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Tamai M, Harada K, Takemoto K, Koshino K, Naito K, Ochiai T, Otsuji E. [Clinical Features and Treatment for Cholangiolocellular Carcinoma(CoCC)-Report of Three Cases]. Gan To Kagaku Ryoho 2022; 49:1968-1970. [PMID: 36733060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We report 3 cases of cholangiolocellular carcinoma(CoCC)experienced from April 2017 to March 2021 in our hospital. The average age of the cases is 74.3 years old, 2 males and 1 female respectively. Hepatectomy was performed in 2 cases, and transcatheter arterial embolization(TAE)and radiofrequency ablation(RFA)therapy was performed in 1 case because of old age and his wishes as the background liver disease. Chronic hepatitis C was found in 1 case, fatty liver in 1 case, and alcoholic liver disease in 1 case. Two patients who underwent hepatectomy had good long-term prognosis, but another patient who underwent TAE and RFA developed early recurrence at bone and died in 3 months after treatment. Therefore, we consider that the risk of recurrence should be examined and the treatment should be performed accordingly.
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Affiliation(s)
- Mizuki Tamai
- Dept. of Surgery, North Medical Center Kyoto Prefectural University of Medicine
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2
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Li Q, Ochiai H, Ochiai T, Takayama N, Kumeda S, Miura T, Aoyagi Y, Imai M. Effects of forest bathing (shinrin-yoku) on serotonin in serum, depressive symptoms and subjective sleep quality in middle-aged males. Environ Health Prev Med 2022; 27:44. [PMID: 36328588 PMCID: PMC9665960 DOI: 10.1265/ehpm.22-00136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/15/2022] [Accepted: 09/11/2022] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND We previously found that a forest bathing (shinrin-yoku) program significantly reduced the scores for depression, anxiety, anger, fatigue, and confusion and increased the score for vigor in the profile of mood states (POMS) test and showed a potential preventive effect on the depressive status in both males and females. In the present study, we investigated the effects of a forest bathing program on the level of serotonin in serum, depressive symptoms and subjective sleep quality in middle-aged males. METHODS Twenty healthy male subjects aged 57.3 ± 8.4 years were selected after obtaining informed consent. These subjects took day trips to a forest park, the birthplace of forest bathing in Japan named Akasawa Shizen Kyuyourin, Agematsu, Nagano Prefecture (situated in central Japan), and to an urban area of Nagano Prefecture as a control in June 2019. On both trips, they walked 2.5 km for 2 hours each in the morning and afternoon on Saturday and Sunday, respectively. Blood was sampled in the afternoon before and after each trip. Concentrations of serotonin and lactic acid in serum were measured. The POMS test and a questionnaire for subjective sleep quality were conducted before and after the trips. Ambient temperature and humidity were monitoring during the trips. The Ethics Committees of the Nippon Medical School and Nagano Prefectural Kiso Hospital approved this study. RESULTS The forest bathing program significantly increased level of serotonin in serum, and significantly increased the score for vigor and decreased the score for fatigue in the POMS test. The forest bathing program also improved the sleepiness on rising and feeling refreshed (recovery from fatigue) in the Oguri-Shirakawa-Azumi sleep inventory MA version (OSA-MA). CONCLUSIONS Taken together, the present study suggests that forest bathing may have potential preventive effects on depression (depressive status).
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Affiliation(s)
- Qing Li
- Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School
| | - Hiroko Ochiai
- Department of Plastic and Reconstructive Surgery, Laboratory of Regenerative Medicine, Division of Hearing and Balance Disorder, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center
| | | | - Norimasa Takayama
- Forestry and Forest Products Research Institute, Forest Research and Management Organization
| | | | | | - Yoichiro Aoyagi
- Department of Rehabilitation Medicine, Graduate School of Medicine, Nippon Medical School
| | - Michiko Imai
- INFOM (International Society of Nature and Forest Medicine)
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3
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Ochiai T, Nagayama T, Matsui K, Amano K, Sano T, Wakabayashi T, Iwatsubo T. Tauroursodeoxycholic Acid Attenuates Diet-Induced and Age-Related Peripheral Endoplasmic Reticulum Stress and Cerebral Amyloid Pathology in a Mouse Model of Alzheimer's Disease. J Prev Alzheimers Dis 2021; 8:483-494. [PMID: 34585224 DOI: 10.14283/jpad.2021.33] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Obesity and diabetes are well-established risk factors of Alzheimer's disease (AD). In the brains of patients with AD and model mice, diabetes-related factors have been implicated in the pathological changes of AD. However, the molecular mechanistic link between the peripheral metabolic state and AD pathophysiology have remained elusive. Endoplasmic reticulum (ER) stress is known as one of the major contributors to the metabolic abnormalities in obesity and diabetes. Interventions aimed at reducing ER stress have been shown to improve the systemic metabolic abnormalities, although their effects on the AD pathology have not been extensively studied. OBJECTIVES We examined whether interventions targeting ER stress attenuate the obesity/diabetes-induced Aβ accumulation in brains. We also aimed to determine whether ER stress that took place in the peripheral tissues or central nervous system was more important in the Aβ neuropathology. Furthermore, we explored if age-related metabolic abnormalities and Aβ accumulation could be suppressed by reducing ER stress. METHODS APP transgenic mice (A7-Tg), which exhibit Aβ accumulation in the brain, were used as a model of AD to analyze parameters of peripheral metabolic state, ER stress, and Aβ pathology in the brain. Intraperitoneal or intracerebroventricular administration of taurodeoxycholic acid (TUDCA), a chemical chaperone, was performed in high-fat diet (HFD)-fed A7-Tg mice for ~1 month, followed by analyses at 9 months of age. Mice fed a normal diet were treated with TUDCA by drinking water for 4 months and intraperitoneally for 1 month in parallel, and analyzed at 15 months of age. RESULTS Intraperitoneal administration of TUDCA suppressed ER stress in the peripheral tissues and ameliorated the HFD-induced obesity and insulin resistance. Concomitantly, Aβ levels in the brain were significantly reduced. In contrast, intracerebroventricular administration of TUDCA had no effect on the Aβ levels. Peripheral administration of TUDCA was also effective against the age-related obesity and insulin resistance, and markedly reduced amyloid accumulation. CONCLUSIONS Interventions that target peripheral ER stress might be beneficial therapeutic and prevention strategies against brain Aβ pathology associated with metabolic overload and aging.
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Affiliation(s)
- T Ochiai
- Tomoko Wakabayashi, Takeshi Iwatsubo, Department of Neuropathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan, Tel: +81-3-5841-3541, Fax: +81-3-5841-3613 ,
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Inoue H, Kawaguchi T, Ikoma H, Morimura R, Yamamoto Y, Ochiai T, Shimizu H, Arita T, Konishi H, Shiozaki A, Kuriu Y, Kubota T, Fujiwara H, Okamoto K, Takahashi H, Takabe K, Tsung A, Otsuji E. Oligometastasis scoring system for predicting survival of patients with colorectal liver metastasis after hepatectomy. J Surg Oncol 2021; 124:791-800. [PMID: 34196000 DOI: 10.1002/jso.26575] [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: 03/13/2021] [Revised: 05/19/2021] [Accepted: 05/22/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Oligometastasis, the presence of a small number of resectable metastatic tumors, usually has favorable outcomes. Here we examined whether the novel oligometastatic score (OLGS), which divides the number of colorectal liver metastases (CRLMs) by the time from colorectal resection to liver recurrence, better predicts CRLM patient survival than the commonly used clinical risk score. METHODS A total of 143 patients who underwent curative hepatectomy for CRLMs between 2007 and 2018 were analyzed. We investigated their clinical characteristics and outcomes using OLGS. RESULTS Of the 143 CRLM patients, 70 had synchronous CRLMs and 73 had metachronous CRLMs. Patients with metachronous CRLMs were divided into OLGS-low (n = 59) and OLGS-high (n = 14) subgroups. The 5-year overall survival (OS) rates after hepatectomy differed significantly between the subgroups (p < .001). In the multivariate Cox model, a high OLGS was an independent predictor of 5-year OS (p < .001), and the hazard ratio (HR) of the OLGS-high group (HR = 7.171) was higher than that of the high clinical risk score group (HR = 4.337). CONCLUSION The OLGS, a simple and handy scoring system, better predicts the 5-year OS of patients with CRLMs after hepatectomy and warrants prospective validation.
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Affiliation(s)
- Hiroyuki Inoue
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan
| | - Tsutomu Kawaguchi
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan
| | - Hisashi Ikoma
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan
| | - Ryo Morimura
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan
| | - Yusuke Yamamoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan
| | - Toshiya Ochiai
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan.,Department of Surgery, North Medical Center Kyoto Prefectural, University of Medicine, Kyoto, Japan
| | - Hiroki Shimizu
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan
| | - Tomohiro Arita
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan
| | - Hirotaka Konishi
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan
| | - Atsushi Shiozaki
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan
| | - Yoshiaki Kuriu
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan
| | - Takeshi Kubota
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan
| | - Hitoshi Fujiwara
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan
| | - Kazuma Okamoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan
| | - Hideo Takahashi
- Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Kazuaki Takabe
- Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Allan Tsung
- Division of Surgical Oncology, Department of Surgery, Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural, University of Medicine, Kyoto, Japan
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Inoue H, Ochiai T, Kubo H, Yamamoto Y, Morimura R, Ikoma H, Otsuji E. Laparoscopic cholecystectomy for gangrenous cholecystitis in around nineties: Two case reports. World J Clin Cases 2021; 9:3424-3431. [PMID: 34002154 PMCID: PMC8107906 DOI: 10.12998/wjcc.v9.i14.3424] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/05/2021] [Accepted: 03/17/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gangrenous cholecystitis is a form of acute cholecystitis which involves gangrenous alterations in the gallbladder wall and it often follows an acute and serious course. We herein report on two cases of very elderly people diagnosed early with gangrenous cholecystitis, who safely underwent laparoscopic cholecystectomy (LC) and both demonstrated a good outcome.
