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Uomori T, Horimoto Y, Ueki Y, Ishizuka Y, Onagi H, Hayashi T, Watanabe J, Shikama N. Efficacy of radiation therapy in Japanese patients with positive margins after breast-conserving surgery. Jpn J Clin Oncol 2024:hyad196. [PMID: 38251759 DOI: 10.1093/jjco/hyad196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/30/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Additional surgical resection is recommended after breast-conserving surgery if the surgical margin is pathologically positive. However, in clinical practice, radiation therapy is sometimes used instead for several reasons. Irradiation may be appropriate for some patients, but real-world data is still insufficient to establish it as standard treatment. We retrospectively investigated the status of local control in patients who received irradiation for positive margins. METHODS We investigated 85 patients with positive margins after curative partial mastectomy who were treated with irradiation instead of additional excision during the period 2006-2013. The patients received whole-breast irradiation (43.2-50 Gy) using photon beams and additional tumour-bed boost (8.1-16 Gy) using electron beams. Intrabreast tumour recurrence was defined as secondary cancer within the ipsilateral conserved breast. Surgical margin was defined as positive if tumour cell exposure was pathologically confirmed on the margin. RESULTS Seven patients (8.2%) developed intrabreast tumour recurrence during a mean observation period of 119 months. As to components of positive margin, 76 cases were positive for an intraductal component, of which seven (9.2%) developed intrabreast tumour recurrence. Meanwhile, all nine cases positive for an invasive component were free from intrabreast tumour recurrence. Two of the intrabreast tumour recurrence cases seemed to develop new lesions rather than recurrence, considering tumour location. The cumulative incidence of intrabreast tumour recurrence over 10 years was 6.1%. Limited to true recurrence, intrabreast tumour recurrence incidence was 4.9%. CONCLUSION Our real-world data supports irradiation as an alternative to additional surgical intervention for positive margins after breast-conserving surgery and offers a basis for further research.
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Affiliation(s)
- Toshitaka Uomori
- Faculty of Medicine, Department of Breast Oncology, Juntendo University,2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yoshiya Horimoto
- Faculty of Medicine, Department of Breast Oncology, Juntendo University,2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- Faculty of Medicine, Department of Human Pathology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
- Department of Breast Surgery and Oncology, Tokyo Medical University, 6-1-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Yuko Ueki
- Faculty of Medicine, Department of Breast Oncology, Juntendo University,2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yumiko Ishizuka
- Faculty of Medicine, Department of Breast Oncology, Juntendo University,2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Hiroko Onagi
- Faculty of Medicine, Department of Human Pathology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Takuo Hayashi
- Faculty of Medicine, Department of Human Pathology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Junichiro Watanabe
- Faculty of Medicine, Department of Breast Oncology, Juntendo University,2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Naoto Shikama
- Faculty of Medicine, Department of Radiation Oncology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Saeki H, Horimoto Y, Hlaing MT, Men Y, Rong L, Ishizuka Y, Uomori T, Yoshida E, Terao Y, Arakawa A, Saito T, Yao T. Clinicopathological and molecular pathological characteristics in tamoxifen‑related endometrial cancer. Oncol Lett 2024; 27:9. [PMID: 38034487 PMCID: PMC10688500 DOI: 10.3892/ol.2023.14142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/21/2023] [Indexed: 12/02/2023] Open
Abstract
Tamoxifen (TAM), a selective estrogen receptor modulator, is often used for long-term adjuvant endocrine therapy in patients with hormone receptor-positive breast cancer. TAM is known to increase the risk of endometrial cancer (EC); however, the mechanism has not yet been fully elucidated. Therefore, molecular genetic analysis of EC following TAM administration (TAM-related EC) was conducted. A total of 10 samples of TAM-related EC and 20 sporadic EC samples (as controls) were analyzed. Copy number variation analysis was conducted, microsatellite instability (MSI) status was assessed, and mismatch repair (MMR) protein expression was examined immunohistochemically. Copy number variation analysis revealed that KDR, NOTCH1, NTRK1, NTRK3 and PDGFRB were more frequently amplified in TAM-related EC (P=0.039, P<0.001, P=0.011, P=0.006 and P=0.035, respectively). In MSI analysis, 4 cases were classified as MSI-high (40%), which is a higher frequency compared with that among patients with sporadic EC (~10% in Japanese women). Loss of MMR proteins was confirmed in all MSI-high cases. In 1 MSI-high case, a benign lesion of hyperplasia prior to EC development was also MSI-high with loss of some MMR protein expression. Several genes were specifically amplified in TAM-related ECs. Furthermore, TAM-related ECs were frequently MSI-high. Further studies are required to be conclusive; however, the present findings may lead to a reduction of unnecessary gynaecological testing in clinical practice and also encourage the testing for MSI status for optimal individualized treatment.
