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Matsunaga T, Saito H, Osaki T, Fukuda K, Fukumoto Y, Takahashi S, Taniguchi K, Iwamoto A, Kuroda H, Katano K, Shimizu S, Shishido Y, Miyatani K, Sakamoto T, Fujiwara Y. Using the geriatric nutritional risk index to predict outcomes in older patients with remnant gastric cancer after gastrectomy: a retrospective multicenter study in Japan. Surg Today 2024:10.1007/s00595-024-02850-w. [PMID: 38652300 DOI: 10.1007/s00595-024-02850-w] [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: 02/08/2024] [Accepted: 03/31/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE This study investigated the prognostic value of the geriatric nutritional risk index (GNRI) in patients undergoing curative gastrectomy for remnant gastric cancer (RGC). METHODS This multicenter retrospective study included 105 patients with RGC of ≥ 65 years of age who underwent curative gastrectomy at 10 institutions in Japan between January 2000 and December 2016. Postoperative complications, overall survival (OS), and disease-specific survival (DSS) were analyzed. RESULTS Receiver operating curve analyses indicated that the optimal cutoff value of the GNRI for OS was 95.4. Patients were categorized into high and low GNRI groups based on the optimal GNRI cutoff value. The GNRI was significantly correlated with body mass index (p < 0.001), amount of bleeding (p = 0.021), Clavien-Dindo grade 5 postoperative complications (p = 0.040), death caused by primary disease (p = 0.010), and death caused by other diseases (p = 0.002). The OS and DSS were significantly worse in the low GNRI group. A low GNRI and T3 or deeper tumor invasion were independent prognostic factors for OS and DSS. CONCLUSIONS The GNRI is a promising predictor of both short- and long-term outcomes in older patients with RGC.
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Affiliation(s)
- Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, Yonago, 683-8504, Japan.
| | - Hiroaki Saito
- Department of Surgery, Japanese Red Cross Tottori Hospital, Tottori, 680-8517, Japan
| | - Tomohiro Osaki
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, 680-0901, Japan
| | - Kenji Fukuda
- Department of Surgery, Sanin Rosai Hospital, Yonago, 683-8605, Japan
| | - Yoji Fukumoto
- Division of Gastroenterology, Matsue City Hospital, Matsue, 690-8509, Japan
| | - Sadamu Takahashi
- National Hospital Organization, Hamada Medical Center, Hamada, 697-8511, Japan
| | - Kenjiro Taniguchi
- Department of Surgery, Yonago Medical Center of National Hospital Organization, Yonago, 683-0006, Japan
| | - Akemi Iwamoto
- Division of Digestive Surgery, Tottori Prefectural Kousei Hospital, Kurayoshi, 682-0804, Japan
| | - Hirohiko Kuroda
- Department of Surgery, Japanese Red Cross Masuda Hospital, Masuda, 698-8501, Japan
| | - Kuniyuki Katano
- Department of Surgery, Nanbu Town National Health Insurance Saihaku Hospital, Nanbu, 683-0323, Japan
| | - Shota Shimizu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, Yonago, 683-8504, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, Yonago, 683-8504, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, Yonago, 683-8504, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, Yonago, 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, Yonago, 683-8504, Japan
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Kubo T, Sunami K, Koyama T, Kitami M, Fujiwara Y, Kondo S, Yonemori K, Noguchi E, Morizane C, Goto Y, Maejima A, Iwasa S, Hamaguchi T, Kawai A, Namikawa K, Arakawa A, Sugiyama M, Ohno M, Yoshida T, Hiraoka N, Yoshida A, Yoshida M, Nishino T, Furukawa E, Narushima D, Nagai M, Kato M, Ichikawa H, Fujiwara Y, Kohno T, Yamamoto N. The impact of rare cancer and early-line treatments on the benefit of comprehensive genome profiling-based precision oncology. ESMO Open 2024; 9:102981. [PMID: 38613908 PMCID: PMC11033064 DOI: 10.1016/j.esmoop.2024.102981] [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: 07/11/2023] [Revised: 03/04/2024] [Accepted: 03/04/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND Comprehensive genome profiling (CGP) serves as a guide for suitable genomically matched therapies for patients with cancer. However, little is known about the impact of the timing and types of cancer on the therapeutic benefit of CGP. MATERIALS AND METHODS A single hospital-based pan-cancer prospective study (TOP-GEAR; UMIN000011141) was conducted to examine the benefit of CGP with respect to the timing and types of cancer. Patients with advanced solid tumors (>30 types) who either progressed with or without standard treatments were genotyped using a single CGP test. The subjects were followed up for a median duration of 590 days to examine therapeutic response, using progression-free survival (PFS), PFS ratio, and factors associated with therapeutic response. RESULTS Among the 507 patients, 62 (12.2%) received matched therapies with an overall response rate (ORR) of 32.3%. The PFS ratios (≥1.3) were observed in 46.3% (19/41) of the evaluated patients. The proportion of subjects receiving such therapies in the rare cancer cohort was lower than that in the non-rare cancer cohort (9.6% and 17.4%, respectively; P = 0.010). However, ORR of the rare cancer patients was higher than that in the non-rare cancer cohort (43.8% and 20.0%, respectively; P = 0.046). Moreover, ORR of matched therapies in the first or second line after receiving the CGP test was higher than that in the third or later lines (62.5% and 21.7%, respectively; P = 0.003). Rare cancer and early-line treatment were significantly and independently associated with ORR of matched therapies in multivariable analysis (P = 0.017 and 0.004, respectively). CONCLUSION Patients with rare cancer preferentially benefited from tumor mutation profiling by increasing the chances of therapeutic response to matched therapies. Early-line treatments after profiling increase the therapeutic benefit, irrespective of tumor types.
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Affiliation(s)
- T Kubo
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo; Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo
| | - K Sunami
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo; Division of Genome Biology, National Cancer Center Research Institute, Tokyo
| | - T Koyama
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo
| | - M Kitami
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo
| | - Y Fujiwara
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo; Department of Thoracic Oncology, Aichi Cancer Center Hospital, Aichi
| | - S Kondo
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo; Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo
| | - K Yonemori
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo; Department of Medical Oncology, National Cancer Center Hospital, Tokyo
| | - E Noguchi
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo
| | - C Morizane
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo
| | - Y Goto
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo
| | - A Maejima
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo; Department of Urology, National Cancer Center Hospital, Tokyo
| | - S Iwasa
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo; Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo
| | - T Hamaguchi
- Department of Medical Oncology, Saitama Medical University International Medical Center, Saitama
| | - A Kawai
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo
| | - K Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo
| | - A Arakawa
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo
| | - M Sugiyama
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo
| | - M Ohno
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo
| | - T Yoshida
- Department of Genetic Services and Medicine, National Cancer Center Hospital, Tokyo
| | - N Hiraoka
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo
| | - A Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo
| | - M Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo
| | - T Nishino
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo
| | - E Furukawa
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - D Narushima
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - M Nagai
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - M Kato
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo
| | - H Ichikawa
- Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo; Division of Translational Genomics, National Cancer Center Exploratory Oncology Research & Clinical Trial Center, Tokyo, Japan
| | - Y Fujiwara
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo
| | - T Kohno
- Division of Genome Biology, National Cancer Center Research Institute, Tokyo; Division of Translational Genomics, National Cancer Center Exploratory Oncology Research & Clinical Trial Center, Tokyo, Japan
| | - N Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo.
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Kono Y, Matsunaga T, Makinoya M, Shimizu S, Shishido Y, Miyatani K, Kihara K, Yamamoto M, Takano S, Tokuyasu N, Sakamoto T, Hasegawa T, Fujiwara Y. Preoperative low skeletal muscle volume can result in insufficient administration of S-1 adjuvant chemotherapy in older patients with stage II/III gastric cancer. Surg Today 2024; 54:340-346. [PMID: 37589768 DOI: 10.1007/s00595-023-02737-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/16/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND AND PURPOSE Older patients are more likely to encounter difficulties receiving chemotherapy, but the factors involved in the continuation of chemotherapy in these patients remain unclear. We investigated the importance of muscle mass as a factor involved in delivering a sufficient dose of postoperative S-1 adjuvant chemotherapy (ACT) to older patients with gastric cancer. METHODS The subjects of this study were 79 patients aged ≥ 65 years with stage II/III gastric adenocarcinoma, who underwent curative gastrectomy and received S-1 ACT. RESULTS The overall median relative dose intensity (RDI) was 75.0% (18.8-93.5%). Patients were divided into two groups for receiver operating characteristic analysis according to the cutoff value. Significantly more patients in the high skeletal muscle index (SMI) group achieved > 62% RDI of S-1 ACT (p = 0.03). Conversely, more patients in the low SMI group suffered from S-1-induced nausea (p = 0.03) and discontinued chemotherapy because of adverse events (p = 0.02). Multivariate analysis identified low SMI as an independent factor for insufficient S-1 dose delivery (p = 0.03, hazard ratio = 2.87). CONCLUSION Preoperative SMI is an indicator of the low-dose intensity of S-1 ACT in older patients following curative gastrectomy.
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Affiliation(s)
- Yusuke Kono
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
| | - Tomoyuki Matsunaga
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Masahiro Makinoya
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Shota Shimizu
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Yuji Shishido
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Kozo Miyatani
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Kyoichi Kihara
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Manabu Yamamoto
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Shuichi Takano
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Naruo Tokuyasu
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Teruhisa Sakamoto
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Toshimichi Hasegawa
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
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Matsunaga T, Satio H, Sakano Y, Makinoya M, Shimizu S, Shishido Y, Miyatani K, Hanaki T, Kihara K, Yamamoto M, Tokuyasu N, Takano S, Sakamoto T, Hasegawa T, Fujiwara Y. Prognostic significance of the cachexia index in patients with unresectable advanced gastric cancer receiving palliative chemotherapy: a retrospective single-center study. Surg Today 2024; 54:231-239. [PMID: 37526733 DOI: 10.1007/s00595-023-02721-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/13/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE To investigate the prognostic utility of the cachexia index (CXI) in unresectable advanced gastric cancer (UAGC). METHODS The relationship between CXI and the outcomes was evaluated in 102 patients with UAGC who had received first-line palliative 5-fluorouracil-based chemotherapy between January 2012 and December 2021. RESULTS The median survival time (MST) from first-line chemotherapy initiation was 16.2 months, and the cohort included 60 and 42 patients with high and low CXIs, respectively, based on the optimal CXI cutoff. The rates of patients with a performance status score of 0, recurrence, third-line chemotherapy, and all grade 3-4 side effects, including febrile neutropenia (FN), were significantly higher in the CXIhigh group than in the CXIlow group. The prognosis based on MST was significantly better in the CXIhigh group than in the CXIlow group (22.5 vs. 11.6 months, p < 0.001). According to a multivariate analysis, a low CXI and performance status score of 1-2 were poor prognostic factors. CONCLUSIONS Patients with UAGC and a low CXI had poorer prognoses and more frequent grade 3-4 side effects, including FN, than those with a high CXI. Patients with UAGC and a low CXI should be carefully managed to control for side effects to receive subsequent treatment.
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Affiliation(s)
- Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, 683-8504, Japan.
| | - Hiroaki Satio
- Department of Surgery, Japanese Red Cross Tottori Hospital, 117 Shotoku-Cho, Tottori, 680-8517, Japan
| | - Yu Sakano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Shota Shimizu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Shuichi Takano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
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Nishikawa K, Kimura Y, Kishi K, Inoue K, Matsuyama J, Akamaru Y, Tamura S, Kawada J, Kawase T, Kawabata R, Fujiwara Y, Kanno H, Yamada T, Shimokawa T, Imamura H. Effects of postoperative oral elemental nutritional supplement on skeletal muscle loss after gastrectomy for gastric cancer. Int J Clin Oncol 2024; 29:266-275. [PMID: 38227091 DOI: 10.1007/s10147-023-02462-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/15/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND We previously showed that daily nutritional intervention with an oral elemental diet (ED) at 300 kcal/day for 6-8 weeks postoperatively decreased the percentage of body weight loss (%BWL), and that the effect was maintained for 1 year. This post hoc analysis aimed to determine whether this intervention decreased skeletal muscle mass loss 1-year post-gastrectomy. METHODS Data from consecutive, untreated patients with histopathologically confirmed stage I-III gastric adenocarcinoma who planned to undergo total gastrectomy (TG) or distal gastrectomy (DG) and were enrolled in a previously published randomized trial were used. The primary endpoint was the percentage of skeletal muscle mass index (%SMI) loss from baseline at 1 year postoperatively, based on abdominal computed tomography images obtained preoperatively and at 1 year postoperatively. RESULTS The overall median %SMI loss was lower in the ED versus control group, but the difference was not significant. The difference in %SMI loss in the ED and control groups was greater in patients with TG (10.1 vs. 13.0; P = 0.12) than in those with DG (5.5 vs. 6.8; P = 0.69). A correlation was observed between %BWL and %SMI loss in both groups (ED group, coefficient 0.591; control group, coefficient 0.644; P < 0.001 for both). Type of gastrectomy (coefficient 7.38; P = 0.001) and disease stage (coefficient - 6.43; P = 0.04) were independent predictors of postoperative skeletal muscle mass loss. CONCLUSION ED administration for 6-8 weeks following gastrectomy had no inhibitory effect on skeletal muscle loss at 1 year postoperatively. CLINICAL TRIAL REGISTRATION UMIN000023455.
