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Kanemura H, Yokoyama T, Nakajima R, Nakamura A, Kuroda H, Kitamura Y, Shoda H, Mamesaya N, Miyata Y, Okamoto T, Okishio K, Oki M, Sakairi Y, Chen-Yoshikawa TF, Aoki T, Ohira T, Matsumoto I, Ueno K, Miyazaki T, Matsuguma H, Yokouchi H, Otani T, Ito A, Sakai K, Chiba Y, Nishio K, Yamamoto N, Okamoto I, Nakagawa K, Takeda M. The Tumor Immune Microenvironment Is Associated With Recurrence in Early-Stage Lung Adenocarcinoma. JTO Clin Res Rep 2024; 5:100658. [PMID: 38651033 PMCID: PMC11033192 DOI: 10.1016/j.jtocrr.2024.100658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/24/2024] [Accepted: 03/03/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction Immune checkpoint inhibitors have recently been approved for the treatment of early-stage NSCLC in the perioperative setting on the basis of phase 3 trials. However, the characteristics of such patients who are susceptible to recurrence after adjuvant chemotherapy or who are likely to benefit from postoperative immunotherapy have remained unclear. Methods This biomarker study (WJOG12219LTR) was designed to evaluate cancer stem cell markers (CD44 and CD133), programmed death-ligand 1 (PD-L1) expression on tumor cells, CD8 expression on tumor-infiltrating lymphocytes, and tumor mutation burden in completely resected stage II to IIIA NSCLC with the use of archived DNA and tissue samples from the prospective WJOG4107 trial. Tumors were classified as inflamed or noninflamed on the basis of the PD-L1 tumor proportion score and CD8+ tumor-infiltrating lymphocyte density. The association between each potential biomarker and relapse-free survival (RFS) during adjuvant chemotherapy was assessed by Kaplan-Meier analysis. Results A total of 117 patients were included in this study. The median RFS was not reached (95% confidence intervals [CI]: 22.4 mo-not reached; n = 39) and 23.7 months (95% CI: 14.5-43.6; n = 41) in patients with inflamed or noninflamed adenocarcinoma, respectively (log-rank p = 0.02, hazard ratio of 0.52 [95% CI: 0.29-0.93]). Analysis of the combination of tumor inflammation category and TP53 mutation status revealed that inflamed tumors without TP53 mutations were associated with the longest RFS. Conclusions PD-L1 expression on tumor cells, CD8+ T cell infiltration, and TP53 mutation status may help identify patients with early-stage NSCLC susceptible to recurrence after adjuvant chemotherapy.
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Affiliation(s)
- Hiroaki Kanemura
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Toshihide Yokoyama
- Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Ryu Nakajima
- Department of General Thoracic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Atsushi Nakamura
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Hiroaki Kuroda
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | | | - Hiroyasu Shoda
- Department of Respiratory Medicine, Hiroshima City Hiroshima Citizen Hospital, Hiroshima, Japan
| | - Nobuaki Mamesaya
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yoshihiro Miyata
- Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan
| | - Tatsuro Okamoto
- Department of Thoracic Oncology, NHO Kyushu Cancer Center, Fukuoka, Japan
| | - Kyoichi Okishio
- Department of Clinical Research Center, NHO Kinki Chuo Chest Medical Center, Osaka, Japan
| | - Masahide Oki
- Department of Respiratory Medicine, NHO Nagoya Medical Center, Nagoya, Japan
| | - Yuichi Sakairi
- Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | | | - Tadashi Aoki
- Department of Chest Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Tatsuo Ohira
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Isao Matsumoto
- Department of Thoracic Surgery, Kanazawa University, Kanazawa, Japan
| | - Kiyonobu Ueno
- Department of Respiratory Medicine, Osaka General Medical Center, Osaka, Japan
| | - Takuro Miyazaki
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Haruhisa Matsuguma
- Department of Thoracic Surgery, Tochigi Cancer Center, Utsunomiya, Japan
| | | | - Tomoyuki Otani
- Department of Pathology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Akihiko Ito
- Department of Pathology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Kazuko Sakai
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Yasutaka Chiba
- Clinical Research Center, Kindai University Hospital, Osaka-Sayama, Japan
| | - Kazuto Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | | | - Isamu Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Masayuki Takeda
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
- Department of Cancer Genomics and Medical Oncology, Nara Medical University, Nara, Japan
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Kuroda S, Miura K, Shimizu N, Kitamura Y, Nishio W. The effect of lobar shifting following right upper lobectomy on postoperative pulmonary function. Gen Thorac Cardiovasc Surg 2024:10.1007/s11748-024-02019-9. [PMID: 38532170 DOI: 10.1007/s11748-024-02019-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/13/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVES Lobes occasionally displace after lobectomy, referred to as "lobar shifting". However, the benefits, especially in postoperative pulmonary function, remain controversial. This study aimed to measure the effect of lobar shifting on postoperative pulmonary function especially in the right upper lobe. METHODS This retrospective study includes 273 right upper lobectomy patients (lobectomy group) and 24 right upper segmentectomy patients (segmentectomy group) from 2012 to 2021. The lobectomy group was further subdivided based on their Synapse Vincent® image: with their postoperative middle lobe bronchus shifted toward the head (shift group: 176 cases) and without (non-shift group: 97 cases). Several factors were examined to determine the cause of lobar shifting. The rate of measured actual postoperative forced expiratory volume in 1 s (FEV1.0) to predicted postoperative FEV1.0 was analyzed and compared among the three groups. RESULTS Factors that correlated with lobar shifting included age (p < 0.001), a relatively small middle lobe volume (p = 0.03), no adhesions (p < 0.001), and good upper/middle and middle/lower lobulation (p = 0.04, p = 0.02). The rate of measured actual postoperative FEV1.0 to predicted postoperative FEV1 for the shift, non-shift, and segmentectomy groups were 112.5%, 107.9%, and 103.1% (shift vs non-shift: p = 0.04, shift vs segmentectomy: p = 0.02, non-shift vs segmentectomy: p = 0.19). CONCLUSIONS Lobar shifting after right upper lobectomy is influenced by morphological factors and may have a beneficial impact on postoperative pulmonary function.
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Affiliation(s)
- Sanae Kuroda
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, Kitaoji-Cho, Akashi City, 673-8558, Japan.
| | - Kenji Miura
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, Kitaoji-Cho, Akashi City, 673-8558, Japan
| | - Nahoko Shimizu
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, Kitaoji-Cho, Akashi City, 673-8558, Japan
| | - Yoshitaka Kitamura
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, Kitaoji-Cho, Akashi City, 673-8558, Japan
| | - Wataru Nishio
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, Kitaoji-Cho, Akashi City, 673-8558, Japan
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Tanizaki J, Kuroda H, Yokoyama T, Takahama M, Shoda H, Nakamura A, Kitamura Y, Mamesaya N, Kadota Y, Sawa K, Okishio K, Okada M, Suminaka C, Noda K, Sakai K, Chiba Y, Nishio K, Chamoto K, Honjo T, Yamamoto N, Nakagawa K, Hayashi H. Lack of Association of Plasma Levels of Soluble Programmed Cell Death Protein 1, Programmed Death-Ligand 1, and CTLA-4 With Survival for Stage II to IIIA NSCLC After Complete Resection and Adjuvant Chemotherapy. JTO Clin Res Rep 2023; 4:100590. [PMID: 38029041 PMCID: PMC10679776 DOI: 10.1016/j.jtocrr.2023.100590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Perioperative treatment in NSCLC has gained marked attention with the introduction of immune checkpoint inhibitors. Such a paradigm shift has given us additional opportunities to evaluate potential biomarkers in patients with these curable disease stages. Methods This study (WJOG12319LTR) was designed as a biomarker study to evaluate whether soluble immune markers were prognostic or predictive on relapse-free survival in patients with stage II to IIIA NSCLC who underwent complete resection and adjuvant chemotherapy with cisplatin plus S-1, which is an oral fluoropyrimidine formulation that consists of tegafur, gimeracil, and oteracil, or S-1 alone in the previous WJOG4107 study. Archived plasma samples were assayed for soluble (s) forms of programmed cell death protein 1 (sPD-1), programmed death-ligand 1(sPD-L1), and CTLA-4 (sCTLA-4) with the highly sensitive HISCL system. Using time-dependent receiver operating characteristic curve analysis, the area under the curves were derived and optimal cutoff values were determined. Using the cutoff values, whether the marker was prognostic or predictive was assessed by survival analysis. Results A total of 150 patients were included in the study. The time-dependent receiver operating characteristics analysis revealed that the area under the curves for sPD-1, sPD-L1, and sCTLA-4 were 0.54, 0.51, and 0.58, respectively. The survival analysis did not reject that hazard ratios were 1 in terms of the soluble immune marker and the treatment-marker interaction for all three markers. Conclusions There was no proof that circulating concentrations of sPD-1, sPD-L1, and sCTLA-4 were prognostic or predictive factors of the outcome for adjuvant chemotherapy after complete resection in patients with NSCLC.
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Affiliation(s)
- Junko Tanizaki
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hiroaki Kuroda
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Toshihide Yokoyama
- Department of Respiratory Medicine, Kurashiki Central Hospital, Kurashiki, Japan
| | - Makoto Takahama
- Department of General Thoracic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Hiroyasu Shoda
- Department of Respiratory Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Atsushi Nakamura
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | | | - Nobuaki Mamesaya
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yoshihisa Kadota
- Department of General Thoracic Surgery, Osaka Habikino Medical Center, Osaka, Japan
| | - Kenji Sawa
- Department of Clinical Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Kyoichi Okishio
- Department of Thoracic Oncology, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Osaka, Japan
| | - Morihito Okada
- Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan
| | | | - Kenta Noda
- Central Research Laboratories, Sysmex Corporation, Hyogo, Japan
| | - Kazuko Sakai
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yasutaka Chiba
- Clinical Research Center, Kindai University Hospital, Osaka, Japan
| | - Kazuto Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kenji Chamoto
- Department of Immunology and Genomic Medicine, Center for Cancer Immunotherapy and Immunobiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Immuno-Oncology PDT, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tasuku Honjo
- Department of Immunology and Genomic Medicine, Center for Cancer Immunotherapy and Immunobiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hidetoshi Hayashi
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
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Kuroda S, Tane S, Kitamura Y, Maniwa Y, Nishio W. The dynamic pulmonary functional change after thoracoscopic lower lobe segmentectomy. Asian Cardiovasc Thorac Ann 2022; 31:229-237. [PMID: 36584028 DOI: 10.1177/02184923221147781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The advantages of segmentectomy over lobectomy in sparing pulmonary function remain controversial. Lower lobe segmentectomy is divided into simple segmentectomy, such as segment 6; and complex segmentectomy that includes the basal segments. Here, we compared residual lung function after thoracoscopic segmentectomy versus lobectomy in the lower lobe using the three-dimensional computed tomography volumetric method. METHODS Between January 2012 and October 2020, 67 patients who underwent thoracoscopic segmentectomy of the lower lobe were matched to 67 patients who underwent thoracoscopic lower lobectomy during the same period using propensity score matching analysis. The postoperative decrease in the rate of forced expiratory volume in 1 s was compared between methods. The regional forced expiratory volume in 1 s of the residual lobe rescued by segmentectomy was measured using volumetric and spirometric analyses and compared to lower lobectomy. The ratio of the actual to predicted postoperative forced expiratory volume in 1 s in the residual lobe was defined as the preservation rate. RESULTS Of the 67 thoracoscopic segmentectomies, 43 were S6, seven were S8, three were S8 + 9, seven were S10, and seven were S9 + 10. The percentage of postoperative/preoperative forced expiratory volume in 1 s was significantly higher in the segmentectomy versus lobectomy group (90.7% vs. 85.7%, p = 0.001). The preservation rates after simple segmentectomy (n = 43) and complex segmentectomy (n = 24) did not differ significantly (82.2% vs. 80.2%, p = 0.709). CONCLUSIONS Thoracoscopic lower lobe segmentectomy versus lobectomy preserves postoperative lung function. Even complex segmentectomy exhibited outcomes relevant to simple segmentectomy by sparing the residual lobe.
