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Umetani Y, Aoyagi K, Kaku H, Tanaka Y, Minami T, Isobe T, Kizaki J, Murakami N, Fujita F, Akagi Y. Factors Associated with Perioperative Edema in Patients with Stage I Gastric Cancer Using a Body Composition Analyzer. Kurume Med J 2024; 69:201-208. [PMID: 38233179 DOI: 10.2739/kurumemedj.ms6934010] [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] [Indexed: 01/19/2024]
Abstract
PURPOSE Assessment of nutritional status and nutritional interventions is important in gastric cancer patients. We investigated the factors associated with perioperative edema in patients with stage I gastric cancer using a body composition analyzer. METHODS The study included 106 patients with stage I gastric cancer who underwent distal gastrectomy. The body composition of each patient was evaluated by bioelectrical impedance analysis (BIA) using an InBody 720 body composition analyzer. Patients with an extracellular water to total body water ratio of ≥ 0.4 before and 1 week after gastrectomy were considered to have edema, the cause of which was determined retrospectively. RESULTS Patients with preoperative edema were significantly older, had a significantly higher lymph node metastasis rate and disease stage, and had a significantly poorer Controlling Nutritional Status (CONUT) score, and Prognostic Nutritional Index (PNI) compared with patients without preoperative edema. The group with postoperative edema had significantly higher proportions of elderly and female patients as well as a higher rate of Billroth-II reconstruction compared with the group without postoperative edema. The group with postoperative edema also had significantly lower intracellular water content, total body water content, protein content, skeletal muscle mass, and PNI. CONCLUSIONS Preoperative edema occurs in elderly patients with poor nutritional status, and postoperative edema occurs in elderly patients with a shorter operative time. Perioperative edema status assessed by BIA is thought to be related to perioperative nutritional status.
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Affiliation(s)
- Yuki Umetani
- Department of Surgery, Kurume University of Medicine
| | | | - Hideaki Kaku
- Department of Surgery, Kurume University of Medicine
| | - Yuya Tanaka
- Department of Surgery, Kurume University of Medicine
| | - Taizan Minami
- Department of Surgery, Kurume University of Medicine
| | - Taro Isobe
- Department of Surgery, Kurume University of Medicine
| | - Junya Kizaki
- Department of Surgery, Kurume University of Medicine
| | | | | | - Yoshito Akagi
- Department of Surgery, Kurume University of Medicine
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Yoshida N, Nakamura K, Shigaki T, Fujiyoshi K, Koushi K, Yoshida T, Isobe T, Mori N, Sudo T, Sakai H, Hisaka T, Ishibashi N, Akiba J, Fujita F. Laparoscopic transabdominal approach for resection of presacral epidermoid cyst in an obese man: a case report. Surg Case Rep 2024; 10:120. [PMID: 38739350 DOI: 10.1186/s40792-024-01924-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/08/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Complete resection of presacral epidermoid cysts is recommended due to the potential for infection or malignancy. Transsacral and transabdominal approaches have been used to treat presacral tumors. However, there are no standard surgical approaches to resection. We present the case of a presacral epidermoid cyst in an obese male patient who underwent laparoscopic transabdominal resection. CASE PRESENTATION A 44-year-old man was referred to our hospital for treatment of a cystic tumor on the pelvic floor. Contrast-enhanced computed tomography revealed a 45 × 40-mm tumor on the left ventral side of the rectum, right side of the ischial spine, dorsal side of the seminal vesicles, and in front of the 5th sacrum. Enhanced magnetic resonance imaging revealed a multilocular cystic tumor with high and low signal intensities on T2-weighted images. The tumor was diagnosed as an epidermoid cyst. We considered the transsacral or laparoscopic approach and decided to perform a laparoscopic-assisted transabdominal resection since the tumor was in front of away from the sacrum, and a transsacral approach would result in a larger scar due to poor visibility from the thickness of the buttocks. The entire tumor was safely resected under laparoscopic guidance, because the laparoscopic transabdominal approach can provide a good and magnified field of view even in a narrow pelvic cavity with small skin incisions, allowing safe resection of the pelvic organs, vessels, and nerves while observing the tumor contour. CONCLUSIONS The laparoscopic transabdominal approach is an effective method for treating presacral tumors in obese patients.
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Affiliation(s)
- Naohiro Yoshida
- Department of Surgery, Kurume University School of Medicine, 67, Asahi-machi, Kurume-shi, Fukuoka, 8300011, Japan.
| | - Koki Nakamura
- Department of Surgery, Kurume University School of Medicine, 67, Asahi-machi, Kurume-shi, Fukuoka, 8300011, Japan
| | - Takahiro Shigaki
- Department of Surgery, Kurume University School of Medicine, 67, Asahi-machi, Kurume-shi, Fukuoka, 8300011, Japan
| | - Kenji Fujiyoshi
- Department of Surgery, Kurume University School of Medicine, 67, Asahi-machi, Kurume-shi, Fukuoka, 8300011, Japan
| | - Kenichi Koushi
- Department of Surgery, Kurume University School of Medicine, 67, Asahi-machi, Kurume-shi, Fukuoka, 8300011, Japan
| | - Takefumi Yoshida
- Department of Surgery, Kurume University School of Medicine, 67, Asahi-machi, Kurume-shi, Fukuoka, 8300011, Japan
| | - Taro Isobe
- Department of Surgery, Kurume University School of Medicine, 67, Asahi-machi, Kurume-shi, Fukuoka, 8300011, Japan
| | - Naoki Mori
- Department of Surgery, Kurume University School of Medicine, 67, Asahi-machi, Kurume-shi, Fukuoka, 8300011, Japan
| | - Tomoya Sudo
- Department of Surgery, Kurume University School of Medicine, 67, Asahi-machi, Kurume-shi, Fukuoka, 8300011, Japan
| | - Hisamune Sakai
- Department of Surgery, Kurume University School of Medicine, 67, Asahi-machi, Kurume-shi, Fukuoka, 8300011, Japan
| | - Toru Hisaka
- Department of Surgery, Kurume University School of Medicine, 67, Asahi-machi, Kurume-shi, Fukuoka, 8300011, Japan
| | - Nobuya Ishibashi
- Department of Surgery, Kurume University School of Medicine, 67, Asahi-machi, Kurume-shi, Fukuoka, 8300011, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, 67, Asahi-machi, Kurume-shi, Fukuoka, 8300011, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, 67, Asahi-machi, Kurume-shi, Fukuoka, 8300011, Japan
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Saisho K, Mori N, Nakagawa M, Nakamura E, Tanaka Y, Kaku H, Tanaka Y, Isobe T, Otsuka H, Sudo T, Sakai H, Ishibashi N, Hisaka T, Tayama E, Fujita F. Aortoesophageal fistula due to esophageal cancer: a case report of successful management. Surg Case Rep 2024; 10:88. [PMID: 38630370 PMCID: PMC11024079 DOI: 10.1186/s40792-024-01893-y] [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: 09/30/2023] [Accepted: 04/08/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Aortoesophageal fistula (AEF) is a rare but potentially life-threatening condition. The best treatment for the AEF due to esophageal carcinoma is still unresolved. Here, we report a rare case of AEF caused by esophageal cancer, that was successfully treated with emergency thoracic endovascular aortic repair (TEVAR), followed by esophagectomy and gastric tube reconstruction. CASE PRESENTATION A 64-year-old man presented with loss of consciousness and hypotension during chemoradiotherapy for advanced esophageal cancer. Enhanced computed tomography showed extravasation from the descending aorta into the esophagus at the tumor site. We performed emergency TEVAR for the AEF, which stabilized the hemodynamics. We then performed thoracoscopic subtotal esophagectomy on day 4 after TEVAR to prevent graft infection, followed by gastric tube reconstruction on day 30 after TEVAR. At 9 months after the onset of AEF, the patient continues to receive outpatient chemotherapy and leads a normal daily life. CONCLUSION TEVAR is a useful hemostatic procedure for AEF. If the patient is in good condition and can continue treatment for esophageal cancer, esophagectomy and reconstruction after TEVAR should be performed to prevent graft infection and maintain quality of life.
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Affiliation(s)
- Kohei Saisho
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Naoki Mori
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Masashi Nakagawa
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Eiji Nakamura
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yu Tanaka
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hideaki Kaku
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yuya Tanaka
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Taro Isobe
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hiroyuki Otsuka
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Tomoya Sudo
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hisamune Sakai
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Nobuya Ishibashi
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Toru Hisaka
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Eiki Tayama
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, 67, Asahi Machi, Kurume, Fukuoka, 830-0011, Japan
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Nishikawa Y, Horimatsu T, Oka S, Yamada T, Mitsui K, Yamamoto H, Takahashi K, Shiomi A, Hotta K, Takeuchi Y, Kuwai T, Ishida F, Kudo SE, Saito S, Ueno M, Sunami E, Yamano T, Itabashi M, Ohtsuka K, Kinugasa Y, Matsumoto T, Sugai T, Uraoka T, Kurahara K, Yamaguchi S, Kato T, Okajima M, Kashida H, Fujita F, Ikematsu H, Ito M, Esaki M, Kawai M, Yao T, Hamada M, Koda K, Fukai Y, Komori K, Saitoh Y, Kanemitsu Y, Takamaru H, Yamada K, Nozawa H, Takayama T, Togashi K, Shinto E, Torisu T, Toyoshima A, Ohmiya N, Kato T, Otsuji E, Nagata S, Hashiguchi Y, Sugihara K, Ajioka Y, Tanaka S. Outcomes of Metastatic and Unresectable Small Bowel Adenocarcinoma in Japan According to the Treatment Strategy: A Nationwide Observational Study. JCO Glob Oncol 2024; 10:e2300392. [PMID: 38330276 PMCID: PMC10860990 DOI: 10.1200/go.23.00392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 11/20/2023] [Indexed: 02/10/2024] Open
Abstract
PURPOSE Limited information is available regarding the characteristics and outcomes of stage IV small bowel adenocarcinoma (SBA) in Japan. This study examined the clinical and pathological characteristics and outcomes according to the treatment strategies in patients with stage IV SBA. METHODS This retrospective observational study used the data of patients with jejunal or ileal adenocarcinoma collected by the Small Bowel Malignant Tumor Project of the Japanese Society for Cancer of the Colon and Rectum. Descriptive statistics were expressed as the mean (standard deviation) or median (range). Survival analysis was performed using Kaplan-Meier curves and pairwise log-rank tests. RESULTS Data from 128 patients were analyzed. The treatment strategies were chemotherapy alone (26 of 128, 20.3%), surgery alone (including palliative surgery; 21 of 128, 16.4%), surgery + chemotherapy (74 of 128, 57.8%), and best supportive care (7 of 128, 5.5%). The median (range) overall survival was 16 (0-125) months overall, and 11 (1-38) months, 8 (0-80) months, 18 (0-125) months, and 0 (0-1) months for the chemotherapy, surgery, surgery + chemotherapy, and best supportive care groups, respectively. Three main categories of chemotherapeutic regimen were used: a combination of fluoropyrimidine and oxaliplatin (F + Ox), fluoropyrimidine and irinotecan (F + Iri), and single-agent fluoropyrimidine. Among patients treated with chemotherapy, the median (range) OS was 16 (1-106) months overall, and 17 (1-87) months, 29 (7-39) months, and 16 (1-106) months in patients treated with fluoropyrimidine, F + Iri, and F + Ox, respectively. CONCLUSION Patients treated with surgery, chemotherapy, or both had a better prognosis than those who received best supportive care. Among patients who received chemotherapy, survival did not differ according to the chemotherapeutic regimen.
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Affiliation(s)
- Yoshitaka Nishikawa
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
- Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan
| | - Takahiro Horimatsu
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Shiro Oka
- Department of Gastroenterology, Hiroshima University Hospital, Hiroshima, Japan
| | - Takeshi Yamada
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan
| | - Keigo Mitsui
- Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan
| | - Hironori Yamamoto
- Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, Japan
| | - Keiichi Takahashi
- Department of Colorectal Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Akio Shiomi
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kinichi Hotta
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yoji Takeuchi
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Toshio Kuwai
- Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Fumio Ishida
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | - Shin-Ei Kudo
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | - Shoichi Saito
- Department of Lower Gastrointestinal Medicine, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Masashi Ueno
- Department of Gastroenterological and Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Eiji Sunami
- Department of Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | - Tomoki Yamano
- Division of Lower Gastrointestinal Surgery, Department of Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Michio Itabashi
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Kazuo Ohtsuka
- Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Kinugasa
- Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takayuki Matsumoto
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan
| | - Tamotsu Sugai
- Department of Diagnostic Pathology, Iwate Medical University, Iwate, Japan
| | - Toshio Uraoka
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Koichi Kurahara
- Division of Gastroenterology, Matsuyama Red Cross Hospital, Ehime, Japan
| | - Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Tomohiro Kato
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Masazumi Okajima
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Hiroshi Kashida
- Department of Gastroenterology and Hepatology, Kindai University, Osaka, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroaki Ikematsu
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Chiba, Japan
| | - Masaaki Ito
- Department of Colorectal Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Motohiro Esaki
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Masaya Kawai
- Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Takashi Yao
- Department of Human Pathology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Madoka Hamada
- Department of Gastrointestinal Surgery, Kansai Medical University Hospital, Osaka, Japan
| | - Keiji Koda
- Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan
| | - Yasumori Fukai
- Department of Gastroenterology, Maebashi Red Cross Hospital, Gunma, Japan
| | - Koji Komori
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan
| | - Yusuke Saitoh
- Department of Gastroenterology, Asahikawa City Hospital, Asahikawa, Japan
| | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | | | - Kazutaka Yamada
- Department of Surgery, Coloproctology Center Takano Hospital, Kumamoto, Japan
| | - Hiroaki Nozawa
- Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan
| | - Tetsuji Takayama
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Kazutomo Togashi
- Department of Coloproctology, Aizu Medical Center Fukushima Medical University, Fukushima, Japan
| | - Eiji Shinto
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Takehiro Torisu
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akira Toyoshima
- Department of Colorectal Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Naoki Ohmiya
- Department of Advanced Endoscopy, Fujita Health University School of Medicine, Aichi, Japan
| | - Takeshi Kato
- Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shinji Nagata
- Department of Gastroenterology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
| | - Yojiro Hashiguchi
- Department of Surgery, Japanese Red Cross Omori Hospital, Tokyo, Japan
| | | | - Yoichi Ajioka
- Division of Molecular and Diagnostic Pathology Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Tanaka T, Nagasu S, Furuta T, Gobaru M, Suzuki H, Shimotsuura Y, Akiba J, Nomura M, Fujita F, Kawaguchi T, Miwa K. Case report: A case of fulminant type 1 diabetes mellitus after COVID-19 vaccination during treatment of advanced gastric cancer: pitfall in managing immune-related adverse events. Front Oncol 2023; 13:1264281. [PMID: 38173838 PMCID: PMC10762640 DOI: 10.3389/fonc.2023.1264281] [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] [Accepted: 11/14/2023] [Indexed: 01/05/2024] Open
Abstract
The occurrence of fulminant type 1 diabetes mellitus as an adverse event during cancer immunotherapy has been previously reported. However, little is known about the causal relationship between the coronavirus disease 2019 (COVID-19) vaccination and fulminant type 1 diabetes mellitus. A 60-year-old man with advanced gastric cancer, receiving S-1 + oxaliplatin and nivolumab therapy, followed by nab-paclitaxel + ramucirumab as a second-line treatment, with steroid supplementation for complications of hypopituitarism-induced hypoadrenocorticism, was administered a COVID-19 vaccine after three cycles of nab-paclitaxel + ramucirumab. Two days later, he developed severe malaise and anorexia, which required emergency admission to our hospital for suspected adrenal insufficiency. Despite increasing steroids, his general condition changed suddenly after 12 hours leading to his death. Histopathological analysis of autopsy samples revealed loss of the islets of Langerhans, indicating fulminant type 1 diabetes mellitus. We failed to recognize the onset of fulminant type 1 diabetes mellitus because its symptoms were similar to those of adrenal insufficiency. The number of reports on the onset of fulminant type 1 diabetes mellitus after COVID-19 vaccination has been increasing, and in this case, the onset occurred on the second day after COVID-19 vaccination, suggesting an association between vaccination and fulminant type 1 diabetes mellitus. Clinicians should be aware of the risk of fulminant type 1 diabetes mellitus, although rare, after COVID-19 vaccination.