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Affiliation(s)
- Kazuhiro Nishikawa
- Cancer Treatment Center, Osaka Police Hospital, 10-31 Kitayama-Cho, Tennoji-Ku, Osaka, 543-0035, Japan.
| | - Yutaka Kimura
- Department of Surgery, Kindai University Nara Hospital, 1248-1 Otoda-Cho, Ikoma, Nara, 630-0293, Japan
| | - Kentaro Kishi
- Department of Surgery, Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokutanji-Cho, Nishinomiya, Hyogo, 662-0918, Japan
| | - Kentaro Inoue
- Department of Surgery, Kansai Medical University, 2 Chome-5-1 Shin-Machi, Hirakata, Osaka, 573-1010, Japan
| | - Jin Matsuyama
- Department of Gastroenterological Surgery, Higashiosaka City Medical Center, 3 Chome-4-5 Nishiiwata, Higashiosaka, Osaka, 578-8588, Japan
| | - Yusuke Akamaru
- Department of Surgery, Osaka Rosai Hospital, 1179-3 Nagasonecho, Kita-Ku, Sakai City, Osaka, 591-8025, Japan
| | - Shigeyuki Tamura
- Department of Surgery, Yao Municipal Hospital, 1 Chome-3-1, Ryugecho, Yao City, , Osaka, 581-0069, Japan
| | - Junji Kawada
- Department of Surgery, Osaka General Medical Center, 3-1-56 Bandaihigashi, Sumiyoshi-Ku, Osaka, 593-8304, Japan
| | - Tomono Kawase
- Department of Surgery, Toyonaka Municipal Hospital, 4 Chome-14-1 Shibaharacho, Toyonaka City, Osaka, 560-8565, Japan
| | - Ryohei Kawabata
- Department of Surgery, Sakai City Medical Center, 1-1-1 Ebarajicho, Nishi-Ku, Sakai City, , Osaka, 593-8304, Japan
| | - Yoshiyuki Fujiwara
- Faculty of Medicine, Division of Surgical Oncology, Department of Surgery, Tottori University, 86 Nishi-Cho, Yonago City, Tottori, 683-8503, Japan
| | - Hitoshi Kanno
- Department of Health Policy and Management, Nippon Medical School, 1 Chome-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8602, Japan
| | - Takeshi Yamada
- Department of Digestive Surgery, Nippon Medical School, 1 Chome-1-5 Sendagi, Bunkyo-Ku, Tokyo, 113-8602, Japan
| | - Toshio Shimokawa
- Clinical Study Support Center, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama, 641-8509, Japan
| | - Hiroshi Imamura
- Department of Surgery, Toyonaka Municipal Hospital, 4 Chome-14-1 Shibaharacho, Toyonaka City, Osaka, 560-8565, Japan
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Hanaki T, Honjo S, Kishino M, Murakami Y, Yamamoto M, Naruo T, Sakamoto T, Hasegawa T, Fujiwara Y. An Intrahepatic Fluorodeoxyglucose (FDG)-PET/CT False-Positive Tumor Secondary to Foreign Body Granuloma Masquerading as Colon Cancer Liver Metastasis: A Case Report. Cureus 2024; 16:e52657. [PMID: 38380204 PMCID: PMC10878015 DOI: 10.7759/cureus.52657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 02/22/2024] Open
Abstract
A suture placed next to a dissected liver section during the initial hepatectomy may become an unlikely intrahepatic foreign body granuloma. In this report, we describe a case where a silk suture in the liver section plane placed during initial hepatectomy for synchronous colon cancer metastasis became an intrahepatic foreign body granuloma that exhibited fluorodeoxyglucose (FDG) accumulation on positron emission tomography/computed tomography (PET/CT). The granuloma was resected as the second metachronous liver metastatic lesion. A 73-year-old female was referred for a planned second hepatectomy. She had undergone colectomy and hepatectomy for advanced cancer of the ascending colon and synchronous liver metastasis approximately two years ago. However, two possible liver metastases with FDG accumulation were identified in hepatic segments IV and V after one year and nine months after the initial resection. A second hepatectomy was planned after administering systemic chemotherapy. She underwent a left lobectomy with a middle hepatic vein and partial segment V hepatectomy six months after liver lesion identification. The segment IV lesion was histologically proven to be a liver metastasis adenocarcinoma. The segment V lesion revealed a silk thread on the residual liver side at the initial hepatectomy, which was histologically diagnosed as a foreign body granuloma. The possibility of intrahepatic foreign body granuloma development should be considered in subsequent follow-ups in cases where sutures were applied to the dissected residual liver plane during the initial hepatectomy. Additionally, a thorough second hepatectomy should be considered if recurrence is suspected.
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Affiliation(s)
- Takehiko Hanaki
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine, Yonago, JPN
| | - Soichiro Honjo
- Department of Surgery, Matsue City Hospital, Matsue, JPN
| | - Mikiya Kishino
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine, Yonago, JPN
| | - Yuki Murakami
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine, Yonago, JPN
| | - Manabu Yamamoto
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine, Yonago, JPN
| | - Tokuyasu Naruo
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine, Yonago, JPN
| | - Teruhisa Sakamoto
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine, Yonago, JPN
| | - Toshimichi Hasegawa
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine, Yonago, JPN
| | - Yoshiyuki Fujiwara
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine, Yonago, JPN
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7
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Shimizu S, Matsunaga T, Sakano Y, Makinoya M, Shishido Y, Miyatani K, Kono Y, Murakami Y, Hanaki T, Kihara K, Yamamoto M, Tokuyasu N, Takano S, Sakamoto T, Hasegawa T, Fujiwara Y. A gastroduodenal artery that branched from the celiac artery in gastrectomy: A rare case of an anatomical variant. Asian J Endosc Surg 2024; 17:e13268. [PMID: 38093466 DOI: 10.1111/ases.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/31/2023] [Accepted: 11/23/2023] [Indexed: 01/13/2024]
Abstract
Understanding anatomical anomalies of the branch of the celiac artery for safe gastrectomy is important. We report a case of laparoscopic distal gastrectomy with D1+ lymph node dissection for early gastric cancer with a vascular anatomical anomaly of the celiac artery. A 45-year-old woman was referred to our hospital because of early gastric cancer. Computed tomography showed an anatomical variation of the gastroduodenal artery, which branched from the celiac artery. The celiac artery also branched into the left gastric artery, the splenic artery, and the common hepatic artery. Preoperative understanding of an unusual branch of the celiac artery enabled a safe laparoscopic surgery. There were no postoperative complications. The Adachi classification or Michel classification is used for an anatomical anomaly of the celiac artery, but to the best of our knowledge, this case has not been previously classified and is the first reported case.
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Affiliation(s)
- Shota Shimizu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yu Sakano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yusuke Kono
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yuki Murakami
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Shuichi Takano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
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Osaki T, Tatebe S, Orihara J, Uchinaka E, Ashida K, Hirooka Y, Fujiwara Y. Impact of Frailty and Sarcopenia on Short- and Long-Term Outcomes in Elderly Patients Undergoing Radical Gastrectomy for Gastric Cancer. World J Surg 2023; 47:3250-3261. [PMID: 37777671 DOI: 10.1007/s00268-023-07200-4] [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] [Accepted: 09/09/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND The impact of frailty and sarcopenia in patients with gastric cancer is unclear. This study aimed to comprehensively examine the impact of frailty and sarcopenia on the short- and long-term outcomes in elderly patients undergoing radical gastrectomy for gastric cancer. METHODS We retrospectively assessed 246 patients aged ≥ 65 years who underwent radical gastrectomy. Frailty and sarcopenia were assessed using the modified frailty index (mFI) and psoas muscle mass index (PMI), respectively. RESULTS There were 30 (12.2%) and 60 (24.4%) patients with High-mFI and Low-PMI, respectively. As the age increased, both sexes showed significant correlations with PMI and mFI (r = - 0.238, 0.322, P = 0.003 and 0.002, respectively). High-mFI and Low-PMI did not affect the short-term outcomes. However, High-mFI was an independent risk factor for non-home discharge (P = 0.004) and was a significant predictor of 3- and 5-year overall survival (OS) (HR = 2.76 and 2.26; P = 0.002 and 0.005, respectively) and 1-, 3- and 5-year non-cancer-specific survival (non-CSS) (HR = 4.88, 8.05, and 4.01; P = 0.017, < 0.001, < 0.001, respectively). Low-PMI was a significant predictor of only 5-year OS (HR = 2.03, P = 0.003) and non-CSS (HR = 2.10, P = 0.020). CONCLUSIONS Frailty is significant predictor of non-home discharge and 1-, 3-, 5-year OS and 3- and 5-year non-CSS. Sarcopenia is a significant predictor of 5-year OS and non-CSS. Preoperative assessment of both frailty and sarcopenia can help surgeons to select adequate treatment strategies for the elderly population.
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Affiliation(s)
- Tomohiro Osaki
- Tottori Prefectural Central Hospital, Department of Surgery, Tottori, Japan.
| | - Shigeru Tatebe
- Tottori Prefectural Central Hospital, Department of Surgery, Tottori, Japan
| | - Junpei Orihara
- Tottori Prefectural Central Hospital, Department of Surgery, Tottori, Japan
| | - Ei Uchinaka
- Tottori Prefectural Central Hospital, Department of Surgery, Tottori, Japan
| | - Keigo Ashida
- Tottori Prefectural Central Hospital, Department of Surgery, Tottori, Japan
| | - Yasuaki Hirooka
- Tottori Prefectural Central Hospital, Department of Surgery, Tottori, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine Graduate, Tottori, Japan
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9
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Hasegawa T, Takano S, Masuda K, Fujiwara Y, Miyahara A, Miura M. Retrospective Analysis of Neonatal Surgery at Tottori University over the Past Ten Years. Yonago Acta Med 2023; 66:413-421. [PMID: 38028267 PMCID: PMC10674064 DOI: 10.33160/yam.2023.11.003] [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: 08/10/2023] [Accepted: 09/13/2023] [Indexed: 12/01/2023]
Abstract
Background In recent years, the number of neonatal surgeries has been on the rise despite the decline in the number of births, and we examined the actual trends and problems at Tottori University Hospital located in the Sanin region. Methods Medical records were retrospectively searched for patients who underwent major surgery during the neonatal period (within 30 days of age) at the Tottori University Hospital over the past 10 years (Jan. 2011 to Dec. 2020). Results Sixty-five cases were included. Early birth infants (< 37 gestational weeks) comprised 15 cases (23%) and low birth weight (< 2500 g) infants involved 27 cases (42%). In the latter half (2016-2020), early birth and low birth weight infants were significantly less than in the first half (2011-2015). The common diseases were anorectal malformation (14 cases), esophageal atresia (10), duodenal atresia (10), and diaphragmatic hernia (9). Prenatal diagnosis was obtained in 26 cases (40%), with high diagnostic rate obtained in duodenal atresia (100%), abdominal wall defect (100%), ileal atresia (75%), meconium peritonitis (67%), and diaphragmatic hernia (67%). Fifty-five cases (85%) were operated on within 7 days of age. Other major malformations were associated in 23 cases (35%). There were 6 deaths (9%), of which 3 cases were low birth weight infants with gastrointestinal perforation, 2 cases with severe chromosomal abnormalities (esophageal atresia, omphalocele), and 1 case with diaphragmatic hernia with severe pulmonary hypertension. Home medical care has been required with gastrostomy tube in 2 cases. Conclusion Neonatal surgery at Tottori University has been well performed as required with acceptable results along with the progression of other perinatal care. However, further investigation for improvements in premature delivery or organ hypoplasia may be required.
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Affiliation(s)
- Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan and
| | - Shuichi Takano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan and
| | - Kohga Masuda
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan and
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan and
| | - Ayako Miyahara
- Department of Pediatrics, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Mazumi Miura
- Department of Pediatrics, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
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10
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Miyatani K, Sakano Y, Makinoya M, Miyauchi W, Shimizu S, Shishido Y, Hanaki T, Kihara K, Matsunaga T, Yamamoto M, Tokuyasu N, Takano S, Sakamoto T, Hasegawa T, Saito H, Fujiwara Y. A low cumulative perioperative prognostic nutritional index predicts poor long-term outcomes in patients with gastric cancer: A single-center retrospective study in Japan. Surg Today 2023; 53:1294-1304. [PMID: 37072523 DOI: 10.1007/s00595-023-02688-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/21/2023] [Indexed: 04/20/2023]
Abstract
PURPOSE Perioperative surgical stress and systemic inflammation resulting from complex interactions between cancer and the host play an important role in cancer progression. This retrospective study compared the prognostic impact of various perioperative cumulative inflammation- and nutrition-based markers in patients with gastric cancer (GC). METHODS This study included 301 patients with a histopathological diagnosis of gastric adenocarcinoma who underwent curative surgery. Perioperative cumulative markers were calculated using the newly developed trapezoidal area method. RESULTS The cumulative prognostic nutritional index (cum-PNI) had the highest area under the receiver operating characteristic (ROC) curve for predicting the overall survival (OS) as well as the relapse-free survival (RFS). The cum-PNI was significantly correlated with tumor-related factors, including tumor size, depth of invasion, lymph node metastasis, lymphatic involvement, vascular involvement, and TNM stage classification. The cum-PNI was also significantly correlated with surgical factors, including surgical approach, gastrectomy, lymphadenectomy, intraoperative blood loss, and postoperative complications. Furthermore, the OS and RFS were poorer in patients with a low cum-PNI (< 236.3) than in those with a high cum-PNI (> 236.3). A multivariate analysis indicated that a low cum-PNI was an independent prognostic indicator in patients with GC. CONCLUSIONS The cum-PNI might be useful for predicting the prognosis and guiding the perioperative management of patients with GC.
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Affiliation(s)
- Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan.
| | - Yu Sakano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Wataru Miyauchi
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Shota Shimizu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Shuichi Takano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Hiroaki Saito
- Department of Surgery, Japanese Red Cross Tottori Hospital, Tottori, 680‑8517, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
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11
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Sunaguchi T, Horikoshi Y, Hanaki T, Sakamoto T, Nakaso K, Sakai C, Yamashita K, Ohno S, Fujiwara Y, Matsura T. High Glucose-stimulated aPKC Activation Promotes Pancreatic Cancer Cell Progression Through YAP Signaling. Anticancer Res 2023; 43:4843-4853. [PMID: 37909958 DOI: 10.21873/anticanres.16681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND/AIM Persistent hyperglycemia caused by diabetes mellitus is a risk factor for pancreatic cancer (PC). We have previously reported that aberrant activation of atypical protein kinase C (aPKC) enhances PC cell progression. However, no reports have elucidated whether hyperglycemia promotes PC cell progression and whether aPKC activation is related to PC cell progression mechanisms. MATERIALS AND METHODS We examined whether high-glucose stimulation accelerates PC cell proliferation, migration, and invasion. Furthermore, to determine whether PC cells activate aPKC upon high-glucose stimulation, we measured the phosphorylation of aPKC at T560 in PC cells. RESULTS High-glucose stimulation accelerated PC cell proliferation, migration, and invasion. High-glucose treatment increased aPKC's activated form, with T560 phosphorylation, in PC cells. However, aPKC knockdown attenuated these effects. aPKC reportedly induces cell transformation through Yes-associated protein (YAP) activation. YAP expression was increased in high glucose-treated PC cells but not in aPKC-knockdown cells. aPKC interacts with partitioning defective 3 (Par-3), which aids in establishing cell polarity and inhibits aPKC by binding as a substrate. In Par-3-knockdown PC cells, YAP expression increased independently of high-glucose treatment. Over-expression of Par-3 and aPKC-dominant negative mutants prevented the high glucose-stimulated nuclear localization of YAP. YAP forms a complex with the zinc finger E-box binding homeobox 1 protein (ZEB1), an activator of epithelial-mesenchymal transition. ZEB1 expression was increased by high glucose treatment or Par-3 knockdown, but aPKC knockdown suppressed this increase. CONCLUSION High glucose-induced aPKC activation promotes PC progression by enhancing the YAP signaling pathway.
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Affiliation(s)
- Teppei Sunaguchi
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
- Division of Biochemistry, Department of Pathophysiological and Therapeutic Sciences, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yosuke Horikoshi
- Division of Biochemistry, Department of Pathophysiological and Therapeutic Sciences, Faculty of Medicine, Tottori University, Yonago, Japan;
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Kazuhiro Nakaso
- Division of Biochemistry, Department of Pathophysiological and Therapeutic Sciences, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Chieko Sakai
- Department of Adult and Elderly Nursing, School of Health Sciences, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kazunari Yamashita
- Departments of Pathology and Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - Shigeo Ohno
- Laboratory of Cancer Biology, Institute for Diseases of Old Age, Juntendo University School of Medicine, Tokyo, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Tatsuya Matsura
- Division of Biochemistry, Department of Pathophysiological and Therapeutic Sciences, Faculty of Medicine, Tottori University, Yonago, Japan
- Department of Nutritional Sciences, Faculty of Human Ecology, Yasuda Women's University, Hiroshima, Japan
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12
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Hasegawa T, Takano S, Masuda K, Fujiwara Y, Miyahara A, Miura M. Erratum for Hasegawa et al., "Retrospective Analysis of Neonatal Surgery at Tottori University over the Past Ten Years". Yonago Acta Med 2023; 66:474. [PMID: 38188192 PMCID: PMC10764603 DOI: 10.33160/yam.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
[This corrects the article DOI: 10.33160/yam.2023.11.003.].