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Affiliation(s)
- Sanae Kuroda
- Division of Chest Surgery, 13794Hyogo Cancer Center, Akashi, Japan
| | - Shinya Tane
- Division of Thoracic Surgery, 38303Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Yoshimasa Maniwa
- Division of Thoracic Surgery, 38303Kobe University Graduate School of Medicine, Kobe, Japan
| | - Wataru Nishio
- Division of Chest Surgery, 13794Hyogo Cancer Center, Akashi, Japan
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Nishikubo M, Tane S, Kimura K, Shimizu N, Kitamura Y, Nishio W. Comparison of oncological outcomes between trisegmentectomy and lobectomy for non-small cell lung cancer in the left upper division. J Thorac Dis 2022; 14:4614-4623. [PMID: 36647461 PMCID: PMC9840034 DOI: 10.21037/jtd-22-950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/04/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND The left upper lobe is one of the largest lobes in the lungs and is divided into two anatomical units: the upper division (segments 1+2 and segment 3) and lingula (segments 4 and 5). This anatomical classification is similar to that used for the right upper and middle lobes. Although bilobectomy is not recommended for right upper or middle lobe tumors close to the interlobar plane, lobectomy is often performed for tumors located close to the intersegmental plane in the left upper division. To aid in establishing trisegmentectomy as a standard treatment for clinical N0 non-small cell lung cancer (NSCLC) in the left upper lobe, we aimed to re-assess its feasibility based on oncological outcomes according to tumor location. METHODS We retrospectively analyzed the data of patients with clinical N0 NSCLC in the left upper division who underwent left upper lobectomy or trisegmentectomy between April 2006 and December 2020. After propensity score matching, oncological outcomes were compared between the trisegmentectomy and lobectomy groups. To verify whether trisegmentectomy was indicated regardless of tumor distance from the intersegmental plane, we compared the recurrence-free survival (RFS) rates following trisegmentectomy between patients with tumors ≤20 and >20 mm from the intersegmental plane. RESULTS After propensity score matching, 46 patients were included in each group. There was no significant difference in the 5-year RFS rate between the lobectomy and trisegmentectomy groups (75.5% vs. 84.0%, P=0.41). In the trisegmentectomy cohort, the 5-year RFS rate did not significantly differ according to tumor distance from the intersegmental plane (≤20 or >20 mm) measured using three-dimensional computed tomography (79.4% vs. 81.2%, P=0.69). Multivariate analysis indicated that tumor distance from the intersegmental plane was not a significant predictor of RFS (hazard ratio: 1.75, 95% confidence interval: 0.52-5.91, P=0.37). CONCLUSIONS Our analysis suggests that oncological outcomes (i.e., RFS rates) following trisegmentectomy for clinical N0 NSCLC in the left upper division are not significantly inferior to those following lobectomy, even if the tumor is located close to the intersegmental plane.
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Affiliation(s)
| | | | - Kenji Kimura
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | - Nahoko Shimizu
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | | | - Wataru Nishio
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Hyogo, Japan
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Kitazume M, Tane S, Shimizu N, Kitamura Y, Maniwa Y, Nishio W. Segmental volumetric analysis with ventilated or perfused area: identifying the intersegmental plane. Eur J Cardiothorac Surg 2022; 62:6825312. [DOI: 10.1093/ejcts/ezac537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/26/2022] [Accepted: 11/26/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
There are two methods to identify the intersegmental plane during segmentectomy: the inflation-deflation method, based on ventilation area; and injection of indocyanine green method, based on pulmonary arterial distribution. However, whether the intersegmental plane created by these two methods matches, remains unknown. We aimed to comprehend the demarcation lines based on bronchial and arterial territories using three-dimensional computed tomography-based volumetry.
Methods
We collected data from patients who underwent thoracoscopic segmentectomy in our hospital between April 2012 and May 2021. Three-dimensional images were reconstructed from the preoperative contrast-enhanced computed tomography data using the SYNAPSE VINCENT software program. The volume of the affected area and the tumor distance from the intersegmental plane was calculated based on each affected artery and bronchus. Each calculated volume was compared according to each affected segment, using a paired t-test.
Results
Of 195 patients, 114 underwent upper lobe segmentectomy, and 81 underwent lower lobe segmentectomy. In upper lobe segmentectomy, the affected arterial segmental volume was smaller than the bronchial volume (505.0 ml vs 539.4 ml, p < 0.001). In lower lobe segmentectomy, there was no significant difference between arterial and bronchial volume (234.6 ml vs 236.9 ml, p = 0.607). The affected arterial segmental lung volume and the tumor distance from the intersegmental plane was significantly smaller than the bronchial volume in upper lobe segmentectomies.
Conclusions
As per the results, the affected segmental volume delineated by the indocyanine green method would be underestimated in upper lobe segmentectomy.
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Affiliation(s)
- Mai Kitazume
- Hyogo Cancer Center Division of Chest Surgery, , 13-70, kitaoji-cho, Akashi, Japan
| | - Shinya Tane
- Kobe University Hospital Department of General Thoracic Surgery, , 7-5-2, Kusunokicho, chuo ward, Kobe, Japan
| | - Nahoko Shimizu
- Hyogo Cancer Center Division of Chest Surgery, , 13-70, kitaoji-cho, Akashi, Japan
| | - Yoshitaka Kitamura
- Hyogo Cancer Center Division of Chest Surgery, , 13-70, kitaoji-cho, Akashi, Japan
| | - Yoshimasa Maniwa
- Kobe University Hospital Department of General Thoracic Surgery, , 7-5-2, Kusunokicho, chuo ward, Kobe, Japan
| | - Wataru Nishio
- Hyogo Cancer Center Division of Chest Surgery, , 13-70, kitaoji-cho, Akashi, Japan
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Yokouchi H, Mizugaki H, Ikezawa Y, Morita R, Tateishi K, Yokoo K, Sumi T, Kikuchi H, Nakamura A, M. kobayashi, Aso M, Tsukita Y, Yoshiike F, Furuta M, Tanaka H, Sekikawa M, Hachiya T, Nakamura K, Kitamura Y. 335P Real-world data of first-line treatment with pembrolizumab for non-small cell lung cancer with high PD-L1 expression (HOT/NJLCG2001). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.373] [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: 12/05/2022] Open
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Kitamura Y, Okumura Y, Shirakawa Y, Ikeda Y, Kita Y. Characteristics of shifting ability in children with mild intellectual disabilities: an experimental study with a task-switching paradigm. J Intellect Disabil Res 2022; 66:853-864. [PMID: 36065757 DOI: 10.1111/jir.12974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 07/11/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Shifting enables flexible switch between tasks or mental sets. It is a component of the executive function that plays critical roles in human behaviour control. However, shifting ability in individuals with intellectual disability (ID) has not been well clarified because of the use of intellectually demanding tasks in previous studies. The present study invented a novel shifting task with minimal intellectual demands and aimed to clarify the characteristics of shifting in adolescents with ID. METHODS Adolescents with ID (n = 21) and chronological-age-matched (n = 10) and mental-age-matched controls (n = 33) performed a novel shifting task with simple rule switching (i.e. change in direction). Analyses focused on the switch cost or the increase in the reaction time associated with rule switching. RESULTS Two subtypes of adolescents with ID were found with respect to the switch cost: one that lacks it and another with an increased switch cost. The lack of a switch cost was unique to the subgroup adolescents with ID and was not indicated in the control group. CONCLUSIONS The present study indicated that shifting in adolescents with ID does not depend solely on their intellectual function and is highly heterogeneous. This finding further implies that executive functions, including shifting, must be evaluated separately from their intellectual functions.
