-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
[Background]Aldehyde dehydrogenase 1 (ALDH1) has been identified as a breast cancer stem cell marker. The clinical significance of ALDH1 as a chemo-resistant and prognostic indicator has been reported recently. However, the analysis according to each intrinsic subtype was not reported.
[Aims] To investigate the impact of ALDH1 on chemo-resistance and prognosis according to intrinsic subtypes in invasive breast cancers.
[Methods]
1) Patients and tumor specimens; A total of 653 primary breast cancer patients were enrolled in this study from 2004 to 2013 at the Yokohama City University Medical Center in Japan. We performed immunohistochemical analyses using paraffin-embedded core needle biopsy sections prior to the treatment.
2) Correlation of ALDH1 with clinicopathological factors;
Analyses were performed to investigate association of ALDH1 expression with other biomarkers and clinicopathological factors in breast cancers. Age, histologic type, tumor size, nodal status, ER/PgR/HER2 status, nuclear grade, Ki67, Topo2, p53, CK5/6 and EGFR were observed.
3) Neoadjuvant patient cohort study
234 breast cancer patients receiving neoadjuvant chemotherapy were enrolled. The correlation between ALDH1 and pathological complete response (pCR) rate was investigated in each intrinsic subtype.
4) Prognostic cohort study
We performed a Cox analysis of disease free survival and overall survival of all 653 cases according to each subtype, taking account of clinicopathological factors.
[Results]
ALDH1 expression in tumor cells was seen in 139 of 653 cases (21.3%). The ALDH1 expression correlated significantly with tumor size, clinical node metastasis, clinical staging, nuclear grade and HER2 status positively, ER and PgR status negatively. ALDH1 expression was significantly seen in HER2-positive cancers and triple negative type.
In neoadjuvant study, we analyzed 234 patients treated with neoadjuvant chemotherapy including 63 luminal type, 20 luminal-HER2 type, 45 HER2-enriched type and 106 triple negative type. The pCR rate was significantly lower in patients with ALDH1-positive cases (13.5%vs.30.3%,p=0.003). In multivariate analysis, ALDH1 and ER are correlated with pCR rate significantly. According to the intrinsic subtypes, the correlation between pCR and ALDH1 expression was extremely significant in triple negative type (p=0.003). In HER2 positive type, ALDH1 expression had tendency with low pCR, but with no significance. In luminal type, two patients achieved pCR and both had no ALDH1 expression.
In prognostic analysis, patients with ALDH1 expression had significantly poor disease free survival (DFS; p<0.001) and overall survival (OS; p=0.044). In the multivariate COX regression model, ALDH1 expression was an independent prognostic indicator of DFS (p=0.033), but not significant predictor of OS (p=0.124). According to each intrinsic subtypes, ALDH1 had a higher impact on prognosis of luminal type ,though not significant on triple negative type.
[Conclusions]
Breast cancers with ALDH1 expression posse biologically aggressive phenotypes that tend to have a poor prognosis. Chemoresistance was significantly seen in ALDH1-positive triple negative type, on the other hand, impact on prognosis was seen in luminal type more highly than triple negative type.
Citation Format: Kumiko Kida, Takashi Ishikawa, Akimitsu Yamada, Kazutaka Narui, Sadataka Sugae, Mikiko Tanabe, Yasushi Ichikawa, Itaru Endo. The impact of ALDH1 on chemo-resistance and prognosis according to intrinsic subtype in breast cancers [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P2-06-16.