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Affiliation(s)
- Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan and
| | - Shuichi Takano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan and
| | - Kohga Masuda
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan and
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan and
| | - Ayako Miyahara
- Department of Pediatrics, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Mazumi Miura
- Department of Pediatrics, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
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Tanio A, Yamamoto M, Uejima C, Tada Y, Yamanashi T, Matsuo R, Miura A, Kajitani N, Nishiguchi T, Iwata M, Fujiwara Y. A Prospective Randomized Study of the Herbal Medicine Yokukansan for Preventing Delirium After Gastrointestinal Cancer Surgery. Yonago Acta Med 2023; 66:432-439. [PMID: 38028268 PMCID: PMC10674061 DOI: 10.33160/yam.2023.11.008] [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: 08/29/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023]
Abstract
Background Yokukansan, the Chinese Herbal Medicine, may be effective for treating postoperative delirium. However, there is no sufficient evidence supporting this notion. This study aimed to investigate whether yokukansan was effective for preventing delirium after gastrointestinal cancer surgery by the prospective randomized study. Methods This was a double-blind, randomized, controlled trial. Patients aged 75 years or older who underwent surgery between May 2017 and December 2019 were randomized to the yokukansan or anchusan (another Herbal Medicine) group. They received treatments with oral intake of assigned medicine from the day before surgery until postoperative day 3. Then, the incidence of postoperative delirium was compared. A psychiatrist diagnosed patients with postoperative delirium. Results Seventy-seven patients were enrolled in this study, and the full analysis set comprised 68 patients. In total, 25 of 68 (36.8%) patients presented with postoperative delirium. Specifically, 13 (37.1%) patients in the control group and 12 (36.4%) in the yokukansan group were diagnosed with postoperative delirium. However, the results did not differ significantly in both groups. Moreover, there was no remarkable difference in terms of delirium severity, and adverse events correlated with the medications were not observed. Conclusion Yokukansan was ineffective in preventing delirium after gastrointestinal cancer surgery.
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Affiliation(s)
- Akimitsu Tanio
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan and
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan and
| | - Chihiro Uejima
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan and
| | - Yoichiro Tada
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan and
| | - Takehiko Yamanashi
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Ryoichi Matsuo
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Akihiko Miura
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Naofumi Kajitani
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Tsuyoshi Nishiguchi
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Masaaki Iwata
- Department of Neuropsychiatry, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan and
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14
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Matsunaga T, Satio H, Sakano YU, Makinoya M, Shimizu S, Shishido Y, Miyatani K, Kono Y, Murakami Y, Hanaki T, Kihara K, Yamamoto M, Tokuyasu N, Takano S, Sakamoto T, Hasegawa T, Fujiwara Y. Skeletal Muscle Mass Before Second-line Chemotherapy Correlates With Subsequent Prognosis and Rate of Late-line Chemotherapy in Patients With Unresectable Gastric Cancer. Anticancer Res 2023; 43:5051-5059. [PMID: 37909949 DOI: 10.21873/anticanres.16704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND/AIM Chemotherapy is the standard treatment for patients with unresectable gastric cancer (UGC); however, the survival outcomes are poor. This study investigated the predictive values of skeletal muscle mass (SMM) index (SMI) before second-line chemotherapy and the survival outcomes of patients with UGC. PATIENTS AND METHODS A total of 79 patients diagnosed with UGC at our hospital who received at least second-line palliative chemotherapy were included. The cross-sectional SMM at the third lumbar vertebra was obtained before second-line chemotherapy. SMI was defined as the muscle area normalized by height squared (m2), and SMI before second-line chemotherapy was defined as 2ndSMI. RESULTS Using 2ndSMI for men and women (35.4 and 31.7 cm2/m2, respectively) as the cutoff value, patients were divided into high (2ndSMIHigh; n=54) and low (2ndSMILow; n=25) 2ndSMI groups. The number of patients receiving fourth-line chemotherapy was significantly higher in the 2ndSMIHigh group than in the 2ndSMILow group (p=0.039). The overall survival time after the start of second-line chemotherapy was significantly higher in the 2ndSMIHigh group than in the 2ndSMILow group (p=0.008). The incidence of grade 3 or 4 side effects was significantly higher in the 2ndSMILow than in the 2ndSMIHigh group (p=0.028). The multivariate analysis identified 2ndSMI as independent prognostic factor after the start of second-line chemotherapy. CONCLUSION The 2ndSMILow group had a significantly worse prognosis and significantly less conversion to fourth-line chemotherapy than the 2ndSMIHigh group. Moreover, 2ndSMILow was associated with grade 3 or 4 side effects of second-line chemotherapy.
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Affiliation(s)
- Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan;
| | - Hiroaki Satio
- Department of Surgery, Japanese Red Cross Tottori Hospital, Tottori, Japan
| | - Y U Sakano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Shota Shimizu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yusuke Kono
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yuki Murakami
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Shuichi Takano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
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15
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Shimizu S, Matsunaga T, Sakano YU, Makinoya M, Shishido Y, Miyatani K, Kono Y, Murakami Y, Hanaki T, Kihara K, Yamamoto M, Tokuyasu N, Takano S, Sakamoto T, Hasegawa T, Fujiwara Y. Preoperative Osteopenia as Risk Factor for Death from Other Diseases After Gastrectomy in Elderly Patients. In Vivo 2023; 37:2662-2668. [PMID: 37905614 PMCID: PMC10621444 DOI: 10.21873/invivo.13375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND/AIM Preoperative osteopenia, defined as low bone mineral density, is a prognostic factor in patients with digestive tract cancers, including gastric cancer (GC). However, the correlation between preoperative osteopenia and GC in elderly patients is unclear. PATIENTS AND METHODS We enrolled 251 patients who had undergone curative surgery for histopathologically diagnosed gastric adenocarcinoma from January 2008 to December 2012. Patients were classified into the non-elderly group (n=169) and the elderly group (n=82). Bone mineral density was calculated as the average pixel density (Hounsfield units) within a circle of the mid-vertebral core at the bottom of the 11th thoracic vertebra on preoperative computed tomography. RESULTS Although overall survival was significantly shorter in the elderly compared to the non-elderly group (p=0.0062), there was no significant difference in disease-specific survival between the two groups (p=0.71) because of the higher rate of death from other diseases. In addition, the elderly group had a significantly higher incidence of osteopenia (p<0.001) and a significantly lower prognostic nutritional index (p<0.001). Multivariate analysis revealed that preoperative osteopenia and a low preoperative prognostic nutritional index were significant risk factors for death from other diseases after gastrectomy in elderly patients. CONCLUSION In elderly patients with GC, preoperative osteopenia is an important factor to consider in terms of both curability and death from other diseases.
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Affiliation(s)
- Shota Shimizu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Y U Sakano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yusuke Kono
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yuki Murakami
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Shuichi Takano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
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16
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Hanaki T, Tokuyasu N, Yata S, Kishino M, Murakami Y, Shishido Y, Miyatani K, Kihara K, Matsunaga T, Yamamoto M, Sakamoto T, Hasegawa T, Fujiwara Y. Hepatectomy for massive hepatic necrosis after transcatheter arterial embolization hemostasis for hepatic hemorrhage following hepatic trauma: A case report. Clin Case Rep 2023; 11:e7888. [PMID: 37731968 PMCID: PMC10507280 DOI: 10.1002/ccr3.7888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 09/22/2023] Open
Abstract
Key Clinical Message Although partial hepatic necrosis often occurs following endovascular treatment for bleeding associated with hepatic trauma, it is relatively rare that additional treatment is required. However, invasive procedures such as hepatic resection should sometimes be considered when infection occurs over massive hepatic necrosis. Abstract Although partial hepatic necrosis following endovascular treatment for bleeding associated with hepatic trauma is occasionally experienced, it is relatively rare for the necrotic area of the liver to require additional treatment. However, invasive procedures such as hepatic resection should sometimes be considered when infection occurs over massive hepatic necrosis.
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Affiliation(s)
- Takehiko Hanaki
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Faculty of MedicineTottori UniversityYonagoJapan
| | - Naruo Tokuyasu
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Faculty of MedicineTottori UniversityYonagoJapan
| | - Shinsaku Yata
- Department of Multidisciplinary Internal Medicine, Division of Radiology, School of Medicine, Faculty of MedicineTottori UniversityYonagoJapan
| | - Mikiya Kishino
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Faculty of MedicineTottori UniversityYonagoJapan
| | - Yuki Murakami
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Faculty of MedicineTottori UniversityYonagoJapan
| | - Yuji Shishido
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Faculty of MedicineTottori UniversityYonagoJapan
| | - Kozo Miyatani
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Faculty of MedicineTottori UniversityYonagoJapan
| | - Kyoichi Kihara
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Faculty of MedicineTottori UniversityYonagoJapan
| | - Tomoyuki Matsunaga
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Faculty of MedicineTottori UniversityYonagoJapan
| | - Manabu Yamamoto
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Faculty of MedicineTottori UniversityYonagoJapan
| | - Teruhisa Sakamoto
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Faculty of MedicineTottori UniversityYonagoJapan
| | - Toshimichi Hasegawa
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Faculty of MedicineTottori UniversityYonagoJapan
| | - Yoshiyuki Fujiwara
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Faculty of MedicineTottori UniversityYonagoJapan
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17
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Taniguchi T, Timmerman D, Ichikawa S, Tatebayashi J, Fujiwara Y. Electrically driven europium-doped GaN microdisk. Opt Lett 2023; 48:4590-4592. [PMID: 37656562 DOI: 10.1364/ol.494616] [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] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/05/2023] [Indexed: 09/03/2023]
Abstract
For the practical implementation of microdisk resonators as active nanophotonic devices, it is essential that they can be electrically driven. However, it is difficult to inject current in such small-scale devices without severely degrading their optical properties. We demonstrate the successful fabrication of an electrically injected microdisk based on Eu-doped GaN, in which an SiO2 spacer is used to prevent the interaction of the metal contact with the optical resonances. The microdisk shows Eu-related emission upon electrical injection and from the observed resonance peak, a cavity quality (Q)-factor of 3400 is concluded.
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18
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Shimizu S, Kondo J, Onuma K, Coppo R, Ota K, Kamada M, Harada Y, Tanaka Y, Nakazawa MA, Tamada Y, Okuno Y, Kawada K, Obama K, Coffey RJ, Fujiwara Y, Inoue M. Inhibition of the bone morphogenetic protein pathway suppresses tumor growth through downregulation of epidermal growth factor receptor in MEK/ERK-dependent colorectal cancer. Cancer Sci 2023; 114:3636-3648. [PMID: 37357017 PMCID: PMC10475764 DOI: 10.1111/cas.15882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 05/22/2023] [Accepted: 05/27/2023] [Indexed: 06/27/2023] Open
Abstract
The bone morphogenetic protein (BMP) pathway promotes differentiation and induces apoptosis in normal colorectal epithelial cells. However, its role in colorectal cancer (CRC) is controversial, where it can act as context-dependent tumor promoter or tumor suppressor. Here we have found that CRC cells reside in a BMP-rich environment based on curation of two publicly available RNA-sequencing databases. Suppression of BMP using a specific BMP inhibitor, LDN193189, suppresses the growth of select CRC organoids. Colorectal cancer organoids treated with LDN193189 showed a decrease in epidermal growth factor receptor, which was mediated by protein degradation induced by leucine-rich repeats and immunoglobulin-like domains protein 1 (LRIG1) expression. Among 18 molecularly characterized CRC organoids, suppression of growth by BMP inhibition correlated with induction of LRIG1 gene expression. Notably, knockdown of LRIG1 in organoids diminished the growth-suppressive effect of LDN193189. Furthermore, in CRC organoids, which are susceptible to growth suppression by LDN193189, simultaneous treatment with LDN193189 and trametinib, an FDA-approved MEK inhibitor, resulted in cooperative growth inhibition both in vitro and in vivo. Taken together, the simultaneous inhibition of BMP and MEK could be a novel treatment option in CRC cases, and evaluating in vitro growth suppression and LRIG1 induction by BMP inhibition using patient-derived organoids could offer functional biomarkers for predicting potential responders to this regimen.
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Affiliation(s)
- Shota Shimizu
- Department of Clinical Bioresource Research and DevelopmentKyoto University Graduate School of MedicineKyotoJapan
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of MedicineTottori University Faculty of MedicineTottoriJapan
| | - Jumpei Kondo
- Department of Clinical Bioresource Research and DevelopmentKyoto University Graduate School of MedicineKyotoJapan
- Department of BiochemistryOsaka International Cancer InstituteOsakaJapan
- Department of Molecular Biochemistry and Clinical Investigation, Division of Health ScienceOsaka University Graduate School of MedicineOsakaJapan
- Epithelial Biology CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Kunishige Onuma
- Department of Clinical Bioresource Research and DevelopmentKyoto University Graduate School of MedicineKyotoJapan
| | - Roberto Coppo
- Department of Clinical Bioresource Research and DevelopmentKyoto University Graduate School of MedicineKyotoJapan
| | - Kasumi Ota
- Graduate School of Medicine and Faculty of MedicineKyoto UniversityKyotoJapan
| | - Mayumi Kamada
- Graduate School of Medicine and Faculty of MedicineKyoto UniversityKyotoJapan
| | - Yohei Harada
- Graduate School of Medicine and Faculty of MedicineKyoto UniversityKyotoJapan
| | - Yoshihisa Tanaka
- Graduate School of Pharmaceutical SciencesKyoto UniversityKyotoJapan
- RIKEN Center for Computational Science(R‐CCS)HPC/HPC‐ and AI‐driven Drug Development Platform DivisionKobeJapan
| | - Mai Adachi Nakazawa
- Graduate School of Medicine and Faculty of MedicineKyoto UniversityKyotoJapan
- Department of Medical Data Intelligence and Data Analysis Division, Innovation Center for Health PromotionHirosaki UniversityHirosakiJapan
| | - Yoshinori Tamada
- Department of Medical Data Intelligence and Data Analysis Division, Innovation Center for Health PromotionHirosaki UniversityHirosakiJapan
| | - Yasushi Okuno
- Graduate School of Medicine and Faculty of MedicineKyoto UniversityKyotoJapan
- RIKEN Center for Computational Science(R‐CCS)HPC/HPC‐ and AI‐driven Drug Development Platform DivisionKobeJapan
| | - Kenji Kawada
- Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Kazutaka Obama
- Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Robert J. Coffey
- Epithelial Biology CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of MedicineTottori University Faculty of MedicineTottoriJapan
| | - Masahiro Inoue
- Department of Clinical Bioresource Research and DevelopmentKyoto University Graduate School of MedicineKyotoJapan
- Department of BiochemistryOsaka International Cancer InstituteOsakaJapan
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19
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Shimizu S, Matsunaga T, Sawata S, Sakano YU, Makinoya M, Shishido Y, Miyatani K, Kono Y, Murakami Y, Hanaki T, Kihara K, Yamamoto M, Tokuyasu N, Takano S, Sakamoto T, Hasegawa T, Fujiwara Y. Preoperative Osteopenia Is a Risk Factor for Death in Patients Undergoing Gastrectomy for Gastric Cancer. Anticancer Res 2023; 43:3665-3672. [PMID: 37500136 DOI: 10.21873/anticanres.16548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND/AIM Preoperative osteopenia, defined as low bone mineral density (BMD), has been reported as a prognostic factor in patients with digestive tract cancers. However, the correlation between preoperative osteopenia and the prognosis of gastric cancer (GC) remains unclear. The aim of this study was to reveal the importance of preoperative osteopenia as a prognostic factor in patients undergoing gastrectomy for GC. PATIENTS AND METHODS We enrolled 251 patients who had undergone curative surgery for histopathologically diagnosed gastric adenocarcinoma from January 2008 to December 2012. BMD was calculated as the average pixel density (Hounsfield units) within a circle of the mid-vertebral core at the bottom of the 11th thoracic vertebra on preoperative computed tomography. RESULTS Osteopenia had a high area under the curve and predictive value for both overall survival (OS) and disease-specific survival (DSS). The study cohort was categorized into an osteopenia group and non-osteopenia group based on the optimal BMD cutoff values for OS (157.5) and DSS (195) determined by receiver operating characteristic analysis. The multivariate analysis revealed that OS (hazard ratio=3.607, p<0.001) and DSS (hazard ratio=2.797, p=0.03) were significantly worse in patients with than without preoperative osteopenia. CONCLUSION Preoperative osteopenia is associated with poor OS and DSS in patients undergoing gastrectomy for GC.
