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Ohashi Y, Shiga K, Katagiri K, Saito D, Oikawa S, Tsuchida K, Miyaguchi J, Kusaka T, Yamada H. A case of complete remission of Hodgkin lymphoma confirmed histopathologically by neck dissection. Cancer Rep (Hoboken) 2023; 6:e1838. [PMID: 37254805 PMCID: PMC10432426 DOI: 10.1002/cnr2.1838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/14/2023] [Accepted: 05/22/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Hodgkin lymphoma (HL) is diagnosed definitively by biopsy, and treatment is based on stage. Owing to the nature of the disease, post-treatment efficacy is determined mainly by fluorodeoxyglucose-positron emission tomography/computed tomography, and the efficacy of treatment is not confirmed by histopathology. We report a case of tongue cancer after treatment for HL, in which a post-treatment lymph node with complete remission was histopathologically confirmed by neck dissection. CASE The patient was a 74-year-old man who was referred to our hospital for cancer on the right side of his tongue. He had previously undergone chemotherapy for HL involving the right side of his neck and achieved complete remission. Because he had cT3N2cM0 tongue cancer, glossectomy and bilateral neck dissection were performed. Surprisingly, histopathological examination revealed that there was neither metastatic lymph nodes nor lymphoma cells in his right neck. Moreover, there was no lymphatic structure in his remnant lymph nodes. CONCLUSION This was a rare case in which complete remission of HL was confirmed by histopathological analysis. The absence of lymph node structure and lymphatic flow led to contralateral neck lymph node metastases of tongue cancer.
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Affiliation(s)
- Yu Ohashi
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial SurgeryIwate Medical University, School of DentistryMoriokaIwateJapan
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaIwateJapan
| | - Kiyoto Shiga
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaIwateJapan
- Department of Otolaryngology‐Head and Neck SurgeryIwate Medical University, School of MedicineYahabaIwateJapan
| | - Katsunori Katagiri
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaIwateJapan
- Department of Otolaryngology‐Head and Neck SurgeryIwate Medical University, School of MedicineYahabaIwateJapan
| | - Daisuke Saito
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaIwateJapan
- Department of Otolaryngology‐Head and Neck SurgeryIwate Medical University, School of MedicineYahabaIwateJapan
| | - Shin‐ichi Oikawa
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaIwateJapan
- Department of Otolaryngology‐Head and Neck SurgeryIwate Medical University, School of MedicineYahabaIwateJapan
| | - Kodai Tsuchida
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaIwateJapan
- Department of Otolaryngology‐Head and Neck SurgeryIwate Medical University, School of MedicineYahabaIwateJapan
| | - Jun Miyaguchi
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaIwateJapan
- Department of Otolaryngology‐Head and Neck SurgeryIwate Medical University, School of MedicineYahabaIwateJapan
| | - Takahiro Kusaka
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaIwateJapan
- Department of Otolaryngology‐Head and Neck SurgeryIwate Medical University, School of MedicineYahabaIwateJapan
| | - Hiroyuki Yamada
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial SurgeryIwate Medical University, School of DentistryMoriokaIwateJapan
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaIwateJapan
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2
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Takeda K, Miyamoto I, Abe R, Kawai T, Ohashi Y, Yamada H. Tophaceous pseudogout of the temporomandibular joint extending into the cranium: a case report with literature review. J Surg Case Rep 2022; 2022:rjac055. [PMID: 35265318 PMCID: PMC8901271 DOI: 10.1093/jscr/rjac055] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/08/2022] [Indexed: 12/13/2022] Open
Abstract
Abstract
Pseudogout is a disease characterized by calcium pyrophosphate crystal deposition. Involvement of the temporomandibular joint (TMJ) is rare. We herein report a case of tophaceous pseudogout of the TMJ with cranial extension. An 83-year-old woman was referred to our institution for treatment of right TMJ pain. The patient’s medical and family histories were unremarkable. Magnetic resonance imaging showed a mass of about 35 mm in diameter compressing the bottom of the right temporal lobe of the brain. Based on a clinical diagnosis of a right TMJ tumour, biopsy was performed under general anaesthesia. The histopathological diagnosis was pseudogout. Considering the risk of surgically induced brain damage, the patient’s advanced age and her relatively good quality of life, the treatment plan simply involved the observation of the lesion. Fourteen months after biopsy, the patient’s activities of daily living remained unchanged and she had no TMJ pain.
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Affiliation(s)
- Kei Takeda
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University
- Department of Dentistry and Oral Surgery, Aomori Prefectural Central Hospital
| | - Ikuya Miyamoto
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University
| | - Ryosuke Abe
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University
- Department of Dentistry and Oral Surgery, Iwate Prefectural Central Hospital
| | - Tadashi Kawai
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University
| | - Yu Ohashi
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University
| | - Hiroyuki Yamada
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University
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3
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Kon M, Ishikawa T, Ohashi Y, Yamada H, Ogasawara M. Epigallocatechin gallate stimulated histamine production and downregulated histamine H1 receptor in oral cancer cell lines expressing histidine decarboxylase. J Oral Biosci 2022; 64:120-130. [PMID: 35031480 DOI: 10.1016/j.job.2022.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/29/2021] [Accepted: 12/20/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Increased histamine production and the overexpression of receptors (H1R∼H4R) has been reported in several tumors. The effects of TGFβ1 and epigallocatechin gallate (EGCG) on histamine synthesizing enzymes (HDCs), and the histamine transporter systems and receptors were investigated in this study. METHODS Four oral cancer cell lines (HSC2, HSC3, HSC4, and SAS) were treated with or without TGFβ1 or EGCG for 24 h. The expression levels of HDC, SLC22A3, H1R∼H4R, and TAS2R14 were investigated by Western blotting. Histamine concentrations were determined using the enzyme immune assay. Bitter taste receptor (TAS2R14 and TAS2R39) mRNAs were investigated by RT-PCR. RESULTS Varying expression levels of HDC, SLC22A3, H1R∼H4R, and TAS2R14 were observed in the four cell lines, where histamine concentrations were found to be ∼500 fmol/ml in cell culture media and induced 2-2.5 times higher amounts of histamine following EGCG treatment. TGFβ1 increased HDC expression in three cell lines, SLC22A3 expression in three cell lines, H1R expression in two cell lines, H2R expression in three cell lines, H3R expression in three cell lines, and H4R expression in three cell lines. EGCG decreased HDC expression in all four cell lines, SLC22A3 expression in three expression, H1R expression in all four cell lines, H2R expression in two cell lines, H3R expression in three cell lines, and H4R expression in two cell lines. CONCLUSIONS EGCG upregulated histamine production and decreased the expression level of H1R in the oral cancer cell lines. It might prove useful for cancer therapy during histamine regulation.
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Affiliation(s)
- Masashi Kon
- Division of Oral and Maxillofacial Surgery, Department of Oral Surgery, Iwate Medical University, Iwate, Japan; Division of Bioregulatory Pharmacology, Department of Pharmacology, Iwate Medical University, Iwate, Japan
| | - Taichi Ishikawa
- Division of Molecular Microbiology, Department of Microbiology, Iwate Medical University, Iwate, Japan
| | - Yu Ohashi
- Division of Oral and Maxillofacial Surgery, Department of Oral Surgery, Iwate Medical University, Iwate, Japan
| | - Hiroyuki Yamada
- Division of Oral and Maxillofacial Surgery, Department of Oral Surgery, Iwate Medical University, Iwate, Japan
| | - Masahito Ogasawara
- Division of Bioregulatory Pharmacology, Department of Pharmacology, Iwate Medical University, Iwate, Japan.
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Hoshi I, Abe R, Onodera K, Ohashi Y, Kawai T, Miyamoto I, Chiba T, Takeda Y, Yamada H. Osteosarcoma of the Mandible in an Elderly Patient. Case Rep Dent 2022; 2022:2622551. [PMID: 35342653 PMCID: PMC8947915 DOI: 10.1155/2022/2622551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/23/2022] [Indexed: 02/08/2023] Open
Abstract
Osteosarcoma is a malignant tumor in which the cancerous cells produce an osteoid matrix or mineralized bone. Jaw bones are affected in 6% of all osteosarcomas and are the fourth most common site of origin. Surgical treatment of osteosarcoma in elderly patients is rarely reported. Here, we report successful treatment of osteosarcoma arising in the mandible of a 90-year-old man. The patient was referred to our institution for diagnosis and treatment of an oral lesion. Intraoral examination revealed that a hard mass measuring 35 × 27 mm was located on the floor of the oral cavity, attached to the bone, and its growth displaced the tongue posteriorly. Therefore, he experienced difficulty in speech and swallowing. Biopsy of the mandibular mass was suspicious for chondrosarcoma. Preoperative examination did not detect critical risks for general anesthesia or surgery. Based on a clinical diagnosis of a malignant bone tumor of the mandible, segmental mandibular resection with reconstruction using a titanium plate was performed. Surgical site infection occurred on postoperative day 12, which was resolved by drainage, local irrigation, and administration of antibiotics. There was no delirium or cardiovascular or pulmonary complications. Surgery resolved the patient's difficulties in speech and swallowing. There was no evidence of tumor recurrence or metastasis 4 years after surgery. This case showed that it was not necessary to exclude surgical treatment merely because the patient was 90 years old. Indications for surgery should be determined individually to improve the patient's quality of life.