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Affiliation(s)
- Kumiko Kida
- 1Yokohama City University Graduate School of Medicine
| | | | | | | | | | | | | | - Itaru Endo
- 1Yokohama City University Graduate School of Medicine
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Tanaka K, Matsuo K, Murakami T, Kawaguchi D, Hiroshima Y, Koda K, Endo I, Ichikawa Y, Taguri M, Tanabe M. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): short-term outcome, functional changes in the future liver remnant, and tumor growth activity. Eur J Surg Oncol 2015; 41:506-12. [PMID: 25704556 DOI: 10.1016/j.ejso.2015.01.031] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 01/20/2015] [Accepted: 01/23/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND We compared clinical outcomes of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) against those of classical 2-stage hepatectomy in treating metastatic liver disease. METHODS Short-term outcomes, serial changes in volume of the future liver remnant (FLR), functional FLR volume, and tumor growth activity during the treatment period, were compared between our first 11 consecutive patients treated with ALPPS and 54 patients treated with classical 2-stage hepatectomy. RESULTS Mortality in the ALPPS group (9%) tended to be higher than in the classical 2-stage group (2%, P = 0.341). The FLR hypertrophy ratio (FLR volume after vs. before the procedure) 1 week after the first operation in the ALPPS group (1.54 ± 0.18) exceeded that in the classical 2-stage group (1.19 ± 0.29, P = 0.005), being similar to the ratio at 3 weeks after the first procedure in the classical 2-stage group (1.40 ± 0.43). However, functional volume of the FLR in the ALPPS group 1 week after the first procedure (52.1%) tended to be smaller than that in the classical group 3 weeks after the first procedure (59.2%). CONCLUSIONS ALPPS should be used with extreme caution, giving special attention to postoperative complications and grade of functional liver regeneration.
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Affiliation(s)
- K Tanaka
- Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan.
| | - K Matsuo
- Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan
| | - T Murakami
- Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan
| | - D Kawaguchi
- Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan
| | - Y Hiroshima
- Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan
| | - K Koda
- Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan
| | - I Endo
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Y Ichikawa
- Department of Clinical Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - M Taguri
- Department of Biostatistics and Epidemiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - M Tanabe
- Division of Diagnostic Pathology, Yokohama City University Medical Center, Yokohama, Japan
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Okumura Y, Nishimura R, Nakatsukasa K, Yoshida A, Masuda N, Tanabe M, Shien T, Tanaka S, Arima N, Komoike Y, Taguchi T, Iwase T, Inaji H, Ishitobi M. Change in estrogen receptor, HER2, and Ki-67 status between primary breast cancer and ipsilateral breast cancer tumor recurrence. Eur J Surg Oncol 2015; 41:548-52. [PMID: 25682910 DOI: 10.1016/j.ejso.2015.01.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 01/07/2015] [Accepted: 01/19/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Changes in the biological marker status between primary and recurrent tumors are observed in breast cancer. However, their clinical significance is still uncertain, especially for patients with ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery. PATIENTS AND METHODS A total of 117 patients with IBTR without distant metastases were enrolled in this study. All patients were examined for estrogen receptor (ER), HER2, and Ki-67 in both the primary tumors and paired IBTR. We evaluated the impact of changes in these biomarkers between primary tumors and IBTR on the prognosis after IBTR. RESULTS There were no associations of changes in the ER, HER2 status with distant disease-free survival (DDFS) after surgical resection of IBTR, whereas the change in the Ki-67 status between the primary tumors and IBTR was significantly correlated with DDFS (unadjusted: p = 0.0094; adjusted: p = 0.013). Patients in the "increased or remained high" Ki-67 group had a significantly shorter DDFS than those in the "decreased or remained low" Ki-67 group (5-year DDFS: 55.5 vs. 79.3%, respectively, p = 0.0084 by log-rank test). CONCLUSION An increased or persistently high Ki-67 status in the IBTR was significantly correlated with a poorer prognosis after IBTR.