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Affiliation(s)
- Harumi Saeki
- Department of Human Pathology, Juntendo University Faculty of Medicine, Tokyo 113-0033, Japan
- Department of Human Pathology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Yoshiya Horimoto
- Department of Human Pathology, Juntendo University Faculty of Medicine, Tokyo 113-0033, Japan
- Department of Breast Oncology, Juntendo University Faculty of Medicine, Tokyo 113-0033, Japan
| | - May Thinzar Hlaing
- Department of Breast Oncology, Juntendo University Faculty of Medicine, Tokyo 113-0033, Japan
| | - Yuan Men
- Department of Human Pathology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Lu Rong
- Department of Human Pathology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Yumiko Ishizuka
- Department of Breast Oncology, Juntendo University Faculty of Medicine, Tokyo 113-0033, Japan
| | - Toshitaka Uomori
- Department of Breast Oncology, Juntendo University Faculty of Medicine, Tokyo 113-0033, Japan
| | - Emiko Yoshida
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo 113-0033, Japan
| | - Yasuhisa Terao
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo 113-0033, Japan
| | - Atsushi Arakawa
- Department of Human Pathology, Juntendo University Faculty of Medicine, Tokyo 113-0033, Japan
| | - Tsuyoshi Saito
- Department of Human Pathology, Juntendo University Faculty of Medicine, Tokyo 113-0033, Japan
- Department of Human Pathology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Takashi Yao
- Department of Human Pathology, Juntendo University Faculty of Medicine, Tokyo 113-0033, Japan
- Department of Human Pathology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
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3
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Ushiyama Y, Horimoto Y, Uomori T, Ishizuka Y, Okazaki M, Onagi H, Hayashi T, Watanabe J, Saito M. Acute myocarditis during adjuvant therapies for breast cancer: a case report. Surg Case Rep 2023; 9:44. [PMID: 36949265 PMCID: PMC10033794 DOI: 10.1186/s40792-023-01626-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/17/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND With the improvement of optimal perioperative drug therapy for breast cancer patients, physicians now have to treat the adverse effects and comorbidities associated with long-term treatments. We report a case who suffered cardiac arrest due to acute myocarditis developed after initiation of adjuvant treatment. CASE PRESENTATION After completing preoperative chemotherapy and undergoing curative surgery for right breast cancer, a 46-year-old female patient started adjuvant tamoxifen and resumed trastuzumab. Two months later, she complained fever and dyspnea. Blood tests showed a marked increase in hepatic enzymes, and the patient was rushed to our emergency room on suspicion of drug-induced liver injury. In the emergency room, the patient went into cardiac arrest shortly after tachycardia with ST-segment elevation appeared on the monitored electrocardiogram. Resuscitation was started immediately and tracheal intubation, intra-aortic balloon pumping, and extracorporeal membrane oxygenation were started. Coronary angiography results were negative for ischemic heart disease. A diagnosis of fulminant myocarditis was made and steroid pulse therapy and immunoglobulin therapy were started. After the start of treatment, the symptoms of heart failure improved steadily and the patient was discharged on the 28th day. Histological findings of the myocardial biopsy revealed degeneration and necrosis of myocardial cells with marked lymphocytic infiltration, consistent with the histology of lymphocytic myocarditis. Serum cytomegalovirus, coxsackie B virus and adenovirus antibodies were all elevated and these findings were consistent with acute viral myocarditis. CONCLUSIONS We report a case with strong indications for therapy-induced liver damage, who was ultimately diagnosed with acute viral myocarditis and successfully treated with multidisciplinary therapy. We believe that our findings would be useful for other clinicians in managing similar patients.