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Affiliation(s)
- Isao Hoshi
- 1Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka 020-8505, Japan
| | - Ryosuke Abe
- 2Department of Oral and Maxillofacial Surgery, Iwate Prefectural Central Hospital, Morioka 020-0066, Japan
| | - Kei Onodera
- 1Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka 020-8505, Japan
| | - Yu Ohashi
- 1Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka 020-8505, Japan
| | - Tadashi Kawai
- 1Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka 020-8505, Japan
| | - Ikuya Miyamoto
- 1Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka 020-8505, Japan
| | - Toshimi Chiba
- 3Division of Internal Medicine, Department of Oral Medicine, Iwate Medical University, Morioka 020-8505, Japan
| | - Yasunori Takeda
- 4Division of Clinical Pathology, Department of Oral and Maxillofacial Reconstructive Surgery, School of Dentistry, Iwate Medical University, Morioka 020-8505, Japan
| | - Hiroyuki Yamada
- 1Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka 020-8505, Japan
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Mitsunobu S, Ohashi Y, Makita H, Suzuki Y, Nozaki T, Ohigashi T, Ina T, Takaki Y. One-Year In Situ Incubation of Pyrite at the Deep Seafloor and Its Microbiological and Biogeochemical Characterizations. Appl Environ Microbiol 2021; 87:e0097721. [PMID: 34550782 PMCID: PMC8592575 DOI: 10.1128/aem.00977-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/04/2021] [Indexed: 11/20/2022] Open
Abstract
In this study, we performed a year-long in situ incubation experiment on a common ferrous sulfide (Fe-S) mineral, pyrite, at the oxidative deep seafloor in the hydrothermal vent field in the Izu-Bonin arc, Japan, and characterized its microbiological and biogeochemical properties to understand the microbial alteration processes of the pyrite, focusing on Fe(II) oxidation. The microbial community analysis of the incubated pyrite showed that the domain Bacteria heavily dominated over Archaea compared with that of the ambient seawater, and Alphaproteobacteria and Gammaproteobacteria distinctively codominated at the class level. The mineralogical characterization by surface-sensitive Fe X-ray absorption near-edge structure (XANES) analysis revealed that specific Fe(III) hydroxides (schwertmannite and ferrihydrite) were locally formed at the pyrite surface as the pyrite alteration products. Based on the Fe(III) hydroxide species and proportion, we thermodynamically calculated the pH value at the pyrite surface to be pH 4.9 to 5.7, indicating that the acidic condition derived from pyrite alteration was locally formed at the surface against neutral ambient seawater. This acidic microenvironment at the pyrite surface might explain the distinct microbial communities found in our pyrite samples. Also, the acidity at the pyrite surface indicates that the abiotic Fe(II) oxidation rate was much limited at the pyrite surface kinetically, 3.9 × 103- to 1.6 × 105-fold lower than that in the ambient seawater. Moreover, nanoscale characterization of microbial biomolecules using carbon near-edge X-ray absorption fine-structure (NEXAFS) analysis showed that the sessile cells attached to pyrite excreted the acidic polysaccharide-rich extracellular polymeric substances at the pyrite surface, which can lead to the promotion of biogenic Fe(II) oxidation and pyrite alteration. IMPORTANCE Pyrite is one of the most common Fe-S minerals found in submarine hydrothermal environments. Previous studies demonstrated that the Fe-S mineral can be a suitable host for Fe(II)-oxidizing microbes in hydrothermal environments; however, the details of microbial Fe(II) oxidation processes with Fe-S mineral alteration are not well known. The spectroscopic and thermodynamic examination in the present study suggests that a moderately acidic pH condition was locally formed at the pyrite surface during pyrite alteration at the seafloor due to proton releases with Fe(II) and sulfidic S oxidations. Following previous studies, the abiotic Fe(II) oxidation rate significantly decreases with a decrease in pH, but the biotic (microbial) Fe(II) oxidation rate is not sensitive to the pH decrease. Thus, our findings clearly suggest that the pyrite surface is a unique microenvironment where abiotic Fe(II) oxidation is limited and biotic Fe(II) oxidation is more prominent than that in neutral ambient seawater.
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Affiliation(s)
- S. Mitsunobu
- Graduate School of Agriculture, Ehime University, Matsuyama, Ehime, Japan
| | - Y. Ohashi
- Graduate Division of Nutritional and Environmental Sciences, University of Shizuoka, Shizuoka, Shizuoka, Japan
| | - H. Makita
- Department of Ocean Sciences, Tokyo University of Marine Science and Technology, Tokyo, Tokyo, Japan
- Institute for Extra-cutting-edge Science and Technology Avant-garde Research (X-star), Japan Agency for Marine-Earth Science & Technology (JAMSTEC), Yokosuka, Kanagawa, Japan
- Kanagawa Institute of Technology, Atsugi, Kanagawa, Japan
| | - Y. Suzuki
- Kanagawa Institute of Technology, Atsugi, Kanagawa, Japan
| | - T. Nozaki
- Research Institute for Marine Resources Utilization, Japan Agency for Marine-Earth Science & Technology (JAMSTEC), Yokosuka, Kanagawa, Japan
- Frontier Research Center for Energy and Resources, School of Engineering, The University of Tokyo, Tokyo, Tokyo, Japan
- Department of Planetology, Graduate School of Science, Kobe University, Kobe, Hyogo, Japan
- Ocean Resources Research Center for Next Generation, Chiba Institute of Technology, Narashino, Chiba, Japan
| | - T. Ohigashi
- UVSOR Facility, Institute for Molecular Science, Myodaiji, Okazaki, Japan
| | - T. Ina
- SPring-8, Japan Synchrotron Radiation Research Institute (JASRI), Sayo-gun, Hyogo, Japan
| | - Y. Takaki
- Institute for Extra-cutting-edge Science and Technology Avant-garde Research (X-star), Japan Agency for Marine-Earth Science & Technology (JAMSTEC), Yokosuka, Kanagawa, Japan
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Miyamoto I, Tanaka R, Kogi S, Yamaya G, Kawai T, Ohashi Y, Takahashi N, Izumisawa M, Yamada H. Clinical Diagnostic Imaging Study of Osteoradionecrosis of the Jaw: A Retrospective Study. J Clin Med 2021; 10:jcm10204704. [PMID: 34682827 PMCID: PMC8538245 DOI: 10.3390/jcm10204704] [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: 09/07/2021] [Revised: 09/23/2021] [Accepted: 10/13/2021] [Indexed: 01/19/2023] Open
Abstract
Radiation therapy (RT) plays a significant role in the management of head and neck malignancies. This study aimed to review the clinical symptoms and various imaging findings of osteoradionecrosis (ORN) and provide a clinical perspective on the development of ORN. The retrospective cohort was composed of 57 sites in 54 patients who had a history of RT and suspected ORN and 48 sites in 45 patients who were confirmed to have ORN. Image analyses included computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET)/CT, bone scintigraphy, and single-photon emission CT (SPECT). The irradiated tissue was damaged by RT, and the extent of damage was correlated with clinical symptoms. The bone marrow showed sclerotic changes and the devitalized bone showed bone resorption after invasive stimulation. Chronic trismus and pathological fracture are considered severe conditions, typically occurring in the last stage of ORN. Furthermore, neurological symptoms were an important sign of tumor recurrence, since diagnostic imaging was difficult. The possible treatment options vary depending on the stage of ORN. We speculate that bone sclerosis reactions and bone resorption are sequential reactions that seem to be protective measures of the bone to radiation injury.
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Affiliation(s)
- Ikuya Miyamoto
- Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, Faculty of Dental Medicine, Iwate Medical University, Morioka 020-8505, Japan; (S.K.); (G.Y.); (T.K.); (Y.O.); (H.Y.)
- Correspondence: ; Tel.: +81-19-651-5111
| | - Ryoichi Tanaka
- Division of Oral and Maxillofacial Radiology, Department of Oral and Maxillofacial Reconstructive Surgery, Faculty of Dental Medicine, Iwate Medical University, Morioka 020-8505, Japan; (R.T.); (N.T.); (M.I.)
| | - Shintaro Kogi
- Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, Faculty of Dental Medicine, Iwate Medical University, Morioka 020-8505, Japan; (S.K.); (G.Y.); (T.K.); (Y.O.); (H.Y.)
| | - Genki Yamaya
- Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, Faculty of Dental Medicine, Iwate Medical University, Morioka 020-8505, Japan; (S.K.); (G.Y.); (T.K.); (Y.O.); (H.Y.)
| | - Tadashi Kawai
- Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, Faculty of Dental Medicine, Iwate Medical University, Morioka 020-8505, Japan; (S.K.); (G.Y.); (T.K.); (Y.O.); (H.Y.)
| | - Yu Ohashi
- Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, Faculty of Dental Medicine, Iwate Medical University, Morioka 020-8505, Japan; (S.K.); (G.Y.); (T.K.); (Y.O.); (H.Y.)
| | - Noriaki Takahashi
- Division of Oral and Maxillofacial Radiology, Department of Oral and Maxillofacial Reconstructive Surgery, Faculty of Dental Medicine, Iwate Medical University, Morioka 020-8505, Japan; (R.T.); (N.T.); (M.I.)
| | - Mitsuru Izumisawa
- Division of Oral and Maxillofacial Radiology, Department of Oral and Maxillofacial Reconstructive Surgery, Faculty of Dental Medicine, Iwate Medical University, Morioka 020-8505, Japan; (R.T.); (N.T.); (M.I.)
| | - Hiroyuki Yamada
- Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, Faculty of Dental Medicine, Iwate Medical University, Morioka 020-8505, Japan; (S.K.); (G.Y.); (T.K.); (Y.O.); (H.Y.)
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Oikawa S, Shiga K, Katagiri K, Saito D, Ohashi Y, Tsuchida K, Miyaguchi J, Kusaka T. A case report of interdigitating dendritic cell sarcoma originating from the oropharynx. Clin Case Rep 2021; 9:e04866. [PMID: 34584720 PMCID: PMC8457407 DOI: 10.1002/ccr3.4866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/26/2021] [Accepted: 09/06/2021] [Indexed: 11/09/2022] Open
Abstract
Interdigitating dendritic cell sarcoma is an extremely rare tumor and typically originates from lymph nodes. Here, we report a patient with tumor originated from the oropharynx who received successful surgical treatment.