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Affiliation(s)
- Shota Shimizu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Shohei Sawata
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Y U Sakano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yusuke Kono
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yuki Murakami
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Shuichi Takano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
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20
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Sakamoto T, Kishino M, Murakami Y, Miyatani K, Shishido Y, Hanaki T, Matsunaga T, Yamamoto M, Tokuyasu N, Fujiwara Y. Surgical Outcomes of Robotic Distal Pancreatectomy Versus Laparoscopic Distal Pancreatectomy at a Hospital in a Sparsely Populated Area. Yonago Acta Med 2023; 66:375-379. [PMID: 37621978 PMCID: PMC10444586 DOI: 10.33160/yam.2023.08.010] [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: 07/19/2023] [Accepted: 08/04/2023] [Indexed: 08/26/2023]
Abstract
Background Robotic distal pancreatectomy (RDP) has a better or comparable surgical outcome when compared with laparoscopic distal pancreatectomy (LDP). However, whether the surgical outcome for these procedures in local, low-volume hospitals are comparable with those of the typically larger centers described in published reports remains unclear. Methods This study enrolled 48 patients who underwent either RDP or LDP between August 2012 and April 2023. Data were retrospectively analyzed to evaluate the short-term surgical outcomes of RDP versus LDP in our hospital, which is a low-volume center. Results The use of stapling with reinforcement in RDP was significantly higher than in LDP, and the postoperative hospital stay for RDP was significantly shorter than for LDP. Except for these two variables, there were no statistically significant differences between RDP and LDP in preoperative, intraoperative, or postoperative patient characteristics. Conclusion RDP can be performed as safely and effectively as LDP in a low-volume hospital located in a sparsely populated area.
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Affiliation(s)
- Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Mikiya Kishino
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yuki Murakami
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
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21
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Shishido Y, Matsunaga T, Yamasaki M, Sakano Y, Makinoya M, Miyauchi W, Shimizu S, Miyatani K, Kono Y, Murakami Y, Hanaki T, Kihara K, Yamamoto M, Tokuyasu N, Takano S, Sakamoto T, Saito H, Hasegawa T, Fujiwara Y. Right thoracoscopic resection in the supine position for recurrent pretracheal lymph nodes after esophagectomy. Asian J Endosc Surg 2023; 16:571-574. [PMID: 36958291 DOI: 10.1111/ases.13186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/29/2023] [Accepted: 03/12/2023] [Indexed: 03/25/2023]
Abstract
Mediastinal lymph node recurrence is often observed following esophageal cancer surgery; however, no treatment has been established for the same. Surgical resection is often considered for cases of recurrence in a single lymph node region, although the procedures and approaches vary depending on the recurrence site. Right thoracoscopic resection is rarely opted for owing to its high surgical difficulty. Herein, we report a successful case of right thoracoscopic resection in the supine position for recurrent pretracheal lymph nodes following esophagectomy. The intraoperative findings revealed few adhesions around the recurrent lymph nodes due to the initial surgery, and the recurrent lymph nodes were safely resected within a short period. The patient was discharged on postoperative day 4 without any complications, and there was no recurrence after 20 months. Thus, right thoracoscopic resection may be a promising treatment option for recurrent pretracheal lymph nodes after esophagectomy.
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Affiliation(s)
- Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Makoto Yamasaki
- Department of Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1010, Japan
| | - Yu Sakano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Wataru Miyauchi
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Shota Shimizu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Yusuke Kono
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Yuki Murakami
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Shuichi Takano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Hiroaki Saito
- Department of Surgery, Japanese Red Cross Tottori Hospital, 117 Shotoku-cho, Tottori, 680-8517, Japan
| | - Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
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22
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Murakami Y, Sakamoto T, Hanaki T, Tokuyasu N, Fujiwara Y. Current Value of Perioperative Therapies for Resectable or Borderline Resectable Pancreatic Cancer. Yonago Acta Med 2023; 66:202-207. [PMID: 37229366 PMCID: PMC10203636 DOI: 10.33160/yam.2023.05.014] [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: 03/22/2023] [Accepted: 04/17/2024] [Indexed: 05/27/2023]
Abstract
Invasive pancreatic ductal carcinoma is a representative refractory malignant tumor, and even with the development of early diagnosis and treatment techniques, the treatment outcome has been remarkably poor. Surgical resection is the curative treatment for resectable pancreatic cancer and borderline resectable pancreatic cancer. However, the survival rate in patients with pancreatic cancer treated by resection alone is low because of the high postoperative recurrence rate. In this review article, we report recent studies on perioperative treatment for pancreatic cancer. Perioperative therapy is the addition of chemotherapy or radiation therapy before or after surgery to improve resectability and curative effects. Because it is difficult to cure redsecttable pancreatic cancer by surgery alone, multidisciplinary treatment combined with perioperative adjuvant chemotherapy is the current standard of care. Although perioperative chemotherapy and chemoradiotherapy have been investigated for borderline resectable pancreatic cancer, the effectiveness of preoperative treatment has not been sufficiently proven. Potentially curative pancreatic cancer is treated by surgery plus perioperative therapy; treatment cannot be either alone. We regard the successful completion of surgery and perioperative care as the key to improving treatment outcomes. Therefore, ongoing randomized controlled trials for the treatment of BR-pancreatic cancer are expected to induce further improvements survival outcomes of patients with BR-pancreatic cancer.
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Affiliation(s)
- Yuki Murakami
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
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23
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Matsunaga T, Shishido Y, Saito H, Sakano Y, Makinoya M, Miyauchi W, Shimizu S, Miyatani K, Kono Y, Murakami Y, Hanaki T, Kihara K, Yamamoto M, Tokuyasu N, Takano S, Sakamoto T, Hasegawa T, Fujiwara Y. Impact of Robot-Assisted Minimally Invasive Esophagectomy for Esophageal Cancer: A Propensity Score-Matched Short-Term Analysis. Yonago Acta Med 2023; 66:239-245. [PMID: 37229374 PMCID: PMC10203643 DOI: 10.33160/yam.2023.05.012] [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: 03/08/2023] [Accepted: 04/12/2023] [Indexed: 05/27/2023]
Abstract
Background We compared short-term clinical outcomes between robotic-assisted minimally invasive esophagectomy (RAMIE) and video-assisted thoracic esophagectomy (VATS-E) using propensity score-matched analysis. Methods We enrolled 114 patients with esophageal cancer who underwent esophagectomy at our institution from January 2013 to January 2022. Propensity score matching was performed to minimize selection bias between the RAMIE and VATS-E groups. Results After propensity score matching, 72 patients (RAMIE group, n = 36; VATS-E group, n = 36) were selected for analysis. No significant differences in clinical variables were observed between the two groups. The RAMIE group had a significantly longer thoracic operation time (313 ± 40 vs. 295 ± 35 min, P = 0.048), a higher number of right recurrent laryngeal nerve lymph nodes (4.2 ± 2.7 vs. 2.9 ± 1.9, P = 0.039), and a shorter postoperative hospital stay (23.2 ± 12.8 vs. 30.4 ± 18.6 days, P = 0.018) than the VATS-E group. The RAMIE group tended to have a lower rate of anastomotic leakage (13.9% vs. 30.6%) than the VATS-E group, although the difference was not statistically significant (P = 0.089). No significant differences were found in recurrent laryngeal nerve paralysis (11.1% vs. 13.9%, P = 0.722) or pneumonia (13.9% vs. 13.9%, P = 1.000) between the RAMIE group and the VATS-E group. Conclusion Although RAMIE for esophageal cancer requires a longer thoracic surgery time, it might be a feasible and safe alternative to VATS-E for treating esophageal cancer. Further analysis is needed to clarify the advantages of RAMIE over VATS-E, especially in terms of long-term surgical outcomes.
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Affiliation(s)
- Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Hiroaki Saito
- Department of Surgery, Japanese Red Cross Tottori Hospital, Tottori 680-8517, Japan
| | - Yu Sakano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Wataru Miyauchi
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Shota Shimizu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yusuke Kono
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yuki Murakami
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Shuichi Takano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
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Miyauchi W, Matsunaga T, Sakano Y, Makinoya M, Shimizu S, Miyatani K, Shishido Y, Sakamoto T, Fujiwara Y. Perioperative Infusion Management for Adhesive Bowel Obstruction with Congenital Nephrogenic Diabetes Insipidus: A Case Report. Yonago Acta Med 2023; 66:311-316. [PMID: 37229364 PMCID: PMC10203649 DOI: 10.33160/yam.2023.05.015] [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: 03/03/2023] [Accepted: 04/20/2023] [Indexed: 05/27/2023]
Abstract
Congenital nephrogenic diabetes insipidus (CNDI) is a rare disease that results in polyuria due to decreased responsiveness to the antidiuretic hormone in the collecting ducts of the kidney. Without compensation by drinking large amounts of water, dehydration and hypernatremia can rapidly develop. We present a case of a patient originally diagnosed with CNDI who required surgery and a fasting period due to adhesive bowel obstruction. The patient was a 46-year-old man who was originally diagnosed with CNDI. He was prescribed trichlormethiazide but self-discontinued treatment in the process. His normal urine output was about 7,000-8,000 mL/day. He underwent robot-assisted radical cystectomy and uretero-cutaneostomy for bladder cancer. Two years later, he was hospitalized due to adhesive bowel obstruction. A 5% glucose solution was infused, and the dose was adjusted according to the urine volume and electrolytes. An adhesiotomy was performed due to recurrent bowel obstruction in a short period of time. A 5% glucose solution was used as the main infusion during the perioperative period. Once drinking water was resumed after surgery, urinary output and electrolytes were easily controlled. In conclusion, patients with CNDI should be given a 5% glucose solution as the primary infusion, and the infusion volume should be adjusted by monitoring daily urine output, electrolytes, and blood glucose levels. Infusion management is easier if oral intake is initiated as early as possible.
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Affiliation(s)
- Wataru Miyauchi
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yu Sakano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Shota Shimizu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
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25
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Miyauchi W, Fujii M, Saiki N, Ueki M, Sawata S, Makinoya M, Fujiwara Y. Evaluation of the Hemoglobin Concentration in Drainage Fluid After Surgery by Absorbance Spectrophotometry Using an Optical Sensor. Yonago Acta Med 2023; 66:281-286. [PMID: 37234223 PMCID: PMC10203633 DOI: 10.33160/yam.2023.05.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/09/2023] [Indexed: 05/27/2023]
Abstract
Background A drain is often placed in the abdominal cavity for postoperative monitoring and early detection of complications such as rebleeding and pancreatic or bile leaks. Since determining the color of the drainage fluid is subjective, an objective method of judging color is needed. Methods The hemoglobin concentration of the drainage fluid after gastrointestinal surgery was measured using the Hemato Check Module, a newly developed instrument capable of absorbance analysis with an optical sensor. The correlation between the results and those measured by an existing blood count measuring device (XN3000) was investigated. Results A total of 215 specimens were analyzed in 43 patients. For the correlation analysis, there was a strong positive correlation with a correlation coefficient of 0.884 (P < 0.001). The Hemato Check Module showed a clear proportional error compared to the XN3000. Conclusion The Hemato Check Module was a convenient and accurate instrument for measuring hemoglobin concentration in waste fluid to determine the presence of blood.
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Affiliation(s)
- Wataru Miyauchi
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Masashi Fujii
- Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Naofumi Saiki
- Advanced Medicine, Innovation and Clinical Research Center, Tottori University Hospital, Yonago 683-8504, Japan
| | - Masaru Ueki
- Division of Medical Education, Department of Medical Education, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Shohei Sawata
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
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Osuka Y, Okubo Y, Nofuji Y, Maruo K, Fujiwara Y, Oka H, Shinkai S, Lord SR, Sasai H. Occupational Fall Risk Assessment Tool for older workers. Occup Med (Lond) 2023; 73:161-166. [PMID: 36893360 DOI: 10.1093/occmed/kqad035] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND No easy-to-use fall risk assessment tools have been devised to assess occupational fall risk in older workers. AIMS To develop an Occupational Fall Risk Assessment Tool (OFRAT) and report its predictive validity and reliability in older workers. METHODS The baseline fall risk assessment was completed by 1113 participants aged ≥60 years who worked ≥4 days/month in Saitama, Japan. Participants were followed up for falls during occupational activities for 1 year, and 30 participants were assessed twice for test-retest reliability. The following assessment measures were summed to form the OFRAT risk score: older age, male sex, history of falls, physical work participation, diabetes, use of medications increasing fall risk, reduced vision, poor hearing, executive dysfunction and slow stepping. The scores were then classified into four grades (0-2 points: very low, 3 points: low, 4 points: moderate and ≥5 points: high). RESULTS During follow-up, 112 participants fell 214 times during work. The negative binomial regression model showed that participants with higher grades had a higher incidence rate ratio [95% confidence interval] for falls than those with very low grades (low: 1.64 [1.08-2.47], moderate: 4.23 [2.82-6.34] and high: 6.12 [3.83-9.76]). The intraclass correlation coefficient for risk score was 0.86 [0.72-0.93], and the weighted kappa coefficient for grade assessment was 0.74 [0.52-0.95]. CONCLUSIONS The OFRAT is a valid and reliable tool for estimating the occupational fall risk in older workers. It may assist occupational physicians implement strategies to prevent falls in this group.