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Affiliation(s)
- Yumiko Ushiyama
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Yoshiya Horimoto
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
- Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
| | - Toshitaka Uomori
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Yumiko Ishizuka
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Misato Okazaki
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Hiroko Onagi
- Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Takuo Hayashi
- Department of Human Pathology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Junichiro Watanabe
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
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Shikanai A, Horimoto Y, Ishizuka Y, Uomori T, Nakai K, Arakawa A, Saito M. Clinicopathological Features Related to the Efficacy of CDK4/6 Inhibitor-Based Treatments in Metastatic Breast Cancer. Breast Cancer (Auckl) 2022; 16:11782234211065148. [PMID: 35002243 PMCID: PMC8738870 DOI: 10.1177/11782234211065148] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Received: 03/21/2021] [Accepted: 11/17/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Resistance to endocrine therapy has been a major obstacle in the management of hormone receptor (HR)-positive metastatic breast cancer (MBC). Meanwhile, a number of treatments are available to such patients, and physicians often encounter difficulties in choosing the most appropriate treatments for individual patients. The combination of CDK 4/6 inhibitors (CDKi) and endocrine therapy has now become a standard treatment for HR-positive and human epidermal growth factor receptor 2 (HER2)-negative MBC. However, no predictive markers for CDKi-based treatments have been established. Considering their side effects and the financial burden on patients, identifying such markers is crucial. Methods: Clinicopathological features of 107 patients with HR-positive HER2-negative MBC, who received CDKi-based treatments at our institution were retrospectively investigated. HR status in distant metastatic lesions and immunocompetent cells in peripheral blood were also studied. Results: Progression-free survival (PFS) was significantly shorter in patients whose primary tumour was high grade (P = 0.016) or high neutrophil-to-lymphocyte ratio (NLR) at baseline (P = 0.017). Meanwhile, there were no differences in other factors, such as expression levels of hormone receptors. Patients whose metastatic lesions were of low tumour grade or high Ki67 labelling index had longer PFS, and such trends were more obvious than primary lesions. Conclusion: Our data indicate that tumour grade in primary lesion and NLR are potential predictive factors for CDKi-based treatments. Moreover, pathological assessment of metastatic lesions might also be useful.