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Affiliation(s)
- Toshimitsu Tanaka
- Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Japan
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Sachiko Nagasu
- Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Japan
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Takuya Furuta
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Mizuki Gobaru
- Division of Endocrinology and Metabolism, Kurume University School of Medicine, Kurume, Japan
| | - Hiroyuki Suzuki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yasutaka Shimotsuura
- Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Japan
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Masatoshi Nomura
- Division of Endocrinology and Metabolism, Kurume University School of Medicine, Kurume, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Keisuke Miwa
- Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Japan
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Matono S, Mori N, Hino H, Saisho K, Nakagawa M, Fujisaki M, Tanaka T, Ishibashi N, Fujita F, Akagi Y. [A Patient Who Had Postoperative Three-Field Lymph Node Recurrence of Cancer of the Esophagogastric Junction Obtains Complete Response by DCF Treatment]. Gan To Kagaku Ryoho 2023; 50:1323-1326. [PMID: 38247073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
A 64-year-old woman underwent left-thoracoabdominal esophagectomy and esophagojejunostomy for cancer of the esophagogastric junction. The pathological examination of the resected specimen showed a poorly squamous cell carcinoma (SCC). The pathological stage was pT3, pN1, sM0, and fStage Ⅲ. Three months after surgery, an SCC antigen related to a tumor marker was found to be outside the normal range, and CT showed lymph node recurrence of the three fields(No. 101R, No. 104RL, No. 106recRL, No. 106pre, and No. 16b1). Because the lymph node recurrence was in the three fields, we performed systemic chemotherapy with docetaxel, cisplatin(CDDP), and 5-fluorouracil(5-FU)(collectively, DCF). After the patient received 2 courses of DCF therapy, the lymph nodes where the recurrent occurred decreased in size(partial response), and SCC became within normal range. She received additional chemotherapy with 2 courses of DCF and achieved a complete response. Currently, she has been alive without recurrence for 7 years and 9 months after 4 courses of DCF therapy. We think that we can select DCF therapy as a first-line treatment for lymph node recurrence alone but not for CRT with FP.
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Affiliation(s)
- Satoru Matono
- Dept. of Surgery, Kurume University School of Medicine
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Sakai H, Goto Y, Shimose S, Niizeki T, Kawaguchi T, Akiba J, Yano H, Akagi Y, Fujita F, Hisaka T. [Minimally Invasive Conversion Hepatectomy for Advanced Hepatocellular Carcinoma]. Gan To Kagaku Ryoho 2023; 50:1572-1574. [PMID: 38303345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Some cases of advanced hepatocellular carcinoma(HCC)diagnosed as unresectable(UR)have been reported to undergo conversion surgery following systemic therapy. Furthermore, the combination of atezolizumab plus bevacizumab(Atez/Bev) shows potential therapeutic effects in conversion surgery for UR-HCC. At our hospital, neoadjuvant chemotherapy(NAC) using New-FP therapy(hepatic arterial infusion chemotherapy: HAIC)has been performed for borderline resectable HCC. New-FP therapy for advanced HCC with macrovascular invasion has a high response rate of 70%. For hepatectomy after NAC, a high response rate is required as a pretreatment, and New-FP therapy may be useful as the initial treatment. Limited reports exist of the laparoscopic approach in conversion surgery for advanced HCC. However, 14 cases of minimally invasive liver resection, including 10 cases after New-FP therapy and 4 cases after Atez/Bev therapy, have been safely performed conversion surgery for advanced HCC. In selected patients with advanced HCC, minimally invasive liver resection may be safely performed if the tumor shows shrinkage with various treatments.
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Arai S, Miyazaki D, Hashimoto K, Midorikawa R, Fukutomi S, Muroya D, Akashi M, Goto Y, Sakai H, Fujita F, Hisaka T. [A Case of the Spontaneously Ruptured Recurrence Hepatic Angiosarcoma after Hepatic Resection]. Gan To Kagaku Ryoho 2023; 50:1408-1410. [PMID: 38303290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
A 67-year-old male was referred to our hospital in a state of shock. Transcatheter arterial embolization(TAE)was performed for the diagnosis of liver tumor rupture, followed by extended posterior area resection 18 days later. Histopathologically, he was diagnosed with hepatic angiosarcoma. The patient was discharged 18 days after the surgery, but readmitted on the 51st day due to bleeding shock caused by the rupture of a recurrent tumor in the liver. Although TAE was performed, the patient developed hepatic failure and died on postoperative day 81. Autopsy revealed multiple intrahepatic recurrence and peritoneal dissemination. Herein, we report a case of ruptured hepatic angiosarcoma that underwent hepatic resection after TAE and had a rapid outcome due to early postoperative rupture of recurrent lesion.
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Mitsuoka M, Kashihara M, Nishi T, Yoshiyama K, Hashiguchi T, Yokoyama S, Murakami D, Fujita F, Takamori S, Akagi Y. Cone-Beam Computed Tomography-Guided Marking of Small Pulmonary Nodules with Surgical Clips. Kurume Med J 2023; 68:183-189. [PMID: 37316291 DOI: 10.2739/kurumemedj.ms6834006] [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] [Indexed: 06/16/2023]
Abstract
BACKGROUND Preoperative computed tomography-guided marking can help identify small non-palpable pulmonary nodules during surgery. However, this technique is associated with the risk of air embolism. We retrospectively evaluated whether small pulmonary nodules could be intraoperatively localized using cone-beam computed tomography (CBCT). METHODS A hybrid operating room permitting stable lateral positioning and scanning from the pulmonary apex to the base was used in all patients. CBCT images were obtained using a 10-s protocol with 180º rotation of the C-arm flat panel detector around the patient. Clips were placed on the visceral pleura to help guide pulmonary nodule localization. Partial pulmonary resection was performed using video-assisted thoracoscopic surgery at the predicted nodule site. RESULTS Between July 2013 and June 2019, 132 patients with 145 lesions underwent this procedure at our center. The detection rate of lesions on CBCT was 100%. The pathological diagnoses were primary lung cancer, metastatic pulmonary tumors, and benign lesions. The average consolidation-to-tumor ratio was 0.65 for all nodules, with ratios of 0.33, 0.96, and 0.70 for primary lung cancer, metastatic pulmonary tumors, and benign lesions, respectively. No complications related to this localization method were observed. CONCLUSIONS CBCT-guided intraoperative localization is safe and feasible for non-palpable small pulmonary nodules. This technique may eliminate the risk of serious complications such as air embolism.
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Affiliation(s)
| | | | - Tatsuya Nishi
- Department of Surgery, Kurume University School of Medicine
| | | | | | | | - Daigo Murakami
- Department of Surgery, Kurume University School of Medicine
| | | | | | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine
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10
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Moriyama E, Nagasu S, Tanaka T, Shimotsuura Y, Ono T, Umeno H, Akiba J, Kawahara A, Fujita F, Kawaguchi T, Miwa K. Case Report: A case of complete response to entrectinib in NTRK fusion gene-positive parotid gland cancer. Front Oncol 2023; 13:1247435. [PMID: 37601665 PMCID: PMC10436465 DOI: 10.3389/fonc.2023.1247435] [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: 06/26/2023] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Expression of the NTRK gene is rare in solid tumors but is highly prevalent in salivary gland secretory carcinomas. Here, we report a case of a complete response to entrectinib in a patient with NTRK fusion gene-positive parotid carcinoma. Case description The patient was a 44-year-old man who underwent total left parotidectomy and left cervical lymph node dissection for a left parotid tumor at 24 years of age. The histopathological diagnosis was mammary analog secretory carcinoma. Postoperatively, the patient received only radiation therapy. Sixteen years after the surgery, the patient became aware of a mass in the left parotid region. A close examination revealed local recurrence and multiple cervical lymph node metastases. S-1 monotherapy was started as chemotherapy but was discontinued 3 years later because of disease progression. As there was no standard treatment, a comprehensive genomic profiling test using a next-generation sequencer was performed, and the ETV6-NTRK3 fusion gene was identified. Entrectinib, an NTRK inhibitor, was immediately administered at a dose of 600 mg/day. The local recurrence rapidly shrank grossly from the beginning of treatment, and a complete response was observed 6 months later. However, creatinine levels exhibited an increase at week 68 of treatment; consequently, entrectinib dosage was lowered to 400 mg/day, leading to an immediate improvement in creatinine levels. Entrectinib was associated with additional side effects, including dysgeusia, fatigue, dizziness, and weight gain, all of which were also alleviated by the reduction in entrectinib dose. Thirty months after treatment initiation, the patient maintained a complete response and continued to receive entrectinib. Conclusion The NTRK fusion gene should always be checked in the presence of salivary gland secretory carcinoma.
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Affiliation(s)
- Etsuko Moriyama
- Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Japan
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Sachiko Nagasu
- Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Japan
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Toshimitsu Tanaka
- Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Japan
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yasutaka Shimotsuura
- Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Japan
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takeharu Ono
- Department of Otolaryngology, Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hirohito Umeno
- Department of Otolaryngology, Head and Neck Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Akihiko Kawahara
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Takumi Kawaguchi
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Keisuke Miwa
- Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Japan
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11
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Nakane H, Sudo T, Kawahara A, Yomoda T, Shigaki T, Fujiyoshi K, Ohchi T, Koushi K, Yoshida T, Ogata T, Fujita F, Akagi Y. Simplified and Optimized Immune Score for Colorectal Cancer Microenvironment. Anticancer Res 2023; 43:3793-3798. [PMID: 37500158 DOI: 10.21873/anticanres.16565] [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: 05/13/2023] [Revised: 06/01/2023] [Accepted: 06/07/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND/AIM Immunoscore (IS) is an important evaluation method for the tumor immune microenvironment (TIME); however, formal IS analysis requires designated reagents and a specific digital pathology software and image data analysis. This study aimed to investigate whether simplified IS (s-IS) can substitute formal IS upon modifying the location of the assessment of the numbers of immune cells and verify that the addition of T cell subset markers to s-IS can enhance the prognostic impact in patients with colorectal cancer (CRC). PATIENTS AND METHODS A total of 82 CRC cases were included in this study. Immunohistochemical analysis was performed using CD3/CD8/CD45RO/FOXP3 on tissue specimens; the expression levels were calculated in the center and perimeter of the tumors using digital pathology. The clinical prognostic significance of the expression of these markers was investigated by concordance index comparison according to their location of assessment and combinations. RESULTS In the univariate analysis, the CD3, CD8, and FOXP3 levels were significant prognostic factors. Moreover, for each T cell subset marker, the assessment of each T cell subset marker at the tumor perimeter had a stronger prognostic power than that in the tumor center. The modified s-IS (s-IS plus FOXP3 evaluation) was an independent prognostic factor for recurrence-free survival and overall survival through multivariate analysis and demonstrated the best prognostic power compared to other T subset marker combinations. CONCLUSION In CRC, TIME evaluation could be simplified by assessing CD3- and CD8-positive T cells in the perimeter of the tumor, and additional FOXP3 evaluation would empower the ability of s-IS evaluation in prognostic assessment.
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Affiliation(s)
- Hiroyuki Nakane
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Tomoya Sudo
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Akihiro Kawahara
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Takatou Yomoda
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Takahiro Shigaki
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Kenji Fujiyoshi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Takafumi Ohchi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Kenichi Koushi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Takefumi Yoshida
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Toshiro Ogata
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
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12
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Katagiri M, Sudo T, Tounann T, Kakuma T, Shimomura S, Nagasu S, Tajiri K, Fujino S, Yuge K, Murakami H, Miwa K, Hisaka T, Fujita F, Akagi Y. Development of an Algorithm to Predict Recurrences After Resection of Liver Metastases in Patients With Metastatic Colorectal Cancer. Anticancer Res 2023; 43:3807-3816. [PMID: 37500151 DOI: 10.21873/anticanres.16567] [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: 05/13/2023] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND/AIM Hepatic recurrences after resection of metastatic lesions in advanced colorectal cancer (CRC) have an enormous impact on patient prognosis. Response evaluation criteria in solid tumor (RECIST) or morphologic response on computed tomography (CT) have been reported as surrogate prognostication markers. This study assessed a novel algorithm for the prognostication of liver metastasis treatment. PATIENTS AND METHODS Forty-seven patients with liver metastases from CRC who underwent liver resection after systemic chemotherapy were included. The CT values examined before and after chemotherapy were collected. The velocity of CT values (CTvΔ) was calculated, and the subjects were divided into CTvΔ_high and _low groups. Clinicopathological variables, recurrence-free survival (RFS), and overall survival (OS) were statistically compared between the two groups. In addition, the effect of the combined evaluation of CTvΔ and carcinoembryonic antigen (CEA) was evaluated. RESULTS In univariate analyses, the hazard ratio (HR) for a recurrence after liver resection was relatively higher in the RECIST_stable disease (SD) or _progressive disease (PD) and the CTvΔ_low groups. In multivariate analysis, the HR was significantly higher in the CEA_high, the RECIST_SD or PD, and the CTvΔ_low groups. The RFS was significantly longer in the CTvΔ_high group. Furthermore, the combination of CTvΔ and CEA predicted the RFS and OS. CONCLUSION Our algorithm using CTvΔ could be a useful tool to select patients suitable for liver resection of hepatic CRC metastases.
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Affiliation(s)
| | - Tomoya Sudo
- Department of Surgery, Kurume University, Kurume, Japan;
| | | | | | | | | | | | - Shinya Fujino
- Department of Surgery, Kurume University, Kurume, Japan
| | - Koutarou Yuge
- Department of Surgery, Kurume University, Kurume, Japan
| | | | - Keisuke Miwa
- Multidisciplinary Therapeutic Center, Kurume University, Kurume, Japan
| | - Toru Hisaka
- Department of Surgery, Kurume University, Kurume, Japan
| | | | - Yoshito Akagi
- Department of Surgery, Kurume University, Kurume, Japan
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13
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Hirakawa H, Sakai H, Kanno H, Goto Y, Akashi M, Fukutomi S, Arai S, Sato T, Sudo T, Nagasu S, Miwa K, Naito Y, Akiba J, Yano H, Fujita F, Hisaka T. Significance of Desmoplastic Histopathological Growth Pattern for Colorectal Liver Metastases Treated With Preoperative Chemotherapy. Anticancer Res 2023; 43:3727-3733. [PMID: 37500130 DOI: 10.21873/anticanres.16557] [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: 05/13/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND/AIM The aim of this study was to evaluate hepatectomy cases that underwent preoperative chemotherapy to examine the relationship between the development of desmoplastic histopathological growth pattern (dHGP) and prognosis and recurrence and determine whether it is useful for evaluating preoperative chemotherapy. PATIENTS AND METHODS A total of 133 cases with hepatic metastasis for colorectal cancer that underwent surgical resection. RESULTS Of the 102 cases that underwent preoperative chemotherapy, 34 (33%) were determined to be dHGP positive, which was statistically significantly higher than the 2 of 31 cases (6.5%) that had not undergone preoperative chemotherapy. Regarding the 5-year recurrence-free survival, the dHGP group had a value of 50.3%, whereas the non-dHGP group had a value of 7.1%. For the 5-year overall survival, the dHGP group had a better prognosis than the non-dHGP group (57.6% vs. 37.1%, respectively), with a statistically significant difference. Univariate analysis of recurrence-free survival showed that the number of tumours, the Response Evaluation Criteria in Solid Tumors, and the presence or absence of dHGP were prognostic factors, whereas multivariate analysis showed that the presence or absence of dHGP was an independent prognostic factor. Univariate analysis of the overall survival showed that the number of tumours, the Response Evaluation Criteria in Solid Tumors, and presence or absence of dHGP were prognostic factors. Multivariate analysis showed that the presence or absence of dHGP was an independent prognostic factor. CONCLUSION dHGP is useful as a new evaluation method for evaluating the efficacy of preoperative chemotherapy.