CASE SUMMARY Case 1: An 89-year-old female. She underwent abdominal contrast-enhanced computed tomography (CECT) due to abdominal pain and diarrhea. Her gallbladder wall indicated the absence of contrast enhancement, thus leading to diagnosis of gangrenous cholecystitis and she therefore underwent LC. Although her gallbladder demonstrated diffuse necrosis and it was also partly perforated, she was able to be discharged without any serious complications. Case 2: A 91-year-old female. She made an emergency visit with a chief complaint of abdominal pain. Abdominal CECT revealed swelling of the gallbladder and an ambiguous continuity of the gallbladder wall. She was diagnosed with gangrenous cholecystitis and underwent LC. Her gallbladder had swelling and diffuse necrosis. Although her preoperative blood culture was positive, she showed a good outcome following surgery.
CONCLUSION Although a definite diagnosis of gangrenous cholecystitis is difficult to make prior to surgery, if an early diagnosis can be made and appropriate treatment can be carried out, then even very elderly individuals may be discharged without major complications.
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Affiliation(s)
- Hiroyuki Inoue
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectual University of Medicine, Kyoto 6028566, Japan
| | - Toshiya Ochiai
- Department of Surgery, North Medical Center Kyoto Prefectural University of Medicine, Kyoto 6292261, Japan
| | - Hidemasa Kubo
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
| | - Yusuke Yamamoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
| | - Ryo Morimura
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
| | - Hisashi Ikoma
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
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Harada K, Sumiyoshi S, Takemoto K, Koshino K, Toma A, Ochiai T. [Curative Resection of Advanced Rectal Cancer with Direct Invasion of the Prostate and Extra-Regional Lymph Node Metastases after Chemotherapy]. Gan To Kagaku Ryoho 2020; 47:1827-1829. [PMID: 33468842] [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: 06/12/2023]
Abstract
A-69-year-old man presented with an obstructed defecation. He was diagnosed as having advanced lower rectal cancer with direct invasion of the prostate and metastases to regional and para-aortic lymph nodes. Biopsy examination of the tumor showed RAS wild-type expression and negative BRAF V600E mutation. The patient received 13 courses of mFOLFOX6 and panitumumab(Pmab)in combination and 1 course of mFOLFOX6 alone. After the chemotherapy, the size of the primary tumor and lymph node metastases decreased remarkably. 18F-fluorodeoxyglucose-positron emission tomography(18F-FDG- PET)showed no 18F-FDG accumulation in the tumor and lymph nodes. We performed laparoscopic abdominoperineal resection with D3LD2 lymph node dissection and left external iliac lymph node(293-lt)sampling. Pathological examination revealed no residual cancer at the primary tumor location and only a few malignant cells remained in the 293-lt lymph node. The patient has shown no recurrence for 1 year without adjuvant chemotherapy. We conclude that mFOLFOX6 and Pmab in combination is an effective preoperative chemotherapy against advanced RAS wild-type rectal cancer. This strategy may reduce surgical invasion and save the surrounding organs while maintaining curability.
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Affiliation(s)
- Kyoichi Harada
- Dept. of Surgery, North Medical Center Kyoto Prefectural University of Medicine
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Takemoto K, Harada K, Toma A, Imura T, Ochiai T, Otsuji E. [Case of a 5mm Rectal Neuroendocrine Tumor(G1)with Lymph Node Metastasis]. Gan To Kagaku Ryoho 2020; 47:652-654. [PMID: 32389973] [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
Screening colorectal endoscopy revealed a 5mm rectal neuroendocrine tumor(NET: G1)in a 72-year-old man. Endoscopic mucosal resection(EMR)was performed, and the histopathological examination demonstrated lymphatic and vessel invasion with a possible positive vertical margin. Therefore, we performed laparoscopic low anterior resection, lymphadenectomy, and ileostomy as additional surgical resections. No residual tumor was found in the specimen, but 3 metastatic lymph nodes were identified. The rate of lymph node metastasis in rectal NETs of diameter<10mm is low, and additional surgery can reduce the patient's quality of life affected due to impaired anorectal function. However, in the Japanese guidelines for NET, additional surgery is adopted in cases with high-risk factors for lymph node metastasis. Therefore, it is necessary to select between additional surgery and careful follow-upfor rectal NETs of diameter<10mm with high-risk factors because of possible lymph node metastasis.
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Affiliation(s)
- Kenichi Takemoto
- Dept. of Surgery, North Medical Center Kyoto Prefectural University of Medicine
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Brown R, Imawari M, Izumi N, Osaki Y, Bentley R, Baykal T, Ochiai T, Kano T. Abstract No. 617 Lusutrombopag reliably increases platelets regardless of baseline platelet counts in thrombocytopenic chronic liver disease patients undergoing planned invasive procedures: results of two phase 3 trials. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.678] [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: 10/25/2022] Open
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Brown R, Imawari M, Izumi N, Osaki Y, Ochiai T, Kano T, Bentley R, Peck-Radosavljevic M. Abstract No. 615 Lusutrombopag is a safe and efficacious treatment option for thrombocytopenia in patients with chronic liver disease undergoing planned invasive procedures: integrated analysis of two phase 3 trials. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.676] [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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Brown R, Izumi N, Kano T, Ochiai T, Kurosaki M, Violi F, Shrestha P. Abstract No. 616 Lusutrombopag is a safe treatment option for thrombocytopenia in patients with chronic liver disease undergoing a planned invasive procedure: pooled safety analysis from three studies. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.677] [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: 10/25/2022] Open
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Ochiai T, Inoue H, Watanabe N, Ito H, Toma A, Morimura R, Ikoma H, Otsuji E. Outcome of a second hepatectomy in octogenarians with hepatocellular carcinoma recurrence: single centre's experience. ANZ J Surg 2019; 89:1270-1274. [PMID: 31280497 DOI: 10.1111/ans.15330] [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: 01/16/2019] [Revised: 05/22/2019] [Accepted: 05/24/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND Physicians rarely select surgery a second time as the treatment for octogenarians with hepatocellular carcinoma (HCC) recurrence. METHODS We encountered eight male and three female octogenarians underwent surgery a second time as the treatment for HCC recurrence (octo group). We studied these cases clinically and compared them with 25 younger people underwent surgery a second time (young group). All patients of octo group have resectable HCC according to the Japanese guideline, that is HCC patients with Child-Pugh status A or B and who have solitary or only a few HCC nodules, in addition, no serious comorbidities, no serious dementia, a performance status of 0-1 and the will to receive hepatectomy. RESULTS The average maximum tumour size at the first hepatectomy was significantly larger than that at the second hepatectomy (P < 0.05). The extent of the first hepatectomy was significantly greater than that of the second one (P < 0.05). There were no mortalities at either hepatectomy. The morbidities of the first and the second hepatectomies were 9.1% and 18.2%, respectively. All complications were bile leakage. Furthermore, there were no significant differences in the clinical features, including the prognosis, between the octo and young groups. CONCLUSION Selected octogenarians who received a second hepatectomy showed a relatively good post-operative course after the first and second hepatectomies. Repeated hepatectomy for octogenarians seems to have same positive influence on the prognosis in comparison to the young group. But on the data analysed, we have not shown repeated hepatectomy is superior to non-surgical treatments.
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Affiliation(s)
- Toshiya Ochiai
- Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroyuki Inoue
- Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Nobuyuki Watanabe
- Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroshi Ito
- Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsushi Toma
- Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryo Morimura
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hisashi Ikoma
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Inoue H, Toma A, Watanabe N, Ito H, Ochiai T, Otsuji E. [Successful curative resection after chemotherapy for initially unresectable advanced gallbladder cancer with rectal metastasis:a case report]. Nihon Shokakibyo Gakkai Zasshi 2018; 115:905-913. [PMID: 30305572 DOI: 10.11405/nisshoshi.115.905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A 42-year-old male was referred to our hospital with bloody feces and lower back pain. He was diagnosed with unresectable gallbladder cancer with rectal metastasis (T3aN1M1, Stage IVB). The patient was administered gemcitabine plus cisplatin (GC). After nine courses of GC, computed tomography showed regression of the tumor and the patient's tumor marker levels had decreased. Therefore, curative resection was performed. Ten months after the operation, recurrence was observed in the rectal margin and GC was restarted. Because the total dose of cisplatin was 1040mg, we stopped cisplatin and continued to administer only gemcitabine (at the same dose). A follow-up examination 2 years after the operation showed no evidence of recurrence. Conversion therapy might be an effective multidisciplinary treatment for advanced gallbladder cancer that is initially unresectable. Herein, we report the case of a patient with advanced gallbladder cancer and rectal metastasis who was successfully treated by curative resection after chemotherapy;we also review the relevant literature.