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Affiliation(s)
- Ayana Shikanai
- Department of Breast Oncology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Yoshiya Horimoto
- Department of Breast Oncology, School of Medicine, Juntendo University, Tokyo, Japan.,Department of Human Pathology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Yumiko Ishizuka
- Department of Breast Oncology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Toshitaka Uomori
- Department of Breast Oncology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Katsuya Nakai
- Department of Breast Oncology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Atsushi Arakawa
- Department of Human Pathology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Mitsue Saito
- Department of Breast Oncology, School of Medicine, Juntendo University, Tokyo, Japan
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5
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Myojin M, Horimoto Y, Ito M, Kitano S, Ishizuka Y, Sasaki R, Uomori T, Himuro T, Murakami F, Nakai K, Iijima K, Saito M. Neutrophil-to-lymphocyte ratio and histological type might predict clinical responses to eriburin-based treatment in patients with metastatic breast cancer. Breast Cancer 2020; 27:732-738. [PMID: 32108306 DOI: 10.1007/s12282-020-01069-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/19/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Metastatic breast cancer (MBC) is generally considered to be incurable. Although many options are available for treating MBC, physicians often encounter difficulties in choosing the most appropriate treatment because the MBCs of individual patients respond differently even to the same treatments. Thus, predictive markers for therapeutic efficacy are urgently needed. Neutrophil- and platelet-to-lymphocyte ratios (NLR and PLR, respectively), have been studied and established as prognostic markers for breast cancer patients but whether either or both of these markers are predictive of treatment responses is still unclear. Herein, we investigated predictive markers for eribulin-based treatment responsiveness in patients with MBC, by examining clinicopathological features, including several markers of immunocompetent cells in peripheral blood. METHODS Clinicopathological features of the 104 patients with metastatic/Stage IV breast cancer given eribulin-based regimens were investigated in relation to clinical responses to eribulin-based treatments and progression-free-survival (PFS). RESULTS Special histological types and high NLR at baseline were independently related to poor clinical responses to the treatments (p = 0.023 and 0.039, respectively). The Cox hazard model revealed that patients with oestrogen receptor (ER)-negative tumours and high NLR, monocyte-to-lymphocyte ratio (MLR) and PLR showed significantly shorter PFS (p = 0.021, 0.005, 0.008 and 0.030, respectively). On multivariate analysis, only ER status and NLR remained independent factors related to PFS (p = 0.011 and 0.003, respectively). CONCLUSIONS Our data revealed that special histological types and high NLR might be factors related to low responsiveness to eribulin-based regimens in patients with MBC.
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Affiliation(s)
- Mayu Myojin
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Yoshiya Horimoto
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Mayuko Ito
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Shigehisa Kitano
- Department of Experimental Therapeutics, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Tokyo, Japan
| | - Yumiko Ishizuka
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Ritsuko Sasaki
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Toshitaka Uomori
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Takanori Himuro
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Fumi Murakami
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Katsuya Nakai
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kotaro Iijima
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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Ito M, Horimoto Y, Tokuda E, Murakami F, Uomori T, Himuro T, Nakai K, Orihata G, Iijima K, Saito M. Impact of circulating tumour cells on survival of eribulin-treated patients with metastatic breast cancer. Med Oncol 2019; 36:89. [PMID: 31520329 DOI: 10.1007/s12032-019-1314-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 09/06/2019] [Indexed: 12/21/2022]
Abstract
Several clinical studies have examined circulating tumour cells (CTCs). However, the application of CTCs as a predictive/prognostic marker for breast cancer patients has yet to be established, particularly the selection of suitable markers for detecting CTCs. We recently investigated CTCs, including mesenchymal status, from metastatic breast cancer patients who had received eribulin-based treatment. We found that assessment of both mesenchymal and epithelial CTCs might be important for predicting eribulin responsiveness. In the current study, we followed up the outcomes of these patients after eribulin treatment and investigated the possibility of CTC analysis results serving as prognostic markers for this patient population. Twenty-one patients were enrolled and peripheral blood samples were collected before eribulin-based treatments. CTCs were then examined using a Microfluidic Chip device. CTCs positive for vimentin and pan-cytokeratin were defined as mesenchymal and epithelial CTCs, respectively. Overall survival (OS) was assessed in relation to the number of CTCs and clinicopathological factors. During the observation period, 13 patients (62%) died due to breast cancer and the median OS was 18 months. Patients with high-grade tumours and a high total number of CTCs showed significantly shorter OS than those with low-grade tumours and smaller CTC burdens (p = 0.026 and 0.037, respectively). Patients who received eribulin as the first chemotherapy for metastatic disease showed longer OS (p = 0.006). Our data suggest that determining numbers of both mesenchymal and epithelial CTCs might predict survival for patients receiving eribulin.