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Affiliation(s)
- Hiroaki Hirakawa
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Hisamune Sakai
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Hiroki Kanno
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yuichi Goto
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Masanori Akashi
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Shogo Fukutomi
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Shoichiro Arai
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Toshihiro Sato
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Tomoya Sudo
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Sachiko Nagasu
- Department of Pathology, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Keisuke Miwa
- Department of Pathology, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yoshiki Naito
- Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Japan
| | - Jun Akiba
- Department of Clinical Laboratory Medicine, Kurume University Hospital, Kurume, Japan
| | - Hirohisa Yano
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Fumihiko Fujita
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Toru Hisaka
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan;
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14
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Tanaka Y, Aoyagi K, Umetani Y, Tanaka YU, Kaku H, Minami T, Isobe T, Murakami N, Fujita F, Akagi Y. Impact of Skeletal Muscle Mass Reduction on Long-term Survival After Radical Resection of Gastric Cancer. Anticancer Res 2023; 43:3779-3786. [PMID: 37500123 DOI: 10.21873/anticanres.16563] [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: 05/13/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND/AIM This study aimed to investigate the effect of preoperative skeletal muscle mass and muscle mass loss after surgery on overall survival in patients with gastric cancer who underwent radical resection. We also examined factors involved in postoperative skeletal muscle loss. PATIENTS AND METHODS One hundred fifty gastric cancer patients who underwent radical resection were retrospectively examined. Skeletal muscle index (SMI) was measured using computed tomography before surgery and 1 year after. Degree of muscle reduction (MR) was calculated. Patients were stratified according to preoperative SMI (high/low) and MR (high/low) for analysis. In addition, patients were grouped according to SMI and MR stratification as follows: group A, low SMI/high MR; group B, low SMI/low MR; group C, high SMI/high MR; and group D, high SMI/low MR. RESULTS In multivariate analysis, preoperative SMI and MR were independent predictors of overall survival. Overall survival significantly differed among groups A, B, C, and D (p<0.0001). The list of groups in order of worsening overall survival was as follows: group D, group C, group B, and group A. In multivariate analysis, patient group according to SMI and MR stratification was an independent predictor of overall survival. MR was affected by operation time (>430 min) and surgical procedure (total gastrectomy). CONCLUSION Preoperative SMI and reduction in skeletal muscle mass after gastric cancer surgery were significantly associated with overall survival. Long-term management of these patients should focus on maintenance of postoperative skeletal muscle mass.
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Affiliation(s)
- Yuya Tanaka
- Department of Surgery, School of Medicine Kurume University, Kurume, Japan
| | - Keishiro Aoyagi
- Department of Surgery, School of Medicine Kurume University, Kurume, Japan
| | - Yuki Umetani
- Department of Surgery, School of Medicine Kurume University, Kurume, Japan
| | - Y U Tanaka
- Department of Surgery, School of Medicine Kurume University, Kurume, Japan
| | - Hideaki Kaku
- Department of Surgery, School of Medicine Kurume University, Kurume, Japan
| | - Taizan Minami
- Department of Surgery, School of Medicine Kurume University, Kurume, Japan
| | - Taro Isobe
- Department of Surgery, School of Medicine Kurume University, Kurume, Japan
| | - Naotaka Murakami
- Department of Surgery, School of Medicine Kurume University, Kurume, Japan
| | - Fumihiko Fujita
- Department of Surgery, School of Medicine Kurume University, Kurume, Japan
| | - Yoshito Akagi
- Department of Surgery, School of Medicine Kurume University, Kurume, Japan
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15
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Ito Y, Hamaguchi T, Takashima A, Mizusawa J, Shimada Y, Shiozawa M, Mizoguchi N, Kodaira T, Komori K, Ohue M, Konishi K, Teraishi F, Kinouchi M, Murata K, Fujita F, Watanabe M, Iinuma G, Ishida F, Saida Y, Matsuda T, Katayama H, Fukuda H, Kanemitsu Y. Definitive S-1/mitomycin-C chemoradiotherapy for stage II/III anal canal squamous cell carcinoma: a phase I/II dose-finding and single-arm confirmatory study (JCOG0903). Int J Clin Oncol 2023:10.1007/s10147-023-02361-7. [PMID: 37286878 DOI: 10.1007/s10147-023-02361-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 05/18/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Definitive chemoradiotherapy (CRT) with 5-fluorouracil plus mitomycin-C is a standard treatment for stage II/III squamous cell carcinoma of the anal canal (SCCA). We performed this dose-finding and single-arm confirmatory trial of CRT with S-1 plus mitomycin-C to determine the recommended dose (RD) of S-1 and evaluate its efficacy and safety for locally advanced SCCA. METHODS Patients with clinical stage II/III SCCA (UICC 6th) received CRT comprising mitomycin-C (10 mg/m2 on days 1 and 29) and S-1 (60 mg/m2/day at level 0 and 80 mg/m2/day at level 1 on days 1-14 and 29-42) with concurrent radiotherapy (59.4 Gy). Dose-finding used a 3 + 3 cohort design. The primary endpoint of the confirmatory trial was 3-year event-free survival. The sample size was 65, with one-sided alpha of 5%, power of 80%, and expected and threshold values of 75% and 60%, respectively. RESULTS Sixty-nine patients (dose-finding, n = 10; confirmatory, n = 59) were enrolled. The RD of S-1 was determined as 80 mg/m2/day. Three-year event-free survival in 63 eligible patients who received the RD was 65.0% (90% confidence interval 54.1-73.9). Three-year overall, progression-free, and colostomy-free survival rates were 87.3%, 85.7%, and 76.2%, respectively; the complete response rate was 81% on central review. Common grade 3/4 acute toxicities were leukopenia (63.1%), neutropenia (40.0%), diarrhea (20.0%), radiation dermatitis (15.4%), and febrile neutropenia (3.1%). No treatment-related deaths occurred. CONCLUSIONS Although the primary endpoint was not met, S-1/mitomycin-C chemoradiotherapy had an acceptable toxicity profile and favorable 3-year survival and could be a treatment option for locally advanced SCCA. CLINICAL TRIAL INFORMATION jRCTs031180002.
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Affiliation(s)
- Yoshinori Ito
- Department of Radiation Oncology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-Ku, Tokyo, 142-8666, Japan.
| | - Tetsuya Hamaguchi
- Department of Gastroenterological Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Atsuo Takashima
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Junki Mizusawa
- Japan Clinical Oncology Group Data Center, National Cancer Center Hospital, Tokyo, Japan.
| | - Yasuhiro Shimada
- Division of Clinical Oncology, Kochi Health Sciences Center, Kochi, Japan
| | - Manabu Shiozawa
- Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Koji Komori
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masayuki Ohue
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Koji Konishi
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Fuminori Teraishi
- Department of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi, Japan
| | | | - Kohei Murata
- Department of Surgery, Suita Municipal Hospital, Suita, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Masahiko Watanabe
- Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Gen Iinuma
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Fumio Ishida
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Yoshihisa Saida
- Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Takahisa Matsuda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Katayama
- Japan Clinical Oncology Group Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Haruhiko Fukuda
- Japan Clinical Oncology Group Data Center, National Cancer Center Hospital, Tokyo, Japan
| | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
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16
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Yuge K, Miwa K, Fujita F, Murotani K, Shigaki T, Yoshida N, Yoshida T, Koushi K, Fujiyoshi K, Nagasu S, Akagi Y. Comparison of long-term quality of life based on surgical procedure in patients with rectal cancer. Front Oncol 2023; 13:1197131. [PMID: 37274255 PMCID: PMC10235785 DOI: 10.3389/fonc.2023.1197131] [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: 03/30/2023] [Accepted: 05/09/2023] [Indexed: 06/06/2023] Open
Abstract
Introduction Reports on the long-term quality of life (QOL) over 3 years after surgery in patients who have undergone surgery for rectal cancer are limited. Therefore, we aimed to evaluate the long-term QOL of patients who underwent high anterior resection (HAR), low anterior resection (LAR), internal sphincter resection (ISR), or abdominoperineal resection (APR) for rectal cancer. Methods A questionnaire regarding QOL was sent to 360 patients with rectal cancer who underwent curative resection by HAR, LAR, ISR, or APR between January 2005 and December 2015. QOL was assessed using the short-form 36 (SF-36) and modified fecal incontinence QOL (mFIQL) questionnaire. QOL between surgical procedures was analyzed using a multivariate model adjusted for age, sex, and postoperative time. Results A total of 144 patients responded with a median follow-up period of 94 months (range 38-233 months). According to surgical procedure, HAR was performed in 26 patients, LAR in 80 patients, ISR in 32 patients, and APR in 6 patients. Patients who underwent HAR had significantly better mFIQL scores than those who underwent LAR and ISR (p=0.013 and p=0004, respectively) and significantly better role/social component summary scores on the SF-36 subscales (p=0.007). No difference was observed in the mFIQL scores between patients who underwent ISR and those who underwent APR (p=0.8423). In addition, postoperative anastomotic leakage sutures did not influence the mFIQL and SF-36 scores after surgery. Conclusion The QOL of patients who underwent anus-preserving surgery was best in the HAR group, with the QOL of other groups similar to the APR group. These results suggest that anus- preserving surgery is acceptable from a QOL standpoint. However, a colostomy may be a more satisfactory procedure in some patients.
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Affiliation(s)
- Kotaro Yuge
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Keisuke Miwa
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
- Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Fukuoka, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kenta Murotani
- Biostatistics Center, Kurume University, Kurume, Fukuoka, Japan
| | - Takahiro Shigaki
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Naohiro Yoshida
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Takefumi Yoshida
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kenichi Koushi
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kenji Fujiyoshi
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Sachiko Nagasu
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
- Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Fukuoka, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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17
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Kanno H, Hisaka T, Fujiyoshi K, Akiba J, Hashimoto K, Fujita F, Akagi Y. ASO Visual Abstract: Prognostic Significance of the Histopathologic Growth Pattern and Tumor-Infiltrating Lymphocytes in Stratifying Survival After Hepatectomy for Colorectal Liver Metastases. Ann Surg Oncol 2023; 30:3149. [PMID: 36732486 DOI: 10.1245/s10434-022-13038-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Hiroki Kanno
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Toru Hisaka
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kenji Fujiyoshi
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Kazuaki Hashimoto
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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18
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Fujita F, Yasushi K, Ohchi T, Mizobe T, Ogata S, Nakane H, Koushi K, Yoshida T, Yamaguchi K, Sudo T, Kinugasa T, Akagi Y. A Case of Immediate Anastomotic Leakage After Low Anterior Resection for Rectal Cancer. Kurume Med J 2023. [PMID: 37062724 DOI: 10.2739/kurumemedj.ms682010] [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] [Indexed: 04/18/2023]
Abstract
A man in his seventies was referred to our hospital for radical therapy for advanced rectal cancer with multiple liver metastases. A colonic stent had already been placed in his rectum at the previous hospital because of malignant colorectal obstruction, so our therapeutic strategy was to perform systematic chemotherapy after resection of the primary tumor. Laparoscopic low anterior resection with a covering stoma was performed under general anesthesia. At about one hour after the surgery, the patient had sudden abdominal pain with watery diarrhea, and a similar discharge from his drainage tube. We suspected peritonitis caused by bowel perforation and emergency surgery was performed. The operative findings showed that his peritonitis was caused by anastomotic leakage from the rectum. Radical lavage of the abdominal space and reconstruction of colostomy was performed. The patient gradually recovered and we were able to start systematic chemotherapy at one month after the surgery. Anastomotic leakage immediately after anterior resection caused by watery diarrhea is rare, and it may be concerned with several issues. The covering stoma is intended to stop anastomotic leakage but it cannot prevent all cases of leakage especially when obstruction is present. We recommend that preventive measures be taken against anastomotic leakage, including intraoperative leakage tests or anal decompression tube placement.
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Affiliation(s)
| | | | - Takafumi Ohchi
- Department of Surgery, Kurume University School of Medicine
| | - Tomoaki Mizobe
- Department of Surgery, Kurume University School of Medicine
| | - Suguru Ogata
- Department of Surgery, Kurume University School of Medicine
| | | | - Kenichi Koushi
- Department of Surgery, Kurume University School of Medicine
| | | | | | - Tomoya Sudo
- Department of Surgery, Kurume University School of Medicine
| | | | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine
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19
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Saisho K, Mori N, Tanaka T, Matono S, Hino H, Kadoya K, Nishida R, Fujisaki M, Nakagawa M, Fujita F, Fujii M, Yanagawa T, Mitsuoka M, Akagi Y. Effectiveness of the Gerdq Questionnaire for Diagnosing Gastroesophageal Reflux Disease After Esophagectomy for Esophageal Cancer. Kurume Med J 2023; 68:25-31. [PMID: 36754379 DOI: 10.2739/kurumemedj.ms681004] [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] [Indexed: 02/10/2023]
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) is a common complication after esophagectomy with gastric tube reconstruction. The GerdQ questionnaire was developed for diagnosing GERD in primary care patients. Its effectiveness in patients after esophagectomy remains unknown. In this study, we evaluated the usefulness of the GerdQ questionnaire for diagnosing GERD after esophagectomy for esophageal cancer. MATERIALS AND METHODS A total of 124 patients with esophageal cancer underwent right transthoracic esophagectomy with gastric tube reconstruction between January 2010 and December 2016. Esophagogastroduodenoscopy and 24-hour esophageal pH-metry were performed at 1 month, 1 year, and 2 years postoperatively. The GerdQ questionnaire was administered at the same postoperative time points. We assessed any correlation between the GerdQ scores and the endoscopy and pH-metry findings. RESULTS The incidence rates of GERD at 1 month, 1 year and 2 years post-surgery were 31.6%, 46.9%, and 49.2%, respectively. The GerdQ questionnaire showed 77% sensitivity and 56% specificity for diagnosing GERD at 2 years after esophagectomy when the cutoff point was 7. However, the optimal cutoff points were different at each postoperative time, and the scores showed some imbalance between sensitivity and specificity. Regurgitation may be a useful indicator, as the frequency of regurgitation was significantly higher in patients with GERD than in patients without GERD at 1 year (P = 0.046) and 2 years postoperatively (P = 0.048). CONCLUSION The GerdQ questionnaire is not a useful diagnostic tool for GERD in patients who have undergone esophagectomy for esophageal cancer.