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Affiliation(s)
- Hiroyuki Inoue
- Department of Surgery, North Medical Center Kyoto Prefectural University of Medicine.,Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine
| | - Atsushi Toma
- Department of Surgery, North Medical Center Kyoto Prefectural University of Medicine.,Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine
| | - Nobuyuki Watanabe
- Department of Surgery, North Medical Center Kyoto Prefectural University of Medicine.,Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine
| | - Hiroshi Ito
- Department of Surgery, North Medical Center Kyoto Prefectural University of Medicine.,Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine
| | - Toshiya Ochiai
- Department of Surgery, North Medical Center Kyoto Prefectural University of Medicine.,Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine
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Onoe A, Matsuura D, Terui T, Morikawa H, Fujii M, Ochiai T. Erythematous lesion with peripheral purpura on the face. Clin Exp Dermatol 2018; 44:428-431. [DOI: 10.1111/ced.13750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2018] [Indexed: 12/27/2022]
Affiliation(s)
- A. Onoe
- Department of Dermatology Nihon University Hospital TokyoJapan
| | - D. Matsuura
- Department of Dermatology Nihon University Hospital TokyoJapan
| | - T. Terui
- Division of Dermatological Science Department of Dermatology Nihon University School of Medicine Tokyo Japan
| | | | - M. Fujii
- Department of Digestive Surgery Nihon University Hospital Tokyo Japan
| | - T. Ochiai
- Department of Dermatology Nihon University Hospital TokyoJapan
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Ochiai T, Tomiyama H, Ikebe H, Fujii S, Kimura K, Matsumoto C, Shiina K, Chikamori D. 421Effect of wave reflection and arterial stiffness on the risk of development of hypertension in Japanese men. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Ochiai
- Tokyo Medical University Ibaraki Medical Center, The Department of Cardiology, Ibaraki, Japan
| | - H Tomiyama
- Tokyo Medical University, The Department of Cardiology, Tokyo, Japan
| | - H Ikebe
- Tokyo Medical University, The Department of Cardiology, Tokyo, Japan
| | - S Fujii
- Tokyo Medical University, The Department of Cardiology, Tokyo, Japan
| | - K Kimura
- Tokyo Medical University Ibaraki Medical Center, The Department of Cardiology, Ibaraki, Japan
| | - C Matsumoto
- Tokyo Medical University, The Department of Cardiology, Tokyo, Japan
| | - K Shiina
- Tokyo Medical University, The Department of Cardiology, Tokyo, Japan
| | - D Chikamori
- Tokyo Medical University, The Department of Cardiology, Tokyo, Japan
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Ito H, Ochiai T, Nakatsuji H, Inoue H, Watanabe N, Yoshiyama A, Toma A, Nakamura K, Otsuji E. [A Case Report of an Elderly Patient's Intrahepatic Cholangiocellular Carcinoma with Cholangitis]. Gan To Kagaku Ryoho 2017; 44:1823-1825. [PMID: 29394788] [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: 06/07/2023]
Abstract
We report a case of an elderly patient diagnosed with intrahepatic cholangiocellular carcinoma with cholangitis.An 88- year-old woman presented with fever.Computed tomography examination showed a hepatic tumor and dilation of the peripheral bile duct.Cholangiocarcinoma was diagnosed.Biliary tract drainage and palliative care were suggested because of her age.However, her family asked for a second opinion about operative management and consulted our hospital.Radical operations for intrahepatic cholangiocellular carcinoma that has spread to the left lobe are usually accompanied by widespread lymph node dissection and extensive hepatectomy with biliary tract reconstruction.However, in this case, the patient was very elderly and was able to safely undergo an operation by reduction of the excision range and by omitting lymph node dissection.We conclude that appropriate surgery and postoperative care to prevent complications are necessary when performing very invasive surgery in elderly patients.
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Affiliation(s)
- Hiroshi Ito
- Dept. of Surgery, North Medical Center, Kyoto Prefectural University of Medicine
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16
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Inoue H, Ochiai T, Nakatsuji H, Watanabe N, Ito H, Yoshiyama A, Toma A, Nakamura K, Otsuji E. [A Successful Curative Resection Case of Metastatic Hepatocellular Carcinoma to the Kidney Which Extended into the Renal Vein]. Gan To Kagaku Ryoho 2017; 44:1820-1822. [PMID: 29394787] [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: 06/07/2023]
Abstract
A 78-year-old woman underwent partial hepatectomy for the treatment of hepatocellular carcinoma(HCC).After surgery, she was further treated with radiofrequency ablation(RFA)and transcatheter arterial embolization(TAE)for the intrahepatic reccurence of HCC.Thirty months after surgery, her tumor marker levels increased and computed tomography (CT)revealed an intrahepatic mass and right renal tumor which extended into the renal vein.We therefore suspected a reccurence of HCC and right renal cell carcinoma which extended into the renal vein, and thus performed right nephrectomy before again performing TAE to treat the reccurence of HCC.The pathological findings showed HCC metastasis in the kidney. Nephrectomy should be performed as soon as possible in patients with a renal vein tumor thrombus in order to prevent the occurrence of a pulmonary embolism.We herein describe a very rare oncologic emergency case and review the relevant literature.
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Affiliation(s)
- Hiroyuki Inoue
- Dept. of Surgery, North Medical Center Kyoto Prefectural University of Medicine
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17
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Watanabe N, Akagi S, Inoue H, Nakatsuji H, Ito H, Toma A, Nakamura K, Ochiai T, Otsuji E. [Long-Term Survival of a Patient with Metastatic Liver and Para-Aortic Lymph Node Cancer from Colon Cancer Treated with Regorafenib]. Gan To Kagaku Ryoho 2017; 44:1732-1734. [PMID: 29394758] [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: 06/07/2023]
Abstract
A 54-year-old man was presented at our hospital with weight loss.He diagnosed with colorectal cancer, multiple liver metastases and para-aortic lymph node metastasis.After undergoing colostomy, he was treated sequentially with mFOLFOX6 plus bevacizumab(Bmab), FOLFIRI plus Bmab or Pmab, according to the guideline.Since these chemotherapy resulted in progressive disease, regorafenib was administered as a salvage-line treatment.PET -CT showed only para-aortic lymph node swelling with high FDG uptake.Severe adverse effects were developed shortly after regorafenib treatment so he requireda reduction in dose.Three years after treatment with regorafenib, the response of the target lesion was stable disease according to the RECIST criteria.Tumor growth had been controlled for a long time.
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Affiliation(s)
- Nobuyuki Watanabe
- Dept. of Surgery, North Medical Center Kyoto Prefectural University of Medicine
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18
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Ochiai T, Inoue H, Nakatsuji H, Watanabe N, Yoshiyama A, Ito H, Toma A, Nakamura K. [Neoadjuvant FOLFIRINOX for Unresectable Adenocarcinoma of the Pancreas - A Case Report]. Gan To Kagaku Ryoho 2017; 44:1349-1351. [PMID: 29394630] [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: 06/07/2023]
Abstract
A 38-year-old male presented to our hospital with complaint of vomiting. A CT demonstrated a mass sized 42mm in the pancreatic head invading to the duodenum and a liver mass sized 15mm in the medial segment. Biopsy revealed adenocarcinoma. Due to liver metastasis, he was deemed surgically unresectable. He was started on FOLFIRINOX therapy after gastrojejunum bypass operation. After 15 courses of the therapy, restaging showed a decrease in pancreatic tumor size and a disappearance of a liver mass along with PET-CT revealing no FDG-avid uptake. A serum value of DUPAN-2 was also normalized. He was offered resection as a potentially curative treatment. He underwent curative pancreaticoduodenectomy(PD), which was difficult to perform because of adhesion and hard fibrous tissues. Operating time and blood loss were 600 minutes and 1,933 mL, respectively. Histologic examination revealed Grade 1a histological chemotherapy effect. His cancer recurred 11 months after PD. He received nab-paclitaxel and gemcitabine regimen at out-patients clinic.
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Affiliation(s)
- Toshiya Ochiai
- Dept. of Surgery, North Medical Center, Kyoto Prefectural University of Medicine
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19
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Hasegawa H, Okabayashi K, Tsuruta M, Koike J, Funahashi K, Yokomizo H, Yoshimatsu K, Kan H, Yamada T, Ishida H, Ishibashi K, Saida Y, Enomoto T, Katsumata K, Koda K, Ochiai T, Sakamoto K, Ogawa S, Itabashi M, Kameoka S. Updated survival results of FACT trial: Multicenter phase II trial of neoadjuvant chemotherapy with mFOLFOX6 for stage II/III rectal cancer with a T3/T4 tumor. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.033] [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: 11/14/2022] Open
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20
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Watanabe N, Mitsuda M, Yamashita E, Ito H, Toma A, Nakamura K, Ochiai T. [A Case Report of Early Gastric Cancer with Submucosal Heterotopic Gastric Glands]. Gan To Kagaku Ryoho 2016; 43:1881-1883. [PMID: 28133163] [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]
Abstract
We reported a case of early gastric cancer with submucosal heterotopic gastric glands.A 62-year-old woman presented with poor appetite, weight loss, and epigastric pain.Endoscopy examination identified giant gastric folds and a gastric ulcer on the posterior wall of the upper-middle stomach.Biopsy specimen analysis showed adenocarcinoma.We preoperatively diagnosed the lesion as type II c-like advanced cancer and performed a total gastrectomy.Pathologically, the lesion was diagnosed as gastric cancer(non-solid type poorly differentiated adenocarcinoma)located in the mucosal layer and accompanied by submucosal heterotopic gastric glands.Submucosal gastric gland heterotopia is a relatively rare disease, and it is difficult to diagnose the glands before surgery is performed.However, endoscopic ultrasonography helps to demonstrate diffuse cystic lesion preoperatively.It is often associated with multiple gastric cancers.Therefore, we must diagnose and treat the disease with great care.
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Affiliation(s)
- Nobuyuki Watanabe
- Dept. of Surgery, North Medical Center, Kyoto Prefectural University of Medicine
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21
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Mizutani T, Ikoma H, Kosuga T, Konishi H, Morimura R, Murayama Y, Komatsu S, Shiozaki A, Kriu Y, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Ochiai T, Otsuji E. [A Case of Bismuth III b Hilar Cholangiocarcinoma Resected with Extended Left Hepatic Lobectomy after ERCP Induced Pancreatitis]. Gan To Kagaku Ryoho 2016; 43:1588-1590. [PMID: 28133066] [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]
Abstract
Endoscopic retrograde cholangiopancreatography(ERCP)is widely accepted as the standard therapy before surgery for hilar cholangiocarcinoma. The patient is a 68-year-old man who presented with liver dysfunction. Computed tomography (CT)revealed abnormal lesions in his liver. He was referred to our hospital for therapy. We present a rare case of expansion of left lobectomy for Bismuth III b hilar cholangiocarcinoma after grade 2 severe pancreatitis caused by ERCP. He received arterial infusion therapy and endoscopic necrosectomy 6 times and percutaneous transhepatic biliary drainage(PTBD). The surgical procedure could be performed after the severe pancreatitis resolved. His postoperative course was uneventful.