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Affiliation(s)
- Mayuko Ito
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Yoshiya Horimoto
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Emi Tokuda
- Department of Medical Oncology, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan
| | - Fumi Murakami
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Toshitaka Uomori
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Takanori Himuro
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Katsuya Nakai
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Gotaro Orihata
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kotaro Iijima
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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Uomori T, Horimoto Y, Arakawa A, Iijima K, Saito M. Breast Cancer in Lean Postmenopausal Women Might Have Specific Pathological Features. In Vivo 2019; 33:483-487. [PMID: 30804130 DOI: 10.21873/invivo.11499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 01/14/2019] [Accepted: 01/15/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIM The rate of obesity, an independent risk factor for breast cancer in post-menopausal women, is quite low in Japan, indicating breast cancer in lean women to be more common in the Japanese than in Westerners. However, biological characteristics of such breast cancers have not been adequately investigated. PATIENTS AND METHODS We retrospectively investigated clinicopathological breast cancer features of 566 postmenopausal Japanese women, who underwent curative surgery, in relation to patient physique based on the body mass index. RESULTS There were no differences in several factors examined such as tumour size according to patient physique. On the other hand, mean values of the Ki67 labelling index were significantly higher in lean compared to obese patients (p=0.027). Likewise, HER2-positive tumours were more often observed in lean patients (p=0.051). CONCLUSION Lean postmenopausal women had more aggressive tumours, apparently contradicting the widely held view for breast cancer in obese women.
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Affiliation(s)
- Toshitaka Uomori
- Deartment of Breast Oncology, Juntendo University School of Medcine, Tokyo, Japan
| | - Yoshiya Horimoto
- Deartment of Breast Oncology, Juntendo University School of Medcine, Tokyo, Japan .,Deartment of Pathology and Oncology, Juntendo University School of Medcine, Tokyo, Japan
| | - Atsushi Arakawa
- Deartment of Human Pathology, Juntendo University School of Medcine, Tokyo, Japan
| | - Kotaro Iijima
- Deartment of Breast Oncology, Juntendo University School of Medcine, Tokyo, Japan
| | - Mitsue Saito
- Deartment of Breast Oncology, Juntendo University School of Medcine, Tokyo, Japan
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Horimoto Y, Tokuda E, Murakami F, Uomori T, Himuro T, Nakai K, Orihata G, Iijima K, Togo S, Shimizu H, Saito M. Analysis of circulating tumour cell and the epithelial mesenchymal transition (EMT) status during eribulin-based treatment in 22 patients with metastatic breast cancer: a pilot study. J Transl Med 2018; 16:287. [PMID: 30342534 PMCID: PMC6195982 DOI: 10.1186/s12967-018-1663-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 10/12/2018] [Indexed: 01/02/2023] Open
Abstract
Background Liquid biopsy approaches, such as measuring circulating tumour cells (CTCs), have recently been introduced in several clinical studies. However, the development of CTCs as a predictive marker for treatment effects on breast cancer remains an enormous task. We investigated CTCs, including epithelial mesenchymal transition (EMT) status, from metastatic breast cancer patients who had received eribulin-based treatment, which reportedly suppresses EMT as a means of tumour suppression. Our aim was to test the possibility of this method serving as a tool predicting eribulin efficacy. Methods Twenty-two patients were enrolled and peripheral blood samples were collected before eribulin treatment. CTCs were then examined using a Microfluidic Chip device. CTCs positive for vimentin and pan-cytokeratin were defined as mesenchymal and epithelial CTCs, respectively. Progression-free survival (PFS) and clinical response were assessable in 20 and 18 patients, respectively, in relation to the number of CTCs. Results Numbers of total CTCs were significantly increased in patients with progressive disease during treatment (p = 0.006). Median PFS was 14.6 weeks and patients with more total and mesenchymal CTCs at baseline had significantly shorter PFS (p = 0.0013 and 0.013, respectively). Multivariate logistic regression analysis revealed small number of total baseline CTCs and long disease-free survival to be related to long PFS (p = 0.0004 and 0.020, respectively). Conclusions Our data suggest that determining both mesenchymal and epithelial CTCs at baseline might be a good tool for predicting eribulin responsiveness. Evaluation of mesenchymal CTC can be considered as a parameter in larger studies, while most clinical trials are currently employing only the detection of the epithelial cellular adhesion molecule (EpCAM). Electronic supplementary material The online version of this article (10.1186/s12967-018-1663-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yoshiya Horimoto