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Affiliation(s)
- Kohei Saisho
- Department of Surgery, Kurume University School of Medicine
| | - Naoki Mori
- Department of Surgery, Kurume University School of Medicine
| | | | - Satoru Matono
- Department of Surgery, Kurume University School of Medicine
| | - Haruhiro Hino
- Department of Surgery, Kurume University School of Medicine
| | | | | | | | | | | | - Masahiro Fujii
- Biostatistics Center, Kurume University School of Medicine
| | | | | | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine
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20
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Kanno H, Hisaka T, Fujiyoshi K, Akiba J, Hashimoto K, Fujita F, Akagi Y. Prognostic Significance of the Histopathological Growth Pattern and Tumor-Infiltrating Lymphocytes in Stratifying Survival After Hepatectomy for Colorectal Liver Metastases. Ann Surg Oncol 2022; 30:3139-3147. [PMID: 36520232 DOI: 10.1245/s10434-022-12905-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/16/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND A histopathological growth pattern (HGP) occurs at the interface between tumor cells and the surrounding liver parenchyma. Desmoplastic HGP (dHGP) is associated with a favorable prognosis and shows denser infiltration of lymphocytes than other HGPs. Tumor-infiltrating lymphocytes (TILs) exert antitumor immunity, nonetheless, their prognostic significance in patients with dHGP is unknown. This study aimed to identify the prognostic significance of HGP and TILs in colorectal liver metastasis (CRLM). METHODS The study analyzed 140 patients who underwent hepatectomy for CRLM. Depending on the type of HGP and TIL, the patients were categorized into four groups (dHGP/high TIL, dHGP/low TIL, non-dHGP/high TIL, and non-dHGP/low TIL) for a comparison of their recurrence-free survival (RFS) and overall survival (OS). Uni- and multivariate analyses were performed using a Cox proportional hazards model. RESULTS The RFS and OS curves differed significantly between the groups. The multivariate analysis showed that a combination of HGP and TIL could stratify the recurrence and survival outcomes. CONCLUSION This study indicated that a combination of HGP and TIL can stratify the risk of survival after hepatectomy in patients with CRLM.
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Affiliation(s)
- Hiroki Kanno
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan.
| | - Toru Hisaka
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Kenji Fujiyoshi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Kazuaki Hashimoto
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
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21
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Fukuda J, Fujita F, Kawamoto Y, Shimamura S, Koga F, Kikuchi M, Noguchi T, Shigaki T, Fujiyoshi K, Yoshida N, Koushi K, Yoshida T, Yamaguchi K, Sudo T, Akagi Y. [Retrospective Analysis of Treatment Strategies for Local Recurrence following Radical Resection of Rectal Cancer]. Gan To Kagaku Ryoho 2022; 49:1509-1511. [PMID: 36733118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We report the findings from a retrospective study to determine the optimum treatment strategy for local recurrence following radical resection of rectal cancer. In our department, among all 430 patients that underwent radical resection of rectal cancer from 2012 to 2018, there were 28 patients that developed local recurrence. Of those patients, 12 underwent surgical treatment(Op group)and 16 did not(N-Op group). In the Op group, 8 patients underwent radical resection, of which 2 patients remained recurrence-free, and the other 6 patients developed recurrence. In the N-Op group, 6 patients were treated with systemic chemotherapy alone, a further 6 patients had palliative irradiation in addition to systemic chemotherapy, and the other 4 selected best supportive care(2 patients were treated with palliative irradiation). In the 8 patients who had palliative irradiation, 7 showed a decrease in numerical rating scale(NRS)after irradiation. The adverse events of palliative irradiation were scrotal dermatitis in 1 patient and perianal inflammation in another 3 patients. Our surgical results for local recurrence of rectal cancer in our department were worse in terms of recurrence rate, so these findings suggest that the preoperative surgical strategy could be reviewed, as well as the actual surgical methods such as the optimal circumferential resection margin. Palliative irradiation was found to be useful for pain control. However, the occurrence of adverse events remains a concern.
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Affiliation(s)
- Junya Fukuda
- Dept. of Surgery, Kurume University School of Medicine
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22
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Isobe T, Murakami N, Minami T, Tanaka Y, Kaku H, Umetani Y, Kizaki J, Aoyagi K, Kashihara M, Fujita F, Akagi Y. Initial Experience with Robotic Gastrectomy in Patients with Gastric Cancer: An Assessment of Short-Term Surgical Outcomes. Kurume Med J 2022; 67:77-82. [PMID: 36123025 DOI: 10.2739/kurumemedj.ms6723003] [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] [Indexed: 06/15/2023]
Abstract
Robotic gastrectomy (RG) is an alternative minimally invasive surgical technique that has gradually come into use for the treatment of gastric cancer (GC). This study aimed to assess the feasibility and safety of RG for the treatment of GC. We retrospectively reviewed the use of RG in 47 patients with GC, and clinicopathological features and surgical outcomes were evaluated. The median age and body mass index of the patients were 68 years and 21.9 kg/m2, respectively. Distal gastrectomy, total gastrectomy, and proximal gastrectomy were performed in 39 (83.0%), 5 (10.6%), and 3 (6.4%) patients, respectively. The median operative time was 354 (256- 603) min. None of the operations were converted to open or laparoscopic procedures. The median blood loss was 15 (2-350) ml. None of the patients required blood transfusion. The mean number of resected lymph nodes was 43 (7-93). The median duration of postoperative hospital stay was 13 (9-37) days. Approximately 4.3% and 2.1% of the patients had anastomotic leakage and pancreatic fistula, respectively. One (2.1%) patient had Clavien-Dindo classification grade IIIa surgical complication (anastomotic leakage). No treatment-related deaths were observed. These findings suggest that RG might be a safe and feasible procedure for the treatment of GC.
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Affiliation(s)
- Taro Isobe
- Department of Surgery, Kurume University School of Medicine
| | | | - Taizan Minami
- Department of Surgery, Kurume University School of Medicine
| | - Yuya Tanaka
- Department of Surgery, Kurume University School of Medicine
| | - Hideaki Kaku
- Department of Surgery, Kurume University School of Medicine
| | - Yuki Umetani
- Department of Surgery, Kurume University School of Medicine
| | - Junya Kizaki
- Department of Surgery, Kurume University School of Medicine
| | | | | | | | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine
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23
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Ogata S, Fujita F, Fujiyoshi K, Sudou T, Yoshida T, Koushi K, Murotani K, Yamauchi S, Sugihara K, Akagi Y. Prognostic Value of Preoperative Carcinoembryonic Antigen and Carbohydrate Antigen 19-9 Levels for Adjuvant Chemotherapy in Stage II Colorectal Cancer: A Nationwide Multicenter Retrospective Study. J Anus Rectum Colon 2022; 6:249-258. [PMID: 36348948 PMCID: PMC9613416 DOI: 10.23922/jarc.2022-020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/25/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Adjuvant chemotherapy for stage II colorectal cancer patients with high-risk factors for recurrence can be useful; however, its advantage in prognosis remains to be controversial. Thus, in this study, we aimed to assess whether a combination of preoperative serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels can predict the prognosis and advantage of adjuvant chemotherapy. METHODS Using a Japanese nationwide database, in total, 3,688 patients with curative resected stage II colorectal cancer were registered retrospectively between 2008 and 2012 in 24 referral institutions. Patients were classified into three groups as follows: Group A (both non-high levels of CEA and CA19-9), Group B (either high levels of CEA or CA19-9), and Group C (both high levels of CEA and CA19-9). RESULTS Multivariable Cox regression analysis, adjusting the depth of tumor invasion, number of dissected lymph nodes, tumor differentiation, lymphatic and venous invasion, and other covariates, showed that the 5-year disease-free survival and overall survival were shorter in Group C than in Groups A and B. Furthermore, in Group C, the 5-year disease-free survival rate was improved in the surgery-plus-AC group compared to the surgery-alone group. CONCLUSIONS As with existing high-risk factors for recurrence, the combination assessment of preoperative serum CEA and CA19-9 can predict the prognosis for colorectal cancer. Adjuvant chemotherapy may provide a prolonged disease-free survival advantage in stage II colorectal cancer patients with high levels of both tumor markers.
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Affiliation(s)
- Suguru Ogata
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Kenji Fujiyoshi
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Tomoya Sudou
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Takefumi Yoshida
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Kenichi Koushi
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | | | - Shinichi Yamauchi
- Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenichi Sugihara
- Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
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24
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Shigaki T, Fujiyoshi K, Sudo T, Kawahara A, Nakane H, Yomoda T, Nagasu S, Kinugasa T, Akiba J, Fujita F, Akagi Y. Mismatch repair proteins expression and tumor‑infiltrating T‑cells in colorectal cancer. Oncol Lett 2022; 24:396. [PMID: 36276483 PMCID: PMC9533364 DOI: 10.3892/ol.2022.13516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/31/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Takahiro Shigaki
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Kenji Fujiyoshi
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Tomoya Sudo
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Akihiro Kawahara
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Hiroyuki Nakane
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Takato Yomoda
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Sachiko Nagasu
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Tetsushi Kinugasa
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Jun Akiba
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan
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25
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Watanabe J, Kanemitsu Y, Suwa H, Kakeji Y, Ishihara S, Shinto E, Ozawa H, Suto T, Kawamura J, Fujita F, Itabashi M, Ohue M, Ike H, Sugihara K. A multicenter cohort study on mapping of lymph node metastasis for splenic flexural colon cancer. Ann Gastroenterol Surg 2022; 7:265-271. [PMID: 36998296 PMCID: PMC10043763 DOI: 10.1002/ags3.12620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/01/2022] [Indexed: 04/01/2023] Open
Abstract
Aim There have been no reports of searching for metastases to lymph nodes along the accessory middle colic artery (aMCA). The aim of this study was to investigate the metastasis rate of the aMCA for splenic flexural colon cancer. Methods Patients with histologically proven colon carcinoma located in the splenic flexure, clinically diagnosed as stage I-III were eligible for this study. Patients were retrospectively and prospectively enrolled. The primary endpoint was frequency of lymph node metastasis to the aMCA (station 222-acc and 223-acc). The secondary endpoint was the frequency of lymph node metastasis to the middle colic artery (MCA) (station 222-lt and 223) and left colic artery (LCA) (station 232 and 253). Results Between January 2013 and February 2021, a total of 153 consecutive patients were enrolled. The location of the tumor was 58% in the transverse colon and 42% in the descending colon. Lymph node metastases were observed in 49 cases (32%). The presence of aMCA rate was 41.8% (64 cases). The metastasis rates of stations 221, 222-lt, and 223 were 20.0%, 1.6%, and 0%, and stations 231, 232, and 253 were 21.4%, 1.0%, and 0%, respectively. The metastasis rates of stations 222-acc and 223-acc were 6.3% (95% confidence interval: 1.7%-15.2%) and 3.7% (95% confidence interval: 0.1%-19%), respectively. Conclusions This study identified the distribution of lymph node metastases from splenic flexural colon cancer. If the aMCA is present, this vessel should be targeted for dissection, taking into account the frequency of lymph node metastasis.
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Affiliation(s)
- Jun Watanabe
- Department of Surgery, Gastroenterological CenterYokohama City University Medical CenterYokohamaJapan
| | - Yukihide Kanemitsu
- Department of Colorectal SurgeryNational Cancer Center HospitalTokyoJapan
| | - Hirokazu Suwa
- Department of SurgeryYokosuka Kyosai HospitalYokosukaJapan
| | - Yoshihiro Kakeji
- Division of Gastrointestinal Surgery, Department of SurgeryKobe University Graduate School of MedicineKobeJapan
| | - Soichiro Ishihara
- Department of Surgical Oncology, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Eiji Shinto
- Department of SurgeryNational Defense Medical CollegeTokorozawaJapan
| | - Heita Ozawa
- Department of Colorectal SurgeryTochigi Cancer CenterUtsunomiyaJapan
| | - Takeshi Suto
- Department of Gastroenterological SurgeryYamagata Prefectual Central HospitalYamagataJapan
| | - Junichiro Kawamura
- Department of SurgeryKindai University Faculty of MedicineOsakasayamaJapan
| | | | - Michio Itabashi
- Department of SurgeryInstitute of Gastroenterology, Tokyo Women's Medical UniversityTokyoJapan
| | - Masayuki Ohue
- Department of Gastroenterological SurgeryOsaka International Cancer InstituteOsakaJapan
| | - Hideyuki Ike
- Department of SurgeryJCHO Yokohama Hodogaya Central HospitalYokohamaJapan
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26
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Kanno H, Hisaka T, Akiba J, Hashimoto K, Fujita F, Akagi Y. C-reactive protein/albumin ratio and Glasgow prognostic score are associated with prognosis and infiltration of Foxp3+ or CD3+ lymphocytes in colorectal liver metastasis. BMC Cancer 2022; 22:839. [PMID: 35915403 PMCID: PMC9344720 DOI: 10.1186/s12885-022-09842-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inflammatory indices and tumor-infiltrating lymphocytes (TILs) have prognostic value in many cancer types. This study aimed to assess the prognostic value of inflammatory indices and evaluate their correlation with survival and presence of TILs in patients with colorectal liver metastasis (CRLM). METHODS Medical records of 117 patients who underwent hepatectomy for CRLM were retrospectively reviewed. We calculated inflammatory indices comprising the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, C-reactive protein/albumin ratio (CAR), and Glasgow prognostic score (GPS). Furthermore, we evaluated the relationship between these ratios and the GPS and survival rates and immunohistochemical results of tumor-infiltrating CD3+, CD8+, and Foxp3+ lymphocytes. RESULTS The patients with low CAR values and low GPS had significantly better overall survival as per the log-rank test (p = 0.025 and p = 0.012, respectively). According to the multivariate analysis using the Cox proportional hazard model, the CAR (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.33-0.99; p = 0.048) and GPS (HR, 0.40; 95% CI, 0.19-0.83; p = 0.013) were independent prognostic factors. Additionally, Foxp3+ lymphocytes were more common in samples from the patients with a low CAR (p = 0.041). Moreover, the number of CD3+ TILs was significantly higher in the patients with a low GPS (p = 0.015). CONCLUSIONS The CAR and GPS are simple, inexpensive, and objective markers associated with predicting survival in patients with CRLM. Moreover, they can predict the presence of Foxp3+ and CD3+ lymphocytes in the invasive margin of a tumor. TRIAL REGISTRATION Retrospectively registered. https://www.kurume-u.ac.jp/uploaded/attachment/14282.pdf .
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Affiliation(s)
- Hiroki Kanno
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Japan.
| | - Toru Hisaka
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Japan
| | - Jun Akiba
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Kazuaki Hashimoto
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Japan
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27
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Ogata S, Sudou T, Fujita F, Yoshida T, Koushi K, Noguchi T, Fukuda J, Ogata N, Nobukuni Y, Akagi Y. Experimental Exploration for Genes Related to Susceptibility and Resistance to Irinotecan. Anticancer Res 2022; 42:4011-4016. [PMID: 35896253 DOI: 10.21873/anticanres.15897] [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: 05/20/2022] [Revised: 06/15/2022] [Accepted: 06/30/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Anticancer drug resistance is an important issue in cancer treatment. Multiple genes are thought to be involved in resistance to anticancer drugs; however, this is still not fully understood. This study aimed to identify the genes involved in irinotecan resistance and their functional characteristics. MATERIALS AND METHODS Gene trap insertion mutant Chinese hamster ovary (CHO) cells were used in the experiments, and next-generation sequencing, gene-ontology enrichment, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were used to evaluate the biological functions of differentially expressed genes (DEGs). RESULTS In total, 2,134 DEGs were identified, including 1,216 up-regulated and 918 down-regulated genes. In KEGG pathways, microRNAs in cancer were significantly associated with up-regulated DEGs, while spliceosome and p53 signaling pathways were significantly associated with down-regulated DEGs. The pathway analysis identified several genes that might be involved in irinotecan resistance. CONCLUSION Using CHO cells, the genes involved in irinotecan resistance and functional characteristics were predicted. These results provide new clues for predicting irinotecan resistance.