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Affiliation(s)
- Y Osuka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo 173-0015, Japan
- Department of Frailty Research, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi 474-8511, Japan
| | - Y Okubo
- Falls, Balance and Injury Research Center, Neuroscience Research Australia, Sydney 2031, Australia
- School of Population Health, University of New South Wales, Sydney 2052, Australia
| | - Y Nofuji
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo 173-0015, Japan
| | - K Maruo
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Ibaraki 305-8575, Japan
| | - Y Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo 173-0015, Japan
| | - H Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, University of Tokyo, Tokyo 113-8655, Japan
| | - S Shinkai
- Graduate School of Nutrition and Health Science, Kagawa Nutrition University, Saitama 350-0214, Japan
| | - S R Lord
- Falls, Balance and Injury Research Center, Neuroscience Research Australia, Sydney 2031, Australia
- School of Population Health, University of New South Wales, Sydney 2052, Australia
| | - H Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo 173-0015, Japan
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Nakada K, Kimura A, Yoshida K, Futawatari N, Misawa K, Aridome K, Fujiwara Y, Tanabe K, Kawakubo H, Oshio A, Kodera Y. Effect of Four Main Gastrectomy Procedures for Proximal Gastric Cancer on Patient Quality of Life: A Nationwide Multi-Institutional Study. J Gastric Cancer 2023; 23:275-288. [PMID: 37129152 PMCID: PMC10154134 DOI: 10.5230/jgc.2023.23.e14] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/16/2022] [Accepted: 12/26/2022] [Indexed: 05/03/2023] Open
Abstract
PURPOSE This study aimed to examine the effects of 4 main types of gastrectomy for proximal gastric cancer on postoperative symptoms, living status, and quality of life (QOL) using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45). MATERIALS AND METHODS We surveyed 1,685 patients with upper one-third gastric cancer who underwent total gastrectomy (TG; n=1,020), proximal gastrectomy (PG; n=518), TG with jejunal pouch reconstruction (TGJP; n=93), or small remnant distal gastrectomy (SRDG; n=54). The 19 main outcome measures (MOMs) of the PGSAS-45 were compared using the analysis of means (ANOM), and the general QOL score was calculated for each gastrectomy type. RESULTS Patients who underwent TG experienced the lowest postoperative QOL. ANOM showed that 10 MOMs were worse in patients with TG. Four MOMs improved in patients with PG, while 1 worsened. One MOM was improved in patients with TGJP versus 8 MOMs in patients with SRDG. The general QOL scores were as follows: SRDG (+39 points), TGJP (+6 points), PG (+3 points), and TG (-1 point). CONCLUSIONS The TG group experienced the greatest decline in postoperative QOL. SRDG and PG, which preserve part of the stomach without compromising curability, and TGJP, which is used when TG is required, enhance the postoperative QOL of patients with proximal gastric cancer. When selecting the optimal gastrectomy method, it is essential to understand the characteristics of each and actively incorporate guidance to improve postoperative QOL.
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Affiliation(s)
- Koji Nakada
- Department of Laboratory Medicine, The Jikei University School of Medicine, Tokyo, Japan.
| | - Akitoshi Kimura
- Division of Gastroenterological Surgery, Clinical Oncology Center, Aomori Prefectural Central Hospital, Aomori, Japan
| | | | - Nobue Futawatari
- Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Kazunari Misawa
- Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Japan
| | - Kuniaki Aridome
- Department of Surgery, Saiseikai Sendai Hospital, Kagoshima, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine, Yonago, Japan
| | - Kazuaki Tanabe
- Department of Gastroenterological Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirofumi Kawakubo
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Atsushi Oshio
- Faculty of Letters, Arts, and Sciences, Waseda University, Tokyo, Japan
| | - Yasuhiro Kodera
- Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Hanaki T, Goto K, Tokuyasu N, Endo Y, Sunada H, Noma H, Sunaguchi T, Murakami Y, Matsunaga T, Yamamoto M, Sakamoto T, Hasegawa T, Fujiwara Y. Efficacy of indocyanine green systemic administration for bile leak detection after hepatectomy: a protocol for a prospective single-arm clinical trial with a historical control group. BMJ Open 2023; 13:e068223. [PMID: 36944457 PMCID: PMC10032385 DOI: 10.1136/bmjopen-2022-068223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
INTRODUCTION Bile leakage (BL) after hepatectomy cannot always be detected with conventional methods; moreover, BL cannot be completely prevented. Recently, navigation procedures with indocyanine green (ICG) have been reported. Furthermore, we previously reported the possibility of detecting BLs with high sensitivity during hepatectomy by administering ICG into the bloodstream, which is quickly excreted in the bile. This study aims to verify whether detecting and addressing ICG leakage from the hepatic dissection plane using an ICG camera can reduce the bilirubin concentration in the drainage fluid, and consequently, the incidence of BL. METHODS AND ANALYSIS This prospective single-centre non-randomised single-arm trial will be conducted with historical controls. Overall, 85 patients will be enrolled, including 40 and 45 in the ICG and historical control groups, respectively. In the ICG group, 10 mg/2 mL of ICG will be transvenously or transportally administered during liver surgery. After its uptake by liver cells and excretion into bile, it will be visualised using a camera following the completion of hepatectomy, and the site of ICG leakage will be sutured. Moreover, we will record the number of bile leak spots detected by the naked eye and ICG camera. The primary endpoint of the study will be the total bilirubin concentration in the drain fluid on postoperative day 3, and we will determine whether the concentration differs significantly between the ICG and historical control groups. The results of our study will be used to suggest whether intraoperative ICG administration and evaluation at the hepatic dissection plane can be widely used in liver surgery for more reliable detection of BL and consequent reduction of biliary fistula. ETHICS AND DISSEMINATION The protocol was approved by the Certified Review Board of Tottori University Hospital (approval number: 21C002). Findings from this trial will be published in peer-reviewed journals and presented at academic conferences. TRIAL REGISTRATION NUMBER jRCTs061210043.
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Affiliation(s)
- Takehiko Hanaki
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine Graduate School of Medicine, Yonago, Tottori, Japan
| | - Keisuke Goto
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine Graduate School of Medicine, Yonago, Tottori, Japan
| | - Naruo Tokuyasu
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine Graduate School of Medicine, Yonago, Tottori, Japan
| | - Yusuke Endo
- Department of Advanced Medicine, Tottori University, Tottori, Japan
| | - Hiroshi Sunada
- Department of Advanced Medicine, Tottori University, Tottori, Japan
| | - Hisashi Noma
- Department of Data Science, Institute of Statistical Mathematics, Tachikawa, Tokyo, Japan
| | - Teppei Sunaguchi
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine Graduate School of Medicine, Yonago, Tottori, Japan
| | - Yuki Murakami
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine Graduate School of Medicine, Yonago, Tottori, Japan
| | - Tomoyuki Matsunaga
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine Graduate School of Medicine, Yonago, Tottori, Japan
| | - Manabu Yamamoto
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine Graduate School of Medicine, Yonago, Tottori, Japan
| | - Teruhisa Sakamoto
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine Graduate School of Medicine, Yonago, Tottori, Japan
| | - Toshimichi Hasegawa
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine Graduate School of Medicine, Yonago, Tottori, Japan
| | - Yoshiyuki Fujiwara
- Department of Gastrointestinal and Pediatric Surgery, Tottori University Faculty of Medicine Graduate School of Medicine, Yonago, Tottori, Japan
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29
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Tanio A, Saito H, Hara K, Sugezawa K, Uejima C, Kihara K, Tatebe S, Kurisu Y, Shibata S, Yamamoto T, Nishie H, Shiota S, Naka T, Sugamura K, Katano K, Yamamoto M, Fujiwara Y. Estimation of the physiologic ability and surgical stress scoring system as a useful predictor of postoperative recurrence in patients with stage II colorectal cancer: a multicenter study. Surg Today 2023:10.1007/s00595-023-02656-2. [PMID: 36790474 DOI: 10.1007/s00595-023-02656-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/12/2022] [Indexed: 02/16/2023]
Abstract
PURPOSE We determined the usefulness of the estimation of physiologic ability and surgical stress (E-PASS), initially reported as a predictive factor for postoperative morbidity and mortality, as a prognostic indicator in stage II colorectal cancer (CRC). METHODS Overall, 739 patients who underwent proctocolectomy for CRC at Tottori University Hospital and affiliated hospitals and histologically diagnosed with stage II CRC were included in the current study. RESULTS A receiver operating characteristic (ROC) analysis of the five-year recurrence-free survival indicated that the comprehensive risk score (CRS) of E-PASS predicted postoperative recurrence. A multivariate analysis revealed that the presence of preoperative perforation, T4, v ≥ 2, and CRSHigh (≥ 0.2267) were independent predictors of postoperative recurrence. Patients were assigned a score using these factors, as follows: the presence of perforation = 1, the absence of preoperative perforation = 0, T4 = 1, T3 = 0, v2/3 = 1, v0/1 = 0, CRSHigh = 1, and CRSLow = 0 (total score: 0-4). Accordingly, the respective 5-year relapse-free survival rates were 91.0%, 83.6%, 70.3%, and 52.0% among those with scores of 0, 1, 2, and both 3 and 4 (P < 0.001). CONCLUSIONS The CRS predicts postoperative recurrence in patients with stage II CRC.
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Affiliation(s)
- Akimitsu Tanio
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago, Japan.,Department of Surgery, Japanese Red Cross Tottori Hospital, 117 Shotoku-Cho, Tottori, 680-8517, Japan
| | - Hiroaki Saito
- Department of Surgery, Japanese Red Cross Tottori Hospital, 117 Shotoku-Cho, Tottori, 680-8517, Japan.
| | - Kazushi Hara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Ken Sugezawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Chihiro Uejima
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Shigeru Tatebe
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Yasuro Kurisu
- Department of Surgery, National Hospital Organization Hamada Medical Center, Hamada, Japan
| | | | | | - Hiroshi Nishie
- Department of Gastroenterological Surgery, Tottori Prefectural Kosei Hospital, Kurayoshi, Japan
| | - Setsujo Shiota
- Department of Surgery, Masuda Red Cross Hospital, Masuda, Japan
| | - Takuji Naka
- Department of Surgery, National Hospital Organization, Yonago Medical Center, Yonago, Japan
| | - Kenji Sugamura
- Department of Surgery, Yasugi City Hospital, Yasugi, Japan
| | - Kuniyuki Katano
- Department of Surgery, Nanbu Town National Health Insurance Saihaku Hospital, Nanbu, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
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Kunisawa S, Ishida H, Ikai H, Nagano H, Fujiwara T, Ohdan H, Fujiwara Y, Tajima Y, Ueno T, Fujiwara Y, Shimada M, Suzuki Y, Watanabe Y, Hanazaki K, Kakeji Y, Kumamaru H, Takahashi A, Miyata H, Imanaka Y. Impact of the hospital volume and setting on postoperative complications of surgery for gastroenterological cancers in a regional area of Western Japan. Surg Today 2023; 53:214-222. [PMID: 35947194 DOI: 10.1007/s00595-022-02569-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/14/2022] [Indexed: 01/28/2023]
Abstract
PURPOSE A research subgroup was established by the Japanese Society of Gastroenterological Surgery to improve the health care quality in the Chushikoku area of Western Japan. METHODS The records of four surgical procedures were extracted from the Japanese National Clinical Database and analyzed retrospectively to establish the association between hospital characteristics, defined using a combination of hospital case-volume and patients' hospital travel distance, and the incidences of perioperative complications of ≥ Grade 3 of the Clavien-Dindo classification after gastroenterological surgery. RESULTS This study analyzed 11,515 cases of distal gastrectomy for gastric cancer, 4,705 cases of total gastrectomy for gastric cancer, 4,996 cases of right hemicolectomy for colon cancer, and 5,243 cases of lower anterior resection for rectal cancer, with composite outcome incidences of 5.6%, 10.2%, 5.5%, and 10.7%, respectively. After adjusting for patient characteristics and surgical procedures, no association was identified between the hospital category and surgical outcomes. CONCLUSION The findings of our study of the Chushikoku region did not provide positive support for the consolidation and centralization of hospitals, based solely on hospital case volume. Our grouping was unique in that we included patient travel distance in the analysis, but further investigations from other perspectives are needed.
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Affiliation(s)
- Susumu Kunisawa
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto City, Kyoto, 606-8501, Japan
| | - Haku Ishida
- Department of Medical Informatics and Decision Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Hiroshi Ikai
- Department of Medical Informatics and Clinical Epidemiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroaki Nagano
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Toshiyoshi Fujiwara
- Department of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Tomio Ueno
- Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Japan
| | - Yoshinori Fujiwara
- Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Japan
| | - Mitsuo Shimada
- Department of Surgery, Tokushima University, Tokushima, Japan
| | - Yasuyuki Suzuki
- Department of Surgery, Hyogo Prefectural Awaji Medical Center, Sumoto, Japan
| | - Yuji Watanabe
- Department of Gastrointestinal Surgery and Surgical Oncology, Ehime University Graduate School of Medicine, Touon, Japan
| | | | - Yoshihiro Kakeji
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiraku Kumamaru
- Department of Healthcare Quality Assessment Graduate School of Medicine, University of Tokyo, Bunkyo City, Tokyo, Japan
| | - Arata Takahashi
- Department of Healthcare Quality Assessment Graduate School of Medicine, University of Tokyo, Bunkyo City, Tokyo, Japan
- Department of Health Policy and Management, School of Medicine, Keio University, Minato City, Japan
| | - Hiroaki Miyata
- Department of Healthcare Quality Assessment Graduate School of Medicine, University of Tokyo, Bunkyo City, Tokyo, Japan
- Department of Health Policy and Management, School of Medicine, Keio University, Minato City, Japan
| | - Yuichi Imanaka
- Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto City, Kyoto, 606-8501, Japan.
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Sakamoto T, Murakami Y, Hanaki T, Kihara K, Matsunaga T, Yamamoto M, Takano S, Tokuyasu N, Hasegawa T, Fujiwara Y. Evaluation of perioperative D-dimer concentration for predicting postoperative deep vein thrombosis following hepatobiliary-pancreatic surgery. Surg Today 2023:10.1007/s00595-023-02645-5. [PMID: 36710289 DOI: 10.1007/s00595-023-02645-5] [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: 08/30/2022] [Accepted: 10/16/2022] [Indexed: 01/30/2023]
Abstract
PURPOSE This study was performed to investigate the predictive value of the perioperative D-dimer concentration for the development of postoperative deep vein thrombosis (DVT) after hepatobiliary-pancreatic (HBP) surgery. METHODS The subjects of this retrospective study were 178 patients who underwent HBP surgery in our hospital between January, 2017 and December, 2021. The D-dimer concentration was measured preoperatively and on postoperative days (POD) 1, 3, and 5. Postoperative DVT was diagnosed based on compression ultrasonography in both lower limbs on POD 6 or 7. RESULTS Postoperative DVT developed in 21 (11.8%) of the 178 patients. The D-dimer concentration was significantly higher in the patients with than in those without postoperative DVT before surgery and on PODs 1, 3, and 5. The highest area under the curve of the D-dimer concentration for predicting DVT was 0.762 on POD 3. Multivariate analysis revealed that the D-dimer concentration on POD 3 was an independent predictive risk factor for postoperative DVT, along with the preoperative estimated glomerular filtration rate. Preoperative albumin and D-dimer concentrations were also identified as independent predictive factors of an increase in D-dimer concentration on POD 3. CONCLUSIONS The D-dimer concentration on POD 3 is a useful predictor of DVT after HBP surgery.