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. .,Department of Pathology and Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Emi Tokuda
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Fumi Murakami
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Toshitaka Uomori
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Takanori Himuro
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Katsuya Nakai
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Gotaro Orihata
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kotaro Iijima
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Shinsaku Togo
- Department of Respiratory Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Hideo Shimizu
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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Saito M, Iijima K, Nakai K, Horimoto Y, Mori M, Himuro T, Uomori T, Murakami F, Arakawa A, Sasai K. Risk factors for locoregional recurrence after post-mastectomy radiation therapy (PMRT) and chemotherapy in patients with 4 or more metastatic nodes. Breast 2017. [DOI: 10.1016/s0960-9776(17)30248-5] [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] Open
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10
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Uomori T, Horimoto Y, Mogushi K, Matsuoka J, Saito M. Relationship between alcohol metabolism and chemotherapy-induced emetic events in breast cancer patients. Breast Cancer 2017; 24:702-707. [PMID: 28217830 DOI: 10.1007/s12282-017-0761-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 02/08/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Chemotherapy-induced nausea and vomiting (CINV) can negatively affect quality of life and treatment compliance in breast cancer patients. Habitual alcohol consumption reportedly shows an inverse correlation with CINV, though the underlying mechanism is unknown. Acetaldehyde dehydrogenase 2 (ALDH2), one of the two ALDH isozymes, is reportedly the major factor among several genetic polymorphisms possibly affecting alcohol metabolism. More than 40% of Japanese have ALDH2 mutations, while almost all Westerners have the wild type. We hypothesized that ALDH2 polymorphism status might relate to the metabolism of emetic chemotherapeutic drugs. Relationships among habitual alcohol consumption, ALDH2 polymorphisms, and CINV in Japanese breast cancer patients given adjuvant chemotherapy containing high-emetic drugs were, thus, investigated. METHODS We enrolled 81 women, between 20 and 55 years of age, who had been diagnosed with primary breast cancer and received (neo-) adjuvant chemotherapy at our institution. ALDH2 genotypes were analyzed employing the smart amplification process in peripheral blood samples. RESULTS The wild type (ALDH2*1/*1), heterozygote (ALDH2*1/*2), and mutant homozygote (ALDH2*2/*2) genotypes were found in 53, 44, and 3% of patients, respectively. Complete response, i.e., no vomiting without rescue anti-emetics, was more frequent in patients who habitually consumed alcohol than in those who did not (p = 0.036). This trend remained only in ALDH2 heterozygotes when patients were categorized according to ALDH2 genotype. Logistic regression analysis revealed alcohol intake to be an independent predictive factor for complete response (p = 0.013). CONCLUSIONS Our results revealed habitual alcohol intake to be related to a lower CINV incidence. The impact of alcohol intake on CINV in patients with ALDH2 polymorphisms merits further investigation.
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Affiliation(s)
- Toshitaka Uomori
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan.
| | - Yoshiya Horimoto
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - Kaoru Mogushi
- Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Joe Matsuoka
- Clinical Research Support Center, Juntendo University School of Medicine, 3-1-3 Bunkyo-ku, Hongo, Tokyo, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
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11
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Ogata H, Saito M, Tsuneizumi M, Kutomi G, Hosoya K, Kawai Y, Sugizaki K, Katsumata N, Senuma K, Kitabatake T, Suda M, Uomori T, Miura K, Kurata M, Nitta Y, Yonemoto N, Matsuoka J. Abstract P5-11-03: Difference between 1st and 2nd generation serotonin receptor antagonists in triplet antiemetic therapy for highly emetogenic chemotherapy in breast cancer patients – according to recent multi-institutional double-blind randomized clinical research on the AC regimen. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-11-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
<Background>
The information presented herein extends our recent study of TTT (Trial for Triplet Antiemetic Therapy).