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Affiliation(s)
- Suguru Ogata
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Tomoya Sudou
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Takefumi Yoshida
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Kenichi Koushi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Takashi Noguchi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Junya Fukuda
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Nanae Ogata
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshitaka Nobukuni
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
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28
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Kaku H, Aoyagi K, Sudo T, Tanaka Y, Minami T, Isobe T, Kizaki J, Umetani Y, Murakami N, Fujita F, Akagi Y. Significance of Intraperitoneal-free KRT20 and CEACAM6 mRNA Expression for Peritoneal Recurrence of Gastric Cancer. Anticancer Res 2022; 42:4003-4010. [PMID: 35896219 DOI: 10.21873/anticanres.15896] [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: 05/20/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Peritoneal lavage cytology is widely used to predict peritoneal recurrence after surgery, but cases of peritoneal recurrence are often recognized in patients with peritoneal lavage cytology negativity (CY0) who underwent no residual tumour (R0) surgery. We used peritoneal lavage fluid before and after gastric cancer surgery to detect cytokeratin 20 (KRT20) and carcinoembryonic antigen-related cell adhesion molecule 6 (CEACAM6) mRNA by RT-PCR. MATERIALS AND METHODS We collected peritoneal lavage fluid before and after surgery from 58 patients who underwent gastrectomy. RNA was extracted from these samples and RT-PCR was performed. RNA expression was defined as positive and negative in cases with values higher or lower than the median value. We investigated the relationship between mRNA expression and clinicopathological and surgical factors and prognosis. RESULTS Tumour invasion to the sub-serosa (T3) or penetration of the serosa (T4a), lymph node metastasis, and more than 150 ml intraoperative bleeding were significantly correlated with KRT20 mRNA expression. Multivariate analysis of its relationship with peritoneal recurrence showed that the odds ratio of CEACAM6 mRNA for recurrence was high (odds ratio=24.753; 95%CI=0.883-694.06; p=0.0592). All cases with peritoneal recurrence were CEACAM6-positive at pre- or post-surgery. The prognosis of peritoneal recurrence for both KRT20- and CEACAM6-positive cases was significantly poorer than that of other cases. The recurrence-free survival of the CEACAM6-positive group was significantly poorer than that of the CEACAM6-negative group. CONCLUSION Measurement of CEACAM6 mRNA in peritoneal lavage fluid at pre- and post-surgery may be useful as a predictor of peritoneal recurrence.
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Affiliation(s)
- Hideaki Kaku
- Department of Gastrointestinal Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Keishiro Aoyagi
- Department of Gastrointestinal Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Tomoya Sudo
- Department of Gastrointestinal Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Yuya Tanaka
- Department of Gastrointestinal Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Taizan Minami
- Department of Gastrointestinal Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Taro Isobe
- Department of Gastrointestinal Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Junya Kizaki
- Department of Gastrointestinal Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Yuki Umetani
- Department of Gastrointestinal Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Naotaka Murakami
- Department of Gastrointestinal Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Fumihiko Fujita
- Department of Gastrointestinal Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Yoshito Akagi
- Department of Gastrointestinal Surgery, Kurume University School of Medicine, Fukuoka, Japan
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Yamada T, Hirata K, Ichikawa D, Ikeda M, Fujita F, Eto K, Yukawa N, Kojima Y, Matsuda A, Shimoyama R, Ochiai H, Kumamoto K, Takayama Y, Komono A, Sonoda H, Ohta R, Yokoyama Y, Yoshida H, Kaibori M, Takemasa I. Clinical impact of laparoscopic surgery and adhesion prevention material for prevention of small bowel obstruction. Ann Gastroenterol Surg 2022; 6:651-657. [PMID: 36091308 PMCID: PMC9444862 DOI: 10.1002/ags3.12569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/24/2022] [Accepted: 03/08/2022] [Indexed: 11/25/2022] Open
Abstract
Aim Adhesive small bowel obstructions (SBO) are one of the most common complications following abdominal surgery, and they decrease patient quality of life. Since 2000, laparoscopic surgery has been employed with increasing frequency, as has adhesion prevention material (APM). In this study we tried to evaluate whether laparoscopic surgery and APM reduce the incidence of SBO. Methods In Cohort 1, we included patients who developed SBO and received inpatient treatment between 2015 and 2018. We evaluated the elapsed time between precedent surgery and the onset of SBO, and what kind of surgery most often causes SBO. In Cohort 2, we included patients who underwent digestive surgery between 2012 and 2014 and evaluated SBO incidence within 5 y after the precedent surgery. Results In all, 2058 patients were included in Cohort 1. Of these, 164 had experienced no precedent surgery. Among patients with a history of abdominal surgery, 29.7% experienced SBO within 1 y after the precedent surgery and 48.1% within 3 y. Altogether, 18798 patients were analyzed in Cohort 2. The incidence of SBO after laparoscopic colorectal surgery was lower than that of open colorectal surgery (P < .001), and laparoscopic gastroduodenal surgery was also lower (P = .02). However, there were no differences between laparoscopic and open surgery for other types of surgery. The use of APM had no effect on SBO incidence in any type of abdominal surgery. Conclusions Laparoscopic surgery helps to reduce SBO incidence only in colorectal surgery, and possibly in gastroduodenal surgery. APM does not reduce SBO after abdominal surgery.
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Affiliation(s)
- Takeshi Yamada
- Department of Gastrointestinal and Hepato‐Billiary‐Pancreatic Surgery, Nippon Medical School Tokyo Japan
| | - Keiji Hirata
- First Department of Surgery University of Occupational and Environmental Health Fukuoka Japan
| | | | - Masataka Ikeda
- Division of lower GI, Department of Surgery Hyogo College of Medicine Nishinomiya Japan
| | - Fumihiko Fujita
- Departments of Surgery Kurume University School of Medicine Kurume Japan
| | - Ken Eto
- Department of Surgery The Jikei University School of Medicine Tokyo Japan
| | - Norio Yukawa
- Department of Surgery Yokohama City University Yokohama Japan
| | - Yutaka Kojima
- Department of Coloproctological Surgery Juntendo University Faculty of Medicine Tokyo Japan
| | - Akihisa Matsuda
- Department of Gastrointestinal and Hepato‐Billiary‐Pancreatic Surgery, Nippon Medical School Tokyo Japan
| | - Rai Shimoyama
- Department of Surgery Shonan Kamakura General Hospital Kamakura Japan
| | - Hideto Ochiai
- Department of Gastroenterological Surgery Iwata City Hospital Iwata Japan
| | - Kensuke Kumamoto
- Department of Gastroenterological Surgery Kagawa University Takamatsu Japan
| | | | - Akira Komono
- Department of Gastroenterological Surgery Fukuoka University Faculty of Medicine Fukuoka Japan
| | - Hiromichi Sonoda
- Department of Gastrointestinal and Hepato‐Billiary‐Pancreatic Surgery, Nippon Medical School Tokyo Japan
| | - Ryo Ohta
- Department of Gastrointestinal and Hepato‐Billiary‐Pancreatic Surgery, Nippon Medical School Tokyo Japan
| | - Yasuyuki Yokoyama
- Department of Digestive Surgery, Nippon Medical School Musashi‐Kosugi Hospital Kawasaki Japan
| | - Hiroshi Yoshida
- Department of Gastrointestinal and Hepato‐Billiary‐Pancreatic Surgery, Nippon Medical School Tokyo Japan
| | - Masaki Kaibori
- Department of Surgery Kansai Medical University Osaka Japan
| | - Ichiro Takemasa
- Department of Surgery, Surgical Oncology and Science Sapporo Medical University School of Medicine Sapporo Japan
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30
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Yamada K, Saiki Y, Komori K, Shiomi A, Ueno M, Ito M, Hida K, Yamamoto S, Shiozawa M, Ishihara S, Kanemitsu Y, Ueno H, Kinjo T, Maeda K, Kawamura J, Fujita F, Takahashi K, Mizushima T, Shimada Y, Sasaki S, Sunami E, Ishida F, Hirata K, Ohnuma S, Funahashi K, Watanabe J, Kinugasa Y, Yamaguchi S, Hashiguchi Y, Ikeda M, Sudo T, Komatsu Y, Koda K, Sakamoto K, Okajima M, Ishida H, Hisamatsu Y, Masuda T, Mori S, Minami K, Hasegawa S, Endo S, Iwashita A, Hamada M, Ajioka Y, Usuku K, Ikeda T, Sugihara K. Characteristics of anal canal cancer in Japan. Cancer Med 2022; 11:2735-2743. [PMID: 35274487 PMCID: PMC9302302 DOI: 10.1002/cam4.4631] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/07/2022] [Accepted: 01/20/2022] [Indexed: 01/06/2023] Open
Abstract
Anal canal cancer (ACC) has been reported to be an uncommon cancer in Japan, as in the USA, Europe, and Australia. This retrospective multi‐institutional study was conducted to clarify the characteristics of ACC in Japan. First, the histological ACC type cases treated between 1991 and 2015 were collected. A detailed analysis of the characteristics of anal canal squamous cell carcinoma (SCC) cases was then conducted. The results of the histological types revealed that of the 1781 ACC cases, 435 cases (24.4%) including seven cases of adenosquamous cell carcinomas were SCC and 1260 cases (70.7%) were adenocarcinoma. However, the most common histological type reported in the USA, Europe, and Australia is SCC. Most ACC cases are adenocarcinomas and there is a low incidence of SCC in Japan which is different from the above‐mentioned countries. Moreover, we reclassified T4 into the following two groups based on tumor size: T4a (tumor diameter of 5 cm or less) and T4b (tumor diameter of more than 5 cm). The results of the TNM classification of SCC revealed that the hazard ratio (HR) to T1 of T2, T3, T4a, and T4b was 2.45, 2.28, 2.89, and 4.97, respectively. As T4b cases had a worse prognosis than T4a cases, we propose that T4 for anal canal SCC in Japan be subclassified into T4a and T4b.
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Affiliation(s)
- Kazutaka Yamada
- Department of Surgery, Coloproctology Center Takano Hospital, Kumamoto, Japan
| | - Yasumitsu Saiki
- Department of Surgery, Coloproctology Center Takano Hospital, Kumamoto, Japan
| | - Koji Komori
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Aichi, Japan
| | - Akio Shiomi
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Masashi Ueno
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Masaaki Ito
- Department of Colorectal Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Koya Hida
- Department of Surgery, Kyoto University Hospital, Kyoto, Japan
| | - Seiichiro Yamamoto
- Department of Gastroenterological Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Manabu Shiozawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Kanagawa, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan
| | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Hideki Ueno
- Department of Surgery, National Defense Medical College, Saitama, Japan
| | - Tatsuya Kinjo
- Department of Digestive and General Surgery, Graduate School of Medicine, University of Ryukyus, Okinawa, Japan
| | - Kotaro Maeda
- International Medical Center, Fujita Health University Hospital, Aichi, Japan
| | - Junichiro Kawamura
- Department of Surgery, Kindai University Faculty of Medicine, Osaka, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Keiichi Takahashi
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Tsunekazu Mizushima
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yasuhiro Shimada
- Department of Clinical Oncology, Kochi Health Sciences Center, Kochi, Japan
| | - Shin Sasaki
- Department of Coloproctological Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Eiji Sunami
- Department of Surgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Fumio Ishida
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | - Keiji Hirata
- Department of Surgery1, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Shinobu Ohnuma
- Department of Surgery, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Kimihiko Funahashi
- Department of Gastroenterological Surgery, Toho University Omori Medical Center, Tokyo, Japan
| | - Jun Watanabe
- Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Kanagawa, Japan
| | - Yusuke Kinugasa
- Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yojiro Hashiguchi
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Masataka Ikeda
- Division of Lower Gastrointestinal Surgery, Department of Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Takeshi Sudo
- Department of Gastroenterological Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Yoshito Komatsu
- Department of Cancer Center, Hokkaido University Hospital, Hokkaido, Japan
| | - Keiji Koda
- Department of Surgery, Teikyo University Chiba Medical Center, Chiba, Japan
| | - Kazuhiro Sakamoto
- Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Masazumi Okajima
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Hideyuki Ishida
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Yuichi Hisamatsu
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Taiki Masuda
- Department of Surgery, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan
| | - Shinichiro Mori
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kazuhito Minami
- Department of Surgery, Matsuyama Red Cross Hospital, Ehime, Japan
| | - Seiji Hasegawa
- Department of Surgery, Saiseikai Yokohamashi Nanbu Hospital, Kanagawa, Japan
| | - Shungo Endo
- Department of Coloproctology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan
| | - Akinori Iwashita
- Department of Pathology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Madoka Hamada
- Division of Gastrointestinal Surgery, Kansai Medical University Hospital, Osaka, Japan
| | - Yoichi Ajioka
- Division of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Koichiro Usuku
- Department of Medical Information Sciences and Administration Planning, Kumamoto University Hospital, Kumamoto, Japan
| | - Tokunori Ikeda
- Department of Medical Information Sciences and Administration Planning, Kumamoto University Hospital, Kumamoto, Japan
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Akazawa Y, Morisaki T, Fukuda H, Norimatsu K, Shiota J, Hashiguchi K, Tabuchi M, Kitayama M, Matsushima K, Yamaguchi N, Kondo H, Fujita F, Takeshita H, Nakao K, Takeshima F. Significance of serum palmitoleic acid levels in inflammatory bowel disease. Sci Rep 2021; 11:16260. [PMID: 34376800 PMCID: PMC8355139 DOI: 10.1038/s41598-021-95923-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/28/2021] [Indexed: 01/22/2023] Open
Abstract
Inflammatory bowel diseases (IBDs), including ulcerative colitis (UC) and Crohn’s disease (CD), are chronic intestinal diseases of unknown etiology that present with variable disease extents and outcomes. The use of biomarkers for the diagnosis and management of IBDs is considered beneficial. Palmitoleic acid (PO) is an adipose tissue-derived mono-unsaturated free fatty acid that potentially serves as a lipokine in metabolic and inflammatory diseases. The aim of this study was to investigate the significance of PO levels in the serum of patients with UC and CD. The study included patients with UC (n = 22), patients with CD (n = 35), and controls (n = 22). The levels of serum PO were analyzed using gas chromatography. The association of serum PO levels with the clinical features and disease outcomes in IBD was examined. Serum PO levels were significantly higher in patients with CD than in controls, whereas no difference in these levels was observed between patients with UC and controls. Serum PO levels were significantly associated with the CD activity index. Additionally, high serum PO levels were associated with an increased risk of surgical intervention requirement during follow-up. In a pilot study with a few patients, high PO levels were observed in the mesenteric tissue in the active disease site of patients with CD (n = 7) compared with those with colon cancer (n = 6). Elevated serum PO levels might serve as a marker for local inflammation and prognosis in patients with CD.