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Affiliation(s)
- Toru Mizutani
- Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine
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22
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Ochiai T, Ishii H, Toma A, Ishimoto T, Yamamoto Y, Morimura R, Ikoma H, Otsuji E. Modified high dorsal procedure for performing isolated anatomic total caudate lobectomy (with video). World J Surg Oncol 2016; 14:132. [PMID: 27129389 PMCID: PMC4850680 DOI: 10.1186/s12957-016-0896-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 04/22/2016] [Indexed: 01/10/2023] Open
Abstract
Background Isolated anatomic total caudate lobectomy is indicated in patients who have liver tumors limited to the caudate lobe. However, isolated caudate lobe resection is a challenging surgical procedure that required safe and reliable techniques. All portal and hepatic veins that connect this area originate from the first branch of the portal vein or vena cava; therefore, the operator must be cautious of the potential for massive bleeding. Methods The important points regarding the safety of our procedure include creating an optimal surgical view and preparing for accidental bleeding before parenchymal dissection. Sufficient mobilization and removal of Spiegel’s lobe from the left to the right side of the vena cava allows the operator to perform parenchymal dissection under a right- or front-side view. Results We have performed this technique in two patients with HCC and one patient with primary cystadenocarcinoma. The average operative time and amount of blood loss were 435 min and 1137 ml, respectively. No operative mortalities or postoperative complications were observed in any of the patients. Our three patients are currently doing well without any recurrence. Conclusion Our modified high dorsal resection procedure can be used to safely remove the entire caudate lobe. Electronic supplementary material The online version of this article (doi:10.1186/s12957-016-0896-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Toshiya Ochiai
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. .,Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, 481 Otokoyama, Yosano-cho, Yosa-gun, Kyoto, 629-2261, Japan.
| | - Hiromichi Ishii
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsushi Toma
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takeshi Ishimoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yusuke Yamamoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryo Morimura
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hisashi Ikoma
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
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23
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Shoda K, Ikoma H, Yamamoto Y, Kinoshita O, Morimura R, Konishi H, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Sakakura C, Ochiai T, Taniguchi H, Yasukawa S, Otsuji E. A case of long-term survival following hepatectomy for liver metastasis of Merkel cell carcinoma. Surg Case Rep 2016; 1:30. [PMID: 26943398 PMCID: PMC4747964 DOI: 10.1186/s40792-015-0015-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 01/07/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Merkel cell carcinoma (MCC) is a rare endocrine tumor that presents as a rapidly growing skin nodule of the body, and it is aggressive with regional nodal and distant metastases without clearly defined treatment. There are no reports of long survivors among patients with liver metastasis of MCC. The current case was a patient who underwent surgical resection for liver metastasis of Merkel cell carcinoma. CASE PRESENTATION This case describes a 73-year-old female with a papule on the dorsal side of the right third finger and liver tumor. The papule of the right third finger was histologically diagnosed as MCC by the skin biopsy. She underwent extensive resection and lymph node dissection of the right third finger and partial resection of the liver. The liver tumor was histologically diagnosed as liver metastasis of MCC. The patient remains well without any evidence of tumor recurrence more than 5 years after surgery. CONCLUSIONS This is the first report of a long-term survival of more than 5 years following liver metastasis of MCC, which was surgically resected. Patients with small and solitary metastatic liver tumor of MCC may have a chance for a long-term survival following the hepatic resection.
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Affiliation(s)
- Katsutoshi Shoda
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Hisashi Ikoma
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Yusuke Yamamoto
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Osamu Kinoshita
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan. .,Department of Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Ryo Morimura
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Hirotaka Konishi
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Yasutoshi Murayama
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Shuhei Komatsu
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Atsushi Shiozaki
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Yoshiaki Kuriu
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Masayoshi Nakanishi
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Daisuke Ichikawa
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Hitoshi Fujiwara
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Kazuma Okamoto
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Chohei Sakakura
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
| | - Toshiya Ochiai
- Department of Surgery, North Medical Center Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Hiroki Taniguchi
- Department of Surgery, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan.
| | - Satoshi Yasukawa
- Department of Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Eigo Otsuji
- Department of Digestive Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, Japan.
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24
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Konishi H, Ichikawa D, Yamamoto Y, Arita T, Shoda K, Hiramoto H, Hamada J, Itoh H, Fujita Y, Komatsu S, Shiozaki A, Ikoma H, Ochiai T, Otsuji E. Plasma level of metastasis-associated lung adenocarcinoma transcript 1 is associated with liver damage and predicts development of hepatocellular carcinoma. Cancer Sci 2016; 107:149-54. [PMID: 26614531 PMCID: PMC4768388 DOI: 10.1111/cas.12854] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 11/16/2015] [Accepted: 11/20/2015] [Indexed: 12/26/2022] Open
Abstract
Recent studies have shown that metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) was overexpressed in many human solid cancers, however, its roles in plasma of hepatocellular carcinoma (HCC) patients were unclear. The aim of this study was to investigate the significance of plasma MALAT1 levels in HCC patients. Plasma samples were collected from pre-operative HCC, hepatic disease patients, and healthy controls, and tissue samples from HCC patients and colorectal cancer patients with liver metastasis. Plasma and tissue MALAT1 levels were measured. Plasma MALAT1 levels were progressively and significantly higher in HCC patients than hepatic disease patients, and higher in hepatic disease patients than healthy controls. The expression of MALAT1 in HCC tissue was slightly higher than that in paired non-cancerous liver tissue, but not significant. The expression of MALAT1 in the non-cancerous liver tissue of 20 HCC patients was significantly higher than that in normal liver tissue of 13 colorectal cancer patients. In contrast, plasma MALAT1 levels were significantly low in HCC patients with hepatitis B infection, and significantly high in patients with liver damage B or liver cirrhosis. In a receiver-operator curve analysis of HCC and hepatic disease patients, the cut-off value of plasma MALAT1 was 1.60 and the area under the curve was 0.66. Plasma MALAT1 levels were not correlated with α-fetoprotein or protein induced by vitamin K absence II, whereas sensitivity and specificity for the detection of HCC with the combination of MALAT1, α-fetoprotein, and protein induced by vitamin K absence II were 88.6% and 75%, respectively. In conclusion, the plasma MALAT1 level is associated with liver damage, and has clinical utility for predicting development of HCC.
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Affiliation(s)
- Hirotaka Konishi
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Daisuke Ichikawa
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yusuke Yamamoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomohiro Arita
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Katsutoshi Shoda
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hidekazu Hiramoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Junichi Hamada
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroshi Itoh
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuji Fujita
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shuhei Komatsu
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsushi Shiozaki
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hisashi Ikoma
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toshiya Ochiai
- Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Imamura T, Ikoma H, Morimura R, Hatakeyama T, Kosuga T, Konishi H, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Ochiai T, Otsuji E. [The Clinical Efficacy of Neoadjuvant Chemotherapy for Borderline Resectable Pancreatic Carcinoma--Report of Two Cases Treated by Curative Pancreatectomy with Portal Vein Resection after Neoadjuvant Chemotherapy]. Gan To Kagaku Ryoho 2015; 42:2379-2381. [PMID: 26805370] [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: 06/05/2023]
Abstract
We report 2 cases of curative resection of pancreatic cancer after neoadjuvant chemotherapy. A 60-year-old woman was diagnosed as having borderline resectable pancreatic ductal adenocarcinoma with invasion of the nerve plexus covering the superior mesenteric artery. The preoperative chemotherapy, 4 courses of gemcitabine and S-1, reduced the volume of tumor; pancreaticoduodenectomy with portal vein resection after chemotherapy resulted in R0 resection. Pathological examination of the resected specimen showed fibroid tissue with myxoid degeneration and mucinous lake surrounded by differentiated adenocarcinoma. A 40-year-old woman was diagnosed as having borderline resectable pancreatic ductal adenocarcinoma with invasion of the common hepatic artery and splenic artery. The preoperative chemotherapy, 4 courses of gemcitabine and S-1, reduced the tumor volume; distal pancreatectomy with portal vein resection after chemotherapy obtained R0 resection. Pathological examination of the resected specimen revealed that the majority of the tumor was fibrotic and necrotic tissue, and few cancer cells remained viable. Neoadjuvant chemotherapy has a potential to increase the rate of R0 resection. Furthermore, preoperative chemotherapy can help avoid unnecessary surgery by allowing time for potential metastasis to become obvious.
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Affiliation(s)
- Taisuke Imamura
- Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine
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26
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Ohashi T, Ikoma H, Komatsu S, Morimura R, Kosuga T, Konishi H, Murayama Y, Shiozaki A, Kuriu Y, Nakanishi M, Ichikawa D, Okamoto K, Fujiwara H, Ochiai T, Otsuji E. [A Case of Retroperitoneal Lymphangioma that Was Difficult to Differentiate from Pancreatic Tumor]. Gan To Kagaku Ryoho 2015; 42:1938-1940. [PMID: 26805223] [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: 06/05/2023]
Abstract
We report a rare case of retroperitoneal lymphangioma that was difficult to differentiate from pancreatic tumor. The patient was a 38-year-old woman. In June 2011, CT detected a pancreatic tail tumor. She was expected to undergo radical surgery and was referred to our hospital. The tumor was 55×43×40 mm in size and was described as a multilocular cystic lesion with a partition on CT. MRI demonstrated the tumor as a high-intensity area on T2-weighted images. Sonazoid-enhanced US showed a contrast effect of the partition wall. Therefore, the lesion was diagnosed as a mucinous cystic neoplasm, and the patient underwent surgery. Intraoperatively, the tumor was a white multilocular cystic lesion with a capsule. The cystic lesion was exfoliated from the pancreatic parenchyma. Histologically, the tumor was diagnosed as a cavernous lymphangioma without malignancy. The surgery achieved good progress and the patient was discharged 12 days postoperatively. She is attending our clinic without any recurrence.