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Affiliation(s)
- Y Kitamura
- Department of Design, Graduate School of Design, Kyushu University, Fukuoka, Japan
- School for Children with Intellectual Disabilities, Tokyo Gakugei University, Tokyo, Japan
| | - Y Okumura
- Mori Arinori Institute for Higher Education and Global Mobility, Hitotsubashi University, Tokyo, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Y Shirakawa
- Mori Arinori Institute for Higher Education and Global Mobility, Hitotsubashi University, Tokyo, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Y Ikeda
- Department of Special Needs Education, Joetsu University of Education, Niigata, Japan
| | - Y Kita
- Mori Arinori Institute for Higher Education and Global Mobility, Hitotsubashi University, Tokyo, Japan
- Department of Psychology, Faculty of Letters, Keio University, Tokyo, Japan
- Cognitive Brain Research Unit (CBRU), Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Tane S, Kitamura Y, Kimura K, Shimizu N, Matsumoto G, Uchino K, Nishio W. Segmentectomy versus lobectomy for inner-located small-sized early non-small-cell lung cancer. Interact Cardiovasc Thorac Surg 2022; 35:6671847. [PMID: 35984303 PMCID: PMC9468593 DOI: 10.1093/icvts/ivac218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/06/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Shinya Tane
- Department of General Thoracic Surgery, Osaka Saiseikai Nakatsu Hospital , Osaka, Japan
- Division of Chest Surgery, Hyogo Cancer Center , Akashi, Japan
| | | | - Kenji Kimura
- Division of Chest Surgery, Hyogo Cancer Center , Akashi, Japan
| | - Nahoko Shimizu
- Division of Chest Surgery, Hyogo Cancer Center , Akashi, Japan
| | - Gaku Matsumoto
- Department of General Thoracic Surgery, Osaka Saiseikai Nakatsu Hospital , Osaka, Japan
| | - Kazuya Uchino
- Department of General Thoracic Surgery, Osaka Saiseikai Nakatsu Hospital , Osaka, Japan
| | - Wataru Nishio
- Division of Chest Surgery, Hyogo Cancer Center , Akashi, Japan
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Tabata K, Nishie A, Shimomura Y, Isoda T, Kitamura Y, Nakata K, Yamada Y, Oda Y, Ishigami K, Baba S. Prediction of pathological response to preoperative chemotherapy for pancreatic ductal adenocarcinoma using 2-[ 18F]-fluoro-2-deoxy-d-glucose positron-emission tomography. Clin Radiol 2022; 77:436-442. [PMID: 35410786 DOI: 10.1016/j.crad.2022.03.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/02/2022] [Indexed: 12/24/2022]
Abstract
AIM To determine whether the pathological response to preoperative chemotherapy for pancreatic ductal adenocarcinoma (PDAC) can be predicted using 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography (F-18 FDG-PET). MATERIALS AND METHODS Twenty-eight patients with PDAC who underwent only neoadjuvant chemotherapy (NAC) before surgery were enrolled in the study. All patients had F-18 FDG-PET examinations before NAC. The resected specimen was pathologically evaluated according to the Classification of Pancreatic Carcinoma (7th edn). Patients were categorised into a non-response group and a response group based on the pathological findings. The non-response group (Grades 1a and 1b) showed ≤50% necrosis in the specimen, while the specimens of the response group (Grades 2-3) showed >50% necrosis. The maximum standardised uptake values (SUVmax) of the tumours on F-18 FDG-PET were measured. The mean values of SUVmax were compared between the two groups. The diagnostic performance of SUVmax in distinguishing the two groups was also evaluated using receiver operating characteristic analysis. RESULTS The mean SUVmax of the response group was higher than that of the non-response group (9.00 ± 1.78 versus 4.26 ± 2.35; p<0.001). The optimal cut-off value of SUVmax was 9.28 for distinguishing the two groups. The sensitivity, specificity, and accuracy for the prediction in the response group were 80%, 95.7%, and 92.9%, respectively. CONCLUSIONS SUVmax on F-18 FDG-PET may be useful as a biomarker to predict the pathological response to NAC in patients with PDAC.
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Affiliation(s)
- K Tabata
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku Fukuoka, 812-8582, Japan
| | - A Nishie
- Department of Radiology Informatics and Network, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku Fukuoka, 812-8582, Japan; Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207, Uehara, Nishihara-cho, Okinawa, 903-0215, Japan.
| | - Y Shimomura
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku Fukuoka, 812-8582, Japan
| | - T Isoda
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku Fukuoka, 812-8582, Japan
| | - Y Kitamura
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku Fukuoka, 812-8582, Japan
| | - K Nakata
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku Fukuoka, 812-8582, Japan
| | - Y Yamada
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku Fukuoka, 812-8582, Japan
| | - Y Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku Fukuoka, 812-8582, Japan
| | - K Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku Fukuoka, 812-8582, Japan
| | - S Baba
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku Fukuoka, 812-8582, Japan
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11
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Fujibayashi Y, Tane S, Kitazume M, Kuroda S, Kimura K, Kitamura Y, Nishio W. Resected stage I anaplastic lymphoma kinase-positive lung adenocarcinoma has a negative impact on recurrence-free survival. Thorac Cancer 2022; 13:1109-1116. [PMID: 35274461 PMCID: PMC9013641 DOI: 10.1111/1759-7714.14365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 11/30/2022] Open
Abstract
Background The clinical and prognostic implications of anaplastic lymphoma kinase (ALK) status in resected lung cancers remain unclear. In this study we analyzed the prognostic and predictive significance of ALK‐positive among patients with completely resected lung adenocarcinoma. Methods We retrospectively reviewed 197 patients with lung adenocarcinoma who underwent complete surgical resection and had been tested for their ALK status. We investigated the impact of an ALK‐positive status on the recurrence‐free survival (RFS) and overall survival (OS) and examined the predictive factors for an ALK‐positive status. Results ALK positivity was noted in 36 (18%) out of 197 patients, and when limited to stage I patients, in 24 (19%) out of 124. In the pathological‐stage I population, while the OS exhibited no significant difference between ALK‐positive and ALK‐negative patients (5‐year OS rate, 81.2% vs. 89.8%, p = 0.226), the RFS of ALK‐positive patients was significantly worse than that of ALK‐negative patients (5‐year RFS rate, 55.9% vs. 78.8%, p = 0.018). A multivariate analysis showed that ALK‐positive status (hazard ratio [HR] 3.431, p = 0.009) was an independent prognostic factor for the RFS. Regarding the relationship between clinicopathological factors and an ALK‐positive status, a high‐grade histological subtype, including solid and micropapillary subtypes (odds ratio [OR] 5.464, p < 0.001), and never‐smokers (OR 4.292, p = 0.018) were associated with ALK‐positive. Conclusion A high‐grade histological subtype and never‐smokers were associated with ALK positivity, and the RFS of ALK‐positive patients was worse than that of ALK‐negative patients among patients with completely resected stage I lung adenocarcinoma.
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Affiliation(s)
| | - Shinya Tane
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Mai Kitazume
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Sanae Kuroda
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Kenji Kimura
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | - Wataru Nishio
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
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12
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Tane S, Kitazume M, Fujibayashi Y, Kuroda S, Kimura K, Kitamura Y, Takenaka D, Nishio W. The difference in postoperative pulmonary functional change between upper and lower thoracoscopic lobectomy. Interact Cardiovasc Thorac Surg 2021; 34:408-415. [PMID: 34606586 PMCID: PMC8860411 DOI: 10.1093/icvts/ivab268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/05/2021] [Accepted: 08/27/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Through 3-dimensional lung volumetric and morphological analyses, we aimed to evaluate the difference in postoperative functional changes between upper and lower thoracoscopic lobectomy. METHODS A total of 145 lung cancer patients who underwent thoracoscopic upper lobectomy (UL) were matched with 145 patients with lung cancer who underwent thoracoscopic lower lobectomy (LL) between April 2012 and December 2018, based on their sex, age, smoking history, operation side, and pulmonary function. Spirometry and computed tomography were performed before and 6 months after the operation. In addition, the postoperative pulmonary function, volume and morphological changes between the 2 groups were compared. RESULTS The rate of postoperative decreased and the ratio of actual to predicted postoperative forced expiratory volume in 1 s were significantly higher after LL than after UL (P < 0.001 for both). The tendency above was similar irrespective of the resected side. The postoperative actual volumes of the ipsilateral residual lobe and contralateral lung were larger than the preoperatively measured volumes in each side lobectomy. Moreover, the increased change was particularly remarkable in the middle lobe after right LL. The change in the D-value, representing the structural complexity of the lung, was better maintained in the left lung after LL than after UL (P = 0.042). CONCLUSIONS Pulmonary function after thoracoscopic LL was superior to that after UL because the upward displacement and the pulmonary reserves of the remaining lobe appeared more robust after LL.
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Affiliation(s)
- Shinya Tane
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Mai Kitazume
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | - Sanae Kuroda
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Kenji Kimura
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | - Daisuke Takenaka
- Division of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan
| | - Wataru Nishio
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Japan
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13
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Tane S, Kimura K, Shimizu N, Kitamura Y, Matsumoto G, Uchino K, Nishio W. Segmentectomy for inner location small-sized non-small-cell lung cancer: Is it feasible? Ann Thorac Surg 2021; 114:1918-1924. [PMID: 34563504 DOI: 10.1016/j.athoracsur.2021.08.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The efficacy of segmentectomy for inner small-sized non-small-cell lung cancer (NSCLC) remains unknown. We aimed to elucidate whether segmentectomy for inner small-sized NSCLC, defined using novel three-dimensional measuring method, yields feasible oncological outcomes compared to segmentectomy for outer lesions. METHODS We retrospectively analyzed patients with small-sized (<2cm) cN0 NSCLC who underwent segmentectomy between January 2007 and December 2020. Tumor centrality ratio, which was measured by using three dimensional reconstruction software, was evaluated, with the location of tumor origin confirmed pathologically. Cases with a ratio below and above 2/3 were allocated to the 'Inner group' and 'Outer group', respectively. Oncological outcomes were compared between the two groups. RESULTS Our cohort was divided into the 'Inner group' (n=75) and 'Outer group' (n=127). The proximal distance from a tumor exceeded 20 mm in all cases. Tumor centrality ratio was associated with the pathological origin of a tumor. The rate of unforeseen positive lymph node metastasis was significantly higher in the 'Inner group' (p=0.04). There were no significant differences in the 5-year recurrence free survival (RFS; 91% versus 87%, p=0.67). Univariate analysis identified age, consolidation/tumor ratio, the presence of ground-glass-opacity (GGO) and lymphovascular invasion, but not tumor centrality, as significant prognostic factors for RFS. In the multivariate analysis, the presence of GGO and lymphovascular invasion remained significant. CONCLUSIONS Regarding oncological outcomes, segmentectomy with a safety proximal distance could be feasible, even for inner small-sized NSCLC. Tumor invasiveness, not tumor centrality, may influence tumor recurrence. (242 words).