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Affiliation(s)
- Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
| | - Yuki Murakami
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Shuichi Takano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
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Miyauchi W, Matsunaga T, Sakano Y, Makinoya M, Shimizu S, Shishido Y, Miyatani K, Sakamoto T, Hasegawa T, Fujiwara Y. Usefulness of the Modified Frailty Index for Predicting Pneumonia Occurrence After Esophagectomy. Yonago Acta Med 2023; 66:1-6. [PMID: 36820293 PMCID: PMC9937958 DOI: 10.33160/yam.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/16/2022] [Indexed: 01/18/2023]
Abstract
Background Esophagectomy is an invasive and complication-prone surgical procedure. Therefore, a tool that can predict the occurrence of postoperative complications may be useful for perioperative management. In this study, we investigated whether the modified frailty index (mFI) could be a useful tool for predicting the postoperative complications of esophagectomy. Methods In this study, 162 patients who underwent curative esophagectomy for esophageal squamous cell carcinoma from 2004 to 2019 at our institution were included. The patients were divided into the high mFI (≥ 0.27) and low mFI (< 0.27) groups, and the short-term postoperative outcomes of each group were examined retrospectively. Results Regarding background factors, age and the American Society of Anesthesiologists physical status classification were significantly higher in the high mFI group (P = 0.049 and P = 0.002, respectively); however, the other items were not significantly different between the two groups. Regarding surgical outcomes, no significant differences in operative time, blood loss, and hospital stay were observed between the two groups. Regarding postoperative complications, pneumonia was significantly more common in the high mFI group (P = 0.035). In multivariate analysis, high mFI (P = 0.034) was an independent predictor of pneumonia, along with operative time ≥ 613 min (P = 0.03) and preoperative BMI < 20.48 (P = 0.006). Conclusion The mFI is useful for predicting pneumonia after esophagectomy.
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Affiliation(s)
- Wataru Miyauchi
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yu Sakano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Shota Shimizu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
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Matsunaga T, Saito H, Fukumoto Y, Kuroda H, Taniguchi K, Takahashi S, Osaki T, Iwamoto A, Fukuda K, Shimizu S, Shishido Y, Miyatani K, Fujiwara Y. The prognostic impact of the lymphocyte-to-C-reactive protein ratio in patients with unresectable or recurrent advanced gastric cancer treated with first- and second-line treatment. Surg Today 2023:10.1007/s00595-022-02638-w. [PMID: 36595075 DOI: 10.1007/s00595-022-02638-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/12/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE The goal of this study was to determine which markers are the most useful as first- and second-line pre-treatment markers in patients with unresectable or recurrent gastric cancer (URGC). METHODS This study included 101 URGC patients who were treated with first- and second-line chemotherapy. Several prognostic scores based on nutrition and inflammation were analyzed using a receiver operating characteristic (ROC) analysis to determine the most useful prognostic marker. RESULTS The lymphocyte-to-C-reactive protein ratio (LCR) had the highest area under the curve for both first- and second-line chemotherapy, according to an ROC analysis. An ROC analysis was used to determine the optimal LCR cut-off for the median survival time before first- and second-line chemotherapy, and patients were divided into high- and low-LCR groups. Patients with a high LCR had a significantly longer survival than those with a low LCR before first- and second-line chemotherapy (p = 0.004, p < 0.001, respectively). A low LCR before both first- and second-line chemotherapy was an independent poor prognostic factor in a multivariate analysis. CONCLUSIONS URGC patients with a low LCR before both first- and second-line chemotherapy had a significantly worse prognosis than those with a high LCR in this study. Nutritional intervention during chemotherapy induction may lead to a better prognosis.
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Affiliation(s)
- Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan.
| | - Hiroaki Saito
- Department of Surgery, Japanese Red Cross Tottori Hospital, Tottori, 680-8517, Japan
| | - Yoji Fukumoto
- Division of Gastroenterology, Matsue City Hospital, Matsue, 690-8509, Japan
| | - Hirohiko Kuroda
- Department of Surgery, Japanese Red Cross Masuda Hospital, Masuda, 698-8501, Japan
| | - Kenjiro Taniguchi
- Department of Surgery, Yonago Medical Center of National Hospital Organization, Yonago, 683-0006, Japan
| | - Sadamu Takahashi
- National Hospital Organization, Hamada Medical Center, Hamada, 697-8511, Japan
| | - Tomohiro Osaki
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, 680-0901, Japan
| | - Akemi Iwamoto
- Divisions of Digestive Surgery, Tottori Prefectural Kousei Hospital, Kurayoshi, 682-0804, Japan
| | - Kenji Fukuda
- Department of Surgery, Sanin Rosai Hospital, Yonago, 683-8605, Japan
| | - Shota Shimizu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
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Kitago M, Seino S, Shinkai S, Nofuji Y, Yokoyama Y, Toshiki H, Abe T, Taniguchi Y, Amano H, Murayama H, Kitamura A, Akishita M, Fujiwara Y. Cross-Sectional and Longitudinal Associations of Creatinine-to-Cystatin C Ratio with Sarcopenia Parameters in Older Adults. J Nutr Health Aging 2023; 27:946-952. [PMID: 37997714 DOI: 10.1007/s12603-023-2029-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/04/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES Accumulating evidence from cross-sectional studies suggests that the serum creatinine-to-cystatin C ratio (CCR) may be a useful biomarker for sarcopenia. This study aimed to assess the cross-sectional and longitudinal associations of CCR with sarcopenia and its parameters in community-dwelling older adults. DESIGN Cross-sectional and longitudinal study. SETTING AND PARTICIPANTS This 6-year prospective cohort study included the repeated measurement data from 1,253 Japanese residents (662 males and 591 females) aged ≥65 years who underwent medical checkups in Kusatsu and Hatoyama, Japan. A total of 4,421 observations were collected. MEASUREMENTS The CCR was grouped into quartiles by sex (Q1-Q4) using Q4 as the reference category. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 algorithm. Skeletal muscle mass index (SMI) measured using segmental multifrequency bioelectrical impedance analysis, handgrip strength (HGS), usual gait speed (UGS), and maximal gait speed (MGS) were measured repeatedly as sarcopenia parameters. The association of the CCR with changes in sarcopenia, SMI, HGS, UGS, and MGS during the 6-year period were analyzed using a generalized linear mixed-effects model. RESULTS The prevalence of sarcopenia at baseline was 13.1% (11.9% in males and 14.5% in females). In a cross-sectional analysis, the CCR quartile was inversely associated with sarcopenia and was positively associated with SMI, HGS, and MGS (P for trend < 0.001). In a longitudinal analysis during the 6 years, a significant increase in sarcopenia in Q2 (B = 1.1% point/year; P = 0.026 for group-by-time interaction) and significant declines in SMI (B = -0.01 kg/m2/year; P = 0.044 for group-by-time interaction) and MGS (B = -0.008 m/sec/year; P = 0.041 for group-by-time interaction) in Q1 were observed compared with Q4. However, the dose-response relationship was significant only for MGS (P = 0.033 for trend). No significant group-by-time interaction was observed for HGS. CCR was not significantly associated with UGS either cross-sectionally or longitudinally. CONCLUSIONS CCR is a useful biomarker regarding the status of sarcopenia. It may be used for sarcopenia screening even in older adults whose physical function is difficult to assess. However, further longitudinal studies are needed to determine whether CCR can be a predictor of future sarcopenia.
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Affiliation(s)
- M Kitago
- Yoshinori Fujiwara, MD, PhD, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae, Itabashi, Tokyo, 173-0015, Japan, Phone: +81-3-3964-3241, E-mail:
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Hara K, Horikoshi Y, Morimoto M, Nakaso K, Sunaguchi T, Kurashiki T, Nakayama Y, Hanaki T, Yamamoto M, Sakamoto T, Fujiwara Y, Matsura T. TYRO3 promotes chemoresistance via increased LC3 expression in pancreatic cancer. Transl Oncol 2022; 28:101608. [PMID: 36577166 PMCID: PMC9803781 DOI: 10.1016/j.tranon.2022.101608] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/27/2022] Open
Abstract
Pancreatic cancer (PC) is an aggressive malignancy with few treatment options, and improved treatment strategies are urgently required. TYRO3, a member of the TAM receptor tyrosine kinase family, is a known oncogene; however, the relationship between TYRO3 expression and PC chemoresistance remains to be elucidated. We performed gain- and loss-of-function experiments on TYRO3 to examine whether it is involved in chemoresistance in PC cells. TYRO3 knockdown decreased cell viability and enhanced apoptosis following treatment of PC cells with gemcitabine and 5-fluorouracil (5-FU). In contrast, no such effects were observed in TYRO3-overexpressing PC cells. It is known that autophagy is associated with cancer chemoresistance. We then examined effects of TYRO3 on autophagy in PC cells. TYRO3 overexpression increased LC3 mRNA levels and induced LC3 puncta in PC cells. Inhibition of autophagy by chloroquine mitigated cell resistance to gemcitabine and 5-FU. In a xenograft mouse model, TYRO3 silencing significantly increased sensitivity of the cells to gemcitabine and 5-FU. To further investigate the involvement of autophagy in patients with PC, we immunohistochemically analyzed LC3 expression in the tissues of patients who underwent pancreatectomy and compared it with disease prognosis and TYRO3 expression. LC3 expression was negatively and positively correlated with prognosis and TYRO3 expression, respectively. Furthermore, LC3- and TYRO3-positive patients had a significantly worse prognosis among patients with PC who received chemotherapy after recurrence. These results indicated that the TYRO3-autophagy signaling pathway confers PC resistance to gemcitabine and 5-FU, and could be a novel therapeutic target to resolve PC chemoresistance.
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Affiliation(s)
- Kazushi Hara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University Faculty of Medicine, Yonago, Japan,Division of Biochemistry, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yosuke Horikoshi
- Division of Biochemistry, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University Faculty of Medicine, Yonago, Japan,Corresponding authors.
| | - Masaki Morimoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University Faculty of Medicine, Yonago, Japan,Corresponding authors.
| | - Kazuhiro Nakaso
- Division of Biochemistry, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Teppei Sunaguchi
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University Faculty of Medicine, Yonago, Japan,Division of Biochemistry, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Tatsuyuki Kurashiki
- Division of Biochemistry, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University Faculty of Medicine, Yonago, Japan,Division of Anesthesiology and Critical Care Medicine, Department of Surgery, Faculty of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yuji Nakayama
- Division of Radioisotope Science, Research Initiative Center, Organization for Research Initiative and Promotion, Tottori University, Yonago, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Faculty of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Tatsuya Matsura
- Division of Biochemistry, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University Faculty of Medicine, Yonago, Japan,Department of Nutritional Sciences, Faculty of Human Ecology, Yasuda Women's University, Hiroshima, Japan
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Osaki T, Matsunaga T, Makinoya M, Shishido Y, Miyatani K, Uchinaka E, Tada Y, Ashida K, Tatebe S, Fujiwara Y. Impact of gastrectomy on body composition within 1 month in patients with gastric cancer. Surg Today 2022:10.1007/s00595-022-02633-1. [PMID: 36515778 DOI: 10.1007/s00595-022-02633-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/15/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE The present study examined the changes in and risk factors for body composition (BC) during the first postoperative month when dynamic biological reactions occur. METHODS We retrospectively assessed 202 patients who underwent gastrectomy. The BC was assessed using a bioelectrical impedance analysis and evaluated within 1 month preoperatively, 1 week postoperatively, and 1 month postoperatively. Multiple regression analyses were performed to identify predictive factors for BC change. RESULTS The mean reduction rate in BC at 1 month postoperatively was - 6.0, - 10.5, - 5.6, - 1.1, - 10.1, and + 1.2% for body weight, body fat, skeletal muscle, bone mineral, extracellular water/total body water, and the whole-body phase angle, respectively. A multiple regression analysis revealed that independent risk factors for weight loss were complications, operative time, and type of gastrectomy (P = 0.004, 0.011, 0.015, respectively), and those for skeletal muscle loss were complications and gastrectomy type (P = 0.002, 0.010, respectively). A segmental lean mass analysis revealed that the lower limbs were markedly reduced at 1 week postoperatively (- 8.0%), and these independent risk factors were the female sex and Stage II/III disease (P = 0.008, 0.036, respectively). CONCLUSION Detailed analyses of BC might help elucidate the mechanisms underlying postoperative physical changes, which might be useful for perioperative management.
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Affiliation(s)
- Tomohiro Osaki
- Department of Surgery, Tottori Prefectural Central Hospital, 730 Ezu, Tottori, 680-0901, Japan.
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
| | - Ei Uchinaka
- Department of Surgery, Tottori Prefectural Central Hospital, 730 Ezu, Tottori, 680-0901, Japan
| | - Yoichiro Tada
- Department of Surgery, Tottori Prefectural Central Hospital, 730 Ezu, Tottori, 680-0901, Japan
| | - Keigo Ashida
- Department of Surgery, Tottori Prefectural Central Hospital, 730 Ezu, Tottori, 680-0901, Japan
| | - Shigeru Tatebe
- Department of Surgery, Tottori Prefectural Central Hospital, 730 Ezu, Tottori, 680-0901, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan
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Kihara K, Koyama Y, Hanaki T, Miyatani K, Matsunaga T, Yamamoto M, Morizane S, Tokuyasu N, Sakamoto T, Fujiwara Y. Robot-assisted total pelvic exenteration for rectal cancer after neoadjuvant chemoradiotherapy: a case report. Surg Case Rep 2022; 8:191. [PMID: 36205818 PMCID: PMC9547043 DOI: 10.1186/s40792-022-01547-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 09/28/2022] [Indexed: 11/05/2022] Open
Abstract
Background There are numerous indications for minimally invasive surgery. However, the laparoscopic approach for extended pelvic surgery is currently provided by only a few institutions specializing in cancer treatment, primarily because of technical difficulties that arise in cases involving a narrow pelvis and rigid forceps. We report a case of robot-assisted total pelvic exenteration for rectal cancer involving the prostate. We assessed the feasibility of robot-assisted total pelvic exenteration and compared the short-term outcomes of other conventional and minimally invasive approaches. Case presentation A 67-year-old man was referred to our hospital after positive fecal blood test results. The initial diagnosis was clinical T4bN2aM0, Stage IIIC rectal cancer involving the prostate. The patient underwent neoadjuvant chemoradiotherapy. Consequently, robot-assisted total pelvic exenteration with an ileal conduit and end colostomy creation were performed. The total operative duration was 9 h and 20 min. The durations of robot console usage by the colorectal and urological teams were 2 h 9 min and 2 h 23 min, respectively. The patient was discharged on postoperative day 21. The pathological diagnosis was T4b (prostate) N0M0, Stage IIC. The resection margin was 2.5 mm. During reassessment at 2 years after resection, no evidence of recurrence was observed. Conclusions Robot-assisted total pelvic exenteration was performed for a patient with advanced rectal cancer without serious complications. Robot-assisted total pelvic exenteration may provide the advantages of minimally invasive surgery, particularly in the enclosed space of the pelvis.