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Affiliation(s)
- Takuma Ohashi
- Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine
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27
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Ishimoto T, Mitsuda M, Hongu H, Watanabe N, Nishida T, Sai S, Osawa R, Toma A, Nakamura K, Suganuma Y, Ochiai T, Shirakata S, Nomi S, Otsuji E. [A Case of Adult Invagination Caused by Rectal Cancer]. Gan To Kagaku Ryoho 2015; 42:2297-2299. [PMID: 26805343] [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: 06/05/2023]
Abstract
An 87-year-old man visited our hospital with a chief complaint of melena. Invagination caused by rectal cancer or sigmoid colon cancer was suspected as a result of physical and radiological examinations. Since there were no subjective symptoms, laparoscopic surgery was planned electively. As an operative finding, a tumor was found in the rectosigmoid colon and caused invagination. The invagination was released during an operation, and high anterior resection with D3 dissection was performed laparoscopically. The operation time was 108 minutes and the amount of blood loss was 22 mL. Although anastomotic leakage occurred as a postoperative complication, recovery was achieved conservatively by percutaneous drainage. In many cases, invagination of adults is caused by a solid tumor such as bowel carcinoma, which commonly occurs at the cecum or sigmoid colon. Although invagination of the rectosigmoid colon fixed to the retroperitoneum is relatively rare, the fragility of the supporting tissues in the pelvis accompanied by aging is considered to be a cause. In cases of a large tumor occupying the lumen of the intestine, appropriate preoperative diagnosis is needed and the method of operation should be chosen carefully.
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Affiliation(s)
- Takeshi Ishimoto
- Dept. of Surgery, Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center
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28
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Ochiai T, Mitsuda M, Ishimoto T, Toma A, Otsuji E. [Successful Treatment of Stenosis of the Portal Vein Using an Expandable Metallic Stent after Extended Right Hepatectomy--A Case Report]. Gan To Kagaku Ryoho 2015; 42:1737-1739. [PMID: 26805156] [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: 06/05/2023]
Abstract
We report successful treatment of stenosis of the portal vein caused by enlargement of the remnant liver after extended right hepatectomy with interventional radiology using an intraportal expandable metallic stent (EMS). A 75-year-old man underwent extended right hepatectomy after percutaneous transhepatic right portal embolization for advanced gallbladder cancer. His portal vein branched out into the anterior, posterior, and left branches. The main portal vein and left branch formed a sharp angle by nature. We ligated the posterior branch and sutured the cut line of the anterior branch during surgery. Several days after the surgery, icterus and massive ascites developed. Computed tomography (CT) and portography showed thrombi and stenosis of the cut line of the right branches due to enlargement of the remnant liver. A covered EMS was placed at the stenosis with interventional radiology. After stent placement, the icterus and massive ascites resolved. The patient remains well and EMS has caused no difficulty for 19 months. Intraportal EMS placement is effective in treating perioperative portal venous complications.
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Affiliation(s)
- Toshiya Ochiai
- Dept. of Surgery, North Medical Center, Kyoto Prefectural University of Medicine
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Miyamae M, Komatsu S, Ichikawa D, Kawaguchi T, Hirajima S, Okajima W, Ohashi T, Imamura T, Konishi H, Shiozaki A, Morimura R, Ikoma H, Ochiai T, Okamoto K, Taniguchi H, Otsuji E. Plasma microRNA profiles: identification of miR-744 as a novel diagnostic and prognostic biomarker in pancreatic cancer. Br J Cancer 2015; 113:1467-76. [PMID: 26505678 PMCID: PMC4815891 DOI: 10.1038/bjc.2015.366] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [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: 05/09/2015] [Revised: 09/16/2015] [Accepted: 09/23/2015] [Indexed: 01/03/2023] Open
Abstract
Background: This study aims to explore novel microRNAs in plasma for screening cancer and predicting clinical outcomes in pancreatic cancer (PCa) patients using a microRNA array-based approach. Methods: We used the Toray 3D-Gene microRNA array-based approach to compare plasma levels between PCa patients and healthy volunteers. Results: (1) Six oncogenic microRNAs (miR-615-5p, -744, -575, -557, -675, and -550a) with high expression in plasma were selected. (2) By quantitative RT–PCR using plasma samples from 94 PCa patients and 68 healthy volunteers, a significantly higher level of plasma miR-744 in PCa patients than in healthy volunteers was validated in small-scale analysis (P=0.0038), two independent cohort analyses, and large-scale analysis (P<0.0001, AUC 0.8307). (3) miR-744 expression was significantly higher in PCa tissues (P=0.0069) and PCa cell lines (P=0.0074) than in normal tissues and fibroblasts, respectively. Preoperative plasma level of miR-744 was significantly reduced in postoperative samples (P=0.0063). (4) A high level of plasma miR-744, which was correlated with lymph node metastasis (P=0.0407) and recurrences (P=0.0376), was an independent poor prognostic factor of PCa patients after pancreatectomy (P=0.0007, HR 21.2 (3.17–436)). Furthermore, a high level of plasma miR-744 contributed to poorer progression-free survival of non-operable PCa patients who underwent gemcitabine-based chemotherapy (P=0.0533). Overexpression of miR-744 in PCa cells induced significant chemoresistance to gemcitabine in vitro. Conclusions: Plasma miR-744 might be useful biomarker for screening PCa, monitoring, and predicting poor prognosis and chemoresistance in PCa patients.
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Affiliation(s)
- Mahito Miyamae
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Shuhei Komatsu
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Daisuke Ichikawa
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Tsutomu Kawaguchi
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Shoji Hirajima
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Wataru Okajima
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Takuma Ohashi
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Taisuke Imamura
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hirotaka Konishi
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Atsushi Shiozaki
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Ryo Morimura
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hisashi Ikoma
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Toshiya Ochiai
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Kazuma Okamoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hiroki Taniguchi
- Department of Surgery, Kyoto Second Red Cross Hospital, 355-5 Kamanzadoori Marutamachi Haruobicho, Kamigyo-ku, Kyoto 602-8026, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
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Ochiai T, Ishii H, Yamamoto Y, Morimura R, Ikoma H, Otsuji E. Significance of Hepatectomy for AJCC/UICC T3 Hepatocellular Carcinoma. Anticancer Res 2015; 35:2921-2928. [PMID: 25964577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND It is difficult to treat the American Joint Committee on Cancer (AJCC)/International Union against Cancer (UICC) T3 hepatocellular carcinoma (HCC), curatively. PATIENTS AND METHODS We compared the clinicopathology of T3 group (n=44: T3a 25, T3b 19) with that of the T1 (n=257) or T2 group (n=120) and evaluated favorable conditions of hepatectomy for T3 HCC patients. RESULTS The T3 group had significantly higher hepatitis B surface antigen (HBsAg)-positive rates and better liver function. Infiltrative large tumors located beyond one sub-segment with intrahepatic metastasis were significantly more common. Significantly, more non-curative large hepatectomies with transarterial embolization were performed. There was no significant difference between T3 and 2 groups in 5-year disease-free survival (DFS) and survival (S). Tumor size more than 55 mm and serum albumin less than 3.5 g/dl were risk factors of hepatectomy for T3 HCC patients by multivariate analysis. CONCLUSION Surgeons should resect AJCC/UICC T3 HCC lesions if the patient is able to tolerate surgery.
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Affiliation(s)
- Toshiya Ochiai
- Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiromichi Ishii
- Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yusuke Yamamoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryo Morimura
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hisashi Ikoma
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Yamamoto Y, Ikoma H, Morimura R, Konishi H, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Kubota T, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Sakakura C, Ochiai T, Otsuji E. Optimal duration of the early and late recurrence of hepatocellular carcinoma after hepatectomy. World J Gastroenterol 2015; 21:1207-1215. [PMID: 25632194 PMCID: PMC4306165 DOI: 10.3748/wjg.v21.i4.1207] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 05/07/2014] [Accepted: 09/16/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To determine the best cut-off value between the early and late recurrence periods after the initial recurrence of hepatocellular carcinoma (HCC).
METHODS: The clinical records of 404 patients who underwent macroscopic curative hepatectomy for HCC between 1980 and 2010 were retrospectively examined. We divided the 252 patients experienced a recurrence of HCC into two groups, the early and late recurrence groups using the “minimum P-value” approach. Factors for early recurrence were investigated using all 404 patients, and factors related to late recurrence were investigated in the patients who were confirmed to be recurrence free at the end of the early recurrence period.
RESULTS: For the 252 patients who experienced a recurrence, the optimal cut-off value for differentiating early and late recurrence based on the overall survival after initial recurrence was 17 mo (5-year overall survival after initial recurrence: 15.4% vs 36.3%, P = 0.000018). Cox proportional hazard analysis identified early recurrence (P = 0.003) as one of the independent prognostic factors associated with overall survival after initial recurrence. A logistic regression model showed that an alpha-fetoprotein level > 100 ng/mL (P < 0.001), multiple HCC (P < 0.001), serosal invasion (P = 0.031), and microvascular invasion (P = 0.012) were independent factors associated with early recurrence, whereas the only independent factor related to late recurrence was liver cirrhosis (P = 0.002).