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Affiliation(s)
- Shin‐ichi Oikawa
- Department of Head and Neck SurgeryIwate Medical UniversityYahabaJapan
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaJapan
| | - Kiyoto Shiga
- Department of Head and Neck SurgeryIwate Medical UniversityYahabaJapan
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaJapan
| | - Katsunori Katagiri
- Department of Head and Neck SurgeryIwate Medical UniversityYahabaJapan
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaJapan
| | - Daisuke Saito
- Department of Head and Neck SurgeryIwate Medical UniversityYahabaJapan
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaJapan
| | - Yu Ohashi
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaJapan
- Department of Oral and Maxillofacial Reconstructive SurgeryDivision of Oral and Maxillofacial SurgeryIwate Medical UniversityMoriokaJapan
| | - Kodai Tsuchida
- Department of Head and Neck SurgeryIwate Medical UniversityYahabaJapan
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaJapan
| | - Jun Miyaguchi
- Department of Head and Neck SurgeryIwate Medical UniversityYahabaJapan
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaJapan
| | - Takahiro Kusaka
- Department of Head and Neck SurgeryIwate Medical UniversityYahabaJapan
- Head and Neck Cancer CenterIwate Medical University HospitalYahabaJapan
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Ohashi Y, Shiga K, Katagiri K, Saito D, Oikawa SI, Tsuchida K, Ikeda A, Miyaguchi J, Kusaka T, Yamada H. Evaluation and comparison of oral function after resection of cancer of the upper gingiva in patients who underwent reconstruction surgery versus those treated with a prosthesis. BMC Oral Health 2021; 21:347. [PMID: 34266443 PMCID: PMC8283937 DOI: 10.1186/s12903-021-01709-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 07/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We retrospectively analyzed the articulation, mastication, and swallowing function of patients who underwent reconstruction or used a prosthesis after resection of the upper gingiva. METHODS This study included patients who underwent resection of cancer of the upper gingiva from January 2014 to December 2018. Articulatory function was evaluated with Hirose's conversational function evaluation criteria. Mastication function was evaluated with the Yamamoto's occlusion table. Swallowing function was assessed with the MTF (Method of intake, Time, Food) score. RESULTS The mean articulatory function score was 8 points in the Reconstruction Surgery Group (RSG) and 8.8 points in the Prosthesis Group (PG). The mean mastication function score was 2.8 points in the RSG and 3.3 points in the PG. The mean swallowing function score was M3T4F4 in the RSG and M4T4F4.3 in the PG. CONCLUSIONS The prosthesis depends on the remaining occlusal support area. Our study suggest that prosthesis is better indication when there is more than one occlusal support area.
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Affiliation(s)
- Yu Ohashi
- Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, Iwate Medical University, Morioka, Japan. .,Head and Neck Cancer Center, Iwate Medical University Hospital, Yahaba, Japan.
| | - Kiyoto Shiga
- Department of Head and Neck Surgery, Iwate Medical University, Yahaba, Japan.,Head and Neck Cancer Center, Iwate Medical University Hospital, Yahaba, Japan
| | - Katsunori Katagiri
- Department of Head and Neck Surgery, Iwate Medical University, Yahaba, Japan.,Head and Neck Cancer Center, Iwate Medical University Hospital, Yahaba, Japan
| | - Daisuke Saito
- Department of Head and Neck Surgery, Iwate Medical University, Yahaba, Japan.,Head and Neck Cancer Center, Iwate Medical University Hospital, Yahaba, Japan
| | - Shin-Ichi Oikawa
- Department of Head and Neck Surgery, Iwate Medical University, Yahaba, Japan.,Head and Neck Cancer Center, Iwate Medical University Hospital, Yahaba, Japan
| | - Kodai Tsuchida
- Department of Head and Neck Surgery, Iwate Medical University, Yahaba, Japan.,Head and Neck Cancer Center, Iwate Medical University Hospital, Yahaba, Japan
| | - Aya Ikeda
- Department of Head and Neck Surgery, Iwate Medical University, Yahaba, Japan.,Head and Neck Cancer Center, Iwate Medical University Hospital, Yahaba, Japan
| | - Jun Miyaguchi
- Department of Head and Neck Surgery, Iwate Medical University, Yahaba, Japan.,Head and Neck Cancer Center, Iwate Medical University Hospital, Yahaba, Japan
| | - Takahiro Kusaka
- Department of Head and Neck Surgery, Iwate Medical University, Yahaba, Japan.,Head and Neck Cancer Center, Iwate Medical University Hospital, Yahaba, Japan
| | - Hiroyuki Yamada
- Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, Iwate Medical University, Morioka, Japan.,Head and Neck Cancer Center, Iwate Medical University Hospital, Yahaba, Japan
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Komatsu Y, Miyamoto I, Ohashi Y, Katagiri K, Saito D, Obara M, Takeda Y, Shiga K, Yamada H. Primary epithelioid angiosarcoma originating from the mandibular gingiva: a case report of an extremely rare oral lesion. World J Surg Oncol 2020; 18:260. [PMID: 33010804 PMCID: PMC7533036 DOI: 10.1186/s12957-020-01999-1] [Citation(s) in RCA: 2] [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: 06/02/2020] [Accepted: 08/11/2020] [Indexed: 11/17/2022] Open
Abstract
Background Angiosarcoma occurs very rarely in the oral cavity, and the epithelioid type is even rarer. Here, we report a rare case involving an elderly man with a primary epithelioid angiosarcoma that originated from the mandibular gingiva and resembled a dentigerous cyst on radiographs. Case presentation A 66-year-old Japanese man visited our hospital with a chief complaint of gingival swelling in right mandibular third molar region. A panoramic radiograph showed bone resorption around the crown of right mandibular third molar, which was impacted. Incisional biopsy confirmed a diagnosis of epithelioid angiosarcoma. The lesion exhibited aggressive proliferation after biopsy resulting in uncontrolled bleeding and difficulty in closing the mouth. Mandibular segmental resection including the tumor was performed without reconstruction. Because of the aggressive preoperative course of the tumor, the patient received adjuvant chemotherapy. There were no signs of recurrence during a 2-year follow-up period. Conclusions A review of the literature yielded only four reported cases of epithelioid angiosarcoma in the jaw region, with the lesions occurring in the maxilla in three cases. To our knowledge, this is the second case of primary epithelioid angiosarcoma in the mandible.
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Affiliation(s)
- Yuko Komatsu
- Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.,Head and Neck Cancer Center, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan
| | - Ikuya Miyamoto
- Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan. .,Head and Neck Cancer Center, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan.
| | - Yu Ohashi
- Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.,Head and Neck Cancer Center, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan
| | - Katsunori Katagiri
- Head and Neck Cancer Center, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan.,Department of Head and Neck Surgery, School of Medicine, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan
| | - Daisuke Saito
- Head and Neck Cancer Center, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan.,Department of Head and Neck Surgery, School of Medicine, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan
| | - Mizuki Obara
- Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.,Head and Neck Cancer Center, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan
| | - Yasunori Takeda
- Division of Clinical Pathology, Department of Oral and Maxillofacial Reconstructive Surgery, School of Dentistry, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan
| | - Kiyoto Shiga
- Head and Neck Cancer Center, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan.,Department of Head and Neck Surgery, School of Medicine, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan
| | - Hiroyuki Yamada
- Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery, School of Dentistry, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.,Head and Neck Cancer Center, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan
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10
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Ishikawa T, Terashima J, Shimoyama Y, Ohashi Y, Mikami T, Takeda Y, Sasaki M. Effects of butyric acid, a bacterial metabolite, on the migration of ameloblastoma mediated by laminin 332. J Oral Sci 2020; 62:435-438. [PMID: 32879156 DOI: 10.2334/josnusd.19-0380] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Ameloblastoma is a benign tumor that develops in the jawbone. Occasionally, however, it may become malignant and metastasize to other tissues. Although it has been suggested that various cytokines and several adhesion factors may play a role in its malignant transformation, the details have not been elucidated. In this context, it has been reported that butyric acid produced by periodontopathic bacteria causes progression of malignant tumors occurring in the mouth via podoplanin. However, the influence of butyric acid on ameloblastoma has not been clarified. In the present study, therefore, the expression of various cytokines and adhesion factors in ameloblastoma upon stimulation with butyric acid or cytokines was investigated using real-time reverse-transcription polymerase chain reaction. Three cell lines (HAM1, HAM2 and HAM3) established from the same ameloblastoma were used in the experiments. It was found that the expression of mRNAs for epidermal growth factor (EGF) and transforming growth factor beta 1 (TGFβ1) was increased in HAM2 and HAM3, respectively, upon stimulation with butyric acid. In addition, stimulation with EGF and TGFβ1 led to an increase in the expression of laminin β-3 mRNA in the respective cell lines. These results suggest that butyric acid may be involved in ameloblastoma exacerbation through the expression of laminin 332 (LM332) via EGF and TGFβ1 produced by ameloblastoma itself.