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Affiliation(s)
- Yuko Akazawa
- Tissue and Histopathology Section, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.
| | | | | | - Kiyuu Norimatsu
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Junya Shiota
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Keiichi Hashiguchi
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Maiko Tabuchi
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Moto Kitayama
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kayoko Matsushima
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoyuki Yamaguchi
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hisayoshi Kondo
- Biostatistics Section, Division of Scientific Data Registry, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Medicine, Nagasaki, Japan
| | | | | | - Kazuhiko Nakao
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Fuminao Takeshima
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Nagasaki Goto Chuoh Hospital, Goto, Japan
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Ito Y, Hamaguchi T, Takashima A, Mizusawa J, Shimada Y, Shiozawa M, Kodaira T, Ohue M, Kinouchi M, Murata K, Iinuma G, Fujita F, Miura H, Ishida F, Saida Y, Matsuda T, Katayama H, Fukuda H, Kanemitsu Y. Final analysis of dose-finding and single-arm confirmatory study (phase I/II study) of definitive chemoradiotherapy (dCRT) with S-1/mitomycin-C (MMC) in patients (pts) with clinical (c) Stage II/III squamous cell carcinoma of the anal canal (SCCA): JCOG0903. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.3521] [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: 11/20/2022] Open
Abstract
3521 Background: dCRT with 5-FU/MMC is a standard treatment for cStage II/III SCCA. S-1 is an oral fluoropyrimidine and has a greater effect on radiosensitivity. We conducted this trial of dCRT with S-1/MMC to determine the recommended dose (RD) of S-1 in dose-finding (phase I) part and to evaluate the efficacy and safety in confirmatory (phase II) part for cStage II/III SCCA. We reported the RD of S-1 and the 3-year survival at 2019 Gastrointestinal Cancers Symposium. We report the final data after 5-year follow-up. Methods: Eligibility criteria included histologically proven SCCA, cStage II/III (UICC 6th), PS 0-1, and age 20-80 years. dCRT consisted of MMC (10 mg/m2 on days 1, 29) and S-1 (60 mg/m2/d in level 0 and 80 mg/m2/d in level 1 on days 1-14, 29-42) with concurrent radiotherapy of 59.4 Gy/33fr. The dose-finding part adopted the 3+3 cohort design. The primary endpoint of confirmatory part was 3-year event-free survival (EFS). The sample size was 65 in the confirmatory part, with one-sided alpha of 5% and power of 80%, threshold and expected 3-year EFS as 60% and 75%. Key secondary endpoints were overall survival (OS) and progression-free survival (PFS) and colostomy-free survival (CFS), and adverse events. Final analysis was planned after 5-year follow-up for all pts. Results: From Feb/2010 to Mar/2015, 69 pts (3 in level 0 and 66 [7 in phase I and 59 in phase II] in level 1) were enrolled. Pts characteristics for level 1 were as follows: M/F, 12/54; Age, median 64 (range 33-80); cStage II/IIIA/IIIB, 29/9/28. Three in level 1 were ineligible and 63 eligible assigned to level 1 were included in efficacy analysis. In the dose-finding part, RD of S-1 was determined as 80 mg/m2/d. The complete response rate was 81% (95% CI, 69.1-90.0%) on central review. With a median follow-up of 5.4 years, 3- and 5-year EFS was 65.0% (90% CI 54.1-73.9%) and 63.4% (95% CI 50.2-73.9%). 5-year OS, PFS, and CFS were 84.1% (95% CI 72.5-91.1%), 84.1% (95% CI 72.4-91.1%), and 73.0% (95% CI 60.2-82.3%), respectively. In a univariable analysis, male sex (p = 0.045) prognosticated for poor OS and cT3 or T4 (p = 0.001), male sex (p = 0.019) and, PS 1 (p = 0.048) prognosticated for poor CFS. Nine (14.3%) of 63 pts at a dose level 1 developed recurrence or disease progression. Locoregional recurrence only and distant metastasis were observed in 1 pts (1.6%) and 8 pts (12.7%) respectively. Among all treated 65 pts, only 5 pts (7.7%) showed grade 3 late toxicities including jejunum obstruction, jejunum ulcer, proctitis, lower gastrointestinal hemorrhage, anal pain, radiation dermatitis, and ureteral stenosis. No Grade 4 or 5 late toxicities were observed. Conclusions: dCRT with S-1/MMC showed acceptable toxicities and favorable 5-year survival and could be a possible treatment option for pts with locally advanced SCCA. Clinical trial information: jRCTs031180002.
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Affiliation(s)
- Yoshinori Ito
- Department of Radiation Oncology, Showa University School of Medicine, Tokyo, Japan
| | - Tetsuya Hamaguchi
- Department of Gastroenterological Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Atsuo Takashima
- Department of Gastrointestinal Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Junki Mizusawa
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuhiro Shimada
- Clinical Oncology Division, Kochi Health Sciences Center, Kochi, Japan
| | - Manabu Shiozawa
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masayuki Ohue
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Makoto Kinouchi
- Department of Surgery, Miyagi Cancer Center, Miyagi Cancer Center, Miyagi, Japan
| | - Kohei Murata
- Department of Surgery, Suita Municipal Hospital, Suita, Japan
| | - Gen Iinuma
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hirohisa Miura
- Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Fumio Ishida
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Yoshihisa Saida
- Department of Surgery, Toho University Ohashi Hospital, Tokyo, Japan
| | - Takahisa Matsuda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Katayama
- JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Haruhiko Fukuda
- Japan Clinical Oncology Group Data Center, National Cancer Center Hospital, Tokyo, Japan
| | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
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Kanno H, Goto Y, Sasaki S, Fukutomi S, Hisaka T, Fujita F, Akagi Y, Okuda K. Geriatric nutritional risk index predicts prognosis in hepatocellular carcinoma after hepatectomy: a propensity score matching analysis. Sci Rep 2021; 11:9038. [PMID: 33907232 PMCID: PMC8079680 DOI: 10.1038/s41598-021-88254-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/07/2021] [Indexed: 12/20/2022] Open
Abstract
The geriatric nutritional risk index (GNRI) is widely used for nutritional assessment in older inpatients and is associated with postoperative complications and cancer prognosis. We investigated the use of GNRI to predict long-term outcomes in hepatocellular carcinoma of all etiologies after hepatectomy. Overall, 346 patients were examined after propensity score matching. We dichotomized the GNRI score into high GNRI (> 98: N = 173) and low GNRI (≤ 98: N = 173) and evaluated recurrence-free survival (RFS) and overall survival (OS) between both groups. Clinicopathological characteristics between the low- and high-GNRI groups were similar after propensity score matching except for the components of the GNRI score (body mass index and serum albumin level), Child–Pugh score (comprising serum albumin level), and preoperative alpha-fetoprotein level (p < 0.0001, p < 0.0001, p = 0.0030, and p = 0.0007, respectively). High GNRI was associated with significantly better RFS and OS (p = 0.0003 and p = 0.0211, respectively; log-rank test). Multivariate analysis revealed that GNRI is an independent prognostic factor of RFS and OS (low vs. high; hazard ratio [HR], 1.8284; 95% confidence interval [CI] 1.3598–2.4586; p < 0.0001, and HR, 1.5452; 95% CI 1.0345–2.3079; p = 0.0335, respectively). GNRI is an objective, inexpensive, and easily calculated assessment tool for nutritional status and can predict prognosis of hepatocellular carcinoma after hepatectomy.
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Affiliation(s)
- Hiroki Kanno
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Japan.
| | - Yuichi Goto
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Japan
| | - Shin Sasaki
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Japan
| | - Shogo Fukutomi
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Japan
| | - Toru Hisaka
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Japan
| | - Koji Okuda
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Japan
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Isobe T, Murakami N, Minami T, Tanaka Y, Kaku H, Umetani Y, Kizaki J, Aoyagi K, Fujita F, Akagi Y. Robotic versus laparoscopic distal gastrectomy in patients with gastric cancer: a propensity score-matched analysis. BMC Surg 2021; 21:203. [PMID: 33882906 PMCID: PMC8059032 DOI: 10.1186/s12893-021-01212-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 04/19/2021] [Indexed: 12/21/2022] Open
Abstract
Background Robotic distal gastrectomy (RDG) has been increasingly used for the treatment of gastric cancer (GC). However, whether RDG has a clinical advantage over laparoscopic distal gastrectomy (LDG) is yet to be determined. Thus, this study aimed to assess the feasibility and safety of RDG for the treatment of GC as compared with LDG. Methods In total, 157 patients were enrolled between February 2018 and August 2020 in this retrospective study. We then compared the surgical outcomes between RDG and LDG using propensity score-matching (PSM) analysis to reduce the confounding differences. Results After PSM, a clinicopathologically well-balanced cohort of 100 patients (50 in each group) was analyzed. The operation time for the RDG group (350.1 ± 58.1 min) was determined to be significantly longer than that for the LDG group (257.5 ± 63.7 min; P < 0.0001). Of interest, there was a decreased incidence of pancreatic fistulas and severe complications after RDG as compared with LDG (P = 0.092 and P = 0.061, respectively). In addition, postoperative hospital stay was statistically slightly shorter in the RDG group as compared with the LDG group (12.0 ± 5.6 vs. 13.0 ± 12.3 days; P = 0.038). Conclusions Our study confirmed that RDG is a feasible and safe procedure for GC in terms of short-term surgical outcomes. A surgical robot might reduce postoperative severe complications and length of hospital stay.
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Affiliation(s)
- Taro Isobe
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Naotaka Murakami
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Taizan Minami
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yuya Tanaka
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hideaki Kaku
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yuki Umetani
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Junya Kizaki
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Keishiro Aoyagi
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
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Tajiri K, Sudo T, Ishi K, Kawahara A, Nagasu S, Shimomura S, Yuge K, Katagiri M, Yomoda T, Fujiyoshi K, Kenichi K, Ohchi T, Yoshida T, Mizobe T, Fujita F, Akiba J, Akagi Y. Investigation of clinicopathological characters and gene expression features in colorectal signet-ring cell carcinoma utilizing CMS classification. Mol Clin Oncol 2021; 14:98. [PMID: 33767867 PMCID: PMC7976453 DOI: 10.3892/mco.2021.2260] [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: 06/03/2020] [Accepted: 02/04/2021] [Indexed: 11/26/2022] Open
Abstract
Signet ring cell carcinoma (SRCC) is a rare pathological type of colorectal cancer, of which the clinicopathological features and genetic background have not yet been fully investigated. Previous research has focused on the optimization of colorectal cancer treatment utilizing consensus molecular subtyping (CMS). However, it is not known what type of CMS would be designated to SRCC treatment. In the current study, of 1,350 patients diagnosed with colorectal cancer who underwent surgery, 14 were diagnosed with SRCC. The case-control cohort that fit the clinical background of the SRCC case was constructed. Statistical comparison between the SRCC group and the case-control cohort was performed among clinicopathological variables. SRCC and well to moderately adenocarcinoma case mRNA were submitted to microarray analysis and CMS analysis. Compared with the case-control cohort, the SRCC group was located more in the right-sided colon, the lymphatic invasion was more severe and the peritoneal dissemination was more frequent. The cancer-specific survival and the progression-free survival were significantly worse in the SRCC group compared with the case-control cohort. Microarray and CMS analysis identified that one SRCC case was significantly well assigned in the CMS 4 group and the other case was assigned in the CMS 1 group. Gene set analysis revealed the upregulation of EMT related genes and the downregulation of fatty acid, glycolysis, differentiation, MYC, HNF4A, DNA repair genes. In conclusion, the clinical characteristics of SRCC are severe but there is a possibility of the presence of different phenotypes according to CMS analysis.
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Affiliation(s)
- Kensuke Tajiri
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan.,Research Center for Innovative Cancer Therapy, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Tomoya Sudo
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan.,Research Center for Innovative Cancer Therapy, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Kazuo Ishi
- Biostatistics Center, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Akihiko Kawahara
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Sachiko Nagasu
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan.,Research Center for Innovative Cancer Therapy, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Susumu Shimomura
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Kotaro Yuge
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Mitsuhiro Katagiri
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan.,Research Center for Innovative Cancer Therapy, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Takato Yomoda
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Kenji Fujiyoshi
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Koshi Kenichi
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Takafumi Ohchi
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Takefumi Yoshida
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Tomoaki Mizobe
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan.,Research Center for Innovative Cancer Therapy, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
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36
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Miwa K, Oki E, Enomoto M, Ihara K, Ando K, Fujita F, Tominaga M, Mori S, Nakayama G, Shimokawa M, Saeki H, Baba H, Mori M, Akagi Y. Randomized phase II study comparing the efficacy and safety of SOX versus mFOLFOX6 as neoadjuvant chemotherapy without radiotherapy for locally advanced rectal cancer (KSCC1301). BMC Cancer 2021; 21:23. [PMID: 33402130 PMCID: PMC7786922 DOI: 10.1186/s12885-020-07766-5] [Citation(s) in RCA: 3] [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: 09/30/2020] [Accepted: 12/23/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Preoperative chemoradiotherapy (CRT), the current standard of care for locally advanced rectal cancer (LARC), is associated with many radiotherapy (RT)-related side effects. We aimed to evaluate whether S-1 and oxaliplatin (SOX) or folinic acid, 5-FU, and oxaliplatin (mFOLFOX6) can be as effective as neoadjuvant chemotherapy (NAC) regimens for LARC without RT. METHODS Patients with untreated resectable LARC were randomly assigned to receive SOX or mFOLFOX6. The NAC protocol period was 3 months. The primary endpoint was 3-year disease-free survival (DFS), and the secondary endpoints included pathological effects, surgical completion rate, 3-year survival, and safety. RESULTS From September 2013 to October 2015, 56 and 54 patients were enrolled in the SOX and mFOLFOX6 arms, respectively. The 3-year DFS rates were 69.4% (95% confidence interval [CI] 54.9-83.6) and 73.4% (95% CI 58.7-83.6) in the SOX and mFOLFOX6 arms, respectively; no significant differences were found between the arms (log-rank test; P = 0.5315, hazard ratio: 0.808, 95% CI 0.414-1.578). The 3-year survival rates were 92.3 and 91.8% in the SOX and mFOLFOX6 arms, respectively. The surgical completion rate was 98.1% overall, 100% in the SOX arm, and 96.0% in the mFOLFOX6 arm. The incidences of pathological response rates ≥grade 1b were 41.5 and 43.8% in the SOX and mFOLFOX6 arms, respectively. Both treatments were manageable and tolerable. CONCLUSION We demonstrated the effectiveness and safety of SOX and mFOLFOX6, both of which may be new neoadjuvant treatment candidates in previously untreated LARC cases. TRIAL REGISTRATION Date of enrolment of the first participant to the trial: 3rd Oct 2013; This study was registered in the UMIN clinical trials registry on 14th Aug, 2013. (Prospectively registered, UMIN-CTR number UMIN000011486). https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&recptno=R000013441&language=J.
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Affiliation(s)
- Keisuke Miwa
- Multidisciplinary Treatment Cancer Center, Kurume University Hospital, Kurume, Japan
| | - Eiji Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Masanobu Enomoto
- Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Keisuke Ihara
- First Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Koji Ando
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Masahiro Tominaga
- Department of Gastroenterological Surgery, Hyogo Cancer Center, Nishinomiya, Japan
| | - Shinichiro Mori
- Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University, Kagoshima, Japan
| | - Goro Nakayama
- Department of Gastroenterological Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Mototsugu Shimokawa
- Cancer Biostatistics Laboratory, Clinical Research Institute, National Hospital Organization Kyusyu Cancer Center, Fukuoka, Japan.,Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Hiroshi Saeki
- Department of Gastroenterological Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medicine, Kumamoto, Japan
| | - Masaki Mori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
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Saisho K, Tanaka T, Matono S, Mori N, Hino H, Kadoya K, Nishida R, Fujisaki M, Fujita F, Akagi Y. Argon plasma coagulation for superficial squamous cell carcinoma in the residual esophagus after esophagectomy. Esophagus 2020; 17:448-455. [PMID: 32211993 DOI: 10.1007/s10388-020-00733-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/18/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Patients after esophagectomy for esophageal squamous cell carcinoma (SCC) occasionally develop metachronous SCC in the residual esophagus. Although most of these second primary lesions are detected as superficial cancer at follow-up endoscopy, it is often difficult to perform endoscopic resection for these lesions near the site of anastomosis. METHODS The objective of this study was to evaluate the effectiveness of argon plasma coagulation (APC) for superficial SCC in the residual esophagus after esophagectomy. Twelve patients (involving 15 s primary lesions) received APC for superficial SCC in the residual esophagus after esophagectomy. These lesions were difficult to perform endoscopic resection and they were treated using APC. RESULTS There was no treatment-related complication. Complete remission (CR) was achieved in 13 (86.6%) of the 15 lesions: CR was achieved in 11 lesions (73.3%) after the first APC course, and in another 2 lesions (13.3%) after two or more APC courses. Of the 2 patients with persisting residual tumor, 1 patient received 12 times repeated-APC courses over 6 years, and eventually achieved local control without metastasis, the other patient received radiotherapy and cervical esophagectomy after treatment failure with APC. All patients survived except for one patient who died of old age and another patient who died of tongue cancer. CONCLUSIONS APC was a safe treatment that was easy to perform. APC was concluded to be an effective treatment for superficial SCC in the residual esophagus after esophagectomy when endoscopic resection was difficult.