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Affiliation(s)
- Kyoichi Kihara
- grid.265107.70000 0001 0663 5064Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago City, Tottori 683-8504 Japan
| | - Yuri Koyama
- grid.265107.70000 0001 0663 5064Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago City, Tottori 683-8504 Japan
| | - Takehiko Hanaki
- grid.265107.70000 0001 0663 5064Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago City, Tottori 683-8504 Japan
| | - Kozo Miyatani
- grid.265107.70000 0001 0663 5064Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago City, Tottori 683-8504 Japan
| | - Tomoyuki Matsunaga
- grid.265107.70000 0001 0663 5064Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago City, Tottori 683-8504 Japan
| | - Manabu Yamamoto
- grid.265107.70000 0001 0663 5064Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago City, Tottori 683-8504 Japan
| | - Shuichi Morizane
- grid.265107.70000 0001 0663 5064Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago City, Tottori 683-8504 Japan
| | - Naruo Tokuyasu
- grid.265107.70000 0001 0663 5064Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago City, Tottori 683-8504 Japan
| | - Teruhisa Sakamoto
- grid.265107.70000 0001 0663 5064Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago City, Tottori 683-8504 Japan
| | - Yoshiyuki Fujiwara
- grid.265107.70000 0001 0663 5064Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago City, Tottori 683-8504 Japan
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Sakamoto T, Sunaguchi T, Goto K, Morimoto M, Murakami Y, Miyatani K, Hanaki T, Shishido Y, Kihara K, Matsunaga T, Yamamoto M, Tokuyasu N, Fujiwara Y. Modified geriatric nutritional risk index in patients with pancreatic cancer: a propensity score-matched analysis. BMC Cancer 2022; 22:974. [PMID: 36096761 PMCID: PMC9465905 DOI: 10.1186/s12885-022-10071-y] [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: 01/26/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background The modified nutritional geriatric risk index (mGNRI) was developed as a novel index and provides a more appropriate prognostic index than the original GNRI, which was reported to be a useful index for predicting prognoses for various malignancies. This study investigated the prognostic significance of the mGNRI compared with that of the GNRI in patients with pancreatic cancer and the association with psoas muscle volume (PMV) for survival outcomes. Methods This retrospective study included 137 patients who had undergone pancreatectomy for pancreatic cancer. The enrolled patients were grouped as high mGNRI (≥ 85.3) or low mGNRI (< 85.3), and high GNRI (≥ 92) or low GNRI (< 92) for prognostic analysis based on cutoff values. A propensity-matched analysis was performed in this study. Results The 5-year overall survival of patients in the high mGNRI group or high GNRI group was significantly longer than those in the low mGNRI group or low GNRI group. Statistically significant differences for the 5-year OS were observed in the three groups with respect to the combination of mGNRI and PMV. Patients with low mGNRI/low PMV had a worse 5-year OS rate compared with patients with high GNRI/high PMV or those with high GNRI or high PMV, but not both. The concordance index of the mGNRI to predict the 5-year overall survival was greater than that of the GNRI or the combination of the GNRI and PMV, but lower than that of the combination of the mGNRI and PMV. Multivariate analysis revealed that the mGNRI was an independent prognostic factor for patients with pancreatic cancer (P = 0.005). Conclusions The mGNRI might be a more useful prognostic factor than the GNRI for patients with pancreatic cancer, and might predict prognostic outcomes more accurately when combined with PMV.
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Fujiwara Y, Sato Y, Fukuda N, Hayashi N, Wang X, Nakano K, Ohmoto A, Urasaki T, Ono M, Tomomatsu J, Toshiyasu T, Mitani H, Takahashi S. 696P Geriatric nutritional risk index as a prognostic factor in elderly patients with locally advanced head and neck cancer receiving definitive chemoradiotherapy with cisplatin. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.820] [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] Open
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Misako N, Sugawara S, Choi CM, Okamoto T, Yanagitani N, Nosaki K, Takahashi T, Fujiwara Y, Hayashi H, Khoury J, Nieva J, Gabayan A, Raez L, Chen H, Dimou A, Pennell N, Liu G, Ou SH, Seto T, Ohe Y. EP08.02-118 TRUST-II: A Global Phase II Study for Taletrectinib inROS1fusion Positive Lung Cancer and Other Solid Tumors. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.801] [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: 10/14/2022]
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Hanaki T, Tsuda A, Sunaguchi T, Goto K, Morimoto M, Murakami Y, Kihara K, Matsunaga T, Yamamoto M, Tokuyasu N, Sakamoto T, Hasegawa T, Fujiwara Y. Influence of the water jet system vs cavitron ultrasonic surgical aspirator for liver resection on the remnant liver. World J Clin Cases 2022; 10:6855-6864. [PMID: 36051129 PMCID: PMC9297427 DOI: 10.12998/wjcc.v10.i20.6855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/23/2022] [Accepted: 05/28/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Several methods, such as finger fracture, Pean crush, cavitron ultrasonic surgical aspirator (CUSA), and water jet (WJ), are used for hepatic parenchymal dissection in liver surgery. CUSA is the conventional method in Japan. WJ is a relatively novel method for parenchymal dissection. Although it has several advantages, such as lower volume of blood loss and shorter operative time, the effect of the WJ system for hepatic dissection on the remnant liver has not yet been investigated.
AIM To investigate and compare the effect of the WJ method vs CUSA on the remnant liver cut surface.
METHODS This observational study compared the two types of parenchymal transection methods (WJ vs CUSA) in liver surgery. In total, 24 and 40 patients who underwent hepatectomy using the WJ method and CUSA, respectively, were included in the analysis. Accordingly, the clinicopathological characteristics and clinical outcomes of 24 and 40 patients were compared. Furthermore, postoperative contrast-enhanced computed tomography (CT) scan was performed to assess the cut surface length of the remnant liver and the degenerative thickness of the areas with a reduced contrast effect in the dissected plane. Then, the two groups were compared.
RESULTS On CT scan, the median areas of denaturation in the liver dissection planes were 522 (range: 109.5-1242) mm2 in the CUSA group and 324 (range: 93.6-1529) mm2 in the WJ group. The area did not significantly differ between the two groups; however, the denaturation thickness of the WJ group was significantly lower than that of the CUSA group [5.8 (range: 0.7-11.1) mm vs 3.3 (range: 1.7-10.4) mm, P < 0.001].
CONCLUSION The WJ group had significantly thinner contrast-enhanced areas in the post hepatectomy detached section than the CUSA group.
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Affiliation(s)
- Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago 683-8504, Tottori, Japan
| | - Ayumi Tsuda
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago 683-8504, Tottori, Japan
| | - Teppei Sunaguchi
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago 683-8504, Tottori, Japan
| | - Keisuke Goto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago 683-8504, Tottori, Japan
| | - Masaki Morimoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago 683-8504, Tottori, Japan
| | - Yuki Murakami
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago 683-8504, Tottori, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago 683-8504, Tottori, Japan
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago 683-8504, Tottori, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago 683-8504, Tottori, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago 683-8504, Tottori, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago 683-8504, Tottori, Japan
| | - Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago 683-8504, Tottori, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, Tottori University Faculty of Medicine, Yonago 683-8504, Tottori, Japan
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Sakamoto T, Makinoya M, Sunaguchi T, Goto K, Morimoto M, Murakami Y, Miyatani K, Hanaki T, Shishido Y, Kihara K, Matsunaga T, Yamamoto M, Tokuyasu N, Fujiwara Y. Geriatric nutritional risk index as a prognostic factor in patients with recurrent pancreatic cancer. PLoS One 2022; 17:e0271073. [PMID: 35797279 PMCID: PMC9262175 DOI: 10.1371/journal.pone.0271073] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/23/2022] [Indexed: 11/18/2022] Open
Abstract
The aim of this study is to investigate the prognostic significance of geriatric nutritional risk index (GNRI) at the time of recurrence in patients with recurrent pancreatic cancer, and the relationship between GNRI and skeletal muscle mass for survival outcomes after recurrence. This study enrolled 77 patients who developed postoperative recurrence. The skeletal muscle mass index (SMI) was used in this study. The patients were divided into a high-GNRI group (n = 36) and a low-GNRI group (n = 41) for the GNRI, and were divided into a high-SMI group (n = 38) and a low-SMI group (n = 39) for SMI. The 2-year post-recurrence overall survival of patients in the high-GNRI group was significantly longer than that of patients in the low-GNRI group (P = 0.001). No significant difference for the 2-year post-recurrence OS curves between the high-SMI group and the low-SMI group was observed (P = 0.125). Upon stratifying the patients with high GNRI or low GNRI according to SMI, There was no significant difference in the 2-year post-recurrence OS curves between the patients with both high GNRI and high SMI and the patients with high GNRI and low SMI (P = 0.399). Similarly, There was no significant difference in the 2-year post-recurrence OS curves between the patients with low GNRI and high SMI and the patients with both low GNRI and low SMI (P = 0.256). Multivariate analysis revealed that the GNRI at the time of recurrence was an independent prognostic risk factor in patients with recurrent pancreatic cancer (P = 0.019). The GNRI at the time of recurrence is useful for predicting the prognosis in patients with recurrence pancreatic cancer. Skeletal muscle mass at the time of recurrence is not contributed to predict post-recurrence survival of patients with recurrent pancreatic cancer.
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Affiliation(s)
- Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Teppei Sunaguchi
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Keisuke Goto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Masaki Morimoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Yuki Murakami
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori prefecture, Japan
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Miyatani K, Sawata S, Makinoya M, Miyauchi W, Shimizu S, Shishido Y, Matsunaga T, Yamamoto M, Tokuyasu N, Takano S, Sakamoto T, Hasegawa T, Saito H, Fujiwara Y. Combined analysis of preoperative and postoperative lymphocyte-C-reactive protein ratio precisely predicts outcomes of patients with gastric cancer. BMC Cancer 2022; 22:641. [PMID: 35690739 PMCID: PMC9188155 DOI: 10.1186/s12885-022-09716-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 05/30/2022] [Indexed: 12/24/2022] Open
Abstract
Background The systemic inflammatory response resulting from the complex interactions between cancer and the host plays an important role in cancer development. Recently, the lymphocyte-C-reactive protein ratio (LCR), which is a hematological and biochemical marker that reflects the systemic inflammatory response and nutritional status, has been reported to be associated with poor survival. Similar results were observed in patients with certain cancer types. However, these studies focused on the preoperative LCR, and thus far, no studies have reported the relationship between postoperative LCR and prognosis in patients with gastric cancer (GC). Methods This study enrolled 455 patients with a histopathological diagnosis of gastric adenocarcinoma who underwent curative surgery at our institution between 2005 and 2018. The relationship between both the preoperative and postoperative LCR and the prognosis of patients with GC was retrospectively investigated. Results Preoperative LCR showed significant correlations with tumor-related factors, such as tumor size, depth of invasion, and lymph node metastasis. By contrast, no correlation was observed between postoperative LCR and tumor-related factors. The 5 year survival rate was significantly worse in patients with low preoperative LCR than in those with high preoperative LCR (65.4% vs. 83.9%, p < 0.0001). Similarly, the 5 year survival rate was also significantly worse in patients with low postoperative LCR than in those with high postoperative LCR (67.0% vs. 84.1%, p < 0.0001). Furthermore, combination analysis of the pre- and postoperative LCR revealed that the prognosis of patients with both low pre- and postoperative LCR was worse in patients with GC (5 year survival rate was 52.0%). A multivariate analysis indicated that a low pre- and postoperative LCR and age and lymph node metastasis were independent prognostic indicators. Conclusions The combination of preoperative and postoperative LCR appears to be useful in predicting the prognosis of patients with GC.
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Affiliation(s)
- Kozo Miyatani
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
| | - Shohei Sawata
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Masahiro Makinoya
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Wataru Miyauchi
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Shota Shimizu
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Yuji Shishido
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Tomoyuki Matsunaga
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Manabu Yamamoto
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Naruo Tokuyasu
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Shuichi Takano
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Teruhisa Sakamoto
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Toshimichi Hasegawa
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Hiroaki Saito
- Department of Surgery, Japanese Red Cross Tottori Hospital, Tottori, 680‑8517, Japan
| | - Yoshiyuki Fujiwara
- Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
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Hanaki T, Tokuyasu N, Sakamoto T, Fujiwara Y. Hepatectomy guided by indocyanine green fluorescent imaging for visualizing bile leakage (with video). Clin Case Rep 2022; 10:e05942. [PMID: 35662771 PMCID: PMC9165200 DOI: 10.1002/ccr3.5942] [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: 03/05/2022] [Revised: 05/03/2022] [Accepted: 05/20/2022] [Indexed: 11/08/2022] Open
Abstract
Using indocyanine green (ICG), a standard reagent used in liver function tests, bile leaks from exfoliated liver sections can be detected with higher sensitivity than naked‐eye observation. This presentation will introduce the technique of using ICG to detect bile leaks that cannot be detected by the naked eye.
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Affiliation(s)
- Takehiko Hanaki
- Department of Gastrointestinal and Pediatric Surgery School of Medicine Tottori University Faculty of Medicine Yonago Japan
| | - Naruo Tokuyasu
- Department of Gastrointestinal and Pediatric Surgery School of Medicine Tottori University Faculty of Medicine Yonago Japan
| | - Teruhisa Sakamoto
- Department of Gastrointestinal and Pediatric Surgery School of Medicine Tottori University Faculty of Medicine Yonago Japan
| | - Yoshiyuki Fujiwara
- Department of Gastrointestinal and Pediatric Surgery School of Medicine Tottori University Faculty of Medicine Yonago Japan
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Matsunaga T, Saito H, Osaki T, Takahashi S, Iwamoto A, Fukuda K, Taniguchi K, Kuroda H, Takeuchi T, Sugamura K, Sumi K, Katano K, Shishido Y, Miyatani K, Fujiwara Y. Impact of geriatric nutritional risk index on outcomes after gastrectomy in elderly patients with gastric cancer: a retrospective multicenter study in Japan. BMC Cancer 2022; 22:540. [PMID: 35549906 PMCID: PMC9103416 DOI: 10.1186/s12885-022-09638-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 03/15/2022] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several studies investigated the utility of inflammation and nutritional markers in predicting the prognosis in patients with gastric cancer; however, the markers with the best predictive ability remain unclear. This retrospective study aimed to determine inflammation and nutritional markers that predicted prognosis in elderly patients over 75 years of age undergoing curative gastrectomy for gastric cancer. METHODS Between January 2005 and December 2015, 497 consecutive elderly gastric cancer patients aged over 75 years underwent curative gastrectomy in 12 institutions. The geriatric nutritional risk index (GNRI), prognostic nutritional index, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and C-reactive protein/albumin ratio were examined as prognostic markers for overall survival (OS) and disease-specific survival (DSS) using area under the curve (AUC) using receiver operating characteristic (ROC) curve analysis. RESULTS The GNRI had the highest AUC and predictive value for both OS (0.637, p < 0.001) and DSS (AUC 0.645, p < 0.001). The study cohort was categorized into the high and low GNRI groups based on the optimal GNRI cut-off values for OS (97.0) and DSS (95.8) determined with the ROC analysis. For both OS and DSS, there was a significant correlation between the GNRI and several clinicopathological factors including age, body mass index, albumin, American Society of Anesthesiologists physical status score, depth of tumor invasion, lymph node metastasis, lymphatic invasion, pathological stage, operation duration, bleeding, procedure, approach, death due to primary disease, and death due to other disease. The GNRI remained a crucial independent prognostic factor for both OS (Hazard ratio [HR] = 1.905, p < 0.001) and DSS in multivariate analysis (HR = 1.780, p = 0.043). CONCLUSIONS Among a panel of inflammation and nutritional markers, the GNRI exhibited the best performance as a prognostic factor after curative gastrectomy in elderly patients with gastric cancer, indicating its utility as a simple and promising index for predicting OS and DSS in these patients.