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Affiliation(s)
- Shinya Tane
- Department of General Thoracic Surgery, Osaka Saiseikai Nakatsu Hospital, 2-10-39, Shibata, kita-ward, Osaka city, Japan.
| | - Kenji Kimura
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, kitaoji-cho, Akashi city, Japan
| | - Nahoko Shimizu
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, kitaoji-cho, Akashi city, Japan
| | - Yoshitaka Kitamura
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, kitaoji-cho, Akashi city, Japan
| | - Gaku Matsumoto
- Department of General Thoracic Surgery, Osaka Saiseikai Nakatsu Hospital, 2-10-39, Shibata, kita-ward, Osaka city, Japan
| | - Kazuya Uchino
- Department of General Thoracic Surgery, Osaka Saiseikai Nakatsu Hospital, 2-10-39, Shibata, kita-ward, Osaka city, Japan
| | - Wataru Nishio
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, kitaoji-cho, Akashi city, Japan
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14
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Komeda M, Toh Y, Tanabe K, Kitamura Y, Misawa T. First demonstration experiment of the neutron rotation method for detecting nuclear material. ANN NUCL ENERGY 2021. [DOI: 10.1016/j.anucene.2021.108300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Nakamura A, Mizugaki H, Ikezawa Y, Morita R, Tateishi K, Yokoo K, Sumi T, Kikuchi H, Kitamura Y, Morita M, Aso M, Tsukita Y, Yoshiike F, Furuta M, Tanaka H, Sekikawa M, Hachiya T, Nakamura K, Yokouchi H. 1306P Real-world data of first-line treatment with pembrolizumab for highly PD-L1 expressing NSCLC (HOT/NJLCG2001). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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16
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Fujibayashi Y, Ogawa H, Kitazume M, Nishikubo M, Nishioka Y, Kimura K, Tane S, Kitamura Y, Nishio W. Pleural invasion, epidermal growth factor receptor mutation and carcinoembryonic antigen level affect pleural lavage cytology-positive status in non-small-cell lung cancer. Eur J Cardiothorac Surg 2021; 59:791-798. [PMID: 33197244 DOI: 10.1093/ejcts/ezaa394] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/10/2020] [Accepted: 09/24/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Pleural invasion (pl) is strongly associated with the pleural lavage cytology (PLC) status. We analysed tumours with pl and evaluated the relationship between the PLC status and pl. METHODS We retrospectively reviewed 428 surgically treated patients who had been diagnosed with non-small-cell lung cancer with pl and had their PLC status examined between 2000 and 2016. We investigated the influence of a PLC-positive status on the prognosis and searched for the factors predictive of a PLC-positive status. RESULTS Seventy-eight (18%) patients were PLC positive. The recurrence-free survival of PLC-positive patients was significantly worse than that of PLC-negative patients in pl1 and pl2, but not in pl3 (5-year recurrence-free survival rate, PLC positive versus PLC negative: pl1, 22.0% vs 60.0%, P = 0.002; pl2, 30.4% vs 59.7%, P = 0.015; pl3, 50.0% vs 59.6%, P = 0.427). A multivariable analysis showed that the degree of pl (pl2-3 versus pl1) [odds ratio (OR) 5.34, P < 0.001] was an independent predictive factor for PLC positivity. Epidermal growth factor receptor (EGFR) mutation positivity (OR 5.48, P = 0.042) and carcinoembryonic antigen (CEA) ≥5 ng/ml (OR 3.78, P = 0.042) were associated with a PLC-positive status in patients with pl2-3. We found that the PLC-positive rate in patients with pl2-3 was 35.6%; however, if the tumour was EGFR mutation positive and had CEA ≥5 ng/ml, the PLC-positive rate increased to 77%. CONCLUSIONS If a tumour was suspected of being pl2-3 and had EGFR mutation positivity and CEA ≥5 ng/ml, the PLC-positive rate was extremely high. CLINICAL TRIAL REGISTRATION NUMBER Hyogo Cancer Center, G-138.
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Affiliation(s)
- Yusuke Fujibayashi
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo Prefecture, Japan
| | - Hiroyuki Ogawa
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo Prefecture, Japan
| | - Mai Kitazume
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo Prefecture, Japan
| | - Megumi Nishikubo
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo Prefecture, Japan
| | - Yuki Nishioka
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo Prefecture, Japan
| | - Kenji Kimura
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo Prefecture, Japan
| | - Shinya Tane
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo Prefecture, Japan
| | - Yoshitaka Kitamura
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo Prefecture, Japan
| | - Wataru Nishio
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo Prefecture, Japan
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17
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Ogawa H, Fujibayashi Y, Nishikubo M, Nishioka Y, Tane S, Kitamura Y, Nishio W. Prognostic significance of preoperative haemoglobin A1c level in patients with lung adenocarcinoma. Interact Cardiovasc Thorac Surg 2021; 33:534-540. [PMID: 34115869 DOI: 10.1093/icvts/ivab140] [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: 03/06/2021] [Accepted: 03/31/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We investigated the influence of the preoperative haemoglobin A1c (HbA1c) value on the prognosis and pathology of patients with lung adenocarcinoma who underwent surgery. METHODS We reviewed the medical records of 400 lung adenocarcinoma patients who underwent lobectomy with mediastinal lymph node dissection between 2009 and 2013 using a prospectively maintained database. We stratified 400 patients into 4 groups according to the preoperative HbA1c value as follows: HbA1c ≤ 5.9 (n = 296), 6.0 ≤ HbA1c ≤ 6.9 (n = 70), 7.0 ≤ HbA1c ≤ 7.9 (n = 21) and HbA1c ≥ 8.0 (n = 12). We compared the recurrence-free survival and overall survival (OS) among these 4 groups. Univariate and multivariate analyses were performed to identify the risk factors for recurrence. RESULTS The median follow-up period was 61.2 months. On comparing the recurrence-free survival and OS rates among these 4 groups, we found that these rates among patients in the HbA1c ≥ 8.0 group were significantly poorer compared with the other 3 groups (5-year recurrence-free survival: HbA1c ≤ 5.9, 70.4%; 6.0 ≤ HbA1c ≤ 6.9, 69.7%; 7.0 ≤ HbA1c ≤ 7.9, 70.7%; ≥8.0 HbA1c, 18.8%; P = 0.002; and 5-year OS: HbA1c ≤ 5.9, 88.7%; 6.0 ≤ HbA1c ≤ 6.9, 80.6%; 7.0 ≤ HbA1c ≤ 7.9, 90.2%; ≥8.0 HbA1c, 66.7%; P = 0.046). Patients in the HbA1c ≥ 8.0 group had significantly more tumours with vascular invasion (P = 0.041) and experienced distant metastasis significantly more often (P = 0.028) than those with other values. A multivariate analysis revealed that preoperative HbA1c ≥ 8.0 [hazard ratio (HR) 2.33; P = 0.026] and lymph node metastasis (HR 3.94; P < 0.001) were significant independent prognostic factors for recurrence. CONCLUSIONS Our results revealed that preoperative HbA1c ≥ 8.0 is associated to poor prognosis due to the occurrence of distant metastasis and we should carefully follow these patients after surgery. CLINICAL REGISTRATION NUMBER Hyogo Cancer Center, G-57.
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Affiliation(s)
- Hiroyuki Ogawa
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | - Megumi Nishikubo
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Yuki Nishioka
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Shinya Tane
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | - Wataru Nishio
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
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18
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Tane S, Nishikubo M, Kitazume M, Fujibayashi Y, Kimura K, Kitamura Y, Takenaka D, Nishio W. Cluster analysis of emphysema for predicting pulmonary complications after thoracoscopic lobectomy. Eur J Cardiothorac Surg 2021; 60:607-613. [PMID: 34008011 DOI: 10.1093/ejcts/ezab237] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 03/22/2021] [Accepted: 04/07/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Despite significant advances in surgical techniques, including thoracoscopic approaches and perioperative care, the morbidity rate remains high after lung resection. This study focused on a low attenuation cluster analysis, which represented the size distribution of pulmonary emphysema and assessed its utility for predicting postoperative pulmonary complications after thoracoscopic lobectomy. METHODS From April 2013 to September 2018, lung cancer patients who received spirometry and computed tomography (CT) before surgery and underwent thoracoscopic lobectomy were included. The cumulative size distribution of the low attenuation area (LAA, defined as ≤-950 Hounsfield unit on CT) clusters followed a power-law characterized by an exponent D-value, a measure of the complexity of the alveolar structure. D-value and LAA% (LAA/total lung volume) were calculated using preoperative 3-dimensional CT software. The relationship between pulmonary complications and patient characteristics, including D-value and LAA%, was investigated. RESULTS Among 471 patients, there were 61 respiratory complication cases (12.9%). Receiver operation characteristic curve analysis revealed that the best predictive cut-off value of D-value and LAA% for pulmonary complications was 2.27 and 16.5, respectively, with an area under the curve of 0.72 and 0.58, respectively. D-value was significantly correlated with % forced expiratory volume in 1 s. Per univariate analysis, gender, smoking history, forced expiratory volume in 1 s/forced vital capacity, LAA% and D-value were risk factors for predicting postoperative pulmonary complications. In the multivariate analysis, D-value remained a significant predictive factor. CONCLUSION Preoperative assessment of emphysema cluster analysis may represent the vulnerability of the operated lung and could be the novel predictor for pulmonary complications after thoracoscopic lobectomy.
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Affiliation(s)
- Shinya Tane
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | - Mai Kitazume
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | - Kenji Kimura
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | - Daisuke Takenaka
- Division of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan
| | - Wataru Nishio
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Japan
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Ozawa Y, Harutani Y, Oyanagi J, Murakami E, Sato K, Akamatsu H, Hayata A, Teraoka S, Ueda H, Kitamura Y, Fukuoka J, Tokudome N, Nakanishi M, Koh Y, Yamamoto N. P60.08 Impact of CD24 and CD47 Tumor Expression on Efficacy and Serum Cytokine Alteration with PD-1/L1 Inhibitors in Non-Small Cell Lung cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.967] [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: 10/21/2022]
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20
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Tane S, Nishio W, Fujibayashi Y, Nishikubo M, Nishioka Y, Ogawa H, Kitamura Y, Takenaka D, Yoshimura M. Thoracoscopic left S1 + 2 segmentectomy as a good resolution for preserving pulmonary function. Interact Cardiovasc Thorac Surg 2020; 31:331-338. [PMID: 32747959 DOI: 10.1093/icvts/ivaa105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/05/2020] [Accepted: 05/13/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Segmentectomies such as S1 + 2, S1 + 2+3 and S4 + 5 segmentectomy are used to treat patients with non-small-cell lung cancer (NSCLC) in the left upper lobe. However, the preservable lung volume and changes after such segmentectomies remain unknown. We compared the residual pulmonary function after thoracoscopic segmentectomy or lobectomy in the left upper lobe and examined the efficacy of S1 + 2 segmentectomy regarding postoperative pulmonary function. METHODS Patients with left upper lobe NSCLC who underwent thoracoscopic segmentectomy or lobectomy were included. Spirometry and computed tomography were performed before and 6 months after resection, and the ipsilateral preserved lobe volume was calculated using 3-dimensional computer tomography. The percentage of postoperative/preoperative forced expiratory volume in 1 s and actual/predicted regional forced expiratory volume in 1 s (preservation rate) in the residual lobe were compared. RESULTS Eighty-eight patients underwent lobectomy and 70 patients underwent segmentectomy (23 S1 + 2, 35 S1 + 2+3 and 12 S4 + 5 segmentectomies). The percentage of postoperative/preoperative forced expiratory volume in 1 s was 97 in S1 + 2, 82 in S1 + 2+3, 86 in S4 + 5 segmentectomy and 73 in left upper lobectomy, indicating that segmentectomy could be a meaningful approach to preserve pulmonary function. The preservation rate was 83% in S1 + 2 and 62% in S1 + 2+3 segmentectomy and was significantly higher in S1 + 2 than in S1 + 2+3 segmentectomy (P < 0.001). CONCLUSIONS Postoperative pulmonary function and the preservable lung volume of the residual lobe after thoracoscopic S1 + 2 segmentectomy were well-preserved among other segmentectomies and lobectomy. Thoracoscopic S1 + 2 segmentectomy is a good alternative for preserving postoperative function.
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Affiliation(s)
- Shinya Tane
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Wataru Nishio
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | | | - Yuki Nishioka
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Hiroyuki Ogawa
- Division of Chest Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | - Daisuke Takenaka
- Division of Diagnostic Radiology, Hyogo Cancer Center, Akashi, Japan
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Ogawa H, Sakai Y, Nishio W, Fujibayashi Y, Nishikubo M, Nishioka Y, Tane S, Kitamura Y, Sudo T, Sakuma T, Yoshimura M. DLL3 expression is a predictive marker of sensitivity to adjuvant chemotherapy for pulmonary LCNEC. Thorac Cancer 2020; 11:2561-2569. [PMID: 32691982 PMCID: PMC7471044 DOI: 10.1111/1759-7714.13574] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 12/14/2022] Open
Abstract
Background The mammalian Notch family ligands delta‐like 3 (DLL3) is reported to be a potential therapeutic target for large cell neuroendocrine carcinomas (LCNEC). The effect of DLL3 expression on LCNEC prognosis has not yet been elucidated. Methods We reviewed the medical records of 70 LCNEC patients undergoing surgical resection between 2001 and 2015 using a prospectively maintained database. We performed immunohistochemistry for DLL3 and investigated the correlation between the sensitivity of LCNEC to platinum‐based adjuvant chemotherapy. Results DLL3 expression was positive in 26 (37.1%) LCNEC patients. A total of 23 patients (32.9%) received platinum‐based adjuvant chemotherapy. Among patients with DLL3 expression‐positive tumors, no difference was found in the five‐year overall survival (OS) or recurrence‐free survival (RFS) between patients with and without adjuvant chemotherapy (surgery + chemotherapy vs. surgery alone, five‐year OS: 58.3% vs. 35.7% P = 0.36, five‐year RFS: 41.7% vs. 35.7% P = 0.74). In contrast, among patients with DLL3‐negative tumors, significantly greater five‐year OS and RFS rates were observed for patients with adjuvant chemotherapy than for those without it (surgery + chemotherapy vs. surgery alone: five‐year OS: 90.0% vs. 26.9% P<0.01, five‐year RFS: 80.0% vs. 21.7% P < 0.01). A multivariate analysis for the RFS revealed that adjuvant chemotherapy was a significant independent prognostic factor among patients with DLL3‐negative tumors (hazard ratio [HR]: 0.05, 95% confidence interval [CI]: 0.01–0.41, P < 0.01), although it was not a factor among patients with DLL3‐positive tumors (HR: 0.73, 95% CI: 0.23–2.27, P = 0.58). Conclusions Our results revealed that DLL3 is a predictive marker of sensitivity to platinum‐based adjuvant chemotherapy for LCNEC. Key points Significant findings of the study DLL3 was a predictive marker of sensitivity to platinum‐based adjuvant chemotherapy for LCNEC. Among patients with DLL3 expression‐negative LCNEC, platinum‐based adjuvant chemotherapy significantly improved the OS and RFS, although it did not do so among patients with DLL3 expression‐positive LCNEC. What this study adds Our results suggest that DLL3 expression‐positive LCNEC may be better treated with other types of adjuvant chemotherapy, such as the anti‐DLL3 therapies if these effects are confirmed by ongoing clinical research.
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Affiliation(s)
- Hiroyuki Ogawa
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Yasuhiro Sakai
- Department of Pathology, Hyogo Cancer Center, Akashi, Japan
| | - Wataru Nishio
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | - Megumi Nishikubo
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Yuki Nishioka
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Shinya Tane
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | | | - Tamotsu Sudo
- Section of Translational Research, Hyogo Cancer Center, Akashi, Japan
| | - Toshiko Sakuma
- Department of Pathology, Hyogo Cancer Center, Akashi, Japan
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Fujibayashi Y, Ogawa H, Nishio W, Nishikubo M, Nishioka Y, Tane S, Kitamura Y, Yoshimura M. Pneumatocele triggered by continuous positive airway pressure after lung resection. Respir Med Case Rep 2020; 30:101119. [PMID: 32551225 PMCID: PMC7287143 DOI: 10.1016/j.rmcr.2020.101119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 05/29/2020] [Accepted: 06/04/2020] [Indexed: 11/16/2022] Open
Abstract
A pneumatocele is a cystic change of the lung that is caused by a check valve in the bronchiole due to infection, trauma and positive-pressure ventilation. We herein report a case of pneumatocele triggered by using of continuous positive airway pressure (CPAP) for sleep apnea syndrome (SAS) after pulmonary resection. A 69-year-old man underwent right upper lobectomy for lung cancer and developed interstitial pneumonia (IP) 10th postoperative day (POD). He was treated with steroid pulse therapy (solmedrol 500 mg × 3 days), and thereafter with oral steroid therapy (predonin 30mg/day). Well responded to the steroid therapy, IP was improved. However, he noticed bloody sputum 29th POD, and chest computed tomography showed a giant cystic lesion on the dorsal right lower lobe. We resected the cyst and the pathological findings revealed that the cystic lesion was pneumatocele, and CPAP was strongly suspected of triggering this disease.
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Tanaka H, Ogawa H, Sakai Y, Nishioka Y, Tane S, Kitamura Y, Takenaka D, Sakuma T, Nishio W, Yoshimura M. [Left Paraganglioma in the Posterior Mediastinum]. Kyobu Geka 2019; 72:1072-1075. [PMID: 31879382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 69-year-old man with hypertension was referred for an abnormal shadow detected on chest computed tomography(CT) at a medical checkup. Enhanced CT showed a highly enhanced posterior mediastinal tumor of 34×27 mm. Magnetic resonance imaging (MRI) revealed a low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. Thus, a neurogenic tumor was suspected and the surgery was performed. The tumor was carefully dissected as it was hyper-vascular and hemorrhagic. Immediately after tumor resection, the patient's blood pressure rapidly decreased, and phenylephrine hydrochloride was needed to maintain the blood pressure. The pathological diagnosis was paraganglioma.
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Affiliation(s)
- Hiroki Tanaka
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
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24
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Kimura K, Tanaka Y, Tauchi S, Kitamura Y, Nishio W, Sakai Y, Hayashi Y, Yoshimura M, Maniwa Y. Psf3 as a possible biomarker of postoperative chemotherapy for patients with early pulmonary adenocarcinoma. Thorac Cancer 2019; 10:2300-2307. [PMID: 31637868 PMCID: PMC6885426 DOI: 10.1111/1759-7714.13230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/04/2019] [Accepted: 10/04/2019] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Partner of Sld five 3 (Psf3) is a member of the heterotetrameric complex that consists of SLD5, Psf1, Psf2, and Psf3. We have shown in previous studies that high Psf3 expression was a poor prognostic marker for pulmonary adenocarcinoma. Here, we statistically evaluated the relationship between clinicopathologic factors and Psf3 expression in stage I pulmonary adenocarcinoma. METHODS A total of 583 patients who had undergone complete resection of stage I pulmonary adenocarcinoma from January 2002 to December 2009 were included in the study. Tissue microarrays were performed, and the resected tumors were divided into groups according to Psf3 expression. RESULTS Of 583 patients, high expression of Psf3 was observed in 211 (36.2%) and low expression of Psf3 observed in 372 (63.8%) patients. Among stage I patients, the five-year survival rate was 76.7% in the Psf3 high expression group and 90.9% in the Psf3 low expression group (P < 0.0001). On multivariate analysis, Psf3 was found to be the independent prognostic factor. Among stage I patients in the Psf3 high expression group, a significantly greater five-year survival rate was observed in patients who received postoperative chemotherapy with tegafur-uracil than in those who underwent surgery alone (P < 0.0001). In contrast, among stage I patients in the Psf3 low expression group, no difference was found in the five-year survival, regardless of the presence or absence of tegafur-uracil (P = 0.873). CONCLUSION The Psf3 expression was an independent prognostic factor and could be a biomarker of adjuvant tegafur-uracil for stage I pulmonary adenocarcinoma. KEY POINTS Significant findings of the study: The Psf3 expression could be a biomarker of adjuvant tegafur-uracil administration for stage I pulmonary adenocarcinoma. WHAT THIS STUDY ADDS Appropriate patients of adjuvant chemotherapy for stage I pulmonary adenocarcinoma using Psf3 expression could be selected.
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Affiliation(s)
- Kenji Kimura
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shunsuke Tauchi
- Division of Thoracic Surgery, Akashi Medical Center, Akashi, Japan
| | | | - Wataru Nishio
- Division of Thoracic Surgery, Hyogo Cancer Center, Akashi, Japan
| | - Yasuhiro Sakai
- Division of Pathology, Hyogo Cancer Center, Akashi, Japan
| | - Yoshitake Hayashi
- Division of Molecular and Medical Genetics, Department of Pathology, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Ogawa H, Sakai Y, Nishio W, Fujibayashi Y, Nishikubo M, Nishioka Y, Tane S, Kitamura Y, Sudo T, Sakuma Y, Yoshimura M. P1.12-23 DLL3 Is a Predictive Marker of Sensitivity to Adjuvant Chemotherapy for High-Grade Neuroendocrine Tumors. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1136] [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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26
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Okuma H, Tane S, Nishioka Y, Ogawa H, Kitamura Y, Nishio W, Yoshimura M. P2.17-15 Clinical Features and Prognosis of Lung Cancer with Cavity Lesion. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Tane S, Nishio W, Nishioka Y, Tanaka H, Ogawa H, Kitamura Y, Takenaka D, Yoshimura M. Evaluation of the Residual Lung Function After Thoracoscopic Segmentectomy Compared With Lobectomy. Ann Thorac Surg 2019; 108:1543-1550. [PMID: 31302085 DOI: 10.1016/j.athoracsur.2019.05.052] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 05/01/2019] [Accepted: 05/20/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Segmentectomy has shown a beneficial effect on preserving lung function after resection. However, the preservable lung volume and changes after thoracoscopic segmentectomy remain unknown. We compared the residual lung function after thoracoscopic segmentectomy and lobectomy, using a novel three-dimensional computed tomography-based volumetric method. METHODS Seventy-four patients who received thoracoscopic segmentectomy were matched to the 74 patients who received thoracoscopic lobectomy. Spirometry and computed tomography were performed before and 6 months after resection, and the ipsilateral residual preserved and nonoperated lobe volume and the contralateral lung volume were calculated using three-dimensional computed tomography. The percentage of actual/predicted regional forced expiratory volume in 1 second (the preservation rate) in each lobe (measured by volumetry and spirometry) was compared with the extent of resection and procedural difficulty (typical or atypical segmentectomy). RESULTS The postoperative lung function was significantly more well preserved in segmentectomy than in lobectomy. After segmentectomy and lobectomy, the regional forced expiratory volume in 1 second of the ipsilateral unaffected lobe was increased in comparison with the preoperative value, whereas that of the residual lobe rescued by segmentectomy was decreased. The preservation rates of the residual and unaffected lobes were inversely and positively correlated, respectively, with the extent of the resected segment. The preservation rates of the residual lobe after typical or atypical segmentectomy were not significantly different. CONCLUSIONS Although the decrease in the actual lung function of the residual lobe was greater than predicted and increased with increasing extent of resection, segmentectomy preserved the whole lung function better than lobectomy.
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Affiliation(s)
- Shinya Tane
- Division of Chest Surgery, Hyogo Cancer Center, Akashi City, Japan
| | - Wataru Nishio
- Division of Chest Surgery, Hyogo Cancer Center, Akashi City, Japan.
| | - Yuki Nishioka
- Division of Chest Surgery, Hyogo Cancer Center, Akashi City, Japan
| | - Hiroki Tanaka
- Division of Chest Surgery, Hyogo Cancer Center, Akashi City, Japan
| | - Hiroyuki Ogawa
- Division of Chest Surgery, Hyogo Cancer Center, Akashi City, Japan
| | | | - Daisuke Takenaka
- Division of Diagnostic Radiology, Hyogo Cancer Center, Akashi City, Japan
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Ogawa H, Tanaka Y, Kitamura Y, Shimizu N, Doi T, Hokka D, Tane S, Nishio W, Yoshimura M, Maniwa Y. Efficacy of perioperative chemotherapy for pulmonary high-grade neuroendocrine carcinomas: a propensity score matching analysis. J Thorac Dis 2019; 11:1145-1154. [PMID: 31179056 DOI: 10.21037/jtd.2019.04.56] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Large-cell neuroendocrine carcinoma (LCNEC) and small cell lung cancer (SCLC) are categorized as high-grade neuroendocrine carcinoma (HGNEC). We analyzed the efficacy of perioperative chemotherapy for HGNEC and the prognostic factors. Methods We retrospectively reviewed the medical records of patients who underwent tumor resection and were diagnosed with HGNEC between January 2001 and December 2014. The overall survival (OS) was estimated by the Kaplan-Meier method. Propensity score matching was performed to compare the OS between the treatment groups. Multivariate analyses using a Cox proportional hazards model were performed to search for prognostic factors for HGNEC. Results We analyzed 146 HGNEC patients (LCNEC n=92, SCLC n=54) without synchronous multiple cancers, who underwent complete resection. Seventy patients (LCNEC n=31, SCLC n=32) received perioperative chemotherapy and all of them received a platinum-based anticancer drug. Perioperative chemotherapy significantly improved the 5-year OS rates of HGNEC patients (all stages: 74.5% vs. 34.7%, P<0.01, stage I: 88.5% vs. 40.0%, P<0.01). The efficacy of perioperative chemotherapy was similar between LCNEC and SCLC patients [LCNEC all stages: hazard ratio (HR) 0.27, P<0.01, LCNEC stage I: HR 0.27, P=0.01; SCLC all stages: HR 0.38, P=0.02, SCLC stage I: HR 0.34, P=0.06]. The survival benefit of perioperative chemotherapy for HGNEC patients was confirmed by propensity score matching analysis (HR 0.31, P<0.01). The multivariate analysis revealed that perioperative chemotherapy (HR 0.29, P<0.01), sublobar resection (HR 2.11, P=0.04), and lymph node metastasis (HR 3.34, P<0.01) were independently associated with survival. Conclusions Surgical resection combined with perioperative chemotherapy was considered to be effective even for stage I HGNEC patients. Sublobar resection might increase the risk of death in HGNEC patients.
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Affiliation(s)
- Hiroyuki Ogawa
- Devision of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan.,Department of Thoracic Surgery, Hyogo Cancer Center, Akashi City, Hyogo, Japan
| | - Yugo Tanaka
- Devision of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan
| | - Yoshitaka Kitamura
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi City, Hyogo, Japan
| | - Nahoko Shimizu
- Devision of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan
| | - Takefumi Doi
- Devision of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan
| | - Daisuke Hokka
- Devision of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan
| | - Shinya Tane
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi City, Hyogo, Japan
| | - Wataru Nishio
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi City, Hyogo, Japan
| | - Masahiro Yoshimura
- Department of Thoracic Surgery, Hyogo Cancer Center, Akashi City, Hyogo, Japan
| | - Yoshimasa Maniwa
- Devision of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan
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Nishioka Y, Tane S, Nishio W, Tanaka H, Ogawa H, Kitamura Y, Sakuma T, Yoshimura M. A rare resected case of pulmonary rhabdomyosarcoma. Gen Thorac Cardiovasc Surg 2019; 67:1089-1092. [PMID: 30806970 DOI: 10.1007/s11748-019-01086-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/17/2019] [Indexed: 11/30/2022]
Abstract
Rhabdomyosarcoma is a well-known neoplasm in children that frequently occurs in the extremities, the head and neck region, and the genitourinary tract. To the best of our knowledge, pulmonary primary rhabdomyosarcoma in adults is exceedingly rare, and few resected cases have been reported. We report a case of pulmonary primary rhabdomyosarcoma that was surgically resected then treated with adjuvant chemotherapy (vincristine, actinomycin-D and cyclophosphamide). At 9 months after surgery, the patient is free from disease. Although the prognosis of rhabdomyosarcoma is unfavorable, surgical resection and adjuvant therapy could be a potential treatment strategy for pulmonary primary rhabdomyosarcoma.
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Affiliation(s)
- Yuki Nishioka
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Japan
| | - Shinya Tane
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Japan
| | - Wataru Nishio
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Japan
| | - Hiroki Tanaka
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Japan
| | - Hiroyuki Ogawa
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Japan
| | - Yoshitaka Kitamura
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Japan
| | - Toshiko Sakuma
- Division of Pathology, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Japan
| | - Masahiro Yoshimura
- Division of Chest Surgery, Hyogo Cancer Center, 13-70, Kitaoji-cho, Akashi, Japan
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30
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Kitano D, Kitamura Y, Yonezawa K, Nishio W, Iwae S, Nakahara M, Sakakibara S. Combined Type Mediastinitis After Thyroidectomy Managed by Negative Pressure Wound Therapy With Instillation: A Case Report. Eplasty 2019; 19:ic10. [PMID: 30858904 PMCID: PMC6402413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | | | - Shigemichi Iwae
- cHead and Neck Surgery, Hyogo Cancer Center, Akashi, Hyogo, Japan
| | | | - Shunsuke Sakakibara
- aDepartments of Plastic Surgery,dDepartment of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan,Correspondence:
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31
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Sugawara Y, Tsuji I, Mizoue T, Inoue M, Sawada N, Matsuo K, Ito H, Naito M, Nagata C, Kitamura Y, Sadakane A, Tanaka K, Tamakoshi A, Tsugane S, Shimazu T. Cigarette smoking and cervical cancer risk: an evaluation based on a systematic review and meta-analysis among Japanese women. Jpn J Clin Oncol 2019; 49:77-86. [PMID: 30407555 DOI: 10.1093/jjco/hyy158] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 10/30/2018] [Indexed: 11/13/2022] Open
Abstract
Background There is a body of evidence to suggest that cigarette smoking increases the risk of cervical cancer in women, but no study has examined the magnitude of the association in Japanese women. Here, we evaluated the association between cigarette smoking and the risk of cervical cancer in Japanese women based on a systematic review of epidemiological evidence. Methods Original data were obtained from a MEDLINE search using PubMed or from a search of the 'Ichushi' database, as well as by a manual search. Evaluation of associations was based on the strength of evidence and the magnitude of association, together with biological plausibility as evaluated previously by the International Agency for Research on Cancer. Meta-analysis of associations was also conducted to obtain a summarized overview of the data. Results We identified two cohort studies and three case-control studies. All five studies had indicated strong positive associations between cigarette smoking and the risk of cervical cancer. Our summary estimate indicated that the relative risk (RR) for individuals who had ever-smoked relative to never-smokers was 2.03 (95% confidence interval: 1.49-2.57). Four studies had also demonstrated dose-response relationships between cigarette smoking and the risk of cervical cancer. Conclusion We conclude that there is convincing evidence that cigarette smoking increases the risk of cervical cancer among Japanese women.
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Affiliation(s)
- Y Sugawara
- Department of Health Informatics and Public Health, Division of Epidemiology, Graduate School of Medicine, Tohoku University School of Public Health, Sendai, Japan
| | - I Tsuji
- Department of Health Informatics and Public Health, Division of Epidemiology, Graduate School of Medicine, Tohoku University School of Public Health, Sendai, Japan
| | - T Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Inoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - N Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - K Matsuo
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan.,Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - H Ito
- Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - M Naito
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - C Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Y Kitamura
- Department of Social and Environmental Medicine, Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Suita, Japan
| | - A Sadakane
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - K Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - A Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - S Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - T Shimazu
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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Zamami Y, Kouno Y, Niimura T, Chuma M, Imai T, Mitsui M, Koyama T, Kayano M, Okada N, Hamano H, Goda M, Imanishi M, Takechi K, Horinouchi Y, Kondo Y, Yanagawa H, Kitamura Y, Sendo T, Ujike Y, Ishizawa K. Relationship between the administration of nicardipine hydrochloride and the development of delirium in patients on mechanical ventilation. Pharmazie 2018; 73:740-743. [PMID: 30522561 DOI: 10.1691/ph.2018.8711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A history of hypertension is a known risk factor for delirium in patients in intensive care units, but the effect of antihypertensive agents on delirium development is unclear. Nicardipine, a calcium channel blocker, is widely used in ICU as a treatment agent for hypertensive emergency. This study investigated the relationship between the administration of nicardipine hydrochloride and delirium development in patients under mechanical ventilation. We conducted a medical chart review of 103 patients, who were divided into two groups according to the use of nicardipine hydrochloride. The prevalence of delirium was compared with respect to factors such as age, sex, laboratory data, and medical history, by multivariate analysis. 21 patients (20.4 %) were treated with nicardipine hydrochloride in 103 patients. The treatment and non-treatment groups differed significantly in age (72 vs. 65 years) and history of high blood pressure (57% vs. 11%). Multivariate analysis revealed that patients in the treatment group developed delirium significantly less often than those in the non-treatment group (19% vs. 48%). These results suggested that treatment of high blood pressure with nicardipine hydrochloride is a possible method for preventing the development of delirium.
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Ogawa H, Tanaka Y, Kitamura Y, Tanaka H, Nishioka Y, Tane S, Nishio W, Maniwa Y, Yoshimura M. P1.12-05 Efficacy of Perioperative Chemotherapy for High-Grade Neuroendocrine Tumors. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.840] [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: 11/17/2022]
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Kita Y, Suzuki K, Shirakawa Y, Kaga Y, Okumura Y, Kitamura Y, Arakaki K, Mitsuhashi S, Inagaki M, Okuzumi H. An ERP study of inhibitory control in adults with developmental coordination disorder. Int J Psychophysiol 2018. [DOI: 10.1016/j.ijpsycho.2018.07.408] [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: 10/28/2022]
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35
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Hattori A, Takamochi K, Kitamura Y, Matsunaga T, Suzuki K, Oh S, Suzuki K. Risk factor analysis of cerebral infarction and clinicopathological characteristics of left upper pulmonary vein stump thrombus after lobectomy. Gen Thorac Cardiovasc Surg 2018; 67:247-253. [PMID: 30251002 DOI: 10.1007/s11748-018-1017-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 09/20/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We aimed to analyze the risk factors of postoperative cerebral infarction (CI) and thrombus formation in the left upper pulmonary vein (PV) stump after lobectomy. METHODS We retrospectively investigated 1670 patients who underwent lobectomy or more intervention, and analyzed the risk factors of postoperative CI. Furthermore, postoperative contrast-enhanced computed tomography (CE-CT) were reviewed in patients who underwent left upper lobectomy (LUL), and risk factors of the thrombus formation in the left upper PV stump were evaluated. Chi-square test or unpaired t test was used to compare the factors. RESULTS Cerebral infarction was observed in 10 (0.60%) patients, being more significant in patients with left side lesions (90%) who underwent LUL (50%). Eighty percent of the CI cases occurred by day 4 postoperative. CI was found in 1.47% after LUL. Among 339 patients who underwent LUL, CE-CT was performed in 137 (40%) postoperatively. Among them, left upper PV stump thrombus was found in 16 (11.7%), which was statistically significant in higher age and p stage II or more disease (= 0.003, 0.040). In contrast, preoperative histories including anticoagulant administration, atrial fibrillation, diabetes mellitus, several surgical procedures or intraoperative factors were not associated statistically with thrombus formation. CONCLUSION Postoperative CI occurred in the very early-phase after lobectomy, and the incidence was significantly higher in patients undergoing LUL. Because left upper PV stump thrombus was frequently found retrospectively, a prospective observation study would be required to investigate the real incidence of PV stump thrombus after lobectomy.
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Affiliation(s)
- Aritoshi Hattori
- Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3, Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan.
| | - Kazuya Takamochi
- Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3, Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan
| | - Yoshitaka Kitamura
- Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3, Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan
| | - Takeshi Matsunaga
- Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3, Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan
| | - Kazuhiro Suzuki
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
| | - Shiaki Oh
- Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3, Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan
| | - Kenji Suzuki
- Department of General Thoracic Surgery, Juntendo University School of Medicine, 1-3, Hongo 3-chome, Bunkyo-ku, Tokyo, 113-8431, Japan
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36
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Sasazuki S, Inoue M, Shimazu T, Wakai K, Naito M, Nagata C, Tanaka K, Tsuji I, Sugawara Y, Mizoue T, Matsuo K, Ito H, Tamakoshi A, Sawada N, Nakayama T, Kitamura Y, Sadakane A, Tsugane S. Evidence-based cancer prevention recommendations for Japanese. Jpn J Clin Oncol 2018; 48:576-586. [PMID: 29659926 DOI: 10.1093/jjco/hyy048] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 03/23/2018] [Indexed: 12/19/2022] Open
Abstract
A comprehensive evidence-based cancer prevention recommendation for Japanese was developed. We evaluated the magnitude of the associations of lifestyle factors and infection with cancer through a systematic review of the literature, meta-analysis of published data, and pooled analysis of cohort studies in Japan. Then, we judged the strength of evidence based on the consistency of the associations between exposure and cancer and biological plausibility. Important factors were extracted and summarized as an evidence-based, current cancer prevention recommendation: 'Cancer Prevention Recommendation for Japanese'. The recommendation addresses six important domains related to exposure and cancer, including smoking, alcohol drinking, diet, physical activity, body weight and infection. The next step should focus on the development of effective behavior modification programs and their implementation and dissemination.
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Affiliation(s)
- S Sasazuki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo
| | - M Inoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo
| | - T Shimazu
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo
| | - K Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya
| | - M Naito
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya
| | - C Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu
| | - K Tanaka
- Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga
| | - I Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai
| | - Y Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai
| | - T Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo
| | - K Matsuo
- Division of Molecular Medicine, Aichi Cancer Center Research Institute.,Department of Epidemiology, Nagoya University Graduate School of Medicine
| | - H Ito
- Department of Epidemiology, Nagoya University Graduate School of Medicine.,Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya
| | - A Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo
| | - N Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo
| | - T Nakayama
- Cancer Control Center, Osaka International Cancer Institute, Osaka
| | - Y Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita
| | - A Sadakane
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan
| | - S Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo
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Suyatno, Kitamura Y, Minami N, Yamada M, Imai H. 192 Culture Conditions Supporting Long-Term Expansion of Bovine Spermatogonial Stem Cells Isolated from Adult and Immature Testes. Reprod Fertil Dev 2018. [DOI: 10.1071/rdv30n1ab192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Spermatogonial stem cells (SSC) self-renew and differentiate into spermatocytes to produce haploid sperm. Because SSC are a small population of adult stem cells in the testis, numerous studies have been reported to derive cell lines from cultured SSC. It has been reported that neonatal and adult mouse SSC can be cultured in vitro over the long term. Male germline stem (GS) cells, embryonic stem (ES)-like cells, and multipotent male germline stem (MGS) cells were derivated from mouse SSC. However, in domestic species including cattle, information about in vitro culture of SSC is mainly available in the neonatal and immature animal. To our knowledge, there are no reports about long-term culture of SSC isolated from adult bovine testis. In this report, we established culture conditions to maintain SSC isolated from adult and immature testes. The SSC were isolated by 3-step enzymatic digestion and enriched by Percoll gradient centrifugation. For adult testicular cell suspensions, SSC were further enriched by differential plating on precoated gelatin dish. After Percoll gradient centrifugation, we found differential expression of SSC markers (GFRα-1 and UCHL-1) in the isolated cells from immature and adult testis. The RT-PCR results also confirmed the expression of differentiated spermatogonia markers (SYCP3 and STRA-8) in adult testicular cell suspensions. It suggests that isolated testicular germ cell population from adult testis are more heterogeneous than those of immature testis. The SSC isolated from adult testes were cultured in low-serum media containing 6-bromoindirubin-3′-oxime (BIO), an inhibitor of glycogen synthase kinase-3α (GSK3), and subsequently the cultures were maintained in the medium containing glial cell line-derived neurotropic factor (GDNF). The cell lines have characteristics resembling mouse GS cell lines as confirmed by their grape-like shape morphology, the expression of SSC markers (UCHL-1, DBA, and GFRa-1), and pluripotent stem cell markers (POU5F1, SOX2, KLF4). The SSC from immature testes were proliferated for more than 3 months in serum-free culture conditions in the presence of GDNF and bovine leukemia inhibitory factor (LIF). The cell lines had ES-like cell morphology, expressed pluripotent stem cell markers and SSC-specific markers. They differentiated in vitro into 3 germ layers confirmed by the expression of ectoderm (NESTIN), mesoderm (BMP4), and endoderm (GATA-6) markers by RT-PCR and neuron like-cells confirmed by the expression of glial fibrillary acidic protein (GFAP) by immunofluorescence analysis. In conclusion, these findings indicate an efficient method to enrich SSC without cell sorting method and different long-term culture systems subsequently established to maintain SSC from adult and immature testes. Furthermore, our data would be useful for further studies that aim to preserve endangered species and improve livestock production through genome editing technology.
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Okuyama M, Kato S, Sato S, Okazaki J, Kitamura Y, Ishikawa T, Sato Y, Isono S. Dynamic behaviour of the soft palate during nasal positive pressure ventilation under anaesthesia and paralysis: comparison between patients with and without obstructive sleep-disordered breathing. Br J Anaesth 2017; 120:181-187. [PMID: 29397128 DOI: 10.1016/j.bja.2017.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Difficult mask ventilation is common and is known to be associated with sleep-disordered breathing (SDB). It is our hypothesis that the incidence of expiratory retropalatal (RP) airway closure (primary outcome) during nasal positive pressure ventilation (PPV) is more frequent in patients with SDB (apnea hypopnea index ≥5 h-1) than non-SDB subjects. METHODS The severity of SDB was assessed before surgery using a portable sleep monitor. In anaesthetized and paralysed patients with (n=11) and without SDB (n=9), we observed the behaviour of the RP airway endoscopically during nasal PPV with the mouth closed and determined the dynamic RP closing pressure, which was defined as the highest airway pressure above which the RP airway closure was reversed. The static RP closing pressure was obtained during cessation of mechanical ventilation in patients with dynamic RP closure during nasal PPV. RESULTS The expiratory RP airway closure accompanied by expiratory flow limitation occurred more frequently in SDB patients (9/11, 82%) than in non-SDB subjects (2/9, 22%; exact logistic regression analysis: P=0.022, odds ratio 3.6, 95% confidence interval 1.1-15.4). Receiver operating characteristic curve analyses indicated AHI >10h-1 and presence of habitual snoring as clinically useful predictors for the occurrence of RP closure during PPV. Dynamic RP closing pressure was greater than the static RP closing pressure by approximately 4-5 cm H2O. CONCLUSIONS Valve-like dynamic RP closure that limits expiratory flow during nasal PPV occurs more frequently in SDB patients.
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Affiliation(s)
- M Okuyama
- Department of Anesthesiology, Chiba University Hospital, Chiba, Japan
| | - S Kato
- Department of Anesthesiology, Chiba University Hospital, Chiba, Japan
| | - S Sato
- Department of Anesthesiology, Chiba University Hospital, Chiba, Japan
| | - J Okazaki
- Department of Anesthesiology and Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Y Kitamura
- Department of Anesthesiology, Chiba University Hospital, Chiba, Japan
| | - T Ishikawa
- Department of Anesthesiology and Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Y Sato
- Department of Global Clinical Research, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - S Isono
- Department of Anesthesiology and Graduate School of Medicine, Chiba University, Chiba, Japan.
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Kitamura Y, Nishio W, Tanaka H, Minami K, Okuma H, Yoshimura M. P1.03-036 Adjuvant Chemotherapy with Uracil-Tegafur for Pathological T1aN0M0 Lung Adenocarcinoma with Lymphatic Vessel Invasion. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Miyazaki I, Murakami S, Kikuoka R, Isooka N, Kitamura Y, Asanuma M. Rotenone-induced dopaminergic neurotoxicity promoted by mesencephalic astrocyte dysfunction. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Asanuma M, Miyazaki I, Isooka N, Kikuoka R, Wada K, Nakayama E, Shin K, Yamamoto D, Kitamura Y. Neuroprotective effects of rotigotine against dopaminergic neurodegeneration by targeting astrocytes. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shimoi T, Hamada A, Kitamura Y, Nishijo T, Shimomura A, Shimizu C, Yoshida M, Kinoshita T, Fujiwara Y, Tamura K. 33P Somatic mutations of PIK3CA and AKT1 in Japanese breast cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw574.006] [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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Shimoi T, Hamada A, Kitamura Y, Nishijo T, Shimomura A, Shimizu C, Yoshida M, Kinoshita T, Fujiwara Y, Tamura K. 33P Somatic mutations of PIK3CA and AKT1 in Japanese breast cancer. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00193-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Kitamura Y, Suzuki K, Teramukai S, Sonobe M, Toyooka S, Nakagawa Y, Yokomise H, Date H. Feasibility of Pulmonary Resection for Lung Cancer in Patients With Coronary Artery Disease or Atrial Fibrillation. Ann Thorac Surg 2016; 103:432-440. [PMID: 27793400 DOI: 10.1016/j.athoracsur.2016.08.077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 08/15/2016] [Accepted: 08/22/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this study was to clarify the outcomes of lung resection for lung cancer in patients with cardiac disease, especially coronary artery disease, in a large-scale multi-institutional cohort. METHODS We retrospectively analyzed the data on 1,254 patients who underwent major lung resection for lung cancer and had been diagnosed with coronary stenosis, atrial fibrillation, or both, in 58 institutions in Japan between January 2009 and December 2011. The primary outcome was 90-day postoperative mortality or in-hospital death. RESULTS Among the 1,254 patients, 902 (71.9%) and 452 patients (36.0%) were preoperatively diagnosed with coronary stenosis and atrial fibrillation, respectively, and 951 patients (75.8%) received antiplatelet therapy. Among the patients with coronary stents (n = 532; 42.4%), 204 (16.3%) received drug-eluting stents. The 90-mortality or in-hospital death rate was 2.6% (n = 32), including stent thrombosis (n = 1), thromboembolic events without stent thrombosis (n = 2), and bleeding events (n = 2). In the multivariate analyses, blood transfusion, history of cerebrovascular disease, amount of bleeding, and history of congestive heart failure were associated with a higher independent risk of 90-day mortality or in-hospital death (odds ratio, 9.400, 3.574, 2.827, and 2.945, respectively). Preoperative discontinuation of antiplatelet therapy was not associated with an independent risk of 90-day mortality or in-hospital death on univariate analysis. CONCLUSIONS Major lung resection for lung cancer in patients with coronary artery disease is feasible. Our study suggests that discontinuation of antiplatelet therapy may not increase postoperative complications in patients with coronary artery disease.
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Affiliation(s)
- Yoshitaka Kitamura
- Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kenji Suzuki
- Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
| | - Satoshi Teramukai
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Makoto Sonobe
- Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan
| | - Shinichi Toyooka
- Department of General Thoracic Surgery, Okayama University Hospital, Okayama, Japan
| | | | - Hiroyasu Yokomise
- Department of General Thoracic, Breast and Endocrinological Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Hiroshi Date
- Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan
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Nishio W, Tane K, Kitamura Y, Yoshimura M. P-195RISK FACTORS FOR LOCAL RECURRENCE AFTER INTENTIONAL SEGMENTECTOMY FOR SMALL RADIOLOGICALLY INVASIVE LUNG CANCER: ARE THERE ANY SEGMENTECTOMY INDICATIONS FOR THE RIGHT UPPER LOBE? Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.193] [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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Kawagoe I, Hayashida M, Suzuki K, Kitamura Y, Oh S, Satoh D, Inada E. Anesthetic Management of Patients Undergoing Right Lung Surgery After Left Upper Lobectomy: Selection of Tubes for One-Lung Ventilation (OLV) and Oxygenation During OLV. J Cardiothorac Vasc Anesth 2016; 30:961-6. [DOI: 10.1053/j.jvca.2015.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Indexed: 11/11/2022]
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Abbasi R, Abe M, Abu-Zayyad T, Allen M, Azuma R, Barcikowski E, Belz J, Bergman D, Blake S, Cady R, Chae M, Cheon B, Chiba J, Chikawa M, Cho W, Fujii T, Fukushima M, Goto T, Hanlon W, Hayashi Y, Hayashida N, Hibino K, Honda K, Ikeda D, Inoue N, Ishii T, Ishimori R, Ito H, Ivanov D, Jui C, Kadota K, Kakimoto F, Kalashev O, Kasahara K, Kawai H, Kawakami S, Kawana S, Kawata K, Kido E, Kim H, Kim J, Kim J, Kitamura S, Kitamura Y, Kuzmin V, Kwon Y, Lan J, Lim S, Lundquist J, Machida K, Martens K, Matsuda T, Matsuyama T, Matthews J, Minamino M, Mukai Y, Myers I, Nagasawa K, Nagataki S, Nakamura T, Nonaka T, Nozato A, Ogio S, Ogura J, Ohnishi M, Ohoka H, Oki K, Okuda T, Ono M, Oshima A, Ozawa S, Park I, Pshirkov M, Rodriguez D, Rubtsov G, Ryu D, Sagawa H, Sakurai N, Scott L, Shah P, Shibata F, Shibata T, Shimodaira H, Shin B, Shin H, Smith J, Sokolsky P, Springer R, Stokes B, Stratton S, Stroman T, Suzawa T, Takamura M, Takeda M, Takeishi R, Taketa A, Takita M, Tameda Y, Tanaka H, Tanaka K, Tanaka M, Thomas S, Thomson G, Tinyakov P, Tkachev I, Tokuno H, Tomida T, Troitsky S, Tsunesada Y, Tsutsumi K, Uchihori Y, Udo S, Urban F, Vasiloff G, Wong T, Yamane R, Yamaoka H, Yamazaki K, Yang J, Yashiro K, Yoneda Y, Yoshida S, Yoshii H, Zollinger R, Zundel Z. Measurement of the proton-air cross section with Telescope Array’s Middle Drum detector and surface array in hybrid mode. Int J Clin Exp Med 2015. [DOI: 10.1103/physrevd.92.032007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Abstract
One of our co-workers was sensitized with a 1% DNCB solution in acetone. Biopsies were obtained from skin lesions 1, 2, 4, 8, 12, 24, 30, 36 and 48 hours after a challenge with 0.1% DNCB solution. In the upper dermis, a rapid decrease of tissue fibrinolytic activity was found which disappeared after 30 hours. In the lower dermis, biphasic changes were observed. Tissue fibrinolytic activity increased one hour and 12-36 hours after challenge, whereas at 48 hours, when erythema was most intensive, it decreased in comparison to the normal activity. Erythema and histological changes of the epidermis and the dermis appeared after approximately 12 hours. As for lymphocytes, T-cells were seen at first. Furthermore, B-cells were noted after approximately 30 hours when marked infiltration began to appear.
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Affiliation(s)
- F Shigemi
- Department of Dermatology, School of Medicine, Tokushima University, Kuramoto-cho, Tokushima 770, Japan
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Tanaka M, Inoue K, Kitamura Y, Shimada A, Takano H. In vitro action of sho-seiryu-to on allergen-exposed mononuclear cells. Int J Immunopathol Pharmacol 2015; 27:607-10. [PMID: 25572740 DOI: 10.1177/039463201402700416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Although Sho-seiryu-to (SST), used as a traditional herbal (Kampo) medicine mainly in China and Korea, is shown to have immunomodulating potential, such as an anti-allergic one, its underlying mechanism has not been completely clarified. To partially address the issue, we explored its effects on allergen-exposed mononuclear cells. Male balb/c mice were intraperitoneally administered ovalbumin (OVA: 20 μg) plus alum or vehicle twice (Day 0 and Day 14). At Day 21, mice were sacrificed and splenocytes (mononuclear cells) were isolated and cultured in the presence or absence of OVA with or without SST. Thereafter, helper T-related cytokines in the culture supernatants were evaluated by means of ELISA. Protein level of interferon-γ was lower than 5.0 pg/mL in the supernatants from OVA non-exposed or -exposed mononuclear cells in the presence or absence of OVA stimulation. On the other hand, SST induced the cytokine from both types of mononuclear cells in the presence (P < 0.05) or absence of OVA stimulation as compared to corresponding control. By contrast, interleukin (IL)-4 level tended to be decreased by SST in OVA-non-exposed mononuclear cells as did IL-13 in both non-exposed and exposed mononuclear cells as compared to vehicle. In conclusion, immunoregulating efficacy by SST on allergy-prone subjects may include, at least in part, restoring helper T balance mainly through hyperproduction of IFN-γ against mononuclear cells such as lymphocytes.
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Affiliation(s)
- M Tanaka
- Center for Medical Science, International University of Health and Welfare, Kitakanemaru, Ohtawara, Tochigi, Japan
| | - K Inoue
- Center for Medical Science, International University of Health and Welfare, Kitakanemaru, Ohtawara, Tochigi, Japan
| | - Y Kitamura
- Center for Medical Science, International University of Health and Welfare, Kitakanemaru, Ohtawara, Tochigi, Japan
| | - A Shimada
- Laboratory of Pathology, School of Life and Environmental Science, Azabu University
| | - H Takano
- Department of Synthetic Chemistry and Biological Chemistry, Graduate School of Engineering, Kyoto University, Katsura, Kyoto, Japan
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Tanaka S, Sasaki H, Kimura T, Kameyama K, Nakamura T, Kitamura Y, Miwa T, Hirose Y, Yoshida K. GE-36 * MOLECULAR-GENETIC AND CLINICAL CHARACTERISTICS OF THE "ASTROCYTIC" GLIOMAS WITH TOTAL 1p19q LOSS. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou256.35] [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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