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Affiliation(s)
- Taichi Ishikawa
- Division of Molecular Microbiology, Department of Microbiology, Iwate Medical University
| | - Jun Terashima
- Division of Pharmacodynamics and Molecular Genetics, School of Pharmacy, Iwate Medical University
| | - Yu Shimoyama
- Division of Molecular Microbiology, Department of Microbiology, Iwate Medical University
| | - Yu Ohashi
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University
| | | | - Yasunori Takeda
- Division of Clinical Pathology, Department of Oral and Maxillofacial Reconstructive Surgery, School of Dentistry, Iwate Medical University
| | - Minoru Sasaki
- Division of Molecular Microbiology, Department of Microbiology, Iwate Medical University
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11
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Chiba T, Ohashi Y, Tsunoda N, Onodera K, Kawai T, Miyamoto I, Yamada H. Radiation Esophagitis in a Patient with Oral Carcinoma and Bone Metastasis. Case Rep Gastroenterol 2020; 14:453-457. [PMID: 33082741 PMCID: PMC7548840 DOI: 10.1159/000508930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/19/2020] [Indexed: 02/05/2023] Open
Abstract
Radiation esophagitis requiring endoscopic evaluation occurs quite rarely, affecting <1% of patients undergoing radiation treatment. Acute radiation esophagitis develops within 3 weeks of radiation therapy. We describe herein a case of radiation esophagitis in a patient with oral carcinoma with multiple general bone metastases. Cisplatin, fluorouracil, and cetuximab were given for 3 cycles. Radiation therapy (30 Gy) to the thoracic vertebrae and lumbar vertebrae was prescribed to prevent worsening of bone metastases and relieve pain. Neutropenia was also observed due to chemotherapy. After the end of radiation therapy, the patient experienced chest pain, heartburn, and dysphagia. Upper gastrointestinal endoscopy revealed severe radiation esophagitis of endoscopic Fukui Acute Radiation Esophagitis grade 4. Oral food was discontinued and an intravenous proton-pump inhibitor was administered. After 3 weeks, upper gastrointestinal endoscopy showed improvement of radiation esophagitis, with scars. The symptoms of chest pain, heartburn, and dysphagia had also disappeared. This is the first case to be reported of acute radiation esophagitis in a patient with oral carcinoma with bone metastasis who experienced dramatic improvement of endoscopic findings. Neutropenia appears to be associated with more severe acute radiation esophagitis.
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Affiliation(s)
- Toshimi Chiba
- Division of Internal Medicine, Department of Oral Medicine, Iwate Medical University, Morioka, Japan
- *Toshimi Chiba, Division of Internal Medicine, Department of Oral Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505 (Japan),
| | - Yu Ohashi
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, Morioka, Japan
| | - Naoko Tsunoda
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, Morioka, Japan
| | - Kei Onodera
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, Morioka, Japan
| | - Tadashi Kawai
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, Morioka, Japan
| | - Ikuya Miyamoto
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, Morioka, Japan
| | - Hiroyuki Yamada
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University, Morioka, Japan
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12
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Onodera K, Ohashi Y, Tsunoda N, Kawai T, Miyamoto I, Yamada H. Computer-assisted surgery to treat fracture of an atrophic mandible. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology 2020. [DOI: 10.1016/j.ajoms.2020.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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13
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Tomida N, Muramatsu N, Niiyama M, Ahn JK, Chang WC, Chen JY, Chu ML, Daté S, Gogami T, Goto H, Hamano H, Hashimoto T, He QH, Hicks K, Hiraiwa T, Honda Y, Hotta T, Ikuno H, Inoue Y, Ishikawa T, Jaegle I, Jo JM, Kasamatsu Y, Katsuragawa H, Kido S, Kon Y, Maruyama T, Masumoto S, Matsumura Y, Miyabe M, Mizutani K, Nagahiro H, Nakamura T, Nakano T, Nam T, Ngan TNT, Nozawa Y, Ohashi Y, Ohnishi H, Ohta T, Ozawa K, Rangacharyulu C, Ryu SY, Sada Y, Sasagawa M, Shibukawa T, Shimizu H, Shirai R, Shiraishi K, Strokovsky EA, Sugaya Y, Sumihama M, Suzuki S, Tanaka S, Tokiyasu A, Tsuchikawa Y, Ueda T, Yamazaki H, Yamazaki R, Yanai Y, Yorita T, Yoshida C, Yosoi M. Search for η^{'} Bound Nuclei in the ^{12}C(γ,p) Reaction with Simultaneous Detection of Decay Products. Phys Rev Lett 2020; 124:202501. [PMID: 32501086 DOI: 10.1103/physrevlett.124.202501] [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] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 02/11/2020] [Accepted: 04/30/2020] [Indexed: 06/11/2023]
Abstract
We measured missing mass spectrum of the ^{12}C(γ,p) reaction for the first time in coincidence with potential decay products from η^{'} bound nuclei. We tagged an (η+p) pair associated with the η^{'}N→ηN process in a nucleus. After applying kinematical selections to reduce backgrounds, no signal events were observed in the bound-state region. An upper limit of the signal cross section in the opening angle cosθ_{lab}^{ηp}<-0.9 was obtained to be 2.2 nb/sr at the 90% confidence level. It is compared with theoretical cross sections, whose normalization ambiguity is suppressed by measuring a quasifree η^{'} production rate. Our results indicate a small branching fraction of the η^{'}N→ηN process and/or a shallow η^{'}-nucleus potential.
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Affiliation(s)
- N Tomida
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - N Muramatsu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - M Niiyama
- Department of Physics, Kyoto Sangyo University, Kyoto 603-8555, Japan
| | - J K Ahn
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - W C Chang
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - J Y Chen
- National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - M L Chu
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - S Daté
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Japan Synchrotron Radiation Research Institute (SPring-8), Sayo, Hyogo 679-5198, Japan
| | - T Gogami
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - H Goto
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Hamano
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Hashimoto
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Q H He
- Department of Nuclear Science & Engineering, College of Material Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - K Hicks
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - T Hiraiwa
- RIKEN SPring-8 Center, Sayo, Hyogo 679-5148, Japan
| | - Y Honda
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Hotta
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Ikuno
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Inoue
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Ishikawa
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - I Jaegle
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J M Jo
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - Y Kasamatsu
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Katsuragawa
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - S Kido
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - Y Kon
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Institute for Radiation Sciences, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Maruyama
- College of Bioresource Sciences, Nihon University, Fujisawa, Kanagawa 252-8510, Japan
| | - S Masumoto
- Department of Physics, University of Tokyo, Tokyo 113-0033, Japan
| | - Y Matsumura
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Miyabe
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - K Mizutani
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - H Nagahiro
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Department of Physics, Nara Women's University, Nara 630-8506, Japan
| | - T Nakamura
- Department of Education, Gifu University, Gifu 501-1193, Japan
| | - T Nakano
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Nam
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T N T Ngan
- Nuclear Physics Department, University of Science, Vietnam National University, Ho Chi Minh City 72711, Vietnam
| | - Y Nozawa
- Department of Radiology, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Y Ohashi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Ohnishi
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Ohta
- Department of Radiology, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - K Ozawa
- Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - C Rangacharyulu
- Department of Physics and Engineering Physics, University of Saskatchewan, Saskatoon SK S7N 5E2, Canada
| | - S Y Ryu
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Sada
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - M Sasagawa
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Shibukawa
- Department of Physics, University of Tokyo, Tokyo 113-0033, Japan
| | - H Shimizu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - R Shirai
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - K Shiraishi
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - E A Strokovsky
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Laboratory of High Energy Physics, Joint Institute for Nuclear Research, Dubna, Moscow Region 142281, Russia
| | - Y Sugaya
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Sumihama
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Department of Education, Gifu University, Gifu 501-1193, Japan
| | - S Suzuki
- Japan Synchrotron Radiation Research Institute (SPring-8), Sayo, Hyogo 679-5198, Japan
| | - S Tanaka
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - A Tokiyasu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - Y Tsuchikawa
- J-PARC Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - T Ueda
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - H Yamazaki
- Radiation Science Center, High Energy Accelerator Research Organization (KEK), Tokai, Ibaraki 319-1195, Japan
| | - R Yamazaki
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - Y Yanai
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Yorita
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - C Yoshida
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - M Yosoi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
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Ohashi Y, Tsunoda N, Onodera K, Iijima S, Miyamoto I, Chiba T, Yamada H. Hypopituitarism manifesting after invasive dental treatment in a patient with carcinoma of the tongue: a case report. BMC Oral Health 2020; 20:106. [PMID: 32293413 PMCID: PMC7160967 DOI: 10.1186/s12903-020-01082-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 03/19/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The symptoms of hypopituitarism are not usually discussed in the clinical setting of oral surgery. CASE PRESENTATION We herein report a case of hypopituitarism that became evident after biopsy and extraction of several teeth in a 68-year-old man with tongue cancer. Three days after biopsy, the patient developed nausea and vomiting, and his serum sodium had fallen to 124 mEq/L. His serum cortisol concentration was low. Although the plasma concentration of adrenocorticotropic hormone (ACTH) was within the normal range, ACTH stimulation testing showed a lack of cortisol response. Given these findings, we suspected secondary adrenal insufficiency. To investigate the cause of secondary adrenal insufficiency, MRI of the head was performed, which revealed pituitary gland atrophy. The results of pituitary anterior lobe hormone-stimulation tests were compatible with hypopituitarism. Thirty days after biopsy, partial tongue resection was successfully performed under general anesthesia with perioperative hydrocortisone supplementation. CONCLUSIONS We must be aware of various signs of hypopituitarism when we perform invasive dental treatment.