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Affiliation(s)
- Y Okumura
- Dept. of Breast & Endocrine Surgery, Kumamoto City Hospital, Kumamoto, Japan
| | - R Nishimura
- Dept. of Breast & Endocrine Surgery, Kumamoto City Hospital, Kumamoto, Japan
| | - K Nakatsukasa
- Dept. of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - A Yoshida
- Dept. of Breast Surgery, St. Luke's International Hospital, Tokyo, Japan
| | - N Masuda
- Dept. of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - M Tanabe
- Division of Breast Oncology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - T Shien
- Dept. of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - S Tanaka
- Section of Breast and Endocrine Surgery, Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan
| | - N Arima
- Dept. of Pathology, Kumamoto City Hospital, Kumamoto, Japan
| | - Y Komoike
- Dept. of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - T Taguchi
- Dept. of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - T Iwase
- Division of Breast Oncology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - H Inaji
- Dept. of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - M Ishitobi
- Dept. of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
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Shimada K, Ishikawa T, Kita K, Narui K, Sugae S, Shimizu D, Tanabe M, Sasaki T, Chishima T, Ichikawa Y, Endo I. Neoadjuvant docetaxel/cyclophosphamide in triple-negative breast cancer: predictive value of class III-β tubulin and non-basal subtype. Anticancer Res 2015; 35:907-912. [PMID: 25667473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM We aimed to clarify which breast cancer subtypes respond best to docetaxel/cyclophosphamide chemotherapy (TC) as neoadjuvant chemotherapy (NAC). PATIENTS AND METHODS We analyzed pathological responses, clinicopathological characteristics and biological markers (estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2), Ki-67, p53, topoisomerase IIα, class III β tubulin, cytokeratin 5/6, epidermal growth factor receptor (EGFR)) in specimens from 79 patients who received NAC-TC. RESULTS Out of 79 patients, 33 (41.8%) achieved quasipathological complete responses (QpCR). Univariate analysis associated negative ER (p<0.001), negative PR (p=0.007), triple-negative subtype (TNBC; p=0.001), high Ki-67 (p=0.022) and low class III β tubulin (p=0.032) with QpCR. Multivariate analyses associated only negative ER (p=0.050) and low class III β tubulin (p=0.028) and only non-basal subtype in TNBC with QpCR. CONCLUSION NAC-TC may be especially effective in ER-breast cancer with low class III β tubulin or non-basal TNBC.
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Affiliation(s)
- Kazuhiro Shimada
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Takashi Ishikawa
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Kumiko Kita
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Kazutaka Narui
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Sadayoshi Sugae
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Daisuke Shimizu
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - Mikiko Tanabe
- Department of Surgical Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Takeshi Sasaki
- Department of Surgical Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Takashi Chishima
- Department of Clinical Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yasushi Ichikawa
- Department of Clinical Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Itaru Endo
- Department of Clinical Oncology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Kida K, Ishikawa T, Yamada A, Shimizu D, Tanabe M, Sasaki T, Ichikawa Y, Endo I. A prospective feasibility study of sentinel node biopsy by modified Indigocarmine blue dye methods after neoadjuvant chemotherapy for breast cancer. Eur J Surg Oncol 2015; 41:566-70. [PMID: 25650249 DOI: 10.1016/j.ejso.2014.10.066] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 10/08/2014] [Accepted: 10/17/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Although sentinel lymph node biopsy (SLNB) is a standard staging method for assessing nodal status of breast cancer patients, SLNB after neoadjuvant chemotherapy (NAC) remains controversial. The aim of this study was to validate the practicality and accuracy of SLNB by our modified Indigocarmine blue dye methods following NAC. METHODS One hundred consecutive cases with breast cancers treated by NAC were enrolled in this study. After NAC, all patients underwent SLNB performed by our modified Indigocarmine blue dye methods without radioisotope, followed by back-up axillary lymph node dissection (ALND). RESULTS Sentinel nodes (SNs) were identified in 94 cases (identification rate, 94%); the accuracy was 94.7% (89/94 cases); and the false negative rate (FNR) 13.5% (5/37 cases). For cases with vs. without clinically evident metastatic nodes before NAC, the identification rate was 92.4% (61/66 cases) vs. 97.1% (33/34 cases); the accuracy 91.8% (56/61 cases) vs. 97.0% (32/33 cases) and the FNR 16.1% (5/31 cases) vs. 0% (0/6 case), respectively. There were six patients without identified SNs, three of them had metastatic nodes. False negatives occurred in five cases; in four, fewer than two sentinel nodes had been removed. CONCLUSION Following NAC, the accuracy of SLNB by modified Indigocarmine blue dye methods is adequate compared with other tracers. In patients in whom no SNs have been identified, lymphatic metastasis is likely and therefore ALND is recommended. For patients with cN0 prior to NAC, SLNB by modified Indigocarmine blue dye methods is clinically feasible, though controversial for patients with positive nodes.
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Affiliation(s)
- K Kida
- Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan.
| | - T Ishikawa
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - A Yamada
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - D Shimizu
- Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Japan
| | - M Tanabe
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - T Sasaki
- Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan
| | - Y Ichikawa
- Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
| | - I Endo
- Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
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