CONCLUSION: Seventeen months after hepatectomy is a useful cut-off value between early and late recurrence of HCC based on the prognosis and different etiologies.
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Yamamoto Y, Ikoma H, Morimura R, Shoda K, Konishi H, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Kubota T, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Sakakura C, Ochiai T, Otsuji E. Post-hepatectomy survival in advanced hepatocellular carcinoma with portal vein tumor thrombosis. World J Gastroenterol 2015; 21:246-253. [PMID: 25574098 PMCID: PMC4284342 DOI: 10.3748/wjg.v21.i1.246] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 06/07/2014] [Accepted: 07/11/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To analyze hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) using the tumor-node-metastasis (TNM) staging system.
METHODS: We retrospectively analyzed 372 patients with HCC who underwent hepatectomy between 1980 and 2009. We studied the outcomes of HCC patients with PVTT to evaluate the American Joint Committee on Cancer TNM staging system (7th edition) for stratifying and predicting the prognosis of a large cohort of HCC patients after hepatectomy in a single-center. Portal vein invasion (vp) 1 was defined as an invasion or tumor thrombus distal to the second branch of the portal vein, vp2 as an invasion or tumor thrombus in the second branch of the portal vein, vp3 as an invasion or tumor thrombus in the first branch of the portal vein, and vp4 as an invasion or tumor thrombus in the portal trunk or extending to a branch on the contralateral side.
RESULTS: The cumulative 5-year overall survival (5yrOS) and 5-year disease-free survival (5yrDFS) rates of the 372 patients were 58.3% and 31.3%, respectively. The 5yrDFS and 5yrOS of vp3-4 patients (n = 10) were 20.0%, and 30.0%, respectively, which was comparable with the corresponding survival rates of vp1-2 patients (P = 0.466 and 0.586, respectively). In the subgroup analysis of patients with macroscopic PVTT (vp2-4), the OS of the patients who underwent preoperative transarterial chemoembolization was comparable to that of patients who did not (P = 0.747). There was a significant difference in the DFS between patients with stage I HCC and those with stage II HCC (5yrDFS 39.2% vs 23.1%, P < 0.001); however, the DFS for stage II was similar to that for stage III (5yrDFS 23.1% vs 13.8%, P = 0.330). In the subgroup analysis of stage II-III HCC (n = 148), only alpha-fetoprotein (AFP) > 100 mg/dL was independently associated with DFS.
CONCLUSION: Hepatectomy for vp3-4 HCC results in a survival rate similar to hepatectomy for vp1-2. AFP stratified the stage II-III HCC patients according to prognosis.
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Yamamoto Y, Ikoma H, Morimura R, Konishi H, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Kubota T, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Sakakura C, Ochiai T, Otsuji E. Clinical analysis of anatomical resection for the treatment of hepatocellular carcinoma based on the stratification of liver function. World J Surg 2014; 38:1154-63. [PMID: 24305927 DOI: 10.1007/s00268-013-2369-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND This study aimed to clarify the efficacy of anatomical resection (AR) for the treatment of hepatocellular carcinoma (HCC) compared with that of nonanatomical resection (NAR) based on the stratification of liver function (LF). METHODS The clinical records of 174 patients with a single HCC, 2-5 cm in diameter and without macroscopic vascular invasion, were analyzed. AR was performed in 132 patients and NAR was performed in 42 patients. The indocyanine green retention rate at 15 min (ICGR15) of the 78 patients classified as the good-LF group was 10-20 % and the ICGR15 of the 54 patients classified as the poor-LF group was 20-40 %. RESULTS The 5-year overall survival (OS) and disease-free survival rates of the 174 patients were 67.6 and 33.4 %, respectively. Cox proportional hazard analysis identified ICGR15 ≥ 20 %, liver cirrhosis, α-fetoprotein ≥ 100 mg/dL, and infiltrating growth as independent prognostic factors. Liver cirrhosis was significantly less frequent in patients who underwent AR than in patients who underwent NAR (52 vs. 79 %, p = 0.002). In the subgroup analysis of the good-LF group, there were no significant differences in 5-year OS after AR and NAR (73.3 vs. 65.2 %, p = 0.857). By contrast, in the subgroup analysis of the poor-LF group, the 5-year OS after AR was significantly worse than after NAR (45.3 vs. 77.4 %, p = 0.044). CONCLUSION In patients with an ICGR15 ≥ 20 %, we recommend NAR rather than AR for the treatment of a solitary 2-5-cm-diameter HCC and without macroscopic vascular invasion.
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Affiliation(s)
- Yusuke Yamamoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 6028566, Japan,
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Ikai A, Fujiwara H, Shiozaki A, Konishi H, Kosuga T, Komatsu S, Ichikawa D, Okamoto K, Morimura R, Kuriu Y, Ikoma H, Nakanishi M, Ochiai T, Sakakura C, Otsuji E. [A long-term survivor of cT4 esophageal carcinoma treated via a multimodal approach - a case report]. Gan To Kagaku Ryoho 2014; 41:2016-2018. [PMID: 25731407] [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: 06/04/2023]
Abstract
The patient was a 53-year-old man whose chief complaint was dysphagia. Pretreatment examination revealed 2 types of locally advanced esophageal squamous cell carcinoma at the middle to lower thoracic esophagus. A computed tomography (CT) scan showed a bulky primary tumor suspicious of aortic invasion and cardiac lymph node metastasis. The pretreatment diagnosis was cT4N2M0, cStageIVa. After induction chemotherapy with 5-fluorouracil (5-FU) and cisplatin (CDDP) (the FP regimen) according to the JCOG9907 regimen, subtotal esophagectomy and 2-field lymphadenectomy with retrosternal stomach roll reconstruction were performed. Intraoperatively, the primary tumor showed extensive and firm adhesion to the aortic wall. The postoperative diagnosis was pT4N0M0, pStageIII, RM1. Postoperative chemoradiotherapy (65 Gy+FP) was performed for the residual tumor at the aortic wall. The patient is alive without recurrences 4 years and 6 months after the esophagectomy. Downstaging of the tumor with induction chemotherapy and effective local control with surgery and postoperative chemoradiotherapy may have contributed to the patient's long-term survival. For multimodal treatment of cT4 esophageal cancer, an effective combination of chemotherapy, surgery, and chemoradiotherapy is essential to improve the treatment outcome.
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Affiliation(s)
- Atsushi Ikai
- Dept. of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine
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Watanabe N, Ikoma H, Yamamoto Y, Morimura R, Konishi H, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Kubota T, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Sakakura C, Ochiai T, Otsuji E. [A case of combined hepatocellular and cholangiocarcinoma with right-sided ligamentum teres hepatis treated via extended left hepatic lobetectomy]. Gan To Kagaku Ryoho 2014; 41:2077-2079. [PMID: 25731428] [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: 06/04/2023]
Abstract
A 78-year-old man presented with fever and jaundice. Computed tomography (CT) revealed a hepatocellular carcinoma in the hepatic left lobe as well as right-sided ligamentum teres (RSLT). Extended left hepatic lobetectomy was performed without division at the left Glissonian root in order to preserve the Glissonian branch at segment 8. No complications occurred during the post-operative course of 13 days. Pathologically, the tumor was diagnosed as a combined hepatocellular and cholangiocarcinoma. Additional congenital variations can exist in RSLT frequently; therefore, we must take care when performing hepatobiliary surgeries. Recently, advanced imaging modalities, such as multi-detector rowcomputed tomography (CT) and magnetic resonance imaging(MRI), help us obtain virtual images of vascular architecture and to plan the operative procedure.
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Affiliation(s)
- Nobuyuki Watanabe
- Dept. of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine
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Ikai A, Fujiwara H, Shiozaki A, Okamoto K, Kosuga T, Konishi H, Komatsu S, Ichikawa D, Morimura R, Kuriu Y, Ikoma H, Nakanishi M, Ochiai T, Sakakura C, Otsuji E. [Gastric cancer arising from gastric polyps in gardner syndrome - a case report]. Gan To Kagaku Ryoho 2014; 41:2262-2263. [PMID: 25731489] [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: 06/04/2023]
Abstract
The patient was a 48-year-old woman who was diagnosed with early gastric cancer during a long-term follow-up period for Gardner syndrome. Subtotal colectomy for colon leiomyoma was performed when the patient was 22 years old. Partial resection of the ileum was performed for ileum leiomyoma at the age of 27. Total resection of the remaining colon with ileostomy was performed for a pelvic desmoid tumor at the age of 40. In addition, resection of a desmoid tumor of the abdominal wall was performed 8 times in the 25 years since the first operation. During the follow-up for gastric polyps associated with Gardner syndrome, gastric cancer was detected from biopsy specimens of a wide range of the fundus polyps. Endoscopic resection was considered not to be applicable because of the extensive nature of the lesion. Total gastrectomy was also considered not to be applicable because of concerns about short bowel syndrome due to intestinal reconstruction. Therefore, proximal gastrectomy with esophagogastric anastomosis was performed. The pathological diagnosis was 0-IIa, 70 × 44 mm, tub1, m, ly0, v0, n0, PM (-), DM (-), stageIA. The postoperative course was uneventful, and the patient was discharged on postoperative day (POD) 16. We speculate that long-term survival of patients with Gardner syndrome without severe short bowel syndrome might result in carcinogenesis of gastric polyps.