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Affiliation(s)
- Yu Ohashi
- grid.411790.a0000 0000 9613 6383Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University School of Dentistry, 19-1, Uchimaru, Morioka, Iwate 020- 8505 Japan
| | - Naoko Tsunoda
- grid.411790.a0000 0000 9613 6383Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University School of Dentistry, 19-1, Uchimaru, Morioka, Iwate 020- 8505 Japan
| | - Kei Onodera
- grid.411790.a0000 0000 9613 6383Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University School of Dentistry, 19-1, Uchimaru, Morioka, Iwate 020- 8505 Japan
| | - Shin Iijima
- grid.411790.a0000 0000 9613 6383Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University School of Dentistry, 19-1, Uchimaru, Morioka, Iwate 020- 8505 Japan
| | - Ikuya Miyamoto
- grid.411790.a0000 0000 9613 6383Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University School of Dentistry, 19-1, Uchimaru, Morioka, Iwate 020- 8505 Japan
| | - Toshimi Chiba
- grid.411790.a0000 0000 9613 6383Division of Internal Medicine of Dentistry, Department of Oral medicine, Iwate Medical University School of Dentistry, 19-1, Uchimaru, Morioka, 020-8505 Japan
| | - Hiroyuki Yamada
- grid.411790.a0000 0000 9613 6383Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, Iwate Medical University School of Dentistry, 19-1, Uchimaru, Morioka, Iwate 020- 8505 Japan
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Ishikawa H, Tsuji D, Miyagi T, Kawasaki Y, Yamamoto K, Nakao M, Nakagaki S, Hayashi T, Ayuhara H, Harada T, Tamaki S, Maeda A, Ohashi Y, Arakawa Y, Fujita Y, Miyamoto Y, Yano T, Tanaka R, Itou K. Irinotecan and cisplatin therapy-induced neutropenia as a prognostic factor in patients with extensive-disease small cell lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz420.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Toyota T, Morimoto T, Iimuro S, Iwata H, Miyauchi K, Inoue T, Nakagawa Y, Daida H, Ozaki Y, Sakuma I, Furukawa Y, Ohashi Y, Matsuzaki M, Nagai R, Kimura T. P832LDL-C levels on statins and cardiovascular event risk in stable coronary artery disease: An observation from the REAL-CAD study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0431] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The relation between very low on-treatment low-density lipoprotein cholesterol (LDL-C) level and the cardiovascular event risk is still unclear in patients receiving the same doses of statins.
Methods
From the REAL-CAD study comparing high-dose with low-dose pitavastatin therapy in Japanese patients with stable coronary artery disease, 11105 patients without reported non-adherence for the study drug were divided into 3 groups according to the on-treatment LDL-C level at 6-month (<70 mg/dL, 70–100 mg/dL, and ≥100 mg/dL; N=1016, N=3078, and N=1665 in the pitavastatin 1 mg/day stratum; N=2431, N=2524, and N=391 in the pitavastatin 4 mg/day stratum). Primary outcome measure was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal ischemic stroke, or unstable angina requiring emergent admission.
Results
In the pitavastatin 1 mg/day stratum, cumulative 4-year incidence of the primary outcome measure was not significantly different across the 3 groups (5.0%, 5.7%, and 5.2%, P=0.51), while in the 4 mg/day stratum, it was significantly higher in the LDL-C ≥100 mg/dL group than in other groups (4.5%, 3.4%, and 9.1%, P<0.001). The adjusted risks of the LDL-C <70 mg/dL group relative to the LDL-C 70–100 mg/dL group (reference) remained insignificant for the primary outcome measure in both 1 mg/day and 4 mg/day strata (HR 0.84, 95% CI 0.58–1.18, P=0.32, and HR 1.25, 95% CI 0.88–1.79, P=0.22). The adjusted risk of LDL-C ≥100 mg/dL group relative to the reference group was not significant for the primary outcome measure in the 1 mg/day stratum (HR 0.82, 95% CI 0.60–1.11, P=0.21), while it was highly significant in the 4 mg/day stratum (HR 3.32, 95% CI 2.08–5.17, P<0.001). In the on-treatment LDL-C ≥100 mg/dL group in the 4 mg/day stratum, LDL-C increased by 6.3 mg/dL from baseline to 6-month despite dose escalation of pitavastatin from 1 mg/day to 4 mg/day, suggesting the presence of unreported poor adherence in this small subgroup.
Adjusted Effects of On-treatment LDL-C
Conclusions
Very low on-treatment LDL-C level (<70 mg/dL) was not associated with lower cardiovascular event risk compared with moderately low on-treatment LDL-C level (70–100 mg/dL) in patients receiving the same doses of statins. Too much emphasis on the target LDL-C strategy might mislead the clinical practice.
Acknowledgement/Funding
The Comprehensive Support Project for Clinical Research of Lifestyle-Related Disease of the Public Health Research Foundation.
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Affiliation(s)
- T Toyota
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - T Morimoto
- Hyogo College of Medicine, Department of Clinical Epidemiology, Nishinomiya, Japan
| | - S Iimuro
- Teikyo University, Teikyo Academic Research Center, Tokyo, Japan
| | - H Iwata
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Miyauchi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Inoue
- Dokkyo Medical University, Department of Cardiovascular Medicine, Mibu, Japan
| | - Y Nakagawa
- Shiga University of Medical Science, Department of Cardiovascular Medicine, Otsu, Japan
| | - H Daida
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - Y Ozaki
- Fujita Health University School of Medicine, Department of Cardiology, Toyoake, Japan
| | - I Sakuma
- Caress Sapporo Hokko Memorial Clinic, Sapporo, Japan
| | - Y Furukawa
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - Y Ohashi
- Chuo University, Department of Integrated Science and Technology for Sustainable Society, Tokyo, Japan
| | | | - R Nagai
- Jichi Medical University, Shimotsuke, Japan
| | - T Kimura
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
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Sakurai H, Goto Y, Yoh K, Takamochi K, Shukuya T, Hishida T, Tsuboi M, Yoshida K, Ohde Y, Okumura S, Ohashi Y, Kunitoh H. P1.17-04 Multicenter Observational Study of Node-Negative Non-Small Cell Lung Cancer Patients Who Are Excluded from a Clinical Trial. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Iwata H, Iimuro S, Inoue A, Miyauchi K, Taguchi I, Hiro T, Nakagawa Y, Ozaki Y, Ohashi Y, Daida H, Shimokawa H, Kimura T, Nagai R. P5320Reduction in high-sensitivity C-reactive protein by pitavastatin was associated with improved outcomes in Japanese patients with stable coronary artery disease: results from REAL-CAD study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0289] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The effect of statins on lowering high sensitivity C-reactive protein (hs-CRP) as well as low density lipoprotein cholesterol (LDL-C) has been associated with reduced risk for cardiovascular events in patients with elevated hs-CRP. However, it remains unclear whether this statin effect applies to low-risk patients with stable coronary artery disease (CAD). In this pre-specified sub-study within the REAL-CAD trial, we explored the association between achieved LDL-C/hs-CRP levels and cardiovascular events in Japanese patients with stable CAD who were treated with pitavastatin 1 mg or 4 mg/day.
Methods
The REAL-CAD trial randomly allocated 13,054 patients with stable CAD to pitavastatin 1 mg or 4 mg/day. LDL-C and hs-CRP were measured at baseline and at 6 months after randomization. We excluded those patients without 6-month data and those with endpoint events before 6 months (N=1915). The primary endpoint of the study was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal ischemic stroke, or unstable angina requiring emergency hospitalization. Outcomes were assessed by landmark analysis beyond 6 months among 4 groups that were configured based on LDL-C (median) and hs-CRP (median) targets: achieving neither target, achieving LDL-C target only, achieving hs-CRP target only, and achieving both targets. Data were adjusted for baseline characteristics including age, gender, diabetes and baseline values of LDL-C and hs-CRP.
Results
Median LDL-C and hs-CRP levels were 88 mg/dL and 0.52 mg/L at baseline and 80 mg/dL and 0.48 mg/L after 6 months, respectively. There was no correlation between the change in LDL-C and hs-CRP levels from baseline to 6 months (correlation coefficient: 0.009, P=0.331). Of the 11,677 patients included in the study, 25.1% (N=2799) achieved both LDL-C and hs-CRP targets, 25.3% (N=2282) met neither target, 24.8% (N=2765) met only the hs-CRP target, and 24.7% (N=2753) met only the LDL-C target. Risk of primary endpoint occurrence was significantly lower in those achieving either or both targets than in those meeting neither target (Figure A). In the subgroup analysis stratified by the randomized dose of pitavastatin, the risk for the primary endpoint was significantly lower in patients achieving both targets in both the 1mg and 4 mg arms, and in patients achieving only hs-CRP target in the 1 mg arm (Figure B, C).
Figure 1
Conclusions
In this subanalysis of the REAL-CAD trial, the hs-CRP lowering effect of pitavastatin was independent from LDL-C lowering. Lower achieved hs-CRP was associated with lower risk for cardiovascular events in Japanese patients with stable CAD.