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Affiliation(s)
- Kohei Saisho
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka, 830-0011, Japan.
| | - Toshiaki Tanaka
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Satoru Matono
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Naoki Mori
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Haruhiro Hino
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Kazutaka Kadoya
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Ryosuke Nishida
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Masahiro Fujisaki
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume, Fukuoka, 830-0011, Japan
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38
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Kinugasa T, Nagasu S, Murotani K, Mizobe T, Ochi T, Isobe T, Fujita F, Akagi Y. Analysis of risk factors for anastomotic leakage after lower rectal Cancer resection, including drain type: a retrospective single-center study. BMC Gastroenterol 2020; 20:315. [PMID: 32977772 PMCID: PMC7519527 DOI: 10.1186/s12876-020-01462-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 09/21/2020] [Indexed: 01/07/2023] Open
Abstract
Background We investigated the correlations between surgery-related factors and the incidence of anastomotic leakage after low anterior resection (LAR) for lower rectal cancer. Methods A total of 630 patients underwent colorectal surgery between 2011 and 2014 in our department. Of these, 97 patients (15%) underwent LAR and were enrolled in this retrospective study. Temporary ileostomy was performed in each patient. Results Anastomotic leakage occurred in 21 patients (21.7%). Univariate analysis showed a significant association between operative duration (p = 0.005), transanal hand-sewn anastomosis (p = 0.014), and operation procedure (p = 0.019) and the occurrence of leakage. Multivariate regression reanalysis showed that underlying disease (p = 0.044), transanal hand-sewn anastomosis (p = 0.019) and drain type (p = 0.025) were significantly associated with the occurrence of leakage. The propensity-score analysis showed that closed drainage were 6.3 times more likely to have anastomotic leakage than open drainage in relation to the amount of postoperative drainage (ml), according to the inverse probability of treatment-weighted analysis. Conclusions Our results indicate that underlying disease, transanal hand-sewn anastomosis, and closed drain may be a risk and predictive factors for anastomotic leakage after LAR for lower rectal cancer. The notable finding was that closed drainage was related to the occurrence of anastomotic leakage and closed drainage was correlated with less volume of postoperative drain discharge than open drain.
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Affiliation(s)
- Tetsushi Kinugasa
- Department of Surgery, School of Medicine, Kurume University, 67 Asahi Machi, Kurume City, Fukuoka, Japan.
| | - Sachiko Nagasu
- Department of Surgery, School of Medicine, Kurume University, 67 Asahi Machi, Kurume City, Fukuoka, Japan
| | - Kenta Murotani
- Biostatistics Center, Graduate School of Medicine, Kurume University, 67 Asahi Machi, Kurume City, Fukuoka, Japan
| | - Tomoaki Mizobe
- Department of Surgery, School of Medicine, Kurume University, 67 Asahi Machi, Kurume City, Fukuoka, Japan
| | - Takafumi Ochi
- Department of Surgery, School of Medicine, Kurume University, 67 Asahi Machi, Kurume City, Fukuoka, Japan
| | - Taro Isobe
- Department of Surgery, School of Medicine, Kurume University, 67 Asahi Machi, Kurume City, Fukuoka, Japan
| | - Fumihiko Fujita
- Department of Surgery, School of Medicine, Kurume University, 67 Asahi Machi, Kurume City, Fukuoka, Japan
| | - Yoshito Akagi
- Department of Surgery, School of Medicine, Kurume University, 67 Asahi Machi, Kurume City, Fukuoka, Japan
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39
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Hisaka T, Sakai H, Sato T, Goto Y, Nomura Y, Fukutomi S, Fujita F, Mizobe T, Nakashima O, Tanigawa M, Naito Y, Akiba J, Ogasawara S, Nakashima K, Akagi Y, Okuda K, Yano H. Quercetin Suppresses Proliferation of Liver Cancer Cell Lines In Vitro. Anticancer Res 2020; 40:4695-4700. [PMID: 32727794 DOI: 10.21873/anticanres.14469] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM We investigated the anti-proliferative effect of quercetin on liver cancer cell lines. MATERIALS AND METHODS Thirteen liver cancer cell lines were cultured followed by treatment with varying concentrations of quercetin (0-100 μM) or quercetin and 5-FU, and the cell viability was analysed by the MTT assay. Flow cytometry was also used to examine cell cycle progression after treatment with quercetin. RESULTS The addition of quercetin resulted in a dose- and time-dependent suppression of cell proliferation. In some cell lines, treatment with quercetin and 5-FU caused an additional or synergistic effect. Most cell lines displayed cell cycle arrest at different phases of the cell cycle. CONCLUSION Quercetin inhibits the proliferation of liver cancer cells via induction of apoptosis and cell cycle arrest.
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Affiliation(s)
- Toru Hisaka
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Hisamune Sakai
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Toshihiro Sato
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yuichi Goto
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yoriko Nomura
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Shogo Fukutomi
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Fumihiko Fujita
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Tomoaki Mizobe
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Osamu Nakashima
- Department of Clinical Laboratory Medicine, Kurume University Hospital, Kurume, Japan
| | - Masahiko Tanigawa
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan.,Department of Pathology, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yoshiki Naito
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Sachiko Ogasawara
- Department of Pathology, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Kouta Nakashima
- Department of Pathology, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yoshito Akagi
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Koji Okuda
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Hirohisa Yano
- Department of Pathology, Faculty of Medicine, Kurume University, Kurume, Japan
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40
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Ozaki K, Fujita F, Koga F, Yokoyama S, Shiratsuchi I, Yoshiyama K, Furuta T, Nishimura Y, Hayashida R, Akagi Y. Mesenteric Myxofibrosarcoma: A Case Report. J Anus Rectum Colon 2020; 4:151-155. [PMID: 32743118 PMCID: PMC7390617 DOI: 10.23922/jarc.2020-002] [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] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/28/2020] [Indexed: 11/30/2022]
Abstract
Myxofibrosarcoma is a soft tissue sarcoma that occurs in elderly patients. Primary myxofibrosarcoma rarely arises in the mesentery; this is the fourth known case of myxofibrosarcoma presenting as a mesenteric tumor. A 62-year-old male with a mesenteric myxofibrosarcoma presented with an abdominal mass; his symptoms were frequent urination and a sense of abdominal pressure. He was admitted for further examination. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a mesenteric lesion. The preoperative diagnosis was a suspected malignant myxoid tumor. We performed a curative resection with wide margins. The histopathological and immunohistochemical findings confirmed that the tumor was mesenteric myxofibrosarcoma. The postoperative course was uneventful, and there have been no signs of relapse for three years to date after surgery. It is difficult to make a definitive diagnosis of mesenteric myxofibrosarcoma using only CT or MRI. However, when the preoperative findings suggest a malignant mesenteric tumor, then the best practice is resection with sufficient margins.
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Affiliation(s)
- Kunihiro Ozaki
- Department of Surgery, Saiseikai Hita Hospital, Hita, Japan
| | | | - Fumiki Koga
- Department of Surgery, Saiseikai Hita Hospital, Hita, Japan
| | | | | | | | - Takuya Furuta
- Department of Pathology, Kurume University, Kurume, Japan
| | | | | | - Yoshito Akagi
- Department of Surgery, Kurume University, Kurume, Japan
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41
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Minami T, Aoyagi K, Kawahara A, Murakami N, Isobe T, Tanaka Y, Kaku H, Fujita F, Akagi Y. Evaluation of the expression of bone marrow-derived mesenchymal stem cells and cancer-associated fibroblasts in the stroma of gastric cancer tissue. Ann Gastroenterol Surg 2020; 4:464-474. [PMID: 32724891 PMCID: PMC7382433 DOI: 10.1002/ags3.12347] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 04/03/2020] [Accepted: 04/17/2020] [Indexed: 12/16/2022] Open
Abstract
AIM Cancer-associated fibroblasts (CAFs) generated by bone marrow-derived mesenchymal stem cells (BM-MSCs) play an important role in cancer progression. In this study, we investigated the relationships of BM-MSCs and CAFs in resected gastric cancers with the clinicopathological factors of patients. METHODS We analyzed 120 gastric cancer patients who underwent gastrectomy. Immunostaining was performed with an anti-CD271 antibody (BM-MSCs) and anti-α-smooth muscle actin (αSMA) antibody (CAFs). Staining intensity was used to divide patients into low and high expression groups. Observation sites in cancer tissues were invasive, central, and whole portions. RESULTS Expression of αSMA was significantly related to depth of tumor invasion (T), lymph node metastasis (N), lymphatic invasion (ly), venous invasion (v), and stage. Expression of CD271 was significantly related to v, stage, stromal volume, and tumor infiltration pattern (INF). Overall survival (OS) of the high expression group was significantly lower than that of the low expression group for both αSMA and CD271. Multivariate analysis showed that N, αSMA (whole), and CD271 (invasive) were independent prognostic factors. CONCLUSIONS Cancer-associated fibroblasts and BM-MSCs are related to the progression, invasion, and prognosis of gastric cancer and may be therapeutic targets of gastric cancer.
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Affiliation(s)
- Taizan Minami
- Department of SurgeryKurume University School of MedicineFukuokaJapan
| | - Keishiro Aoyagi
- Department of SurgeryKurume University School of MedicineFukuokaJapan
| | - Akihiko Kawahara
- Department of Diagnostic PathologyKurume University School of MedicineFukuokaJapan
| | - Naotaka Murakami
- Department of SurgeryKurume University School of MedicineFukuokaJapan
| | - Taro Isobe
- Department of SurgeryKurume University School of MedicineFukuokaJapan
| | - Yuya Tanaka
- Department of SurgeryKurume University School of MedicineFukuokaJapan
| | - Hideaki Kaku
- Department of SurgeryKurume University School of MedicineFukuokaJapan
| | - Fumihiko Fujita
- Department of SurgeryKurume University School of MedicineFukuokaJapan
| | - Yoshito Akagi
- Department of SurgeryKurume University School of MedicineFukuokaJapan
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42
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Fujita F, Torashima Y, Inoue Y, Ito S, Kobayashi K, Kanetaka K, Takatsuki M, Eguchi S. Daikenchuto improved perioperative nutritional status of the patients with colorectal cancer: A prospective open-labeled randomized exploratory study. Interv Med Appl Sci 2020; 11:84-88. [PMID: 32148910 PMCID: PMC7044534 DOI: 10.1556/1646.11.2019.13] [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] [Indexed: 12/05/2022] Open
Abstract
Background and aims The aim of this study is to exploratively evaluate the effect of Tsumura Daikenchuto Extract Granules (DKT, TJ-100) on abdominal symptoms, body weight, and nutritional function following colorectal cancer surgery. Methods The subjects included 20 patients for curative resection of colorectal cancer. A TJ-100 administration group (n = 10) and non-administration group (n = 10) were randomized and compared. In the administration group, TJ-100 was administered from 2 days prior to surgery up to 12 weeks following surgery. The endpoints included body weight gain, Gastrointestinal Symptom Rating Scale (GSRS), and blood biochemical factors. For the purpose of observing safety, drug adverse events were evaluated including liver function tests. Results Excluding one patient, we compared 9 cases in the administration group and 10 cases in the non-administration group. No obvious adverse events were observed in any of the cases. In the comparison of body weight gain, the TJ-100 administration group showed significantly higher values at 2, 4, and 12 weeks following the surgery. There was a tendency for lower stable GSRS scores in the administration group overall, with no statistically significant difference. Conclusion It is suggested that TJ-100 can be safely administered in the perioperative period for cases undergoing colorectal cancer surgery, potentially preventing weight loss during the early postoperative period.
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Affiliation(s)
- Fumihiko Fujita
- Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yasuhiro Torashima
- Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yusuke Inoue
- Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Shinichiro Ito
- Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kazuma Kobayashi
- Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kengo Kanetaka
- Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Mitsuhisa Takatsuki
- Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Saisho K, Matono S, Tanaka T, Mori N, Hino H, Fujisaki M, Nakagawa M, Fujita F, Akagi Y. Surgery for Killian-Jamieson diverticulum: a report of two cases. Surg Case Rep 2020; 6:17. [PMID: 31933008 PMCID: PMC6957605 DOI: 10.1186/s40792-020-0789-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Killian-Jamieson diverticulum (KJD) is a rare diverticulum arising from a muscular gap in the anterolateral wall of the proximal cervical esophagus. The first choice of treatment for KJD remains controversial due to its rare incidence. Here, we report two cases of KJD for which we performed different surgery: diverticulectomy in one case and diverticulopexy in the other. CASE PRESENTATION Case 1 involved a 58-year-old woman presenting progressive pharyngeal discomfort for the past year. She was diagnosed as KJD using endoscopic and radiographic findings. She underwent diverticulectomy with cricopharyngeal and proximal esophageal myotomy. Staple line leakage developed at 1 month after surgery and was successfully treated conservatively. At 5 months after surgery, she was asymptomatic. Case 2 involved a 77-year-old woman presenting dysphagia for the past 2 years. She had a history of bilateral breast cancer and had hypertension, asthma, and osteoporosis. Taking her age and medical history into account, we selected diverticulopexy with cricopharyngeal and proximal esophageal myotomy. The postoperative course was uneventful. At 2 years after surgery, she remained free of dysphagia. CONCLUSION The first choice of surgery for KJD is diverticulectomy. In a high-risk patient, diverticulopexy is a reasonable treatment. We recommend the addition of myotomy as a part of any surgical treatment.
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Affiliation(s)
- Kohei Saisho
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume City, Fukuoka Prefecture 830-0011 Japan
| | - Satoru Matono
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume City, Fukuoka Prefecture 830-0011 Japan
| | - Toshiaki Tanaka
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume City, Fukuoka Prefecture 830-0011 Japan
| | - Naoki Mori
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume City, Fukuoka Prefecture 830-0011 Japan
| | - Haruhiro Hino
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume City, Fukuoka Prefecture 830-0011 Japan
| | - Masahiro Fujisaki
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume City, Fukuoka Prefecture 830-0011 Japan
| | - Masashi Nakagawa
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume City, Fukuoka Prefecture 830-0011 Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume City, Fukuoka Prefecture 830-0011 Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, 67, Asahimachi, Kurume City, Fukuoka Prefecture 830-0011 Japan
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Yoshida N, Fujita F, Ueda K, Ogata S, Shigaki T, Yomoda T, Ohchi T, Mizobe T, Kinugasa T, Akagi Y. Mesocolic hernia following retroperitoneal laparoscopic radical nephrectomy: A case report. Int J Surg Case Rep 2019; 61:313-317. [PMID: 31399395 PMCID: PMC6717955 DOI: 10.1016/j.ijscr.2019.07.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 07/17/2019] [Indexed: 11/18/2022] Open
Abstract
An internal hernia after retroperitoneal laparoscopic nephrectomy is rare. Retroperitoneal approach has the risk of making mesocolic defects directly. To prevent internal hernia, we should close the mesenteric defects intraoperatively.