One of our main clinical questions has been whether a 2nd generation serotonin receptor antagonist (5-HT3ra) would be superior to 1st generation 5-HT3ra when administering triplet antiemetic therapy for the prevention of chemotherapy induced nausea & vomiting (CINV), since a prior Japanese trial demonstrated palonosetron to be superior to granisetron for controlling the delayed phase of CINV induced by highly emetogenic chemotherapy (HEC) and to doublet antiemetic therapy including dexamethasone for anthracycline and cyclophosphamide containing regimens (AC).
<Objectives>
In this study, we assessed the efficacies of 1st and 2nd generation 5-HT3ra agents for use as triplet antiemetic therapy for AC, by monitoring CINV, focusing especially daily CR in the delayed phase.
<Material and method>
Between 2012 and 2015, 491 women with breast cancer receiving AC were recruited from 11 institutions in Japan, and randomly assigned to either single-dose palonosetron (0.75mg) or granisetron (40μg/kg) prior to chemotherapy on day 1, both with dexamethasone (9.9 mg intravenously) and aprepitant (125mg orally) on day 1 followed by additional doses (80mg orally) on days 2 and 3. Age, institution and habitual alcohol intake were used as stratification factors. The primary endpoint was a complete response (CR). Statistical analysis was done by Mantel-Haenszel Method. This trial was registered with UMIN000007882.
<Results>
All 491 patients were included in efficacy analyses (ITT): 246 patients in the palonosetron group and 245 in the granisetron group. We previously reported that the difference in CR during the delayed phase, i.e. 24 hours after the administration of AC, did not reach statistical significance (53.8% vs 58.5%) in MASCC 2016. However, daily CR in the palonosetron group was much higher than that in the granisetron group after 48 hours.
<Conclusions>
Palonosetron showed better efficacy in controlling CINV during the late period of the delayed phase, i.e. 48 hours after AC administration, than granisetron as triplet antiemetic therapy for AC.
<Considerations>
The pattern of CINV reportedly shows two peaks including an acute phase caused by serotonin and a delayed phase caused by substance P, though the pattern of CINV with triplet antiemetic therapy administration might be different if the suppression of each of these peaks were to be achieved more efficiently. CINV may not be divided into two phases in the future, or the borderline area between the acute and delayed phases may require revision. The analysis of the late period of the delayed phase was ad hoc in this trial. However, when conducting studies related to CINV, it might be worthwhile to revise the borderline area between the two phases of CINV to facilitate elucidating the mechanisms underlying this potentially debilitating side effect of chemotherapy.
Citation Format: Ogata H, Saito M, Tsuneizumi M, Kutomi G, Hosoya K, Kawai Y, Sugizaki K, Katsumata N, Senuma K, Kitabatake T, Suda M, Uomori T, Miura K, Kurata M, Nitta Y, Yonemoto N, Matsuoka J. Difference between 1st and 2nd generation serotonin receptor antagonists in triplet antiemetic therapy for highly emetogenic chemotherapy in breast cancer patients – according to recent multi-institutional double-blind randomized clinical research on the AC regimen [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-11-03.