Acknowledgement/Funding
Public Health Research Foundation, The company manufacturing the study drug (Kowa Pharmaceutical Co Ltd) was one of the entities providing financial s
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Affiliation(s)
- H Iwata
- Juntendo University School of Medicine, Tokyo, Japan
| | - S Iimuro
- Teikyo University, Teikyo Academic Research Center, Tokyo, Japan
| | - A Inoue
- Dokkyo Medical University, Mibu, Japan
| | - K Miyauchi
- Juntendo University School of Medicine, Tokyo, Japan
| | - I Taguchi
- Dokkyo Medical University Koshigya Hospital, Koshigaya City, Japan
| | - T Hiro
- Nihon University, Tokyo, Japan
| | - Y Nakagawa
- Shiga University of Medical Science, Otsu, Japan
| | - Y Ozaki
- Fujita Health University School of Medicine, Toyoake, Japan
| | - Y Ohashi
- Chuo University, Department of Integrated Science and Technology for Sustainable Society, Tokyo, Japan
| | - H Daida
- Juntendo University School of Medicine, Tokyo, Japan
| | - H Shimokawa
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Kimura
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - R Nagai
- Jichi Medical University, Shimotsuke, Japan
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YAMAMOTO H, Tsuruya K, Hase H, Nishi S, Yamagata K, Nangaku M, Wada T, Hayashi T, Uemura Y, Ohashi Y, Hirakata H. SUN-291 PREDICTIVE FACTORS OF ESA HYPORESPONSIVENESS IN PRE-DIALYSIS CKD PATIENTS: SECONDARY ANALYSIS OF THE RADIANCE-CKD STUDY. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Yamada H, Takeda Y, Ohashi Y, Abe R, Miyamoto I. Oral diverticulum: a case report with histopathological findings. J Surg Case Rep 2019; 2019:rjz170. [PMID: 31214311 PMCID: PMC6565818 DOI: 10.1093/jscr/rjz170] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 05/13/2019] [Indexed: 11/30/2022] Open
Abstract
Oral diverticulum is rarely encountered, and the histopathological findings are unclear. We herein report a case of an oral diverticulum and describe its histopathological findings. A buccal mucosal outpouching was observed in a 66-year-old man. Food debris was seen within the outpouching. Under the clinical diagnosis of a diverticulum-like lesion, excision of the outpouching was performed through an intraoral incision to stop food impaction. Histopathological examination revealed that the excised lesion was a true diverticular structure composed of a keratinising, squamous epithelial lining with a surrounding fibrous connective tissue wall, with inflammatory cell infiltration and haemorrhage. The histopathological diagnosis was a diverticular pouch of the buccal region. Clinicians should be aware of this lesion to ensure correct diagnosis and treatment.
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Affiliation(s)
- Hiroyuki Yamada
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka, Japan
| | - Yasunori Takeda
- Division of Clinical Pathology, Department of Oral and Maxillofacial Reconstructive Surgery, School of Dentistry, Iwate Medical University, Morioka, Japan
| | - Yu Ohashi
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka, Japan
| | - Ryousuke Abe
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka, Japan
| | - Ikuya Miyamoto
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka, Japan
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21
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Kobayashi K, Taira N, Sawaki M, Sagawa N, Baba S, Saito T, Kawahara T, Hagiwara Y, Uemura Y, Shimozuma K, Ohashi Y, Mukai H. Abstract P2-13-02: Patient-reported outcomes with trastuzumab monotherapy versus trastuzumab plus standard chemotherapy as a postoperative adjuvant therapy in HER2-positive elderly breast cancer patients (RESPECT): A randomized, open-label, phase 3 clinical trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-13-02] [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: 11/16/2022]
Abstract
Abstract
OBJECTIVE: The RESPECT trial compared 1-year trastuzumab monotherapy with trastuzumab plus standard chemotherapy as a postoperative adjuvant therapy in HER2-positive elderly breast cancer patients. Primary objective of this study was to verify the noninferiority of 1-year trastuzumab monotherapy to trastuzumab plus chemotherapy in terms of disease free survival, and the planned analysis showed that the difference of restricted mean survival time between two groups at 3 years was 0.45 months (reported by Sawaki at ASCO2018). This report assesses the patients-reported outcomes and health-related quality of life (HRQoL).
PATIENTS AND METHODS: The study was done at 99 hospitals in Japan. Elderly women (70 to 80 years old) with HER2-positive, stageI-IIIA invasive breast cancer treated by surgery with clear resection margins were randomly assigned to receive either 1-year trastuzumab or 1-year trastuzumab plus standard chemotherapy, stratified by age, hormone-receptor status, pathological lymph node metastasis and institution. Patients completed questionnaires at baseline, 2 months, 1year, and 3 years after protocol treatment started. The primary outcome was global HRQoL assessed using Functional Assessment of Cancer Therapy-General (FACT-G) total score, and secondary outcomes were chemotherapy-induced peripheral neuropathy (CIPN), instrumental activities of daily living (IADL), anxiety, depression, and subjective happiness. We did the analyses by intention to treat, including patients who completed questionnaires at baseline before start of protocol treatment, and 5point or more change is meaningful in FACT-G total score. This study is registered with ClinicalTrials.gov, NCT01104935.
RESULTS: Between Oct 2009 and Oct 2014, 275 patients were enrolled in the study, of whom 9 patients were excluded: 135 assigned to trastuzumab monotherapy and 131 assigned to trastuzumab plus chemotherapy. We detected significant difference between treatment groups for: clinically meaningful HRQoL deterioration rate at 2 months (31% for trastuzumab monotherapy vs 48% for trastuzumab plus chemotherapy; p=0.016) and at 1year (19% vs 38%; p=0.009), clinically meaningful HRQoL improvement rate at 2 months (38% for trastuzumab monotherapy vs 15% for trastuzumab plus chemotherapy; p<0.01) and at 1year (43% vs 25%; p=0.021), severe sensory CIPN rate at 2months (1.9% for trastuzumab monotherapy vs 14.4% for trastuzumab plus chemotherapy; p=0.001), IADL score at 1year (11.97 for trastuzumab monotherapy vs 11.54 for trastuzumab plus chemotherapy; p<0.042), Hospital Anxiety and Depression Scale score at 2months (8.92 for trastuzumab monotherapy vs 10.79 for trastuzumab plus chemotherapy; p<0.003), and subjective happiness score at 1year (12.8 for trastuzumab monotherapy vs 11.8 for trastuzumab plus chemotherapy; p<0.024).
CONCLUSION: Given the small advantage of adjuvant trastuzumab plus chemotherapy compared to trastuzumab monotherapy for elderly HER-2 positive breast cancer women, decisions about treatment should be informed by the risk for adverse health effects associated with chemotherapy.
Citation Format: Kobayashi K, Taira N, Sawaki M, Sagawa N, Baba S, Saito T, Kawahara T, Hagiwara Y, Uemura Y, Shimozuma K, Ohashi Y, Mukai H. Patient-reported outcomes with trastuzumab monotherapy versus trastuzumab plus standard chemotherapy as a postoperative adjuvant therapy in HER2-positive elderly breast cancer patients (RESPECT): A randomized, open-label, phase 3 clinical trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-13-02.
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Affiliation(s)
- K Kobayashi
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - N Taira
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - M Sawaki
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - N Sagawa
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - S Baba
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - T Saito
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - T Kawahara
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Hagiwara
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Uemura
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - K Shimozuma
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Ohashi
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - H Mukai
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
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Takahashi M, Sawaki M, Hagiwara Y, Uemura Y, Kawahara T, Shimozuma K, Ohashi Y, Saito T, Baba S, Kobayashi K, Mukai H, Taira N. Abstract P1-11-21: Analysis of cognitive function in elderly HER2-positive breast cancer patients receiving either trastuzumab monotherapy or trastuzumab plus chemotherapy as a postoperative adjuvant treatment: A cognitive function sub-study of a randomized, open-label, phase 3 clinical trial (RESPECT trial). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-11-21] [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: 11/16/2022]
Abstract
Abstract
OBJECTIVE: The effect of trastuzumab(Tmab) or chemotherapy on cognitive function has not been fully understood, especially in elderly breast cancer patients. The RESPECT trial compared 1-year(yr) Tmab monotherapy with Tmab plus standard chemotherapy as adjuvant therapy in elderly patients with HER2-positive breast cancer. The primary objective was to verify the noninferiority of 1-yr Tmab monotherapy compared to Tmab plus chemotherapy in terms of disease-free survival, and the planned analysis showed that the difference of restricted mean survival time between two groups at 3 yrs was 0.45 months (Sawaki at ASCO2018). The goal of this report was to assess the impact of the treatment groups on longitudinal cognitive function.
PATIENTS AND METHODS: The study was performed with patients from 99 hospitals in Japan. Elderly women with HER2-positive, stage I-IIIA invasive breast cancer surgery treated with clear resection margins were randomly assigned to either receive 1-yr Tmab or 1-yr Tmab plus standard chemotherapy. 15 institutions participated in the cognitive sub-study. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) at baseline and at 1 and 3 yrs after treatment. The primary outcome was the amount of change in the MMSE score from the baseline. A linear mixed-effects model was used for comparisons of change in the MMSE score between groups, controlling for time and baseline score. Secondary outcomes were the proportion of both suspected mild dementia (MMSE≤27) and dementia (MMSE≤23) at each time point.
RESULTS: Between October 2009 and October 2014, 275 patients were enrolled in the RESPECT trial, and 57 patients were enrolled in the cognitive function sub-study with 2 patients subsequently excluded. The 55-patient sub-study comprised 29 patients assigned to the Tmab monotherapy group and 26 patients assigned to the Tmab plus chemotherapy group. Primary analysis revealed that change in the MMSE score was not significantly different between the two groups (difference −0.6 at 1 yr and −0.9 at 3 yrs; p=0.136), whereas the baseline score was the only significant factor that had an effect on the amount of change in the MMSE score (p<0.001). The proportions of suspected mild dementia at baseline, and at 1 yr and 3 yrs were 15.4, 32.0, and 41.7% in the Tmab monotherapy group, and 45.8, 17.6, and 28.6% in the Tmab plus chemotherapy group. The proportions of suspected mild dementia at baseline were significantly higher in the Tmab plus chemotherapy group (p=0.04). The proportions of suspected dementia at baseline, and at 1 yr and 3 yrs were 0%, 0%, and 4.2% in the Tmab monotherapy group, and 4.2%, 0%, and 4.8% in the Tmab plus chemotherapy group. There were no significant differences in the proportions of suspected dementia between the treatment groups at each time point.
CONCLUSION: Postoperative chemotherapy for elderly breast cancer patients was considered to have little effect on the onset of dementia during the follow-up period of 3 yrs. Further long-term observation is necessary to obtain a significant conclusion.