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Affiliation(s)
- Atsushi Ikai
- Dept. of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine
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Yamamoto Y, Ikoma H, Morimura R, Konishi H, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Kubota T, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Sakakura C, Ochiai T, Otsuji E. Optimal duration of the early and late recurrence of pancreatic cancer after pancreatectomy based on the difference in the prognosis. Pancreatology 2014; 14:524-9. [PMID: 25287158 DOI: 10.1016/j.pan.2014.09.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 06/14/2014] [Accepted: 09/14/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND The term "early recurrence" of pancreatic cancer has not been well-defined in most previous studies. METHODS The clinical records of 86 patients who underwent macroscopic curative pancreatectomy for pancreatic cancer between 2000 and 2009 were retrospectively examined. We divided 55 patients who experienced disease recurrence into two groups, the early and late recurrence groups, using the minimum p value approach. The relationships between the interval prior to recurrence and clinical outcomes were investigated. RESULTS The cumulative 5-year overall survival rates for all 86 patients were 30.2%. For 55 patients who experienced disease recurrence, the optimal cut-off value for differentiating early (n = 37) and late (n = 18) recurrence based on the overall survival was 12 months (p = 0.0000045). The Cox proportional hazard analysis identified carbohydrate antigen 19-9 > 100 U/ml (p = 0.017) and surgical margin (p = 0.007) as the independent prognostic factors associated with overall survival. Positive surgical margin (p = 0.037) and severe venous invasion (p = 0.005) were identified as independent factors associated with early recurrence. CONCLUSION Twelve months after pancreatectomy is the optimal cut-off value for defining early versus late recurrence based on the overall survival. Early recurrence was related to the status of the surgical margin and venous invasion.
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Affiliation(s)
- Yusuke Yamamoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan
| | - Hisashi Ikoma
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan.
| | - Ryo Morimura
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan
| | - Hirotaka Konishi
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan
| | - Yasutoshi Murayama
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan
| | - Shuhei Komatsu
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan
| | - Atsushi Shiozaki
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan
| | - Yoshiaki Kuriu
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan
| | - Takeshi Kubota
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan
| | - Masayoshi Nakanishi
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan
| | - Daisuke Ichikawa
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan
| | - Hitoshi Fujiwara
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan
| | - Kazuma Okamoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan
| | - Chouhei Sakakura
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan
| | - Toshiya Ochiai
- Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Japan
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Yamaue H, Kubota T, Tanigawa N, Ohyama S, Sakuramoto S, Inada T, Kitagawa Y, Ochiai T, Terashima M, Gotoh M, Yasuda Y, Hara A, Kato H, Matsuyama J, Kodera Y, Nashimoto A, Yamaguchi T, Takeuchi M, Fujii M, Nakajima T. Exploratory Phase Ii Trial Assessing Relevance of in Vitro Chemosensitivity Test As a Predictor of Survival in Gastric Cancer Undergoing Adjuvant Chemotherapy (Jaccro-Gc04). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.8] [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: 11/12/2022] Open
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Yokomizo H, Yoshimatsu K, Koike J, Funahashi K, Kan H, Yamada T, Ishida H, Ishibashi K, Saida Y, Enomoto T, Katsumata K, Hasegawa H, Koda K, Ochiai T, Sakamoto K, Nakayama M, Naritaka Y, Ogawa S, Itabashi M, Kameoka S. Multicenter Phase Ii Trial of Neoadjuvant Chemotherapy with Mfolfox6 for Stage Ii/Iii Rectal Cancer with a T3/T4 Tumor Fact Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.91] [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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Yamaguchi Y, Ochiai T, Hashizume T, Kobayashi R, Ando T. Assosiation of inflammasome in periodontal desease and atherosclerosis induced by Porphyromonas gingivalis oral infection. J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.joms.2014.06.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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41
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Yoshimura K, Ishii N, Hamada T, Abe T, Ono F, Hashikawa K, Fukuda S, Ohyama B, Koga H, Sogame R, Teye K, Ochiai T, Nakajima H, Nakajima K, Iijima S, Kanzaki M, Kojima K, Nagatani T, Fujimoto W, Karashima T, Nakama T, Ohata C, Furumura M, Tsuruta D, Hashimoto T. Clinical and immunological profiles in 17 Japanese patients with drug‐induced pemphigus studied at Kurume University. Br J Dermatol 2014; 171:544-53. [DOI: 10.1111/bjd.12925] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2013] [Indexed: 11/30/2022]
Affiliation(s)
- K. Yoshimura
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - N. Ishii
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - T. Hamada
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - T. Abe
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - F. Ono
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - K. Hashikawa
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - S. Fukuda
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - B. Ohyama
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - H. Koga
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - R. Sogame
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - K. Teye
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - T. Ochiai
- Department of Dermatology Surugadai Nihon University Hospital Tokyo Japan
| | - H. Nakajima
- Department of Dermatology Kochi University School of Medicine Kochi Japan
| | - K. Nakajima
- Department of Dermatology Kochi University School of Medicine Kochi Japan
| | - S. Iijima
- Department of Dermatology Mito Saiseikai General Hospital Mito Ibaraki Japan
| | - M. Kanzaki
- Department of Dermatology Mito Saiseikai General Hospital Mito Ibaraki Japan
| | - K. Kojima
- Department of Dermatology Kanazawa Medical University School of Medicine Ishikawa Japan
| | - T. Nagatani
- Department of Dermatology Hachioji Medical Center of Tokyo Medical University Tokyo Japan
| | - W. Fujimoto
- Department of Dermatology Kawasaki Medical School of Medicine Okayama Japan
| | - T. Karashima
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - T. Nakama
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - C. Ohata
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - M. Furumura
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
| | - D. Tsuruta
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
- Department of Dermatology Osaka City University Graduate School of Medicine Osaka Japan
| | - T. Hashimoto
- Department of Dermatology Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology 67 Asahimachi Kurume Fukuoka 830‐0011 Japan
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Hatakeyama T, Nakanishi M, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Ikoma H, Ichikawa D, Fujiwara H, Okamoto K, Ochiai T, Kokuba Y, Otsuji E. Laparoscopic resection for colorectal cancer improves short-term outcomes in very elderly colorectal cancer patients. Surg Laparosc Endosc Percutan Tech 2014; 23:532-5. [PMID: 24300931 DOI: 10.1097/sle.0b013e31828e3da5] [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: 11/25/2022]
Abstract
BACKGROUND Laparoscopic-assisted colectomy (LAC) for colorectal cancer has been shown to improve short-term outcomes compared with open colectomy (OC) in colorectal cancer patients. However, there are a few reports that describe the efficacy of LAC in the very elderly population. We investigated whether LAC improves short-term outcomes in elderly patients, especially those 80 years of age or older. METHOD Eighty-two consecutive elderly (80 years of age or older) patients who underwent either OC or LAC for colorectal cancer were reviewed. Continuous variables were analyzed by the Mann-Whitney U test. Categorical variables were compared by χ tests. RESULTS Of the 82 elderly patients with colorectal cancer, 34 patients underwent OC and 48 patients had LAC. There were no significant differences in postoperative complications between the 2 groups. LAC demonstrated less blood loss, fewer days on a liquid diet, and a shorter postoperative stay in the hospital than OC. CONCLUSIONS LAC improved short-term outcomes even in very elderly patients.
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Affiliation(s)
- Tomoya Hatakeyama
- Department of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
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43
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Ochiai T, Ogino S, Ishimoto T, Toma A, Yamamoto Y, Morimura R, Ikoma H, Otsuji E. Prognostic impact of hepatectomy for patients with non-hepatitis B, non-hepatitis C hepatocellular carcinoma. Anticancer Res 2014; 34:4399-4410. [PMID: 25075077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
UNLABELLED BACK GROUND/AIM: The purpose of the present study was to clarify the clinicopathological features of non-hepatitis B and -C (NBNC) hepatocellular carcinoma (HCC), the incidence of which has been increasing. PATIENTS AND METHODS Two hundred and eighty-four patients with HCC were classified into three groups according to viral hepatitis status, namely NBNC, hepatitis B, and hepatitis C. We compared the three groups and studied related risk factors. RESULTS Patients without cirrhosis who had increased number of platelets and diabetes mellitus, and a serum alpha-feto-protein (AFP) level <100 ng/dl were more common in the NBNC group. The cumulative survival and disease-free survival were better in the NBNC group than in the other groups. The tumor size and hepatitis B or C viral status were found to be independent risk factors of disease-free survival and the presence of multiple lesions was the only independent risk factor of survival. CONCLUSION Close follow-up of NBNC liver cirrhosis and early detection of NBNC-HCC can improve the prognosis after surgery.
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Affiliation(s)
- Toshiya Ochiai
- Division of Digestive Surgery, Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shinpei Ogino
- Division of Digestive Surgery, Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takeshi Ishimoto
- Division of Digestive Surgery, Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsushi Toma
- Division of Digestive Surgery, Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yusuke Yamamoto
- Division of Digestive Surgery, Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryo Morimura
- Division of Digestive Surgery, Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hisashi Ikoma
- Division of Digestive Surgery, Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
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44
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Shiozaki A, Fujiwara H, Murayama Y, Komatsu S, Kuriu Y, Ikoma H, Nakanishi M, Ichikawa D, Okamoto K, Ochiai T, Kokuba Y, Otsuji E. Perioperative outcomes of esophagectomy preceded by the laparoscopic transhiatal approach for esophageal cancer. Dis Esophagus 2014; 27:470-8. [PMID: 23088181 DOI: 10.1111/j.1442-2050.2012.01439.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This study was designed to determine the efficacy of esophagectomy preceded by the laparoscopic transhiatal approach (LTHA) with regard to the perioperative outcomes of esophageal cancer. The esophageal hiatus was opened by hand-assisted laparoscopic surgery, and carbon dioxide was introduced into the mediastinum. Dissection of the distal esophagus was performed up to the level of the tracheal bifurcation. En bloc dissection of the posterior mediastinal lymph nodes was performed using LTHA. Next, cervical lymphadenectomy, reconstruction via a retrosternal route with a gastric tube and anastomosis from a cervical approach were performed. Finally, a small thoracotomy (around 10 cm in size) was made to extract the thoracic esophagus and allow upper mediastinal lymphadenectomy to be performed. The treatment outcomes of 27 esophageal cancer patients who underwent LTHA-preceding esophagectomy were compared with those of 33 patients who underwent the transthoracic approach preceding esophagectomy without LTHA (thoracotomy; around 20 cm in size). The intrathoracic operative time and operative bleeding were significantly decreased by LTHA. The total operative time did not differ between the two groups, suggesting that the abdominal procedure was longer in the LTHA group. The number of resected lymph nodes did not differ between the two groups. Postoperative respiratory complications occurred in 18.5% of patients treated with LTHA and 30.3% of those treated without it. The increase in the number of peripheral white blood cells and the duration of thoracic drainage were significantly decreased by this method. Our surgical procedure provides a good surgical view of the posterior mediastinum, markedly shortens the intrathoracic operative time, and decreases the operative bleeding without increasing major postoperative complications.
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Affiliation(s)
- A Shiozaki
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
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45
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Yamamoto Y, Ikoma H, Morimura R, Konishi H, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Kubota T, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Sakakura C, Ochiai T, Otsuji E. The clinical impact of the lymph node ratio as a prognostic factor after resection of pancreatic cancer. Anticancer Res 2014; 34:2389-2394. [PMID: 24778048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND The prognostic value of lymph node (LN) status in patients who underwent resection for pancreatic cancer (PC) was examined in the present study. PATIENTS AND METHODS Fifty-six patients who underwent macroscopic curative resection for PC were analyzed. Twelve factors, including the number of LN metastases, LN ratio, and N category according to the Japanese Pancreatic Society classification, were analyzed using univariate and multivariate analysis. RESULTS The optimal cut-off value was 0.2 for the LN ratio. Positive surgical margins (p=0.022) and LN ratio ≥0.2 (p=0.017) were identified as independent prognostic factors. Among the 33 patients with regional LN metastasis, patients with LN ratio ≥0.2 had significantly worse prognosis than those with LN ratio <0.2 (median survival time 14 vs. 26 months, p=0.048), however, the differences in survival between those with N1 and those with N2 by Japanese Pancreatic Society classification were not statistically significant (p=0.85). CONCLUSION The LN ratio might be more useful than other parameters as a predictor for survival after resection of PC.
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Affiliation(s)
- Yusuke Yamamoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku Kyoto 6028566, Japan.
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46
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Ochiai T, Shioya A, Honma H, Saitoh Y, Matsumura S, Ban D, Irie T, Kudo A, Nakamura N, Fujikawa T, Itai A, Tanaka S, Arii S, Yamaoka S, Tanabe M. Combination Treatment of IκB Kinase β Inhibitor IMD-0354 and Gemcitabine Suppresses Oncogenic Proliferation of Pancreatic Cancer Cells. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.157] [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: 10/25/2022]
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Kou T, Kanai M, Ikezawa K, Ajiki T, Tsukamoto T, Toyokawa H, Yazumi S, Terajima H, Furuyama H, Nagano H, Ikai I, Kuroda N, Awane M, Ochiai T, Takemura S, Miyamoto A, Kume M, Ogawa M, Takeda Y, Taira K, Ioka T. Comparative outcomes of elderly and non-elderly patients receiving first-line palliative chemotherapy for advanced biliary tract cancer. J Gastroenterol Hepatol 2014; 29:403-8. [PMID: 23869919 DOI: 10.1111/jgh.12338] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2013] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIM Few studies have reported the efficacy and safety of palliative chemotherapy in elderly patients with advanced biliary tract cancer. We aimed to investigate the clinical outcomes of palliative chemotherapy for advanced biliary tract cancer in elderly patients. METHODS We retrospectively evaluated 403 consecutive patients who received palliative chemotherapy between April 2006 and March 2009 for pathologically confirmed unresectable or recurrent biliary tract cancer. Clinical outcomes of the elderly group (≥ 75 years old; n = 94) were compared with those of the non-elderly group (< 75 years old; n = 309). RESULTS Except for the extent of disease, patient baseline characteristics were well balanced between both groups. The median overall survival was 10.4 months in the elderly group and 11.5 months in the non-elderly group (hazard ratio, 1.14; 95% confidence interval, 0.89-1.45; P = 0.31). Although the frequency of adverse events between both groups was similar, interstitial pneumonitis was significantly more frequent in the elderly group than in the non-elderly group (4.3% vs 0%, P < 0.01). CONCLUSIONS In advanced biliary tract cancer, overall survival of elderly patients receiving palliative chemotherapy is comparable with that of non-elderly patients. To our knowledge, this is one of the largest studies that have reported the clinical outcomes of elderly patients following palliative chemotherapy.
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Affiliation(s)
- Tadayuki Kou
- Digestive Disease Center, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
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48
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Yamamoto Y, Ikoma H, Morimura R, Konishi H, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Kubota T, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Sakakura C, Ochiai T, Otsuji E. Predictive scoring system assessing the need for intraoperative blood transfusions during hepatectomy for hepatocellular carcinoma. Anticancer Res 2014; 34:313-318. [PMID: 24403480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND It is of great clinical concern to preoperatively predict the need for blood transfusions during hepatectomy for hepatocellular carcinoma (HCC). PATIENTS AND METHODS A total of 168 consecutive patients undergoing elective hepatectomy for HCC were retrospectively reviewed. We investigated preoperative factors potentially influencing intraoperative blood transfusion and established a predictive scoring system for intraoperative blood transfusion. RESULTS Thirty-eight patients (22.6%) received red cell blood transfusion during surgery. A preoperative predicting scoring system for blood transfusion was constructed using the following four factors: platelet count <10×10(4)/mm(3) (2 points), α-fetoprotein ≥80 ng/ml (1 point), tumor size ≥4.0 cm (1 point), and major hepatectomy (1 point). The nomogram showed an area under the curve (AUC) of 0.760. This scoring system was highly predictive for blood transfusion (AUC=0.758). When the score was 0 points, the incidence of intraoperative blood transfusion was 3%. The rate increased to 10% and 38% when the score was 1 and 2 points, respectively, and reached 45% when the score was 3 points or more. CONCLUSION This predictive scoring system would be useful for preoperatively assessing the need for intraoperative blood transfusions during hepatectomy for HCC.
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Affiliation(s)
- Yusuke Yamamoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku Kyoto 6028566, Japan.
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Ishimoto T, Nakanishi M, Konishi H, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Ikoma H, Kubota T, Ichikawa D, Fujiwara H, Okamoto K, Sakakura C, Ochiai T, Otsuji E. [Laparoscopic lateral lymph node dissection technique and short-term results in our hospital]. Gan To Kagaku Ryoho 2013; 40:1924-1926. [PMID: 24393967] [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: 06/03/2023]
Abstract
UNLABELLED We perform preoperative chemoradiotherapy for patients with advanced lower rectal cancer in our department. In April 2012, we started laparoscopic lateral lymph node dissection for preventive dissection in patients without lateral lymph node enlargement on preoperative diagnosis. We compared the short-term results of laparoscopic lateral dissection with those of laparotomy. SUBJECTS The subjects comprised 43 patients undergoing lateral dissection by laparotomy( open group) and 5 patients undergoing laparoscopic lateral dissection (lap group). RESULTS There were no significant differences in the baseline characteristics of patients between the lap group and the open group. However, operative time (min) was significantly longer( 536.2 vs 324.8) and the volume of blood loss( g) was significantly lower( 139.0 vs 697.8) in the lap group. No significant differences were observed in the number of dissected lymph nodes, postoperative complications, or the duration of hospital stay. CONCLUSION Although the operative time was longer with laparoscopy-assisted lateral lymph node dissection, this procedure was safely performed with minimal blood loss. Our findings confirmed that there were no problems with standardization of this technique or oncological outcomes, and hence, we are examining the indications for therapeutic dissection.
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Affiliation(s)
- Takeshi Ishimoto
- Dept. of Surgery, North Medical Center Kyoto Prefectural University of Medicine
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50
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Yamamoto Y, Ikoma H, Morimura R, Konishi H, Murayama Y, Komatsu S, Shiozaki A, Kuriu Y, Kubota T, Nakanishi M, Ichikawa D, Fujiwara H, Okamoto K, Sakakura C, Ochiai T, Otsuji E. Changing trends in long-term outcomes after hepatic resection for hepatocellular carcinoma: A 30-year, single-center experience. Anticancer Res 2013; 33:5097-5105. [PMID: 24222155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND The aim of this study was to characterize changes in outcome following hepatectomy for hepatocellular carcinoma (HCC) over a 30-year period. PATIENTS AND METHODS The clinical records of 372 patients who underwent a macroscopic curative hepatectomy for treatment of HCC between 1980 and 2009 were retrospectively examined. Patients were divided into two groups: an early group (1980-2000) and a late group (2001-2009). The relationship between the chronological treatment period and the surgical outcomes was investigated. RESULTS The disease-free survival (DFS) was comparable between the early and late groups (at 5 years: 30.3% vs. 31.2%, p=0.526), however, the overall survival (OS) of the late group was significantly better than the one of the early group (at 5 years: 80.1% vs. 50.4%, p<0.001), with this being an independent prognostic factor. Among the 148 patients who underwent transarterial chemoembolization (TACE) for initial hepatic recurrence, the OS after initial recurrence of the late group was significantly better than that of the early group (p=0.002). The OS after initial recurrence was significantly better in patients who underwent repeat hepatectomy than in those who underwent TACE (p=0.044). CONCLUSION The results of hepatectomy for HCC have improved over time by use of various combination therapies after initial HCC recurrence. A repeat hepatectomy may be an acceptable treatment option for HCC recurrence in selected patients.
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Affiliation(s)
- Yusuke Yamamoto
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku Kyoto 6028566, Japan.
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