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Affiliation(s)
- H Ogata
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - M Saito
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - M Tsuneizumi
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - G Kutomi
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - K Hosoya
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - Y Kawai
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - K Sugizaki
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - N Katsumata
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - K Senuma
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - T Kitabatake
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - M Suda
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - T Uomori
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - K Miura
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - M Kurata
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - Y Nitta
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - N Yonemoto
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
| | - J Matsuoka
- Toho University Ohmori Medical Center, Tokyo, Japan; Juntendo University, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; Sapporo Medical University, Sapporo, Japan; Tottori University, Yonago, Japan; Tokyo Medical University, Tokyo, Japan; Ohme Municipal General Hospital, Ohme, Japan; Nippon Medical School Musashi Kosugi Hospital, Tokyo, Japan; Juntendo University Shizuoka Branch Hospital, Izunagaoka, Japan; Juntendo University Urayasu Hospital, Urayasu, Japan; Juntendo University Nerima Hospital, Tokyo, Japan
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Uomori T, Yokoyama M, Nara E, Nakano K, Ueda K, Nishimura N, Sakajiri S, Mishima Y, Terui Y, Takahashi S. The Efficacy and Safety Analysis of Carbopratin and Paclitaxel Therapy for Patients with Inoperable, Recurrent or Refractory Adenocarcinoma of the Head and Neck. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32353-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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13
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Nasu M, Yoshimura S, Uomori T, Takehara K, Tanaka R, Miyano S, Machida M, Kitabatake T, Fujisawa M, Kojima K. The efficacy of intraoperative ultrasonography during laparoscopic cholecystectomy. Hepatogastroenterology 2012; 59:1003-5. [PMID: 22580648 DOI: 10.5754/hge10540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIMS Intraoperative ultrasonography (IOUS) has been used to delineate anatomy during laparoscopic cholecystectomy (LapC) and screen for common bile duct stones (CBDS), however no consensus about its efficacy has been reached in Japan. In this study, we compared and evaluated the performance of intraoperative cholangiography(IOC) and IOUS during LapC. METHODOLOGY We evaluated 295 cases of cholecystolithiasis that underwent surgery from 2005- 2009 at our hospital. Frequency of CBDS and duration of surgery was examined in cases with IOC alone or IOC and IOUS in combination. RESULTS There were 5 cases (1.7%) in which IOUS or IOC detected CBDS that had not been detected by preoperative evaluation using abdominal CT, abdominal ultrasonography or MRCP. Out of 62 LapC cases involving both IOC and IOUS, 60 cases showed the same findings, i.e. no false-negative results, indicating that IOUS is a trustworthy examination method. The mean duration of surgery involving IOUS alone was 135 minutes while a longer mean time of 163 minutes was found for that involving IOC alone or IOC and IOUS in combination. CONCLUSIONS This study shows that IOC can be considered useful as it did not produce any false-negative results in screening CBDS and it also shortened the operation time. We also found some problems associated with IOC, such as small calculi falling within the gallbladder during examination procedures and the irradiation of patients and staff.
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Affiliation(s)
- Motomi Nasu
- Department of Surgery, Juntendo University, Tokyo, Japan.
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14
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Fujisawa M, Uomori T, Takehara K, Mitsugi Y, Yoshino K, Okumura M, Machida M, Kitabatake T, Ishibiki Y, Kojima K, Ogura K, Matsumoto T. [A case of recurrent breast cancer responding to vinorelbine/trastuzumab combination therapy]. Gan To Kagaku Ryoho 2009; 36:2631-2635. [PMID: 20009469] [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: 05/28/2023]
Abstract
A 60-year-old woman with Stage II, ER-positive, PgR-positive, HER2 (2+) cancer in the right breast underwent right mastectomy with right axillary dissection after chemotherapy with EC followed by docetaxel (DOC) alone. Exemestane was used for postoperative adjuvant treatment. She underwent a right chest wall tumor resection for local recurrence. Hormone therapy was continued with toremifene in place of exemestane. In December 2007, two years after the second surgery, CEA was elevated and PET showed a local recurrence in the right chest wall and metastases to the right axillary nodes and liver. The tumor was ER-positive, PgR-negative and HER2 (3+) at recurrence, and vinorelbine/trastuzumab combination was initiated as first-line chemotherapy for the recurrent lesion and liver metastasis. All lesions in the right chest wall, right axillary nodes and liver disappeared from PET and CT images after five courses of the regimen, resulting in clinical CR. Vinorelbine combined with trastuzumab appears to be a useful therapy for HER2-positive recurrent breast cancer.
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Affiliation(s)
- Minoru Fujisawa
- Dept. of General Surgery, Juntendo University Nerima Hospital
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