Citation Format: Takahashi M, Sawaki M, Hagiwara Y, Uemura Y, Kawahara T, Shimozuma K, Ohashi Y, Saito T, Baba S, Kobayashi K, Mukai H, Taira N. Analysis of cognitive function in elderly HER2-positive breast cancer patients receiving either trastuzumab monotherapy or trastuzumab plus chemotherapy as a postoperative adjuvant treatment: A cognitive function sub-study of a randomized, open-label, phase 3 clinical trial (RESPECT trial) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-11-21.
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Affiliation(s)
- M Takahashi
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - M Sawaki
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - Y Hagiwara
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - Y Uemura
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - T Kawahara
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - K Shimozuma
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - Y Ohashi
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - T Saito
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - S Baba
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - K Kobayashi
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - H Mukai
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - N Taira
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
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Yonemori K, Ohsumi S, Takao S, Tokuda Y, Ito Y, Nakagami K, Takahashi M, Yoshidome K, Nakayama T, Yamaguchi Y, Ohashi Y, Inaji H, Watanabe T. Abstract P1-13-09: Long-term follow-up of two randomized controlled trials (N-SAS-BC01 trial and CUBC trial) comparing oral tegafur-uracil (UFT) versus classical cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) as adjuvant therapy in early breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-13-09] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Two randomized controlled trials comparing the efficacy of oral tegafur-uracil (UFT) (2 years) with that of classical cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) (6 courses) were conducted in patients with resected early breast cancer. UFT is an oral fluoropyrimidine that combines tegafur, a prodrug of 5-fluorouracil, with uracil in a 1:4 molar ratio. One study was the N-SAS-BC01 trial (Watanabe et al, J Clin Oncol 2009), which was conducted in patients with high-risk node-negative breast cancer (n=733). The other was the CUBC trial (Park et al, Br J Cancer 2009), which was performed in patients with node-positive breast cancer (n=377). We reported the pooled analysis of these two randomized control trials using individual patient data (Ohashi et al, Breast Cancer Res Treat 2010). This pooled analysis showed that UFT was non-inferior to CMF in terms of inhibiting recurrence of estrogen receptor (ER)-positive early breast cancer. In addition, an exploratory subgroup analysis showed that UFT may be more effective in ER-positive patients who were 50 years or older. The present study was conducted to investigate the long-term efficacy of UFT or CMF in patients with early breast cancer.
Methods: Long-term follow-up data for disease recurrence and survival were collected. Hazard ratios (HR) were determined using the Cox model stratified by study and adjusted for clinical characteristics, namely age, tumor size, nodal status, histological type, ER, and progesterone receptor (PgR). Survival curves were estimated by the Kaplan-Meier method. Hochberg multiplicity adjustment was applied in the previous pooled analysis, and non-inferiority of UFT versus CMF was shown in terms of relapse-free survival (RFS) in the ER-positive patient group. We investigated the non-inferiority of UFT in the same patient group with updated data. Restricted mean survival time (RMST) was calculated to consider the relative efficacy of UFT. This study is registered with JapicCTI-163321.
Results: In total, 1,057 patients were analyzed (CMF, n=528; UFT n=529). The median follow-up time was 11.1 years (12.1 years in the N-SAS-BC 01 trial and 8.3 years in the CUBC trial). Table 1 shows the 10-year RFS and overall survival (OS) in all patients and ER-positive patients. The difference in RMST between arms at 20 years in terms of RFS was -2.7 months in all patients and 3.4 months in ER-positive patients. Table 2 shows the HR for RFS according to ER status and age.
UFT (%)CMF (%)UFT to CMF; HR (95% CI)10-year RFSall patients74.477.11.02 (0.81–1.30)ER-positive patients75.075.10.91 (0.66–1.27)10-year OSall patients86.886.90.98 (0.72–1.34)ER-positive patients89.987.90.86 (0.54–1.37)
Age <50 yearsAge ≥50 yearsER negative1.76 (0.95–3.26)0.93 (0.58–1.51)ER positive1.29 (0.74–2.23)0.76 (0.50–1.16)
Conclusion: This study shows that UFT was shown to be non-inferior to CMF in terms of RFS in ER-positive early breast cancer. This result is similar to that of the previous pooled analysis.
Sponsor: Taiho Pharmaceutical Co., LTD
Citation Format: Yonemori K, Ohsumi S, Takao S, Tokuda Y, Ito Y, Nakagami K, Takahashi M, Yoshidome K, Nakayama T, Yamaguchi Y, Ohashi Y, Inaji H, Watanabe T. Long-term follow-up of two randomized controlled trials (N-SAS-BC01 trial and CUBC trial) comparing oral tegafur-uracil (UFT) versus classical cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) as adjuvant therapy in early breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-13-09.
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Affiliation(s)
- K Yonemori
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - S Ohsumi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - S Takao
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Tokuda
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Ito
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - K Nakagami
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - M Takahashi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - K Yoshidome
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - T Nakayama
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Yamaguchi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - Y Ohashi
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - H Inaji
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
| | - T Watanabe
- National Cancer Center Hospital, Chuo, Tokyo, Japan; NHO Shikoku Cancer Center, Matsuyama, Ehime, Japan; Hyogo Cancer Center, Akashi, Hyogo, Japan; Tokai University School of Medicine, Hiratsuka, Kanagawa, Japan; Cancer Institute Hospital, Japanese Foundation for Cancer Research, Koto, Tokyo, Japan; Shizuoka General Hospital, Shizuoka, Japan; NHO, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Osaka Police Hospital, Osaka, Japan; Osaka International Cancer Institute, Osaka, Japan; Taiho Pharmaceutical Co., LTD, Chiyoda, Tokyo, Japan; Chuo University, Bunkyo, Tokyo, Japan; Kaizuka City Hospital, Kaizuka, Osaka, Japan; Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan
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Shitara K, Yamanaka T, Denda T, Tsuji Y, Shinozaki K, Komatsu Y, Kobayashi Y, Furuse J, Okuda H, Asayama M, Akiyoshi K, Kagawa Y, Kato T, Oki E, Ando T, Hagiwara Y, Ohashi Y, Yoshino T. REVERCE: a randomized phase II study of regorafenib followed by cetuximab versus the reverse sequence for previously treated metastatic colorectal cancer patients. Ann Oncol 2019; 30:259-265. [PMID: 30508156 DOI: 10.1093/annonc/mdy526] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The objective of this randomized phase II trial was to evaluate efficacy and safety of the therapeutic sequence of regorafenib followed by cetuximab, compared with cetuximab followed by regorafenib, as the current standard sequence for metastatic colorectal cancer patients. PATIENTS AND METHODS Patients with KRAS exon 2 wild-type metastatic colorectal cancer after failure of fluoropyrimidine, oxaliplatin, and irinotecan were randomized to receive sequential treatment with regorafenib followed by cetuximab ± irinotecan (R-C arm), or the reverse sequence [cetuximab ± irinotecan followed by regorafenib (C-R arm)]. The primary end point was overall survival (OS). Key secondary end points included progression-free survival (PFS) with initial treatment (PFS1), PFS with second treatment (PFS2), safety, and quality of life. Exploratory end points included serial biomarker analyses, including oncogenic alterations from circulating tumor DNA or multiple serum or plasma proteins. RESULTS One-hundred one patients were randomized and eligible for efficacy analysis. Sequential treatment was successful in 86% patients in both arms. Median OS for R-C and C-R was 17.4 and 11.6 months, respectively (P = 0.0293), with a hazard ratio (HR) of 0.61 for OS [95% confidence interval (CI) 0.39-0.96]. The HR for PFS1 (regorafenib in R-C versus cetuximab in C-R) was 0.97 (95% CI 0.61-1.54), and PFS2 (C in R-C versus R in C-R) was 0.29 (95% CI 0.17-0.50). No unexpected safety signals were observed. The quality of life scores during the entire treatment period was not significantly different between the two arms. Circulating biomarker analyses showed emerging oncogenic alterations in RAS, BRAF, EGFR, HER2, and MET, which were more commonly detected after cetuximab than after regorafenib. CONCLUSIONS The therapeutic sequence of regorafenib followed by cetuximab suggests a longer OS than the current standard sequence.
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Affiliation(s)
- K Shitara
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - T Yamanaka
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| | - T Denda
- Division of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - Y Tsuji
- Department of Medical Oncology, Tonan Hospital, Sapporo, Japan
| | - K Shinozaki
- Division of Clinical Oncology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Y Komatsu
- Division of Cancer Chemotherapy, Hokkaido University Hospital Cancer Center, Sapporo, Japan
| | - Y Kobayashi
- Department of Medical Oncology, Kushiro Rosai Hospital, Kushiro, Japan
| | - J Furuse
- Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - H Okuda
- Department of Medical Oncology, Keiyukai Sapporo Hospital, Sapporo, Japan
| | - M Asayama
- Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan
| | - K Akiyoshi
- Department of Clinical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Y Kagawa
- Department of Surgery, Kansai Rosa Hospital, Amagasaki, Japan
| | - T Kato
- Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ando
- School of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Y Hagiwara
- Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Y Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
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Kumagai A, Iijima S, Nomiya T, Furuya I, Ohashi Y, Tsunoda K, Onodera K, Tsunoda N, Komatsu Y, Hirano T. A pilot study of the clinical evidence for the methodology for prevention of oral mucositis during cancer chemotherapy by measuring salivary excretion of 5-fluorouracil. BDJ Open 2018; 4:17041. [PMID: 30479834 PMCID: PMC6251891 DOI: 10.1038/s41405-018-0008-2] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 10/03/2018] [Accepted: 10/09/2018] [Indexed: 11/24/2022] Open
Abstract
Objective to re-examine measures to prevent oral mucositis caused by drugs in head and neck cancer patients during cancer treatment by measuring salivary excretion of 5-fluorouracil. Saliva, blood, and urine were simultaneously collected from oral cancer patients and breast cancer patient at the point in time of before, during, and after the administration of 5-FU, then the 5-FU levels of the samples were quantitatively analysed using LC-MS/MS. In all patients, the 5-FU levels in saliva and serum peaked at 30 min to 3 h after the start of 5-FU treatment, and high levels were maintained throughout the administration of the drug. With regard to urinary 5-FU levels, they remained high from 3 to 120 h after the start of 5-FU treatment. After the completion of 5-FU treatment, even though it not appeared in the patients’ serum and urine promptly, 5-FU was detected in saliva at 12 h after the completion of 5-FU treatment in one oral cancer patient and at 48 h after the completion of 5-FU treatment in the breast cancer patient. It was suggested that the level of hydration after the completion of chemotherapy may be involved in the differences in 5-FU excretion.