Introduction Small bowel obstruction (SBO) caused by an internal hernia through a mesocolon after retroperitoneal laparoscopic nephrectomy (RLN) is rare. Presentation of case A 66-year-old man who had undergone RLN with bladder cuff excision for a left renal pelvic cancer. After the surgery, he experienced SBO repeatedly. Contrast-enhanced computed tomography (CT) and gastrografin contract radiography through a long tube showed an internal hernia through the mesocolon to the retroperitoneal space where the resected left kidney had been located. We performed a subsequent surgery for the internal hernia. Postoperative course was uneventful and currently he has no recurrence of herniation 6 months post-operatively. Discussion Mesenteric defects that cause an internal hernia can be created inadvertently during RLN when the colon is mobilized medially, and the kidney is being detached from retroperitoneum. The removal of a kidney leads to a potential retroperitoneal space to which small intestine can migrate. While there is no absolute necessity in mobilizing the colon during the retroperitoneal laparoscopic approach, there is still a risk of making mesocolic defects directly in the retroperitoneal space. Conclusion We need to perform operations with sufficient anatomical knowledge of retroperitoneal fascia and careful surgical techniques. The critical thing to prevent an internal hernia following RLN is to close the mesenteric defects intraoperatively. It is also important to suspect an internal hernia and do proper examinations promptly when patients had the symptoms of SBO after nephrectomy.
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Affiliation(s)
- Naohiro Yoshida
- Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume-shi, Fukuoka, 8300011, Japan.
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume-shi, Fukuoka, 8300011, Japan.
| | - Kosuke Ueda
- Department of Urology, Kurume University School of Medicine, Asahi-machi 67, Kurume-shi, Fukuoka, 8300011, Japan.
| | - Suguru Ogata
- Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume-shi, Fukuoka, 8300011, Japan.
| | - Takahiro Shigaki
- Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume-shi, Fukuoka, 8300011, Japan.
| | - Takato Yomoda
- Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume-shi, Fukuoka, 8300011, Japan.
| | - Takafumi Ohchi
- Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume-shi, Fukuoka, 8300011, Japan.
| | - Tomoaki Mizobe
- Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume-shi, Fukuoka, 8300011, Japan.
| | - Tetsushi Kinugasa
- Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume-shi, Fukuoka, 8300011, Japan.
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Asahi-machi 67, Kurume-shi, Fukuoka, 8300011, Japan.
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Midorikawa R, Hisaka T, Sakai H, Nomura Y, Goto Y, Sato T, Kawahara R, Ishikawa H, Fujita F, Yasunaga M, Tanigawa M, Naito Y, Akiba J, Yano H, Tanaka H, Akagi Y, Okuda K. Clinical and Prognostic Significance of Neoplastic Spindle Cells in Gallbladder Cancer. Anticancer Res 2019; 39:4561-4568. [PMID: 31366560 DOI: 10.21873/anticanres.13634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Neoplastic spindle cells (NSCs) are believed to play a role in cancer invasion and metastasis, as well as in poor prognosis. The clinicopathological characteristics and prognostic relevance of NSCs was investigated in gallbladder cancer. MATERIALS AND METHODS Specimens were obtained from 62 patients with gallbladder cancer who underwent surgery. The emergence of NSCs and their correlation with clinicopathological factors, prognosis, and EMT markers was evaluated. RESULTS The NSC grade correlated with tumor size, preoperative CA19-9, surgical margin, the degree of differentiation, the depth of invasion, lymph node metastasis, lymphatic invasion, vascular invasion, and perineural invasion. Multivariate analysis of overall survival showed that NSCs were an independent prognostic factor. A correlation between NSCs and EMT was also suggested. CONCLUSION NSCs are an independent prognostic factor for patients with postoperative gallbladder cancer, which also suggests a correlation between NSCs and EMT.
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Affiliation(s)
- Ryuta Midorikawa
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Toru Hisaka
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Hisamune Sakai
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yoriko Nomura
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yuichi Goto
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Toshihiro Sato
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Ryuichi Kawahara
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Hiroto Ishikawa
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Fumihiko Fujita
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Masafumi Yasunaga
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Masahiko Tanigawa
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Yoshiki Naito
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Hirohisa Yano
- Department of Pathology, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Hiroyuki Tanaka
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yoshito Akagi
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Koji Okuda
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
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Sato T, Hisaka T, Sakai H, Ishikawa H, Kawahara R, Goto Y, Nomura Y, Yasunaga M, Fujita F, Tanigawa M, Naito Y, Akiba J, Yano H, Tanaka H, Akagi Y, Okuda K. Clinicopathological Study of Resections of Intraductal Papillary Neoplasm of the Bile Duct. Anticancer Res 2019; 39:4569-4573. [PMID: 31366561 DOI: 10.21873/anticanres.13635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The aim of this study was to examine the clinicopathological features of intraductal papillary neoplasm of the bile duct (IPNB) and investigate their relationships with intraductal papillary mucinous neoplasm (IPMN). PATIENTS AND METHODS Our study included 104 patients who underwent resection of tumors that showed papillary growth within the bile duct and pancreas. RESULTS Comparisons were performed based on subtypes and histological grades. The presence of various histological grades was confirmed in both the IPNB group and the IPMN group, and statistical significance was found in the between-group comparisons of subtypes and histological grades. It was shown that while all patients who underwent IPNB resection did not match the classifications proposed by Nakanuma et al., they did reflect classification characteristics. CONCLUSION IPNB and IPMN have common clinical histological features. Common features between IPNB subtype classifications were also identified, which may provide novel diagnostics.
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Affiliation(s)
- Toshihiro Sato
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Toru Hisaka
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Hisamune Sakai
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Hiroto Ishikawa
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Ryuichi Kawahara
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yuichi Goto
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yoriko Nomura
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Masafumi Yasunaga
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Fumihiko Fujita
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Masahiko Tanigawa
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Yoshiki Naito
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Hirohisa Yano
- Department of Pathology, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Hiroyuki Tanaka
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yoshito Akagi
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Koji Okuda
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
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Akashi M, Hisaka T, Sakai H, Ishikawa H, Kawahara R, Goto Y, Nomura Y, Yasunaga M, Fujita F, Tanigawa M, Naito Y, Akiba J, Yano H, Tanaka H, Akagi Y, Okuda K. Expression of Matrix Metalloproteinases in Intraductal Papillary Mucinous Neoplasm of the Pancreas. Anticancer Res 2019; 39:4485-4490. [PMID: 31366549 DOI: 10.21873/anticanres.13623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/20/2019] [Accepted: 06/21/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Intraductal papillary mucinous neoplasm (IPMN) has a variety of histological and morphological appearances. Matrix metalloproteinases (MMPs) have been considered to be associated with tumor progression or poor prognosis. The aim of this study was to elucidate the molecular basis of IPMN variation in different types of lesions. MATERIALS AND METHODS The expression of MMP-1,2,7,9 in 51 cases of IPMN were investigated. The MMP score was calculated as the sum of the score of staining distribution and the score of the intensity staining. RESULTS MMP scores were correlated with histological grade, histological subtype, and type of invasion. MMP high expression groups (MMP score ≥5) had worse prognosis than low-expression groups. CONCLUSION MMP expression varied between different types of IPMN, a result supporting differences in molecular basis of malignancies. These considerations may be helpful for optimal management or treatment according to various types of IPMN.
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Affiliation(s)
- Masanori Akashi
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Toru Hisaka
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Hisamune Sakai
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Hiroto Ishikawa
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Ryuichi Kawahara
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yuichi Goto
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yoriko Nomura
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Masafumi Yasunaga
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Fumihiko Fujita
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Masahiko Tanigawa
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Yoshiki Naito
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Hirohisa Yano
- Department of Pathology, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Hiroyuki Tanaka
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Yoshito Akagi
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
| | - Koji Okuda
- Department of Surgery, Faculty of Medicine, Kurume University, Kurume, Japan
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Mine Y, Fujita F, Murase T, Ito S, Takatsuki M, Ikematsu K, Eguchi S. Heat Shock Protein 70 Messenger RNA in Rat Leukocytes Elevates After Severe Intestinal Ischemia-Reperfusion. J Surg Res 2019; 242:342-348. [PMID: 31132625 DOI: 10.1016/j.jss.2019.04.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 04/07/2019] [Accepted: 04/25/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Heat shock protein 70 (HSP70) confers protection against heat shock, oxidative stress, infection, and inflammation in many cell types. A recent study reported that the induction of HSP70 was associated with morphologic protection against ischemia-reperfusion injury (IRI) in the rat small intestine. This study investigated the dynamics of HSP70 in leukocytes during intestinal IRI in a rat model. MATERIALS AND METHODS Serial blood samples were collected at 60-minute intervals up to 240 min from male Wistar rats (n = 15). The rats were divided into three groups of five each: the control group, the nonlethal IRI group, and the lethal IRI group. Rats belonging to the control group underwent a sham operation, and laparotomy was performed on rats in the lethal and nonlethal IRI groups. The nonlethal group experienced a 30-minute clamping of the superior mesenteric artery, and the lethal group experienced a 75-minute clamping of the superior mesenteric artery. The expression of HSP70 messenger RNA (mRNA) in leukocytes was measured by real-time quantitative polymerase chain reaction. Mixed-effects modeling of repeated measures was used to carry out the statistical analysis. The Bonferroni correction was applied to multiple comparisons. A P value < 0.0167 was considered to indicate statistical significance. RESULTS The expression of HSP70 mRNA in leukocytes increased 60 min after reperfusion in both IRI groups, and it was 12.8 times higher in the lethal group and 3.6 times higher in the nonlethal group compared with the control group. The expression of mRNA in the lethal group was significantly increased compared with the nonlethal group and the control group at 120 and 180 min after reperfusion. At 120 min after reperfusion, the expression of HSP70 mRNA was 6.1 times higher in the lethal group than in the nonlethal group (P = 0.0075) and 17.7 times higher than in the control group (P = 0.0011). At 180 min after reperfusion, the expression of HSP70 mRNA was 6.8 times higher in the lethal group than in the nonlethal group (P = 0.0007) and 4.3 times higher than in the control group (P = 0.0032). Although the expression of HSP70 mRNA in the nonlethal group was elevated in the early stages of reperfusion, there was no difference between the nonlethal group and the control group (P = 0.0212 at 60 min). CONCLUSIONS The expression of HSP70 mRNA in leukocytes may be a clinically useful indicator for evaluating pathologic conditions in intestinal IRI.
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Affiliation(s)
- Yuka Mine
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Fumihiko Fujita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takehiko Murase
- Department of Forensic Pathology and Sciences, Nagasaki University Graduate School of Biochemical Sciences, Nagasaki, Japan
| | - Shinichiro Ito
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Mitsuhisa Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuya Ikematsu
- Department of Forensic Pathology and Sciences, Nagasaki University Graduate School of Biochemical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Shigaki T, Hisaka T, Fujita F, Kusano H, Naito Y, Midorikawa R, Ohchi T, Shiratsuchi I, Hidaka A, Tanaka T, Akagi Y. Mixed ductal-acinar cell carcinoma of the pancreas: A case report. Mol Clin Oncol 2019; 10:516-520. [PMID: 30967946 DOI: 10.3892/mco.2019.1831] [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: 08/07/2018] [Accepted: 02/25/2019] [Indexed: 11/06/2022] Open
Abstract
Mixed carcinoma of the pancreas is defined as the concurrent existence of pancreatic ductal carcinoma, acinar cell carcinoma, and/or islet cell carcinoma within the same neoplasm. We herein report a rare case of mixed ductal-acinar cell carcinoma in a 74-year-old man who was undergoing treatment for hypertension and diabetes at another hospital. After an abrupt worsening of his blood glucose control, the patient was referred to our hospital for further evaluation. Abdominal contrast-enhanced computed tomography and magnetic resonance imaging revealed a tumor with a multilocular cystic lesion in the head of the pancreas. Endoscopic retrograde cholangiopancreatography revealed obstruction of the main pancreatic duct and dilation of the dorsal pancreatic duct; in addition, adenocarcinoma was detected in the pancreatic juice cytology. Based on the abovementioned findings, the patient was diagnosed with carcinoma of the pancreatic head and underwent subtotal stomach-preserving pancreaticoduodenectomy. Based on the histopathological and immunohistochemical findings, the patient was diagnosed with mixed ductal-acinar cell carcinoma. The patient was prescribed TS-1 as postoperative adjuvant chemotherapy upon discharge. However, treatment was discontinued 2 months later due to marked general malaise, and the patient succumbed to tumor recurrence in the residual pancreas 12 months after the surgery.
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Affiliation(s)
- Takahiro Shigaki
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Toru Hisaka
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Hironori Kusano
- Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
| | - Yoshiki Naito
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Ryuta Midorikawa
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Takafumi Ohchi
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Ichitaro Shiratsuchi
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
| | - Atsuhiro Hidaka
- Department of Surgery, Tagawa Hospital, Tagawa, Fukuoka 826-8585, Japan
| | - Takaho Tanaka
- Department of Surgery, Tagawa Hospital, Tagawa, Fukuoka 826-8585, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University Hospital, Kurume, Fukuoka 830-0011, Japan
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50
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Kobayashi S, Inoue Y, Fujita F, Ito S, Yamaguchi I, Nakayama M, Kanetaka K, Takatsuki M, Eguchi S. Extent of intraluminal exfoliated malignant cells during surgery for colon cancer: Differences in cell abundance ratio between laparoscopic and open surgery. Asian J Endosc Surg 2019; 12:145-149. [PMID: 29992749 DOI: 10.1111/ases.12617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 05/16/2018] [Accepted: 05/21/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Laparoscopic colectomy with intracorporeal anastomosis is a minimally invasive surgical procedure for patients with colon cancer. However, there are often concerns about the presence of intraluminal exfoliated malignant cells in the intracorporeal anastomosis. This study investigated the relationship between colon cancer surgery and the incidence of intraluminal exfoliated malignant cells and several factors. METHODS Eighty-nine consecutive patients who underwent either laparoscopic or open colectomy were prospectively studied in our department between 2007 and 2011. Before anastomosis, the proximal and distal lumens were irrigated with normal saline and subjected to cytological examination. RESULTS In 27 patients (30.3%), exfoliated cancer cells were detected. On the distal side, the frequency of positive cytology findings of exfoliated malignant cells was significantly lower in the laparoscopic colectomy group than in the open colectomy group (P = 0.01). In the laparoscopic colectomy group, there were no cases of positive cytology findings for exfoliated malignant cells more than 100 mm from the primary tumor. The incidence of positive cytology more than 100 mm from the primary tumor was significantly lower than the incidence of positive cytology less than 100 mm from the primary tumor (P = 0.04). CONCLUSIONS Exfoliated malignant cells were detected at anastomosis sites in patients with colon cancer. On the distal side, laparoscopic colectomy may prevent the development of exfoliated malignant cells.
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Affiliation(s)
- Shinichiro Kobayashi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yusuke Inoue
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Shinichiro Ito
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Izumi Yamaguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masahiko Nakayama
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mitsuhisa Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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