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Affiliation(s)
- Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
| | - Hiroaki Saito
- Department of Surgery, Japanese Red Cross Tottori Hospital, Tottori, 680-8517, Japan
| | - Tomohiro Osaki
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, 680-0901, Japan
| | - Sadamu Takahashi
- National Hospital Organization, Hamada Medical Center, Hamada, 697-8511, Japan
| | - Akemi Iwamoto
- Divisions of Digestive Surgery, Tottori Prefectural Kousei Hospital, Kurayoshi, 682-0804, Japan
| | - Kenji Fukuda
- Department of Surgery, Sanin Rosai Hospital, Yonago, 683-8605, Japan
| | - Kenjiro Taniguchi
- Department of Surgery, Yonago Medical Center of National Hospital Organization, Yonago, 683-0006, Japan
| | - Hirohiko Kuroda
- Department of Surgery, Japanese Red Cross Masuda Hospital, Masuda, 698-8501, Japan
| | - Tsutomu Takeuchi
- Department of Surgery, Tottori Seikyo Hospital, Tottori, 680-0833, Japan
| | - Kenji Sugamura
- Department of Surgery, Yasugi Municipal Hospital, Yasugi, 692-0404, Japan
| | - Kenichi Sumi
- Department of Surgery, Hakuai Hospital, Yonago, 683-0853, Japan
| | - Kuniyuki Katano
- Department of Surgery, The Nanbu Town National Health Insurance Saihaku Hospital, Nanbu, 683-0323, Japan
| | - Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan
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Hanaki T, Sunaguchi T, Goto K, Morimoto M, Murakami Y, Tokuyasu N, Takano S, Sakamoto T, Hasegawa T, Fujiwara Y. Laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage for acute cholecystitis in a patient with a left ventricle assist device: A case report and brief review of the literature (with video). Clin Case Rep 2022; 10:e05800. [PMID: 35620263 PMCID: PMC9124613 DOI: 10.1002/ccr3.5800] [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: 02/26/2022] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 12/07/2022] Open
Abstract
For acute cholecystitis in patients with left ventricular assist devices, the use of percutaneous transhepatic gallbladder drainage to calm inflammation before planned laparoscopic cholecystectomy may be helpful in safely adjusting anticoagulation and in performing safe laparoscopic cholecystectomy, as demonstrated in this case.
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Affiliation(s)
- Takehiko Hanaki
- Department of Gastrointestinal and Pediatric SurgerySchool of MedicineTottori University Faculty of MedicineYonagoJapan
| | - Teppei Sunaguchi
- Department of Gastrointestinal and Pediatric SurgerySchool of MedicineTottori University Faculty of MedicineYonagoJapan
| | - Keisuke Goto
- Department of Gastrointestinal and Pediatric SurgerySchool of MedicineTottori University Faculty of MedicineYonagoJapan
| | - Masaki Morimoto
- Department of Gastrointestinal and Pediatric SurgerySchool of MedicineTottori University Faculty of MedicineYonagoJapan
| | - Yuki Murakami
- Department of Gastrointestinal and Pediatric SurgerySchool of MedicineTottori University Faculty of MedicineYonagoJapan
| | - Naruo Tokuyasu
- Department of Gastrointestinal and Pediatric SurgerySchool of MedicineTottori University Faculty of MedicineYonagoJapan
| | - Shuichi Takano
- Department of Gastrointestinal and Pediatric SurgerySchool of MedicineTottori University Faculty of MedicineYonagoJapan
| | - Teruhisa Sakamoto
- Department of Gastrointestinal and Pediatric SurgerySchool of MedicineTottori University Faculty of MedicineYonagoJapan
| | - Toshimichi Hasegawa
- Department of Gastrointestinal and Pediatric SurgerySchool of MedicineTottori University Faculty of MedicineYonagoJapan
| | - Yoshiyuki Fujiwara
- Department of Gastrointestinal and Pediatric SurgerySchool of MedicineTottori University Faculty of MedicineYonagoJapan
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Shishido Y, Matsunaga T, Makinoya M, Miyauchi W, Shimizu S, Miyatani K, Uejima C, Morimoto M, Murakami Y, Hanaki T, Kihara K, Yamamoto M, Tokuyasu N, Takano S, Sakamoto T, Saito H, Hasegawa T, Fujiwara Y. Circular stapling anastomosis with indocyanine green fluorescence imaging for cervical esophagogastric anastomosis after thoracoscopic esophagectomy: a propensity score-matched analysis. BMC Surg 2022; 22:152. [PMID: 35488244 PMCID: PMC9052471 DOI: 10.1186/s12893-022-01602-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/18/2022] [Indexed: 12/24/2022] Open
Abstract
Background Thoracoscopic esophagectomy has been extensively used worldwide as a curative surgery for patients with esophageal cancer; however, complications such as anastomotic leakage and stenosis remain a major concern. Therefore, the objective of this study was to evaluate the efficacy of circular stapling anastomosis with indocyanine green (ICG) fluorescence imaging, which was standardized for cervical esophagogastric anastomosis after thoracoscopic esophagectomy. Methods Altogether, 121 patients with esophageal cancer who underwent thoracoscopic esophagectomy with radical lymph node dissection and cervical esophagogastric anastomosis from November 2009 to December 2020 at Tottori University Hospital were enrolled in this study. Patients who underwent surgery before the anastomotic method was standardized were included in the classical group (n = 82) and patients who underwent surgery after the anastomotic method was standardized were included in the ICG circular group (n = 39). The short-term postoperative outcomes, including anastomotic complications, were compared between the two groups using propensity-matched analysis and the risk factors for anastomotic leakage were evaluated using logistic regression analyses. Results Of the 121 patients, 33 were included in each group after propensity score matching. The clinicopathological characteristics of patients did not differ between the two groups after propensity score matching. In terms of perioperative outcomes, a significantly higher proportion of patients who underwent surgery using the laparoscopic approach (P < 0.001) and narrow gastric tube (P = 0.003), as well as those who had a lower volume of blood loss (P = 0.009) in the ICG circular group were observed after matching. Moreover, the ICG circular group had a significantly lower incidence of anastomotic leakage (39% vs. 9%, P = 0.004) and anastomotic stenosis (46% vs. 21%, P = 0.037) and a shorter postoperative hospital stay (30 vs. 20 days, P < 0.001) than the classical group. According to the multivariate analysis, the anastomotic method was an independent risk factor for anastomotic leakage after thoracoscopic esophagectomy (P = 0.013). Conclusions Circular stapling anastomosis with ICG fluorescence imaging is effective in reducing complications such as anastomotic leakage and stenosis.
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Affiliation(s)
- Yuji Shishido
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan.
| | - Tomoyuki Matsunaga
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Masahiro Makinoya
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Wataru Miyauchi
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Shota Shimizu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Kozo Miyatani
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Chihiro Uejima
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Masaki Morimoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Yuki Murakami
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Takehiko Hanaki
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Naruo Tokuyasu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Shuichi Takano
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Teruhisa Sakamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Hiroaki Saito
- Department of Surgery, Japanese Red Cross Tottori Hospital, 117 Shotoku-cho, 680- 8517, Tottori, Japan
| | - Toshimichi Hasegawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, 683-8504, Yonago, Japan
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Matsunaga T, Saito H, Kuroda H, Osaki T, Takahashi S, Iwamoto A, Fukumoto Y, Taniguchi K, Fukuda K, Miyauchi W, Shishido Y, Miyatani K, Fujiwara Y. CA19-9 in combination with P-CRP as a predictive marker of immune-related adverse events in patients with recurrent or unresectable advanced gastric cancer treated with nivolumab. BMC Cancer 2022; 22:418. [PMID: 35428212 PMCID: PMC9013067 DOI: 10.1186/s12885-022-09482-8] [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: 05/13/2021] [Accepted: 04/02/2022] [Indexed: 12/04/2022] Open
Abstract
Background Immune-check point inhibitors (ICPIs) for treatment of cancer patients sometimes induce potentially life-threatening immune-related adverse events (irAEs), which predict ICPIs treatment efficacy. Prediction of irAEs would be useful for management of irAEs and prediction of ICPIs efficacy. This study aimed to determine predictors of irAEs in patients with recurrent or unresectable advanced gastric cancer (RUGC) treated with nivolumab. Methods Seventy-eight RUGC patients treated with nivolumab at nine institutions between January 2017 and April 2020 were included in this study. The usefulness of specific blood test results as predictors of irAEs was evaluated. Results We observed irAEs in 15 (19.2%) patients. The disease control rate was significantly higher in the patients with irAEs than in those without (86.7% vs. 42.9%; P < 0.001). The median progression-free survival was significantly longer for patients with irAEs than for patients without (4.9 vs. 2.6 months; P = 0.018). The median survival time was longer for patients with irAEs than for those without (9.4 vs. 5.8 months; P = 0.041). The receiver operating characteristic (ROC) curves for irAEs indicated that the area under the curve (AUC) of carbohydrate antigen 19–9 (CA19-9) was highest (0.692; P = 0.022), followed by that for the platelet count × serum C-reactive protein (P-CRP) value (0.680; P = 0.032). The AUC for the CA19-9 + P-CRP combination was 0.782, which was more useful than that for either component and significantly associated with overall survival of nivolumab-treated RUGC patients. Conclusions The CA19-9 + P-CRP combination was predictive of irAEs and prognosis in RUGC patients.
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Yagyu T, Yamamoto M, Tanio A, Hara K, Sugezawa K, Uejima C, Kihara K, Tatebe S, Kurisu Y, Shibata S, Yamamoto T, Nishie H, Shiota S, Saito H, Naka T, Sugamura K, Katano K, Fujiwara Y. Risk factors for recurrence in elderly patients with stage II colorectal cancer: a multicenter retrospective study. BMC Cancer 2022; 22:390. [PMID: 35410196 PMCID: PMC8996530 DOI: 10.1186/s12885-022-09501-8] [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: 02/17/2022] [Accepted: 04/04/2022] [Indexed: 11/21/2022] Open
Abstract
Background Adjuvant chemotherapy for stage II colorectal cancer (CRC) is considered appropriate for patients with risk factors for recurrence, rather than for all patients uniformly. However, the risk factors for recurrence remain controversial, and there is limited information, especially for elderly patients. The Geriatric Nutritional Risk Index (GNRI) is widely used as a simple nutritional screening tool in the elderly and is associated with cancer prognosis and recurrence. This study aimed to investigate the risk factors for recurrence in the elderly with stage II CRC, focusing on the GNRI. Methods We enrolled 348 elderly patients (≥ 75 years) with stage II CRC who underwent curative resection at the Department of Surgery, Tottori University and our 10 affiliated institutions. The patients were divided into GNRIhigh (≥ 93.465) and GNRIlow (< 93.465) groups. Results The GNRIlow group showed a significantly worse overall survival (OS), cancer-specific survival (CSS), and relapse-free survival (RFS) (P < 0.001, P < 0.001, and P < 0.001, respectively). In a multivariate analysis, GNRIlow (hazard ratio [HR]: 2.244, P < 0.001), pathologic T4 stage (HR: 1.658, P = 0.014), and moderate to severe lymphatic or venous invasion (HR: 1.460, P = 0.033) were independent factors affecting RFS. By using these three factors to score the risk of recurrence from 0 to 3 points, the prognosis was significantly stratified in terms of OS, CSS, and RFS (P < 0.001, P < 0.001, and P < 0.001, respectively). The recurrence rate for each score was as follows: 0 points, 9.8%; 1 point, 22.0%; 2 points, 37.3%; and 3 points, 61.9%. Conclusions GNRIlow, pathologic T4 stage, and moderate to severe lymphatic or venous invasion are high-risk factors for recurrence in the elderly with stage II CRC. The scoring system using these three factors appropriately predicted their recurrence and outcome.
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Affiliation(s)
- Takuki Yagyu
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Manabu Yamamoto
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan.
| | - Akimitsu Tanio
- Department of Surgery, Japanese Red Cross Tottori Hospital, Tottori, Japan
| | - Kazushi Hara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Ken Sugezawa
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Chihiro Uejima
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Kyoichi Kihara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
| | - Shigeru Tatebe
- Department of Surgery, Tottori Prefectural Central Hospital, Tottori, Japan
| | - Yasuro Kurisu
- Department of Surgery, National Hospital Organization Hamada Medical Center, Hamada, Japan
| | | | | | - Hiroshi Nishie
- Department of Gastroenterological Surgery, Tottori Prefectural Kosei Hospital, Kurayoshi, Japan
| | - Setsujo Shiota
- Department of Surgery, Masuda Red Cross Hospital, Masuda, Japan
| | - Hiroaki Saito
- Department of Surgery, Japanese Red Cross Tottori Hospital, Tottori, Japan
| | - Takuji Naka
- Department of Surgery, National Hospital Organization, Yonago Medical Center, Yonago, Japan
| | - Kenji Sugamura
- Department of Surgery, Yasugi City Hospital, Yasugi, Japan
| | - Kuniyuki Katano
- Department of Surgery, The Nanbu Town National Health Insurance Saihaku Hospital, Nanbu, Japan
| | - Yoshiyuki Fujiwara
- Division of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, 683-8504, Japan
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50
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Nagasaka M, Sugawara S, Choi CM, Okamoto T, Yanagitani N, Nosaki K, Takahashi T, Fujiwara Y, Hayashi H, Khoury J, Nieva J, Gabayan A, Raez L, Chen H, Dimou A, Pennell N, Liu G, Ou SH, Seto T, Ohe Y. 77TiP TRUST-II: A global phase II study for taletrectinib in ROS1 fusion-positive lung cancer and other solid tumors. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.086] [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: 11/01/2022] Open
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