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Affiliation(s)
- Akiko Kumagai
- Iwate Medical University, Reconstructive Oral and Maxillofacial Surgery, Morioka, Iwate Japan
| | - Shin Iijima
- Iwate Medical University, Reconstructive Oral and Maxillofacial Surgery, Morioka, Iwate Japan
| | - Takayuki Nomiya
- Iwate Medical University, Reconstructive Oral and Maxillofacial Surgery, Morioka, Iwate Japan
| | - Izuru Furuya
- Iwate Medical University, Reconstructive Oral and Maxillofacial Surgery, Morioka, Iwate Japan
| | - Yu Ohashi
- Iwate Medical University, Reconstructive Oral and Maxillofacial Surgery, Morioka, Iwate Japan
| | - Koichi Tsunoda
- Iwate Medical University, Reconstructive Oral and Maxillofacial Surgery, Morioka, Iwate Japan
| | - Kei Onodera
- Iwate Medical University, Reconstructive Oral and Maxillofacial Surgery, Morioka, Iwate Japan
| | - Naoko Tsunoda
- Iwate Medical University, Reconstructive Oral and Maxillofacial Surgery, Morioka, Iwate Japan
| | - Yuko Komatsu
- Iwate Medical University, Reconstructive Oral and Maxillofacial Surgery, Morioka, Iwate Japan
| | - Taifu Hirano
- Iwate Medical University, Reconstructive Oral and Maxillofacial Surgery, Morioka, Iwate Japan
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Ohashi Y, Walker JC, Zhang F, Prindiville FE, Hanrahan JP, Mendelson R, Corcoran T. Preoperative Gastric Residual Volumes in Fasted Patients Measured by Bedside Ultrasound: A Prospective Observational Study. Anaesth Intensive Care 2018; 46:608-613. [DOI: 10.1177/0310057x1804600612] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The purpose of this prospective observational study was to measure gastric volumes in fasted patients using bedside gastric ultrasound. Patients presenting for non-emergency surgery underwent a gastric antrum assessment, using the two-diameter and free-trace methods to determine antral cross-sectional area. Gastric residual volume (GRV) was calculated using a validated formula. Univariate and multivariable analyses were performed to examine any potential relationships between ‘at risk’ GRVs (>100 ml) and patient factors. Two hundred and twenty-two successful scans were performed; of these 110 patients (49.5%) had an empty stomach, nine patients (4.1%) had a GRV >100 ml, and a further six patients (2.7%) had a GRV >1.5 ml/kg. There was no significant relationship between ‘at risk’ GRV and obesity, diabetes mellitus, gastro-oesophageal reflux disease or opioid use, although our study had insufficient power to exclude an influence of one or more of these factors. Our results indicate that despite compliance with fasting guidelines, a small percentage of patients still have GRVs that pose a pulmonary aspiration risk. Anaesthetists should consider this background incidence when choosing anaesthesia techniques for their patients. While future observational studies are required to determine the role of preoperative bedside gastric ultrasound, it is possible that this technique may assist anaesthetists in identifying patients with ‘at risk’ GRVs.
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Affiliation(s)
- Y. Ohashi
- Department of Anaesthesia and Pain Medicine, Fiona Stanley Fremantle Hospitals Group, Perth, Western Australia
| | - J. C. Walker
- Consultant Anaesthetist, Anaesthetic Department, Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - F. Zhang
- Department of Radiology, Sir Charles Gairdner Hospital, Perth, Western Australia
| | - F. E. Prindiville
- Sonographer, Department of Imaging Services, Royal Perth Hospital, Perth, Western Australia
| | - J. P. Hanrahan
- General Practitioner, Queens Park Medical Centre, Perth, Western Australia
| | - R. Mendelson
- Emeritus Consultant Radiologist, Department of Diagnostic and Interventional Radiology, Royal Perth Hospital; Clinical Professor, University of Western Australia; Adjunct Professor, Notre Dame University; Perth, Western Australia
| | - T. Corcoran
- Director of Research, Department of Anaesthesia and Pain Medicine, Royal Perth Hospital; Clinical Professor, School of Medicine and Pharmacology, University of Western Australia; Raine Clinical Research Fellow, Raine Foundation/WA Health Department; Adjunct Clinical Professor, School of Public Health and Preventive Medicine, Monash University Australia; Perth, Western Australia
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Iwata H, Masuda N, Yamamoto Y, Fujisawa T, Toyama T, Taira N, Kashiwaba M, Ohtani S, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Ohashi Y. Distant disease-free survival (DDFS) according to response category in neoadjuvant endocrine therapy (NET): 6-year analysis in phase III NEOS trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Osawa H, Shinozaki E, Nakamura M, Ohhara Y, Shindo Y, Shiozawa M, Uetake H, Matsumoto H, Ureshino N, Satake H, Kobayashi T, Suto T, Kitano S, Ohashi Y, Uemura K, Yamaguchi K. Phase II study of cetuximab rechallenge in patients with ras wild-type metastatic colorectal cancer: E-rechallenge trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Usui K, Yokoyama T, Kisohara A, Mori Y, Takeda Y, Ishida H, Kusano N, Kishi K, Katsushima U, Kuwako T, Aono H, Shikama Y, Minato K, Matsushima H, Uemura K, Ohashi Y, Kunitoh H. The plasma ctDNA monitoring during epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment in patients with EGFR mutant non-small cell lung cancer (JP-CLEAR trial). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yoshino T, Yamanaka T, Denda T, Tsuji Y, Shinozaki K, Komatsu Y, Kobayashi Y, Furuse J, Okuda H, Asayama M, Akiyoshi K, Kagawa Y, Kato T, Oki E, Ando T, Hagiwara Y, Ohashi Y, Shitara K. REVERCE: Randomized phase II study of regorafenib followed by cetuximab versus the reverse sequence for metastatic colorectal cancer patients previously treated with fluoropyrimidine, oxaliplatin, and irinotecan: Quality of life analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kohri H, Shiu SH, Chang WC, Yanai Y, Ahn DS, Ahn JK, Chen JY, Daté S, Ejiri H, Fujimura H, Fujiwara M, Fukui S, Gohn W, Hicks K, Hosaka A, Hotta T, Hwang SH, Imai K, Ishikawa T, Joo K, Kato Y, Kon Y, Lee HS, Maeda Y, Mibe T, Miyabe M, Morino Y, Muramatsu N, Nakano T, Nakatsugawa Y, Nam SI, Niiyama M, Noumi H, Ohashi Y, Ohta T, Oka M, Parker JD, Rangacharyulu C, Ryu SY, Sawada T, Shimizu H, Strokovsky EA, Sugaya Y, Sumihama M, Tsunemi T, Uchida M, Ungaro M, Wang SY, Yosoi M. Differential Cross Section and Photon-Beam Asymmetry for the γ[over →]p → π^{-}Δ^{++}(1232) Reaction at Forward π^{-} Angles for E_{γ}=1.5-2.95 GeV. Phys Rev Lett 2018; 120:202004. [PMID: 29864366 DOI: 10.1103/physrevlett.120.202004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/11/2018] [Indexed: 06/08/2023]
Abstract
Differential cross sections and photon-beam asymmetries for the γ[over →]p→π^{-}Δ^{++}(1232) reaction have been measured for 0.7<cosθ_{π}^{c.m.}<1 and E_{γ}=1.5-2.95 GeV at SPring-8/LEPS. The first-ever high statistics cross-section data are obtained in this kinematical region, and the asymmetry data for 1.5<E_{γ}(GeV)<2.8 are obtained for the first time. This reaction has a unique feature for studying the production mechanisms of a pure uu[over ¯] quark pair in the final state from the proton. Although there is no distinct peak structure in the cross sections, a non-negligible excess over the theoretical predictions is observed at E_{γ}=1.5-1.8 GeV. The asymmetries are found to be negative in most of the present kinematical regions, suggesting the dominance of π exchange in the t channel. The negative asymmetries at forward meson production angles are different from the asymmetries previously measured for the photoproduction reactions producing a dd[over ¯] or an ss[over ¯] quark pair in the final state. Advanced theoretical models introducing nucleon resonances and additional unnatural-parity exchanges are needed to reproduce the present data.
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Affiliation(s)
- H Kohri
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - S H Shiu
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
- Department of Physics, National Central University, Taoyuan City 32001, Taiwan
| | - W C Chang
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - Y Yanai
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - D S Ahn
- RIKEN Nishina Center, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - J K Ahn
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - J Y Chen
- Light Source Division, National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - S Daté
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5143, Japan
| | - H Ejiri
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Fujimura
- Wakayama Medical College, Wakayama 641-8509, Japan
| | - M Fujiwara
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- National Institutes for Quantum and Radiological Science and Technology, Tokai, Ibaraki 319-1195, Japan
| | - S Fukui
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - W Gohn
- Department of Physics, University of Connecticut, Storrs, Connecticut 06269-3046, USA
| | - K Hicks
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - A