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Ishibashi N, Tabata T, Nonomura R, Oshima Y, Sasaki T, Mitomo H, Sugawara T, Sagawa M. Efficacy of durvalumab plus chemotherapy in small-cell lung cancer with Lambert-Eaton myasthenic syndrome. Respir Med Case Rep 2023; 47:101974. [PMID: 38374927 PMCID: PMC10874974 DOI: 10.1016/j.rmcr.2023.101974] [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: 06/12/2023] [Accepted: 12/22/2023] [Indexed: 02/21/2024] Open
Abstract
Lambert-Eaton myasthenic syndrome (LEMS) is a rare disease but is often associated with small-cell lung cancer (SCLC). We discuss the case of a 65-year-old man diagnosed with SCLC-LEMS and treated with carboplatin, etoposide, and durvalumab. Lower extremity weakness and high anti-P/Q voltage-gated calcium channel (VGCC) antibody levels were diagnostic and helpful. The patient showed a reduction in neurological symptoms with treatment for SCLC, including an immune checkpoint inhibitor (ICI), without standard treatment for LEMS. This treatment may be a treatment option, although the recurrence of LEMS as an immune-related adverse events (irAEs) should be noted.
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Affiliation(s)
- Naoya Ishibashi
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Toshiharu Tabata
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Ryo Nonomura
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Yutaka Oshima
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Takanobu Sasaki
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Hideki Mitomo
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Takafumi Sugawara
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Motoyasu Sagawa
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University Hospital, Japan
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2
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Ishibashi N, Tabata T, Nonomura R, Oshima Y, Sasaki T, Mitomo H, Sugawara T, Sagawa M. First case report of erlotinib plus ramucirumab treatment for lung carcinosarcoma with EGFR L858R mutation. Thorac Cancer 2023; 14:3415-3418. [PMID: 37837329 PMCID: PMC10693942 DOI: 10.1111/1759-7714.15134] [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] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/16/2023] Open
Abstract
Lung carcinosarcoma is acknowledged as a rare form of lung cancer. Due to its rarity, the inability to conduct large-scale clinical trials and interventions is currently carried out based on empirical evidence. In this study, we report the case of a 73-year-old female patient diagnosed with postoperative recurrence of lung carcinosarcoma. The resected tumor was diagnosed as lung carcinosarcoma, and genetic testing revealed the presence of the epidermal growth factor receptor (EGFR) exon21 L858R. Approximately 2 years postoperatively, the tumor recurred and the patient was treated with erlotinib plus ramucirumab, which were effective in controlling metastatic disease. Erlotinib plus ramucirumab is therefore a treatment option for EGFR mutation-positive lung carcinosarcoma.
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Affiliation(s)
- Naoya Ishibashi
- Department of Thoracic SurgeryTohoku Medical and Pharmaceutical University HospitalSendai CityJapan
| | - Toshiharu Tabata
- Department of Thoracic SurgeryTohoku Medical and Pharmaceutical University HospitalSendai CityJapan
| | - Ryo Nonomura
- Department of Thoracic SurgeryTohoku Medical and Pharmaceutical University HospitalSendai CityJapan
| | - Yutaka Oshima
- Department of Thoracic SurgeryTohoku Medical and Pharmaceutical University HospitalSendai CityJapan
| | - Takanobu Sasaki
- Department of Thoracic SurgeryTohoku Medical and Pharmaceutical University HospitalSendai CityJapan
| | - Hideki Mitomo
- Department of Thoracic SurgeryTohoku Medical and Pharmaceutical University HospitalSendai CityJapan
| | - Takafumi Sugawara
- Department of Thoracic SurgeryTohoku Medical and Pharmaceutical University HospitalSendai CityJapan
| | - Motoyasu Sagawa
- Department of Thoracic SurgeryTohoku Medical and Pharmaceutical University HospitalSendai CityJapan
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3
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Shimada D, Sagawa M, Seki M. Detection of Mycobacterium avium-intracellulare Complex (MAC) by Bronchial Lavage and the Relationship with Titers of Anti-Glycopeptidolipid-Core IgA Antibodies to MAC in Patients with Pulmonary MAC Disease. Infect Drug Resist 2023; 16:977-984. [PMID: 36824065 PMCID: PMC9942509 DOI: 10.2147/idr.s400200] [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: 12/04/2022] [Accepted: 02/10/2023] [Indexed: 02/19/2023] Open
Abstract
Background Higher rates of diagnosis of pulmonary Mycobacterium avium-intracellulare complex (MAC) disease by bronchoscopy (BS) in patients who could not diagnose by sputum cultures have been suggested, but the detailed utility of BS, especially in combination with anti-glycopeptidolipid-core IgA antibodies (anti-MAC Ab), is still unclear. Methods A total of 111 patients at our hospital with suspected MAC who underwent BS because they were sputum-negative from April 2018 to March 2022 were analyzed prospectively. These patients were also divided into two groups, anti-MAC Ab-positive and anti-MAC Ab-negative, and compared. Results A total of 111 patients underwent BS, though 95 (38.0%) of 250 enrolled patients were sputum smear/culture-positive. The age of the 111 patients was 69.14 (31.0-89.0) years, and 90 (81.0%) were female; 69 (62.2%) of 111 patients were either smear-positive (n = 42, 37.8%) or culture-positive (n = 27, 24.3%) by BS. Of the total 111 patients, 69 (62.2%) were anti-MAC Ab-positive and 57 (82.6%) of 69 patients were also positive by BS. In contrast, only 12 (28.6%) of the 42 anti-MAC Ab-negative patients were positive by BS. The sensitivity and specificity of anti-MAC Ab for positive by BS were 82.6% and 71.4%, respectively, and the area under the curve (AUC) on receiver-operating characteristic (ROC) curve analysis was 0.807. Conclusion BS and anti-MAC Ab showed similar usefulness to confirm the diagnosis in patients who could not be diagnosed by sputum examination, but pulmonary MAC disease was strongly suspected based on chest radiography/CT findings. These two examinations were correlated, and their combination appeared to provide more accurate diagnosis and earlier therapy.
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Affiliation(s)
- Daishi Shimada
- Division of Infectious Diseases, Tohoku Medical and Pharmaceutical University Hospital, Sendai City, Japan
| | - Motoyasu Sagawa
- Division of Endoscopy, Tohoku Medical and Pharmaceutical University Hospital, Sendai City, Japan
| | - Masafumi Seki
- Division of Infectious Diseases, Tohoku Medical and Pharmaceutical University Hospital, Sendai City, Japan,Division of Infectious Diseases and Infection Control, Saitama Medical University International Medical Center, Hidaka City, Japan,Correspondence: Masafumi Seki, Division of Infectious Diseases and Infection Control, Saitama Medical University International Medical Center, Yamane 1397-1, Hidaka City, Saitama, Japan, Tel +81-42-984-4392, Fax +81-42-984-0280, Email
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4
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Ogawa T, Takahashi H, Saito H, Sagawa M, Aoki D, Matsuda K, Nakayama T, Kasahara Y, Kato K, Saitoh E, Morisada T, Saika K, Sawada N, Matsumura Y, Sobue T. Novel Algorithm for the Estimation of Cancer Incidence Using Claims Data in Japan: A Feasibility Study. JCO Glob Oncol 2023; 9:e2200222. [PMID: 36749909 PMCID: PMC10166397 DOI: 10.1200/go.22.00222] [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: 02/09/2023] Open
Abstract
PURPOSE We developed algorithms to identify patients with newly diagnosed cancer from a Japanese claims database to identify the patients with newly diagnosed cancer of the sample population, which were compared with the nationwide cancer incidence in Japan to assess the validity of the novel algorithms. METHODS We developed two algorithms to identify patients with stomach, lung, colorectal, breast, and cervical cancers: diagnosis only (algorithm 1), and combining diagnosis, treatments, and medicines (algorithm 2). Patients with newly diagnosed cancer were identified from an anonymized commercial claims database (JMDC Claims Database) in 2017 with two inclusions/exclusion criteria: selecting all patients with cancer (extract 1) and excluding patients who had received cancer treatments in 2015 or 2016 (extract 2). We estimated the cancer incidence of the five cancer sites and compared it with the Japan National Cancer Registry incidence (calculated standardized incidence ratio with 95% CIs). RESULTS The number of patients with newly diagnosed cancer ranged from 219 to 17,840 by the sites, algorithms, and exclusion criteria. Standardized incidence ratios were significantly higher in the JMDC Claims Database than in the national registry data for extract 1 and algorithm 1, extract 1 and algorithm 2, and extract 2 and algorithm 1. In extract 2 and algorithm 2, colorectal cancer in male and stomach, lung, and cervical cancers in females showed similar cancer incidence in the JMDC and national registry data. CONCLUSION The novel algorithms are effective for extracting information about patients with cancer from claims data by using the combined information on diagnosis, procedures, and medicines (algorithm 2), with 2-year cancer-treatment history as an exclusion criterion (extract 2).
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Affiliation(s)
- Toshio Ogawa
- Division of Public Health, Faculty of Agriculture, Setsunan University, Osaka, Japan
| | | | | | - Motoyasu Sagawa
- Division of Endoscopy, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Miyagi, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Matsuda
- Fukui Health Promotion Center, Fukui Health Care Society, Fukui, Japan
| | - Tomio Nakayama
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Yoshio Kasahara
- Department of Breast Surgery, Fukui Prefecture-Saiseikai Hospital, Fukui, Japan
| | - Katsuaki Kato
- Cancer Detection Center, Miyagi Cancer Society, Miyagi, Japan
| | - Eiko Saitoh
- Department of Preventive Medicine Center, International University of Health and Welfare, Tokyo, Japan
| | - Tohru Morisada
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kyorin University, Tokyo, Japan
| | - Kumiko Saika
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Norie Sawada
- National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Yasushi Matsumura
- National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Tomotaka Sobue
- Graduate School of Medicine, Osaka University School of Medicine, Osaka, Japan
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5
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Sagawa M. [Current Status and Prospects of Lung Cancer Screening]. Kyobu Geka 2021; 74:74-83. [PMID: 33550323] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The prognosis for advanced lung cancer is still poor, even though various therapeutic methods such as molecular targeted therapeutics and immunotherapy have become available. Early detection is still important in the treatment of lung cancer, and the role of lung cancer screening is very essential. The current lung cancer screening system in Japan has many problems. Although low-dose chest computed tomography (CT) screening has appeared as a new screening modality, there are still many things to be studied and improved. In this article, the outline of the current system of lung cancer screening in Japan is presented, and then the problems in the system and future prospects are described.
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Affiliation(s)
- Motoyasu Sagawa
- Division of Endoscopy, Tohoku Medical and Pharmaceutical University, Sendai, Japan
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6
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Sasaki T, Tabata T, Nonomura R, Oshima Y, Mitomo H, Ishibashi N, Sugawara T, Tezuka N, Sagawa M, Kondo T, Yoshimura N. [Clinical Efficacy of Monotherapy with Immune Checkpoint Inhibitors for Advanced Non-Small Cell Lung Cancer]. Gan To Kagaku Ryoho 2020; 47:1443-1447. [PMID: 33130738] [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: 06/11/2023]
Abstract
OBJECTIVE To retrospectively assess data on immune checkpoint inhibitors(ICIs)in an actual clinical setting, examine the factors that contribute to response and survival using real-world data, and compare the effectiveness of the 3 types of ICIs for patients with non-small cell lung cancer(NSCLC). METHODS A retrospective analysis of 127 patients with NSCLC treated with ICIs at our hospital was conducted. RESULTS Nivolumab(56 patients)showed a 3-year survival rate of 21.6% and a disease control rate of 57.1%. These results are consistent with the clinical trials of Nivolumab. Pembrolizumab(36 patients) showed a 2-year survival rate of 60.3%, a response rate of 50.0%, and a disease control rate of 63.9%. Atezolizumab(35 patients)displayed a particularly low response rate with a 1-year survival rate of 58.4%, response rate of 8.6%, and disease control rate of 25.7%. The treatment results for recurrence after surgery for lung cancer were comparable to those for unresectable lung cancer. CONCLUSION Anti-PD-1 antibody displayed better therapeutic results than anti-PD-L1 antibody. The efficacy of ICI administration for postoperative recurrent lung cancer was also shown in this study.
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Affiliation(s)
- Takanobu Sasaki
- Dept. of Chest Surgery, Tohoku Medical and Pharmaceutical University Faculty of Medicine
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7
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Hasegawa T, Suzuki H, Abe J, Sakurada A, Endo C, Sato N, Hasumi T, Deguchi H, Oura H, Takahashi S, Saito H, Uramoto H, Sagawa M, Okada Y. A phase 2 study of adjuvant carboplatin plus S-1 followed by maintenance S-1 therapy for patients with completely resected stage II/IIIA non-small cell lung cancer-Japanese Northern East Area Thoracic Surgery Study Group JNETS1302 study. J Thorac Dis 2020; 12:3591-3601. [PMID: 32802438 PMCID: PMC7399402 DOI: 10.21037/jtd-20-715] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background The standard adjuvant chemotherapy regimen for completely resected pathological stage II/IIIA non-small cell lung cancer (NSCLC) is four courses of cisplatin plus vinorelbine. However, the continuity and toxicity of cisplatin-based regimens remain problematic. Conversely, carboplatin-based chemotherapy is a less toxic and more tolerable regimen for various stages of NSCLC. In particular, the efficacy and tolerability of carboplatin plus S-1 in advanced NSCLC were confirmed by previous pivotal studies such as the LETS trail. Therefore, this phase II study assessed the feasibility, safety, and usefulness of carboplatin plus S-1 followed by maintenance S-1 as an adjuvant treatment. Methods In this single-arm, multicenter phase II study, 40 patients who previously underwent complete resection of NSCLC were enrolled from November 2013 to January 2015. The chemotherapy protocol was four cycles of carboplatin (AUC 5 on day 1) and oral S-1 (80 mg/m2 every other day from days 1 to 21) followed by oral S-1 (80 mg/m2 every other day for 48 weeks). The primary endpoint was the treatment completion rate, and the secondary endpoints were adverse events and 2-year recurrence-free survival. Results The treatment completion rate of the planned schedule was as low as 30.0% (90% confidence interval: 40.3–63.0%). The reasons for adjuvant chemotherapy discontinuation were adverse events, refusal, tumor recurrence, and other reasons in 13, 6, 10, and 2 patients, respectively. The 2-year progression-free survival rate was 66.7% among patients who completed maintenance chemotherapy. There were no treatment-related deaths, and most adverse events were less than grade 3. Conclusions Carboplatin plus S-1 followed by S-1 maintenance for 1 year in the adjuvant treatment of NSCLC was not tolerable, although most adverse events were not severe. However, patients who can fully complete the regimen might experience clinical benefit.
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Affiliation(s)
- Takeo Hasegawa
- Japanese Northern East Area Thoracic Surgery Study Group, Seiryomachi, Sendai Aoba-ku, Japan.,Department of Chest Surgery, Fukushima Medical University, Hikarigaoka, Fukushima, Japan
| | - Hiroyuki Suzuki
- Japanese Northern East Area Thoracic Surgery Study Group, Seiryomachi, Sendai Aoba-ku, Japan.,Department of Chest Surgery, Fukushima Medical University, Hikarigaoka, Fukushima, Japan
| | - Jiro Abe
- Japanese Northern East Area Thoracic Surgery Study Group, Seiryomachi, Sendai Aoba-ku, Japan.,Division of Thoracic Surgery, Miyagi Prefectural Cancer Center, Medeshimashiote Nodayama, Natori, Japan
| | - Akira Sakurada
- Japanese Northern East Area Thoracic Surgery Study Group, Seiryomachi, Sendai Aoba-ku, Japan.,Department of Thoracic Surgery, Tohoku University, Seiryomachi, Sendai Aoba-ku, Japan
| | - Chiaki Endo
- Japanese Northern East Area Thoracic Surgery Study Group, Seiryomachi, Sendai Aoba-ku, Japan.,Department of Thoracic Surgery, Tohoku University, Seiryomachi, Sendai Aoba-ku, Japan
| | - Nobuyuki Sato
- Japanese Northern East Area Thoracic Surgery Study Group, Seiryomachi, Sendai Aoba-ku, Japan.,Division of Thoracic Surgery, Aomori Prefectural Central Hospital, Higashitsukurimichi, Aomori, Japan
| | - Tohru Hasumi
- Japanese Northern East Area Thoracic Surgery Study Group, Seiryomachi, Sendai Aoba-ku, Japan.,Division of Thoracic Surgery, Sendai Medical Center, Miyagino, Sendai Miyagino-ku, Japan
| | - Hiroyuki Deguchi
- Japanese Northern East Area Thoracic Surgery Study Group, Seiryomachi, Sendai Aoba-ku, Japan.,Department of Thoracic Surgery, Iwate Medical University, Uchimaru, Morioka, Japan
| | - Hiroyuki Oura
- Japanese Northern East Area Thoracic Surgery Study Group, Seiryomachi, Sendai Aoba-ku, Japan.,Division of Thoracic Surgery, Iwate Prefectural Central Hospital, Ueda, Morioka, Japan
| | - Satomi Takahashi
- Japanese Northern East Area Thoracic Surgery Study Group, Seiryomachi, Sendai Aoba-ku, Japan.,Division of Thoracic Surgery, Miyagi Prefectural Cancer Center, Medeshimashiote Nodayama, Natori, Japan
| | - Hajime Saito
- Japanese Northern East Area Thoracic Surgery Study Group, Seiryomachi, Sendai Aoba-ku, Japan.,Department of Thoracic Surgery, Iwate Medical University, Uchimaru, Morioka, Japan
| | - Hidetaka Uramoto
- Japanese Northern East Area Thoracic Surgery Study Group, Seiryomachi, Sendai Aoba-ku, Japan.,Department of Thoracic Surgery, Kanazawa Medical University, Daigaku, Kahokugun Uchinadamachi, Japan
| | - Motoyasu Sagawa
- Japanese Northern East Area Thoracic Surgery Study Group, Seiryomachi, Sendai Aoba-ku, Japan.,Division of Endoscopy, Tohoku Medical and Pharmaceutical University, Komatsushima, Sendai Aoba-ku, Japan
| | - Yoshinori Okada
- Japanese Northern East Area Thoracic Surgery Study Group, Seiryomachi, Sendai Aoba-ku, Japan.,Department of Thoracic Surgery, Tohoku University, Seiryomachi, Sendai Aoba-ku, Japan
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Mitomo H, Tabata T, Nonomura R, Oshima Y, Sasaki T, Ishibashi N, Sugawara T, Sagawa M, Kondo T, Murakami K. [Acute Megakaryoblastic Leukemia Developed after the Surgical Treatment of Mediastinal Malignant Germ Cell Tumor]. Kyobu Geka 2020; 73:543-546. [PMID: 32641675] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 26-year-old man was admitted to our hospital for an examination of a mediastinal tumor. Chest computed tomography(CT) showed a giant anterior mediastinal tumor narrowing the trachea and right main bronchus. Although needle biopsy could not be done because of patient respiratory condition, non-seminomatous mediastinal germ cell malignant tumor was strongly suspected by high level of serum AFP without no abnormal finding in his testis. After 1 cycle of chemotherapy by cisplatin, etoposide and bleomycin, the mediastinal tumor decreased in size. Percutaneous biopsy was challenged, however, definite diagnosis could not be established and the surgical resection was performed. The tumor was pathologically diagnosed as mature teratoma with elements of a yolk-sac tumor and some sort of sarcoma. Sudden onset of back pain and thrombocytopenia were encountered 5 months after the operation. Hematologic examination confirmed acute megakaryoblastic leukemia, and remission-induction therapy and allogeneic hematopoietic stem cell transplantation were performed. Twelve months after the operation, the patient is well without recurrence of either disease.
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Affiliation(s)
- Hideki Mitomo
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
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9
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Oshima Y, Tabata T, Nonomura R, Sasaki T, Mitomo H, Ishibashi N, Sugawara T, Sagawa M, Kondo T. [Pericardial Fenestration and Multidisciplinary Treatment to Improve the Prognosis of the Malignant Pericarditis Due to Lung Cancer]. Kyobu Geka 2020; 73:63-67. [PMID: 31956251] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We experienced 3 cases in whom multidisciplinary treatment with pericardial fenestration was effective for malignant pericardial effusion associated with lung cancer. Case 1:Right upper lobectomy for lung adenocarcinoma, EGFR (-) and ALK (-) had been performed. After 34 months, malignant pericarditis occurred and left pericardial fenestration was performed. After fenestration, anticancer drugs and immune checkpoint inhibitor( ICI) were administered. He died of lung cancer in 53 months after fenestration. Case 2:Thirty-three months after left upper lobectomy for lung adenocarcinoma [EGFR (+) and ALK (-)], malignant pleuritis and pericarditis occurred and right pericardial fenestration was performed. After fenestration, anticancer drugs, EGFR-TKI and ICI were administered. He died of lung cancer in 35 months after fenestration. Case 3:Pericardial fenestration was performed for malignant pericarditis due to lung adenocarcinoma with EGFR (-), ALK (-) and PD-L1 [tumor propotion score (TPS) 0%]. After fenestration, anticancer drugs and ICI were administered. The patient died of lung cancer in 15 months after fenestration. Pericardial fenestration for malignant pericarditis is possibly useful for the management of patients, which in turns is also useful in continuing the medical treatment to prolong the prognosis.
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Affiliation(s)
- Yutaka Oshima
- Department of the Second Surgery, Tohoku Medical and Pharmaceutical University Sendai, Japan
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10
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Nonomura R, Tabata T, Oshima Y, Sasaki T, Mitomo H, Ishibashi N, Sugawara T, Sagawa M, Kondo T. [Association Between Juvenile Spontaneous Pneumothorax and Smoking]. Kyobu Geka 2019; 72:1053-1056. [PMID: 31879378] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We assessed the relation between smoking and pneumothorax in patients aged <40. Of 526 patients who underwent surgery for pneumothorax in 2011~2015, 311 were under the age of 40 and they were included in this study. Of 311, 54 cases( 17.4%) were diagnosed with spontaneous pneumothorax associated with emphysematous change by pathological assessment. By the multivariate analysis, 2 parameters exhibited significance for the risk of these spontaneous pneumothorax:a Brinkmann index of ≥165 and a smoking period of ≥9.5 years. It was suggested that smoking is strongly related to the onset of spontaneous pneumothorax even in the younger population less than 40 years of age.
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Affiliation(s)
- Ryo Nonomura
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
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11
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Mitomo H, Tabata T, Nonomura R, Koyanagi A, Oshima Y, Sasaki T, Ishibashi N, Sugawara T, Sagawa M, Kondo T. [Bronchial Artery Aneurysm with Hoarseness;Report of a Case]. Kyobu Geka 2019; 72:1042-1045. [PMID: 31701919] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The patient was a 72-year-old man with a history of bronchiectasis. He was admitted to our hospital for an examination of hoarseness. Chest computed tomography (CT) showed bronchiectasis in the bilateral lungs and bronchial artery aneurysm in the mediastinum. To prevent rupture of the aneurysm, we imaged the bronchial artery aneurysm by selective bronchial artery angiography and performed bronchial artery embolization (BAE) with 19 platinum coils. Three months after successful BAE, his hoarseness had improved, and the bronchial artery aneurysm was reduced in size after 12 months. To our knowledge, this is the 1st report of BAE improving hoarseness due to bronchial artery aneurysm.
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Affiliation(s)
- Hideki Mitomo
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University, Sendai, Japan
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12
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Sagawa M, Machii R, Nakayama T, Sugawara T, Ishibashi N, Mitomo H, Kondo T, Tabata T. The Prefectural Participation Rates of Lung Cancer Screening Had a Negative Correlation with the Lung Cancer Mortality Rates. Asian Pac J Cancer Prev 2019; 20:855-861. [PMID: 30912404 PMCID: PMC6825770 DOI: 10.31557/apjcp.2019.20.3.855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/25/2022] Open
Abstract
Background: The participation rate is one of the most important indexes in the cancer screening. Historically
in Japan, each local government has developed their own equations to calculate the subjects for population-based
screening, which were different from each other, and therefore the participation rates of screening were not comparable.
Recently, local governments were ordered to use the standardized equation in reporting data, which made it possible
to compare the participation rates of cancer screening nationwide for the first time. We therefore investigated the
correlation between the prefectural lung cancer mortality and several indicators of lung cancer screening. Methods:
The prefectural participation rates of lung, gastric and colonic cancer screening, test positive rates, attendance rates
for further examination, lung cancer detection rates and positive predictive values of lung cancer screening were
collected from “Cancer Registration and Statistics” of the National Cancer Research Center website. The age-adjusted
lung, gastric and colonic cancer mortality rates, smoking rates were also collected. The EZR software program was
used for statistical analyses. Results: The participation rates of lung cancer screening had a strong positive correlation
with the participation rates of gastric/colonic cancer screening (P<0.001). The prefectural lung cancer mortality rates
had a moderate to weak negative correlation with the participation rates of lung cancer screening (P=0.009). A little
correlation was noted between other quality assurance indicators of lung cancer screening and lung cancer mortality
rates. Conclusion: These results suggested that participating in lung cancer screening might help reduce lung cancer
mortality rates in some extent.
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Affiliation(s)
- Motoyasu Sagawa
- Division of Endoscopy, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
| | - Ryoko Machii
- Division of Medical Support and Partnership, Center for Cancer Control and Information Service, National Cancer Center, Tokyo, japan
| | - Tomio Nakayama
- Division of Screening Assessment and Management, Center for Public Health Service, National Cancer Center, Tokyo, Japan
| | - Takafumi Sugawara
- Division of Chest Surgery, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Naoya Ishibashi
- Division of Chest Surgery, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Hideki Mitomo
- Division of Chest Surgery, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Takashi Kondo
- Division of Chest Surgery, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Toshiharu Tabata
- Division of Chest Surgery, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
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Nawa T, Fukui K, Nakayama T, Sagawa M, Nakagawa T, Ichimura H, Mizoue T. A population-based cohort study to evaluate the effectiveness of lung cancer screening using low-dose CT in Hitachi city, Japan. Jpn J Clin Oncol 2019; 49:130-136. [PMID: 30541133 PMCID: PMC6366936 DOI: 10.1093/jjco/hyy185] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 11/21/2018] [Indexed: 11/13/2022] Open
Abstract
Objectives To evaluate the effectiveness of lung cancer screening using low-dose computed tomography for the general population, we conducted a retrospective cohort study of screening for participants among Hitachi residents. Materials and Methods Citizens aged 50-74 who underwent low-dose computed tomography screening at least once during 1998-2006 were defined as the computed tomography group, and those who underwent X-ray screening at least once during the same period, but did not receive low-dose computed tomography screening throughout the follow-up period, were defined as the XP group. We investigated the lung cancer incidence rate, mortality rate and all-cause mortality rate for both groups from the first lung cancer screening to the end of 2012. Results In the computed tomography group (17 935 residents; 9790 males and 8145 females), 273 cases of lung cancer (1.5%), 72 cases of lung cancer death (0.4%), and 885 cases of all-cause death (4.9%) were observed. On the other hand, 164 cases (1.1%) of lung cancer, 80 cases (0.5%) of lung cancer death and 1188 cases (7.6%) of all-cause death were observed in the XP group (15 548 residents; 6526 males and 9022 females). The hazard ratios of the computed tomography group to the XP group adjusted for gender, age and smoking history were 1.23 for lung cancer incidence rate, 0.49 for lung cancer mortality rate and 0.57 for all-cause mortality rate. Non-smokers and light smokers (<30 pack-years) had a significantly lower lung cancer mortality (0.41 and 0.21, respectively). Conclusion low-dose computed tomography screening for a population including non-smokers and light smokers may be effective.
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Affiliation(s)
- Takeshi Nawa
- Department of Respiratory Medicine, Hitachi General Hospital, Hitachi Ltd., Hitachi, Ibaraki, Japan
| | - Keisuke Fukui
- Research & Development Center, Osaka Medical College,Takatsuki, Osaka, Japan
| | - Tomio Nakayama
- Center for Public Health Sciences, National Cancer Center Japan, Chuo-ku, Tokyo, Japan
| | - Motoyasu Sagawa
- Department of Endoscopy, Tohoku Medical and Pharmaceutical University, Miyagino-ku, Sendai, Miyagi, Japan
| | - Tohru Nakagawa
- Hitachi Health Care Center, Hitachi Ltd., Hitachi, Ibaraki, Japan
| | - Hideo Ichimura
- Hitachi Medical Education and Research Center, Thoracic Surgery, University of Tsukuba, Hitachi, Ibaraki, Japan
| | - Tetsuya Mizoue
- Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
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Ishibashi N, Tabata T, Koyanagi A, Nonomura R, Sasaki T, Mitomo H, Sugawara T, Kondo T, Murakami K, Sagawa M. [Clinical Assessment of Fourteen Cases of Thoracic Endometriosis]. Kyobu Geka 2019; 72:87-91. [PMID: 30772872] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We retrospectively assessed the clinical and pathological features of 14 patients with thoracic endometriosis who were treated at our hospital from 2007 to 2017. Thirteen patients presented pneumothorax and 1 patient presented bloody sputum. All were treated surgically. Pneumothorax occurs on the right side in all 13 cases and bloody sputum was from left side lesion. Ten patients presented symptoms closely related with their menstrual cycle (days -2 to 5). At surgery, dark red or dark brown spots, small hiatus and scar-like findings on the surface of the visceral pleura or diaphragm were identified in all cases. Pathological or immunohistochemical examinations of diaphragm or lung tissue specimens revealed endometrial tissue in 6 cases of pneumothorax and a case of bloody sputum. Nine patients received hormonal therapy(8:pneumothorax, 1:bloody sputum). Pleurodesis was performed for 1 pneumothorax patient with recurrent pneumothorax after hormonal therapy. In case of young female with repeated pneumothorax, catamenial pneumothorax must be kept in mind as a differential diagnosis and appropriate timing for surgical treatment should be considered to establish pathologically correct diagnosis.
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Affiliation(s)
- Naoya Ishibashi
- Division of Thoracic Surgery,Tohoku Medical and Pharmaceutical University, Sendai, Japan
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15
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Sagawa M, Oizumi H, Suzuki H, Uramoto H, Usuda K, Sakurada A, Chida M, Shiono S, Abe J, Hasumi T, Sato M, Sato N, Shibuya J, Deguchi H, Okada Y. A prospective 5-year follow-up study after limited resection for lung cancer with ground-glass opacity. Eur J Cardiothorac Surg 2019; 53:849-856. [PMID: 29236995 DOI: 10.1093/ejcts/ezx418] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [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] [Received: 07/14/2017] [Accepted: 10/31/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The incidence of small-sized pulmonary adenocarcinomas with ground-glass opacity (GGO) has recently increased, with excellent postoperative prognosis. The limited resection of such cancers has been deemed to be acceptable based on retrospective studies. We conducted a prospective multi-institutional study evaluating the validity of limited resection for small-sized pulmonary adenocarcinoma with GGO. METHODS The inclusion criteria were 25-80 years of age, no prior treatment, a maximum tumour diameter of 8-20 mm, a GGO ratio of ≥ 80%, clinical T1N0M0, lower 18F-fluorodeoxyglucose accumulation than the mediastinum, resectable by sublobar resection, pulmonary lobectomy tolerable and an intraoperative pathological diagnosis of bronchiloalveolar carcinoma. Wedge resection was preferred, but segmentectomy was permitted. Disease-specific survival and overall survival were analysed. RESULTS From November 2006 to April 2012, 73 patients were enrolled from 13 institutions. One patient was ineligible, and the remaining 72 patients were preregistered. The tumours of 3 and 14 patients were intraoperatively diagnosed as benign lesions and adenocarcinomas with mixed subtype, respectively. Intraoperative cytological/histological examination of surgical margin was not performed in 2 patients, and the remaining 53 patients were ultimately eligible for this study. The mean tumour size was 14.0 mm and the mean GGO ratio was 95.9%. Thirty-nine and 14 patients underwent wedge resection and segmentectomy, respectively. Although all tumours were intraoperatively diagnosed as bronchioloalveolar carcinomas, 6 were ultimately diagnosed as adenocarcinoma with a mixed subtype. No completion lobectomy was performed. As of 1 May 2017, no recurrence of the original lung cancer was observed during 60.0-126.3 months after surgery. Two patients died from other diseases. The 5-year disease-specific and overall survival rates were 100% and 98.1%, respectively. The reduction in the pulmonary function after limited resection was minimal. CONCLUSIONS With these criteria, limited resection was performed safely without any recurrence, and the postoperative pulmonary function was well preserved. The outcomes of limited resection for small-sized lung cancer with GGOs that met the criteria of this study were satisfactory.
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Affiliation(s)
- Motoyasu Sagawa
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Division of Endoscopy, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Hiroyuki Oizumi
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Department of Surgery 2, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Hiroyuki Suzuki
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Department of Chest Surgery, Fukushima Medical University, Fukushima, Japan
| | - Hidetaka Uramoto
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Division of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Katsuo Usuda
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Division of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Akira Sakurada
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan
| | - Masayuki Chida
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Department of General Thoracic Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Satoshi Shiono
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Jiro Abe
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Department of Thoracic Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan
| | - Tohru Hasumi
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Department of Thoracic Surgery, Sendai Medical Center, Sendai, Japan
| | - Masami Sato
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Nobuyuki Sato
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Department of Thoracic Surgery, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Jotaro Shibuya
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Department of Thoracic Surgery, Iwate Prefectural Isawa Hospital, Mizusawa, Iwate, Japan
| | - Hiroyuki Deguchi
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Department of General Thoracic Surgery, Iwate Medical University, Morioka, Iwate, Japan
| | - Yoshinori Okada
- Japan North-East Thoracic Surgical Study Group (JNETS), Sendai, Japan.,Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan
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Hayasaka K, Shiono S, Matsumura Y, Suzuki H, Yanagawa N, Abe J, Sagawa M, Sakurada A, Katahira M, Takahashi S, Endoh M, Okada Y. P3.16-03 Uncommon EGFR Mutations as a Worse Prognostic Factor for Surgically Resected Lung Adenocarcinoma. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1910] [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: 11/25/2022]
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17
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Hayasaka K, Shiono S, Matsumura Y, Yanagawa N, Suzuki H, Abe J, Sagawa M, Sakurada A, Katahira M, Takahashi S, Endoh M, Okada Y. Epidermal Growth Factor Receptor Mutation as a Risk Factor for Recurrence in Lung Adenocarcinoma. Ann Thorac Surg 2018; 105:1648-1654. [PMID: 29486179 DOI: 10.1016/j.athoracsur.2018.01.052] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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] [Received: 09/15/2017] [Revised: 01/16/2018] [Accepted: 01/16/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND The presence of epidermal growth factor receptor (EGFR) mutations is an established prognostic factor for patients with advanced lung adenocarcinoma. Here, we examined whether EGFR mutation status is a prognostic factor for patients who had undergone surgery. METHODS Clinicopathologic data from 1,463 patients who underwent complete surgical resection for lung adenocarcinoma between 2005 and 2012 were collected. Differences in postoperative recurrence-free survival and overall survival according to EGFR mutation status were evaluated. RESULTS Of 835 eligible patients, the numbers of patients with wild-type EGFR (WT), exon 19 deletion (Ex19), and exon 21 L858R (Ex21) were 426, 175, and 234, respectively. Patients with Ex19 had a significantly higher incidence of extrathoracic recurrence than patients with Ex21 (p = 0.004). The 5-year recurrence-free survival rates for patients with WT, Ex19, and Ex21 were 63.0%, 67.5%, and 78.2%, respectively. The Ex21 group had a significantly longer recurrence-free survival than the WT group (p < 0.001) and the Ex19 group (p = 0.016). The 5-year overall survival for patients with WT, Ex19, and Ex21 were 76.9%, 86.5%, and 87.5%, respectively. Patients with Ex19 and Ex21 had a significantly longer overall survival than patients with WT (Ex19, p = 0.009; Ex21, p < 0.001). Multivariate analysis for recurrence-free survival showed that Ex19 was significantly associated with a worse prognosis than Ex21 (p = 0.019). CONCLUSIONS Patients with Ex19 had significantly shorter recurrence-free survival and had extrathoracic recurrence more frequently than patients with Ex21 among patients with resected lung adenocarcinoma, implying that Ex19 could be a worse prognostic factor.
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Affiliation(s)
- Kazuki Hayasaka
- Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Satoshi Shiono
- Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
| | - Yuki Matsumura
- Department of Regenerative Surgery, Fukushima Medical University, Fukushima, Japan
| | - Naoki Yanagawa
- Department of Pathology, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Hiroyuki Suzuki
- Department of Regenerative Surgery, Fukushima Medical University, Fukushima, Japan
| | - Jiro Abe
- Department of Thoracic Surgery, Miyagi Cancer Center, Miyagi, Japan
| | - Motoyasu Sagawa
- Department of Endoscopy, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
| | - Akira Sakurada
- Department of Thoracic Surgery, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Masato Katahira
- Department of Thoracic Surgery, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Satomi Takahashi
- Department of Thoracic Surgery, Miyagi Cancer Center, Miyagi, Japan
| | - Makoto Endoh
- Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Yoshinori Okada
- Department of Thoracic Surgery, Tohoku University Graduate School of Medicine, Miyagi, Japan
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18
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Nawa T, Fukui K, Nakayama T, Sagawa M, Nakagawa T, Ichimura H, Mizoue T. MA 14.06 Population Based Cohort Study to Evaluate Lung Cancer Screening Using Low Dose CT in Hitachi City. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.576] [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: 11/28/2022]
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19
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Kato H, Oizumi H, Sagawa M, Suzuki H, Sakurada A, Chida M, Uramoto H, Shiono S, Abe J, Hasumi T, Nakamura Y, Sato N, Shibuya J, Deguchi H, Oura H, Matsumura Y, Minowa M, Ota S, Okada Y. P-144LIMITED RESECTION FOR SMALL-SIZED NON-SMALL CELL LUNG CANCER WITH GROUND-GLASS OPACITIES: A JAPAN NORTH-EAST THORACIC SURGICAL STUDY GROUP (JNETS) PHASE II STUDY. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.144] [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] Open
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20
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Hayasaka K, Shiono S, Matsumura Y, Yanagawa N, Suzuki H, Abe J, Sagawa M, Sakurada A, Katahira M, Machida Y, Takahash S, Okada Y. OA19.07 Difference of Postoperative Survival Due to the Type of EGFR Gene Mutation in Surgically Resected Lung Adenocarcinomas. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.342] [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: 10/20/2022]
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21
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Sagawa M, Sugawara T, Ishibashi N, Koyanagi A, Kondo T, Tabata T. Efficacy of low-dose computed tomography screening for lung cancer: the current state of evidence of mortality reduction. Surg Today 2016; 47:783-788. [PMID: 27815717 DOI: 10.1007/s00595-016-1438-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 10/04/2016] [Indexed: 12/17/2022]
Abstract
The interim and final results of randomized controlled trials on the efficacy of lung cancer computed tomography (CT) screening have been reported recently from Western countries. The outcome of the National Lung Screening Trial (NLST) demonstrated the efficacy of low-dose thoracic CT screening for heavy smokers; however, other studies have found no apparent reduction in the mortality rate, and the outcome of the NELSON study is awaited. To date, a few studies have reported on the efficacy of lung cancer CT screening for non-/light smokers. A report from the Hitachi district, which is an ecological/time series study where non-/light smokers account for approximately half of the CT screening examinees, was published in 2012, with an outcome suggesting efficacy. Currently, a randomized controlled trial (JECS Study) is underway in Japan with non-/light smokers as the subjects, and this trial is very important in terms of cancer prevention.
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Affiliation(s)
- Motoyasu Sagawa
- Department of Endoscopy, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8512, Japan.
| | - Takafumi Sugawara
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8512, Japan
| | - Naoya Ishibashi
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8512, Japan
| | - Akira Koyanagi
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8512, Japan
| | - Takashi Kondo
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8512, Japan
| | - Toshiharu Tabata
- Department of Thoracic Surgery, Tohoku Medical and Pharmaceutical University, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, 983-8512, Japan
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22
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Motono N, Maeda S, Honda R, Tanaka M, Machida Y, Usuda K, Sagawa M, Uramoto H. Atmospheric temperature and pressure influence the onset of spontaneous pneumothorax. Clin Respir J 2016; 12:557-562. [DOI: 10.1111/crj.12562] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 09/04/2016] [Accepted: 09/17/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Nozomu Motono
- Department of Thoracic Surgery; Kanazawa Medical University; Ishikawa Japan
| | - Sumiko Maeda
- Department of Thoracic Surgery; Kanazawa Medical University; Ishikawa Japan
| | - Ryumon Honda
- Department of Social and Environmental Medicine; Kanazawa Medical University; Ishikawa Japan
| | - Makoto Tanaka
- Department of Thoracic Surgery; Kanazawa Medical University; Ishikawa Japan
| | - Yuichiro Machida
- Department of Thoracic Surgery; Kanazawa Medical University; Ishikawa Japan
| | - Katsuo Usuda
- Department of Thoracic Surgery; Kanazawa Medical University; Ishikawa Japan
| | - Motoyasu Sagawa
- Department of Thoracic Surgery; Kanazawa Medical University; Ishikawa Japan
| | - Hidetaka Uramoto
- Department of Thoracic Surgery; Kanazawa Medical University; Ishikawa Japan
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23
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Machida Y, Sagawa M, Tanaka M, Motono N, Matsui T, Usuda K, Uramoto H. Postoperative survival According to the Glasgow Prognostic
Score in Patients with Resected Lung Adenocarcinoma. Asian Pac J Cancer Prev 2016; 17:4677-4680. [PMID: 27892939 PMCID: PMC5454616 DOI: 10.22034/apjcp.2016.17.10.4677] [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] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: The Glasgow Prognostic Score (GPS) is calculated from measured CRP and albumin levels. We here evaluated the significance of the GPS in patients with resected pulmonary adenocarcinoma. Materials and Methods: The present study included 156 patients with lung adenocarcinoma who underwent lobectomy at Kanazawa Medical University between 2002 and 2012. Classification was into three groups: Those with normal albumin (>=3.5 g/dl) and C-reactive protein (CRP) (<=1.0 mg/dl) levels were classified as GPS 0 (n =136), those with low albumin (<3.5 g/dl) or elevated CRP (>1.0 mg/dl) levels as GPS 1 (n = 16), and those with low albumin (<3.5 g/dl) and elevated CRP (>1.0 mg/dl) levels as GPS 2 (n = 4). We retrospectively investigated relationships between the patient characteristics including the GPS, and disease-free survival and cancer-specific survival. Results: The pathological stages of the patients were as follows: IA (n=78, 50%), IB (n=31, 19.9%), IIA (n=20.0, 12.8%), IIB (n=9.0, 5.7%), and IIIA (n=18.0, 11.5%). Lobectomy was performed in all cases. The average GPS was 0.15 (0-2) and showed significant relationships with stage and tumor size. The 2-year survival rates in patients with GPS0, 1 and 2 were 81.4%, 38.4%, and 25.0%, respectively. Clear correlations were noted with both cancer-specific survival and disease-free survival. Furthermore, multivariate analysis revealed that GPS was a significant prognostic factor. Conclusions: The GPS could be a prognostic factor for patients with resected pulmonary adenocarcinoma.
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Affiliation(s)
- Yuichiro Machida
- Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan.
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Higashi K, Yamagishi T, Ueda Y, Ishigaki Y, Shimasaki M, Nakamura Y, Oguchi M, Takegami T, Sagawa M, Tonami H. Correlation of HIF-1α/HIF-2α expression with FDG uptake in lung adenocarcinoma. Ann Nucl Med 2016; 30:708-715. [PMID: 27663442 DOI: 10.1007/s12149-016-1116-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/14/2016] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Hypoxia is a key element involved in the development and progression of tumors. HIF-1α may transiently induce and mediate the response to acute and severe hypoxia, while HIF-2α may induce a longer response and may control the response to chronic and moderate hypoxia. Hypoxia increases the cellular uptake of FDG. Therefore, HIF may play an important role in the process of the cellular uptake of FDG. The aim of this study was to compare HIF-1α/HIF-2α expression with FDG uptake, Glut-1 expression, and prognosis in the patients with lung adenocarcinoma and to investigate the role of HIF-1α/HIF-2α in the uptake of FDG in lung adenocarcinoma. METHODS In the current work, we compared the immunohistochemical expression of HIF-1α and HIF-2α in surgical specimens of 44 patients with lung adenocarcinoma. The relationships between HIF-α expression and Glut-1 expression, FDG uptake, and clinicopathological factors, including prognosis, were analyzed. RESULTS There was a marginal association between HIF-1α and HIF-2α expressions (P = 0.076). We found a significant correlation between HIF-2α expression and FDG uptake (P = 0.0001). HIF-1α expression showed a marginal association with FDG uptake (P = 0.066). FDG uptake correlated more significantly with HIF-2α expression than with HIF-1α expression. A significant correlation was noticed between Glut-1 expression and both HIF-1α and HIF-2α expressions (P = 0.005 and P = 0.003, respectively). Univariate analysis of disease-free survival demonstrated that FDG uptake and HIF-2α expression, but not HIF-1α expression, were related to recurrence (P < 0.0001). CONCLUSION FDG uptake correlated more significantly with HIF-2α expression than with HIF-1α expression, and both FDG uptake and HIF-2α expression, but not HIF-1α expression was correlated with post-operative recurrence in the patients with lung adenocarcinoma. These results suggest that both FDG uptake and HIF-2α expression may represent a more aggressive phenotype and that HIF-2α may play a more important role than HIF-1α in the uptake of FDG in lung adenocarcinoma.
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Affiliation(s)
- Kotaro Higashi
- Department of Radiology, Asanogawa General Hospital, 83 Kosakamachi-Naka, Kanazawa, Ishikawa, 920-8621, Japan.
| | | | - Yoshimichi Ueda
- Department of Pathology, Kanazawa Medical University, Ishikawa, Japan
| | - Yasuhito Ishigaki
- Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan
| | - Miyako Shimasaki
- Department of Pathology, Kanazawa Medical University, Ishikawa, Japan
| | - Yuka Nakamura
- Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan
| | - Manabu Oguchi
- Department of Radiation Therapy, Public Central Hospital of Matto Ishikawa, Ishikawa, Japan
| | - Tsutomu Takegami
- Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan
| | - Motoyasu Sagawa
- Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa, Japan
| | - Hisao Tonami
- Department of Radiology, Kanazawa Medical University, Ishikawa, Japan
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Usuda K, Maeda S, Motono N, Ueno M, Tanaka M, Machida Y, Matoba M, Watanabe N, Tonami H, Ueda Y, Sagawa M. Diffusion Weighted Imaging Can Distinguish Benign from Malignant Mediastinal Tumors and Mass Lesions: Comparison with Positron Emission Tomography. Asian Pac J Cancer Prev 2016; 16:6469-75. [PMID: 26434861 DOI: 10.7314/apjcp.2015.16.15.6469] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diffusion-weighted magnetic resonance imaging (DWI) makes it possible to detect malignant tumors based on the diffusion of water molecules. It is uncertain whether DWI is more useful than positron emission tomography-computed tomography (PET-CT) for distinguishing benign from malignant mediastinal tumors and mass lesions. MATERIALS AND METHODS Sixteen malignant mediastinal tumors (thymomas 7, thymic cancers 3, malignant lymphomas 3, malignant germ cell tumors 2, and thymic carcinoid 1) and 12 benign mediastinal tumors or mass lesions were assessed in this study. DWI and PET-CT were performed before biopsy or surgery. RESULTS The apparent diffusion coefficient (ADC) value (1.51±0.46x10(-3) mm2/sec) of malignant mediastinal tumors was significantly lower than that (2.96±0.86x10(-3) mm2/sec) of benign mediastinal tumors and mass lesions (P<0.0001). Maximum standardized uptake value (SUVmax) (11.30±11.22) of malignant mediastinal tumors was significantly higher than that (2.53±3.92) of benign mediastinal tumors and mass lesions (P=0.0159). Using the optimal cutoff value (OCV) 2.21x10(-3) mm2/sec for ADC and 2.93 for SUVmax, the sensitivity (100%) by DWI was not significantly higher than that (93.8%) by PET-CT for malignant mediastinal tumors. The specificity (83.3%) by DWI was not significantly higher than that (66.7%) for benign mediastinal tumors and mass lesions. The accuracy (92.9%) by DWI was not significantly higher than that (82.1%) by PET-CT for mediastinal tumors and mass lesions. CONCLUSIONS There was no significant difference between diagnostic capability of DWI and that of PET-CT for distinguishing mediastinal tumors and mass lesions. DWI is useful in distinguishing benign from malignant mediastinal tumors and mass lesions.
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Affiliation(s)
- Katsuo Usuda
- Department of Thoracic Surgery, Kanazawa Medical University, Daigaku, Uchinada, Ishikawa, Japan E-mail :
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Usuda K, Maeda S, Motomo N, Tanaka M, Ueno M, Machida Y, Sagawa M, Uramoto H. Pulmonary Function After Lobectomy: Video-Assisted Thoracoscopic Surgery Versus Muscle-Sparing Mini-thoracotomy. Indian J Surg 2016; 79:504-509. [PMID: 29217900 DOI: 10.1007/s12262-016-1510-1] [Citation(s) in RCA: 6] [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: 07/08/2015] [Accepted: 05/26/2016] [Indexed: 11/29/2022] Open
Abstract
Although pulmonary function was better after video-assisted thoracoscopic surgery (VATS) lobectomy than after open thoracotomy lobectomy, it is unclear whether postoperative pulmonary function after VATS lobectomy is better than that after mini-thoracotomy lobectomy. The aim of this study is to determine whether the former is better than the latter. VATS lobectomies were performed using endoscopic techniques through a 3-4-cm skin incision spread by a silicon rubber retractor and two or three trocars. Mini-thoracotomy lobectomies were performed through a 7-12-cm skin incision spread by rib retractors made of metal and one or two trocars. Pulmonary function tests were performed a week before surgery and 3 months after surgery. There were 14 males and 11 females in VATS lobectomy and 32 males and 30 females in mini-thoracotomy lobectomy. For lobe location (right upper/right lower/left upper/left lower), there were 12/1/8/4 in VATS lobectomy and 16/19/13/14 in mini-thoracotomy lobectomy, respectively. The percent predicted postoperative forced vital capacity (FVC) (postoperative FVC/predicted postoperative FVC × 100) (110 ± 15 %) of VATS lobectomy was significantly higher than that (101 ± 16 %) of mini-thoracotomy lobectomy (P = 0.0124). The percent predicted postoperative forced expiratory volume in 1 s (FEV1) (postoperative FEV1/predicted postoperative FEV1 × 100) (110 ± 15 %) of VATS lobectomy was not significantly higher than that (104 ± 15 %) of mini-thoracotomy lobectomy (P = 0.091). Multiple regression analysis revealed that operative procedure (VATS lobectomy or mini-thoracotomy lobectomy) was the only significant variable contributing to percent predicted postoperative FVC (P = 0.0073) and percent predicted postoperative FEV1 (P = 0.0180). Postoperative FVC after VATS lobectomy is better than after mini-thoracotomy lobectomy.
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Affiliation(s)
- Katsuo Usuda
- Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293 Japan
| | - Sumiko Maeda
- Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293 Japan
| | - Nozomu Motomo
- Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293 Japan
| | - Makoto Tanaka
- Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293 Japan
| | - Masakatsu Ueno
- Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293 Japan
| | - Yuichiro Machida
- Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293 Japan
| | - Motoyasu Sagawa
- Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293 Japan
| | - Hidetaka Uramoto
- Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293 Japan
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Hamashima C, Hamashima C C, Hattori M, Honjo S, Kasahara Y, Katayama T, Nakai M, Nakayama T, Morita T, Ohta K, Ohnuki K, Sagawa M, Saito H, Sasaki S, Shimada T, Sobue T, Suto A. The Japanese Guidelines for Breast Cancer Screening. Jpn J Clin Oncol 2016; 46:482-492. [PMID: 27207993 DOI: 10.1093/jjco/hyw008] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
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Usuda K, Sagawa M, Maeda S, Motono N, Tanaka M, Machida Y, Matoba TMM, Watanabe N, Tonami H, Ueda Y, Uramoto H. Diagnostic Performance of Whole-Body Diffusion-Weighted Imaging Compared to PET-CT Plus Brain MRI in Staging Clinically Resectable Lung Cancer. Asian Pac J Cancer Prev 2016; 17:2775-2780. [PMID: 27356689] [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: 06/06/2023] Open
Abstract
BACKGROUND Precise staging of lung cancer is usually evaluated by PET-CT and brain MRI. Recently, however, whole-body diffusion-weighted magnetic resonance imaging (WB-DWI) has be applied. The aim of this study is to determine whether the diagnostic performance of lung cancer staging by WB-DWI is superior to that of PET-CT+brain MRI. MATERIALS AND METHODS PET-CT + brain MRI and WB-DWI were used for lung cancer staging before surgery with 59 adenocarcinomas, 16 squamous cell carcinomas and 6 other carcinomas. RESULTS PET-CT + brain MRI correctly identified the pathologic N staging in 67 patients (82.7%), with overstaging in 5 (6.2%) and understaging in 9 (11.1%), giving a staging accuracy of 0.827. WB-DWI correctly identified the pathologic N staging in 72 patients (88.9%), with overstaging in 1 (1.2%) and understaging in 8 patients (9.9%), giving a staging accuracy of 0.889. There were no significant differences in accuracies. PET-CT + brain MRI correctly identified the pathologic stages in 56 patients (69.1%), with overstaging in 7 (8.6%) and understaging in 18 (22.2%), giving a staging accuracy of 0.691. WB-DWI correctly identified the pathologic stages in 61 patients (75.3%), with overstaging in 4 (4.9%) and understagings in16(19.7%), giving a staging accuracy of 0.753. There were no significant difference in accuracies. CONCLUSIONS Diagnostic efficacy of WB-DWI for lung cancer staging is equivalent to that of PET-CT + brain MRI.
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Affiliation(s)
- Katsuo Usuda
- Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa, Japan E-mail :
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Usuda K, Maeda S, Motono N, Ueno M, Tanaka M, Machida Y, Matoba M, Watanabe N, Tonami H, Ueda Y, Sagawa M. Diagnostic Performance of Diffusion - Weighted Imaging for Multiple Hilar and Mediastinal Lymph Nodes with FDG Accumulation. Asian Pac J Cancer Prev 2015; 16:6401-6. [DOI: 10.7314/apjcp.2015.16.15.6401] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Motono N, Ueno M, Tanaka M, Machida Y, Usuda K, Sakuma T, Sagawa M. Differences in the prognostic significance of the SUVmax between patients with resected pulmonary Adenocarcinoma and squamous cell carcinoma. Asian Pac J Cancer Prev 2015; 15:10171-4. [PMID: 25556443 DOI: 10.7314/apjcp.2014.15.23.10171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine the prognostic significance of the maximum standardized uptake value (SUVmax) on F-18-fluorodeoxyglucose (FDG)-positron emission tomography (PET) in patients undergoing surgical treatment for non-small cell lung cancer. MATERIALS AND METHODS Seventy-eight consecutive patients (58 with adenocarcinomas, 20 with squamous cell carcinomas) treated with potentially curative surgery were retrospectively reviewed. RESULTS The SUVmax was significantly higher in the patients with recurrent than with non-recurrent adenocarcinoma (p<0.01). However, among the patients with squamous cell carcinoma, there were no differences with or without recurrence (p=0.69). Multivariate analysis indicated that the SUVmax of adenocarcinoma lesions was a significant predictor of disease-free survival (p=0.04). In addition, an SUVmax of 6.19, the cut-off point based on ROC curve analysis of the patients with pathological IB or more advanced stage adenocarcinomas, was found to be a significant predictor of disease-free survival (p<0.01). CONCLUSIONS SUVmax is a useful predictor of disease-free survival in patients with resected adenocarcinoma, but not squamous cell carcinoma. Patients with adenocarcinoma exhibiting an SUVmax above 6.19 are candidates for more intensive adjuvant therapy.
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Affiliation(s)
- Nozomu Motono
- Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa, Japan E-mail : ;
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Minato H, Kinoshita E, Nakada S, Nojima T, Tanaka M, Usuda K, Sagawa M, Iwao H, Tanaka M, Doai M, Takahashi T, Shibata N. Thymic lymphoid hyperplasia with multilocular thymic cysts diagnosed before the Sjögren syndrome diagnosis. Diagn Pathol 2015; 10:103. [PMID: 26173602 PMCID: PMC4502560 DOI: 10.1186/s13000-015-0332-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 06/18/2015] [Indexed: 11/22/2022] Open
Abstract
Background Thymic lymphoid hyperplasia is often present with myasthenia gravis as well as other autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. Of the 4 cases of thymic lymphoid hyperplasia associated with Sjögren syndrome that have been reported, no case with a thymic lesion diagnosis that led to the diagnosis of Sjögren syndrome has been reported. We herein report a case of thymic lymphoid hyperplasia with multilocular thymic cysts, diagnosed before Sjögren syndrome. Case presentation A 37-year-old Japanese woman had an approximate 5-cm anterior mediastinal mass detected by chest imaging. The resected lesion revealed multilocular thymic cysts that were filled with colloid-like material. Histology showed lymph follicular hyperplasia with many epithelial cysts. The epithelium consisted of thymic medullary epithelium, and no epithelial proliferation was seen in the lymphoid tissue. Lymphocytes were composed of an organized mixed population of mature T and B cells without significant atypia. The infiltrated B cells did not reveal light chain restriction or immunoglobulin heavy chain gene rearrangement. After the pathological diagnosis of thymic lesion, tests for the presence of autoantibodies were positive for antinuclear antibodies, rheumatic factor, and anti-SSA/Ro antibodies. The Schirmer’s, chewing gum, and Saxon tests showed decreased salivary and lacrimal secretion. Lip biopsy showed focal lymphocytic sialadenitis. The signs and symptoms of Sjögren syndrome had not resolved, without aggravation, 1 year after the thymectomy. Conclusion When a case with thymic lymphoid hyperplasia without myasthenia gravis is encountered, it is essential to consider the presence of another autoimmune disease including Sjögren syndrome.
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Affiliation(s)
- Hiroshi Minato
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 9200293, Japan.
| | - Eriko Kinoshita
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 9200293, Japan.
| | - Satoko Nakada
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 9200293, Japan.
| | - Takayuki Nojima
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 9200293, Japan.
| | - Makoto Tanaka
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
| | - Katsuo Usuda
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
| | - Motoyasu Sagawa
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
| | - Haruka Iwao
- Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
| | - Masao Tanaka
- Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
| | - Mariko Doai
- Department of Radiology, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
| | - Tomoko Takahashi
- Department of Radiology, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
| | - Naoko Shibata
- Department of Ophthalmology, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
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Ichikawa K, Kobayashi T, Sagawa M, Katagiri A, Uno Y, Nishioka R, Matsuyama J. A phantom study investigating the relationship between ground-glass opacity visibility and physical detectability index in low-dose chest computed tomography. J Appl Clin Med Phys 2015. [PMID: 26218991 PMCID: PMC5690005 DOI: 10.1120/jacmp.v16i4.5001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
In this study, the relationship between ground‐glass opacity (GGO) visibility and physical detectability index in low‐dose computed tomography (LDCT) for lung cancer screening was investigated. An anthropomorphic chest phantom that included synthetic GGOs with CT numbers of ‐630 Hounsfield units (HU; high attenuation GGO: HGGO) and ‐800 HU (low attenuation GGO: LGGO), and three phantoms for physical measurements were employed. The phantoms were scanned using 12 CT systems located in 11 screening centers in Japan. The slice thicknesses and CT dose indices (CTDIvol) varied over 1.0–5.0 mm and 0.85–3.30 mGy, respectively, and several reconstruction kernels were used. Physical detectability index values were calculated from measurements of resolution, noise, and slice thickness properties for all image sets. Five radiologists and one thoracic surgeon, blind to one another's observations, evaluated GGO visibility using a five‐point scoring system. The physical detectability index correlated reasonably well with the GGO visibility (R2=0.709,p<0.01 for 6 mm HGGO and R2=0.646,p<0.01 for 10 mm LGGO), and was nearly proportional to the CTDIvol. Consequently, the CTDIvol also correlated reasonably well with the GGO visibility (R2=0.701,p<0.01 for 6 mm HGGO and R2=0.680,p<0.01 for 10 mm LGGO). As a result, the CTDIvol was nearly dominant in the GGO visibility for image sets with different reconstruction kernels and slice thicknesses, used in this study. PACS numbers: 81.70.Tx, 87.57.Q‐
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Usuda K, Sagawa M, Motomo N, Ueno M, Tanaka M, Machida Y, Maeda S, Matoba M, Tonami H, Ueda Y, Sakuma T. Recurrence and metastasis of lung cancer demonstrate decreased diffusion on diffusion-weighted magnetic resonance imaging. Asian Pac J Cancer Prev 2015; 15:6843-8. [PMID: 25169535 DOI: 10.7314/apjcp.2014.15.16.6843] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diffusion-weighted magnetic resonance imaging (DWI) is reported to be useful for detecting malignant lesions. The purpose of this study is to clarify characteristics of imaging, detection rate and sensitivity of DWI for recurrence or metastasis of lung cancer. METHODS A total of 36 lung cancer patients with recurrence or metastasis were enrolled in this study. While 16 patients underwent magnetic resonance imaging (MRI), computed tomography (CT) and positron emission tomography-computed tomography (PET-CT), 17 underwent MRI and CT, and 3 underwent MRI and PET-CT. RESULTS Each recurrence or metastasis showed decreased diffusion, which was easily recognized in DWI. The detection rate for recurrence or metastasis was 100% (36/36) in DWI, 89% (17/19) in PET-CT and 82% (27/33) in CT. Detection rate of DWI was significantly higher than that of CT (p=0.0244) but not significantly higher than that of PET-CT (p=0.22). When the optimal cutoff value of the apparent diffusion coefficient value was set as 1.70?10-3 mm2/sec, the sensitivity of DWI for diagnosing recurrence or metastasis of lung cancer was 95.6%. CONCLUSIONS DWI is useful for detection of recurrence and metastasis of lung cancer.
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Affiliation(s)
- Katsuo Usuda
- Department of Thoracic Surgery, Kanazawa Medical University,Uchinada, Ishikawa, Japan E-mail :
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Sagawa M, Machida Y, Tanaka M, Motono N, Maeda S, Sakuma T, Usuda K. Left Pulmonary Agenesis Showing Extraordinary Chest X-Ray Findings. Am J Respir Crit Care Med 2015; 191:1083. [DOI: 10.1164/rccm.201501-0122im] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Usuda K, Sagawa M, Motono N, Ueno M, Tanaka M, Machida Y, Maeda S, Matoba M, Tonami H, Ueda Y. Advantages of Diffusion Weighted Imaging of Pulmonary Nodules and Masses: Comparison with Positron Emission Tomography. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv046.02] [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: 11/13/2022] Open
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36
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Sagawa M, Kobayashi T, Uotani C, Kibe Y, Tanaka M, Machida Y, Motono N, Maeda S, Usuda K. A survey about further work-up for cases with positive sputum cytology during lung cancer mass screening in Ishikawa Prefecture, Japan: a retrospective analysis about quality assurance of lung cancer screening. Jpn J Clin Oncol 2015; 45:297-302. [PMID: 25583424 DOI: 10.1093/jjco/hyu214] [Citation(s) in RCA: 3] [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] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE In cancer screening programs, performing appropriate further work-up is essential. In order to elucidate whether the further work-up for the subjects with positive screening results by sputum cytology was performed appropriately, the present study was conducted as the first large-scale thorough survey in Japan. METHODS All of the lung cancer screening records from 2007 to 2012 in Ishikawa Prefecture were reviewed. Additional investigations about the further work-up were performed. RESULTS In total, 2 234 984 people were invited to undergo lung cancer screening, and 494 424 people participated in the screening. Of these, 25 264 people underwent sputum cytology, and 68 positive cases were identified. Three of these 68 cases did not undergo further work-up, and another three cases had already been diagnosed to have lung cancer. Forty-five of the remaining 62 cases did not have suspicious chest shadows, and bronchoscopic examinations were performed in 36 cases. Seventeen of these 36 cases were diagnosed as having cancer, whereas none of the nine cases who did not receive the examination was diagnosed (P = 0.038). A bronchoscopic examination was not performed due to other medical conditions in three cases, due to the patient's refusal in another three cases and in the remaining three cases, the reasons were unknown. CONCLUSION The participation rate for further work-up was very high. However, there are some issues to be resolved regarding the transmission of information. With our new registered hospital system, the quality assurance of our screening program will be improved.
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Affiliation(s)
- Motoyasu Sagawa
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa The Lung Cancer Screening Division of Ishikawa, Prefectural Committee for Management of the Cancer Screening System, Kanazawa, Ishikawa
| | - Takeshi Kobayashi
- The Lung Cancer Screening Division of Ishikawa, Prefectural Committee for Management of the Cancer Screening System, Kanazawa, Ishikawa Ishikawa Medical Center for Cancer and Cardiovascular Diseases, Kanazawa, Ishikawa
| | - Chika Uotani
- The Lung Cancer Screening Division of Ishikawa, Prefectural Committee for Management of the Cancer Screening System, Kanazawa, Ishikawa Ishikawa Health Service Association, Kanazawa, Ishikawa Kanazawa Medical Association, Kanazawa, Ishikawa, Japan
| | | | - Makoto Tanaka
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa
| | - Yuichiro Machida
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa
| | - Nozomu Motono
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa
| | - Sumiko Maeda
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa
| | - Katsuo Usuda
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa
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Usuda K, Sagawa M, Motono N, Ueno M, Tanaka M, Machida Y, Matoba M, Taniguchi M, Tonami H, Ueda Y, Sakuma T. Relationships between EGFR mutation status of lung cancer and preoperative factors - are they predictive? Asian Pac J Cancer Prev 2014; 15:657-62. [PMID: 24568474 DOI: 10.7314/apjcp.2014.15.2.657] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The epidermal growth factor receptor (EGFR) mutation status of lung cancer is important because it means that EGFR-tyrosine kinase inhibitor treatment is indicated. The purpose of this prospective study is to determine whether EGFR mutation status could be identified with reference to preoperative factors. MATERIALS AND METHODS One hundred-forty eight patients with lung cancer (111 adenocarcinomas, 25 squamous cell carcinomas and 12 other cell types) were enrolled in this study. The EGFR mutation status of each lung cancer was analyzed postoperatively. RESULTS There were 58 patients with mutant EGFR lung cancers (mutant LC) and 90 patients with wild-type EGFR lung cancers (wild-type LC). There were significant differences in gender, smoking status, maximum tumor diameter in chest CT, type of tumor shadow, clinical stage between mutant LC and wild-type LC. EGFR mutations were detected only in adenocarcinomas. Maximum standardized uptake value (SUVmax:3.66±4.53) in positron emission tomography-computed tomography of mutant LC was significantly lower than that (8.26±6.11) of wild-type LC (p<0.0001). Concerning type of tumor shadow, the percentage of mutant LC was 85.7% (6/7) in lung cancers with pure ground glass opacity (GGO), 65.3%(32/49) in lung cancers with mixed GGO and 21.7%(20/92) in lung cancers with solid shadow (p<0.0001). For the results of discriminant analysis, type of tumor shadow (p=0.00036) was most significantly associated with mutant EGFR. Tumor histology (p=0.0028), smoking status (p=0.0051) and maximum diameter of tumor shadow in chest CT (p=0.047) were also significantly associated with mutant EGFR. The accuracy for evaluating EGFR mutation status by discriminant analysis was 77.0% (114/148). CONCLUSIONS Mutant EGFR is significantly associated with lung cancer with pure or mixed GGO, adenocarcinoma, never-smoker, smaller tumor diameter in chest CT. Preoperatively, EGFR mutation status can be identified correctly in about 77 % of lung cancers.
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Affiliation(s)
- Katsuo Usuda
- Department of Thoracic Surgery, Kanazawa Medical University, Daigaku, Uchinada, Ishikawa, Japan E-mail :
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Tanaka M, Sagawa M, Usuda K, Machida Y, Ueno M, Motono N, Sakuma T. Postoperative drainage with one chest tube is appropriate for pulmonary lobectomy: a randomized trial. TOHOKU J EXP MED 2014; 232:55-61. [PMID: 24492628 DOI: 10.1620/tjem.232.55] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
To expand postoperative residual lungs after pulmonary lobectomy, thoracic drainage with two chest tubes has been recommended. Several studies recently demonstrated that postoperative drainage with one chest tube (PD1) was as safe as that with two chest tubes (PD2). However, most of the patients in those studies underwent lobectomy by standard thoracotomy. Although the number of pulmonary lobectomies by video-assisted thoracic surgery (VATS) has been increasing in recent years, there have been no reports that compared PD1 with PD2 after pulmonary lobectomy, including that by VATS. To elucidate whether postoperative management with PD1 is as safe as that with PD2, we conducted a randomized controlled trial. Lung cancer patients who underwent lobectomies with mediastinal nodal dissection in our hospital were assigned to one of two groups: one chest tube placed in PD1 group and two chest tubes placed in PD2 group. A total of 108 patients were registered in the study. There were no significant differences in the age, gender, pathological stage or histological type between two groups. Since the residual lung expansion was good in both groups, there were no patients who needed thoracentesis. There were no significant differences in the number of cases with pleurodesis, the amount/duration of drainage or the pain of the patients between two groups. In conclusion, since PD1 has advantages in saving cost and time and in low risk of transcutaneous infection, PD1 is appropriate after pulmonary lobectomy by VATS and by open thoracotomy.
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Affiliation(s)
- Makoto Tanaka
- Department of Thoracic Surgery, Kanazawa Medical University
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Sagawa M, Tanaka M, Machida Y, Motono N, Maeda S, Usuda K. [Lung cancer screening in Japan -present and future]. Gan To Kagaku Ryoho 2014; 41:955-959. [PMID: 25219024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Usuda K, Sagawa M, Motono N, Ueno M, Tanaka M, Machida Y, Maeda S, Matoba M, Kuginuki Y, Taniguchi M, Tonami H, Ueda Y, Sakuma T. Diagnostic Performance of Diffusion Weighted Imaging of Malignant and Benign Pulmonary Nodules and Masses: Comparison with Positron Emission Tomography. Asian Pac J Cancer Prev 2014; 15:4629-35. [DOI: 10.7314/apjcp.2014.15.11.4629] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Endo C, Hasumi T, Matsumura Y, Sato N, Deguchi H, Oizumi H, Sagawa M, Tsushima T, Takahashi S, Shibuya J, Hirose M, Kondo T. A prospective study of surgical procedures for patients with oligometastatic non-small cell lung cancer. Ann Thorac Surg 2014; 98:258-64. [PMID: 24746441 DOI: 10.1016/j.athoracsur.2014.01.052] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [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] [Received: 08/29/2013] [Revised: 01/02/2014] [Accepted: 01/14/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND Purely localized, oligometastatic, and widely metastatic tumors are likely to require different therapeutic strategies. Although surgical procedures for isolated pulmonary, brain, or adrenal metastases from lung cancer have been extensively evaluated, most data are from retrospective studies; accordingly, we conducted a prospective multicenter trial. METHODS Patients were eligible if they had previously untreated clinical T1-2N0-1 lung cancer with single-organ metastasis, or single-organ metachronous metastasis after complete resection of pathologic T1-2N0-1 lung cancer. Metastatic lesions were classified into three groups: group A included metastasis in single organs other than brain or lung; group B included synchronous brain metastasis; and group C included pulmonary metastasis. The treatment intervention was surgical resection of metachronous metastasis or of both synchronous metastasis and primary lung cancer. RESULTS From December 2002 through June 2011, 36 patients were enrolled. Two patients were ineligible, and the remaining 34 were analyzed; 6 (18%) had a benign lesion and no metastasis, 5 patients (15%) underwent incomplete resection of primary lung cancer, and 20 patients (59%) underwent complete resection of both primary lung cancer and metastasis. The 5-year survival rate for these 20 cases was 44.7%. CONCLUSIONS Clinical T1-2N0-1 lung cancer with a single-organ metastatic lesion was a good candidate for surgical resection. A 5-year survival rate of about 40% can be expected, which could be comparable with that for stage II non-small cell lung cancer.
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Affiliation(s)
- Chiaki Endo
- Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan.
| | - Tohru Hasumi
- Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Sendai Medical Center, Sendai, Japan
| | - Yuji Matsumura
- Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Ohta Nishinouchi Hospital, Kohriyama, Japan
| | - Nobuyuki Sato
- Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Hiroyuki Deguchi
- Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Iwate Medical University Hospital, Morioka, Japan
| | - Hiroyuki Oizumi
- Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Second Department of Surgery, Yamagata University Hospital, Yamagata, Japan
| | - Motoyasu Sagawa
- Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Kanazawa Medical University Hospital, Kahoku, Japan
| | - Takao Tsushima
- Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic and Cardiovascular Surgery, Hirosaki University Hospital, Hirosaki, Japan
| | - Satomi Takahashi
- Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Miyagi Cancer Center, Natori, Japan
| | - Jotaro Shibuya
- Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Iwate Prefectural Isawa Hospital, Ohshuu, Japan
| | - Masahide Hirose
- Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Takashi Kondo
- Japanese Northern East Area Thoracic Surgery Study Group (JNETS); Department of Thoracic Surgery, Tohoku University Hospital, Sendai, Japan
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Abstract
Two patients were admitted to our hospital due to giant bullae. During thoracoscopic surgery, saline-cooled radiofrequency coagulation devices were used to shrink the wall of the bulla. In each case, the volume of the bulla was gradually reduced and the boundary between the lung and bulla was clearly delineated. This method is considered to be useful for performing thoracoscopic surgery of giant bulla.
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Affiliation(s)
- Motoyasu Sagawa
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Tsutomu Maeda
- Department of Surgery, Houju Memorial Hospital, Nomi, Ishikawa, Japan
| | - Yutaka Yoshimitsu
- Department of Surgery, Houju Memorial Hospital, Nomi, Ishikawa, Japan
| | - Tsutomu Sakuma
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
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Minato H, Kurose N, Fukushima M, Nojima T, Usuda K, Sagawa M, Sakuma T, Ooi A, Matsumoto I, Oda M, Arano Y, Shimizu J. Comparative immunohistochemical analysis of IMP3, GLUT1, EMA, CD146, and desmin for distinguishing malignant mesothelioma from reactive mesothelial cells. Am J Clin Pathol 2014; 141:85-93. [PMID: 24343741 DOI: 10.1309/ajcp5knl7qtellyi] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES To identify useful biomarkers for differentiating between malignant mesothelioma (MM) and reactive mesothelial cells (RMCs). METHODS Formalin-fixed, paraffin-embedded (FFPE) tissues from 34 MM and 40 RMC samples were analyzed using immunohistochemistry, and the findings were compared. RESULTS Positive markers for MM included insulin-like growth factor 2 messenger RNA binding protein 3 (IMP3), glucose transporter 1 (GLUT1), epithelial membrane antigen (EMA), and CD146, which showed sensitivities of 94%, 85%, 79%, and 71% and specificities of 78%, 100%, 88%, and 98%, respectively. In sarcomatoid MM, EMA had significantly lower expression than did IMP3, GLUT1, and CD146 (P < .001). The areas under receiver operating characteristic curves were the highest for IMP3 (0.95), followed by GLUT1 (0.93). When the optimal cutoff points for IMP3 (30%) and GLUT1 (10%) were used, the sensitivity of IMP3 and GLUT1 for MM was 100%, and the specificity of both for MM was 95%. CONCLUSIONS The combination of IMP3 and GLUT1 is most appropriate for distinguishing MM from RMC using FFPE sections.
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Affiliation(s)
- Hiroshi Minato
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Nozomu Kurose
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Mana Fukushima
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Takayuki Nojima
- Department of Pathology and Laboratory Medicine, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Katsuo Usuda
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Motoyasu Sagawa
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Tsutomu Sakuma
- Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Akishi Ooi
- Department of Molecular Pathology, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Isao Matsumoto
- Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Makoto Oda
- Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Yoshihiko Arano
- Department of Surgery, KKR Hokuriku Hospital, Kanazawa, Ishikawa, Japan
| | - Junzo Shimizu
- Department of Surgery, KKR Hokuriku Hospital, Kanazawa, Ishikawa, Japan
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Sagawa M, Shibuya J, Takahashi S, Endo C, Abiko M, Suzuki H, Matsumura Y, Sakuma T, Sato N, Deguchi H, Nakamura Y, Hasumi T, Kondo T. A randomized phase III trial of postoperative adjuvant therapy for completely resected stage IA-IIIA lung cancer using an anti‑angiogenetic agent: irsogladine maleate. MINERVA CHIR 2013; 68:587-597. [PMID: 24193291] [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: 06/02/2023]
Abstract
AIM Although angiogenesis plays an important role in the invasion and metastasis of solid tumors, very few anti-angiogenetic drugs have been developed. Reexamining the anti-angiogenetic effects of existing drugs such as Thalidomide is another possible strategy for drug discovery. Irsogladine maleate (IM) is a drug invented to treat gastric ulcers; however, several reports have shown that IM also exerts anti-angiogenetic effects in vitro, in vivo and in humans. In order to elucidate whether treatment with IM would improve the prognoses of patients with resected lung cancer, we conducted a randomized trial. METHODS In the control group, uracil-tegafur (250 mg/m2/day) was administered for two years to patients with resected stage IB - IIIA lung cancer, and no adjuvant therapy was administered to those with stage IA disease. In the study group, IM (4 mg/body/day) was additionally administered for two years. RESULTS No significant differences were observed in the major prognostic factors among 305 eligible patients between the study and control groups. Adverse effects were minimal. The overall survival of the patients in the study and control groups were not statistically different. When the analysis was stratified by regimen, among the patients with resected stage IA disease, disease-specific survival in the study group was slightly higher than that in the control group; however, the difference was not significant (p=0.07). CONCLUSION Although it could not be proven that IM improves the prognoses of resected lung cancer patients, IM might have some effect on resected stage IA disease, and another trial should be conducted.
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Affiliation(s)
- M Sagawa
- Japanese Northern East Area Thoracic Surgery Study Group (JNETS) -
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Tabayashi T, Tomikawa T, Sagawa M, Nemoto T, Watanabe R, Tokuhira M, Mori S, Kizaki M. Primary Cardiac Lymphoma in Non-Immunocompromised Patients: Three Case Reports and Review of the Literature. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.116] [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: 11/13/2022] Open
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Sasaki TT, Ohkubo T, Hono K, Une Y, Sagawa M. Correlative multi-scale characterization of a fine grained Nd-Fe-B sintered magnet. Ultramicroscopy 2013; 132:222-6. [PMID: 23477852 DOI: 10.1016/j.ultramic.2013.01.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [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: 05/14/2012] [Revised: 10/29/2012] [Accepted: 01/25/2013] [Indexed: 11/18/2022]
Abstract
The Nd-rich phases in pressless processed fine grained Nd-Fe-B sintered magnets have been characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), and three dimensional atom probe tomography (3DAP). The combination of the backscattered electron (BSE) and in-lens secondary electron (IL-SE) images in SEM led to an unambiguous identification of four types of Nd-rich phases, NdOx, Ia3 type phase, which is isostructural to Nd₂O₃, dhcp-Nd and Nd₁Fe₄B₄. In addition, the 3DAP analysis of thin Nd-rich grain boundary layer indicate that the coercivity has a close correlation with the chemistry of the grain boundary phase.
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Affiliation(s)
- T T Sasaki
- National Institute for Materials Science, 1-2-1 Sengen, Tsukuba, Ibaraki 305-0047, Japan.
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Kitade H, Yamada T, Igarashi S, Hokkoku K, Mori M, Shintaku K, Sagawa M, Nakai M, Yano S. [Efficacy of low-dose erlotinib against gefitinib-induced hepatotoxicity in a patient with lung adenocarcinoma harboring EGFR mutations]. Gan To Kagaku Ryoho 2013; 40:79-81. [PMID: 23306923] [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: 06/01/2023]
Abstract
We report a case of a female in her 80s who was diagnosed with recurrent lung adenocarcinoma after primary surgery. She was treated with a systemic chemotherapy regimen consisting of carboplatin plus paclitaxel until the disease showed progression. On detection of epidermal growth factor receptor(EGFR)mutations, we administered gefitinib, an EGFR tyrosine kinase inhibitor, at a dosage of 250 mg daily. After 6 months of gefitinib therapy, laboratory findings revealed elevated serum aspartate aminotransferase(AST)and alanine aminotransferase(ALT)levels(grade 2), indicative of hepatotoxicity. Gefitinib was discontinued and erlotinib was initiated at a dosage of 50 mg daily. She continued the therapy for 3 years, during which her disease stabilized without any further complications or hepatotoxicity. Thus, low-dose erlotinib may be effective and well tolerated by patients with non-small cell lung cancer harboring EGFR mutations who are intolerant to gefitinib.
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Usuda K, Sagawa M, Motono N, Ueno M, Tanaka M, Machida Y, Matoba M, Kuginuki Y, Taniguchi M, Ueda Y, Sakuma T. Advantages of Diffusion-Weighted Imaging Over Positron Emission Tomography-Computed Tomography in Assessment of Hilar and Mediastinal Lymph Node in Lung Cancer. Ann Surg Oncol 2012; 20:1676-83. [DOI: 10.1245/s10434-012-2799-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Indexed: 01/08/2023]
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Sagawa M, Nakayama T, Tanaka M, Sakuma T, Sobue T. A Randomized Controlled Trial on the Efficacy of Thoracic CT Screening for Lung Cancer in Non-smokers and Smokers of <30 Pack-years Aged 50-64 Years (JECS Study): Research Design. Jpn J Clin Oncol 2012; 42:1219-21. [DOI: 10.1093/jjco/hys157] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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50
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Usuda K, Zhao XT, Sagawa M, Aikawa H, Ueno M, Tanaka M, Machida Y, Matoba M, Ueda Y, Sakuma T. Diffusion-weighted imaging (DWI) signal intensity and distribution represent the amount of cancer cells and their distribution in primary lung cancer. Clin Imaging 2012; 37:265-72. [PMID: 23465978 DOI: 10.1016/j.clinimag.2012.04.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 04/18/2012] [Indexed: 01/05/2023]
Abstract
The aim of this study was to interpret diffusion-weighted imaging (DWI) signals in lung cancers. They were converted into several three-dimensional DWI signals patterns, which represent the degree of DWI signal intensity by height and the degree of distribution by area: flat, low elevation, irregular elevation, single-peak elevation, multiple-peak elevation, and nodular elevation. There were 39 adenocarcinomas and 21 squamous cell carcinomas. Three-dimensional DWI signals decreased significantly in order of cell differentiation. Tumor cellular densities were increased according to the increase in three-dimensional DWI signals. DWI signal intensity and distribution can represent the amount of cancer cells and their distribution in the carcinoma.
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Affiliation(s)
- Katsuo Usuda
- Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa, Japan.
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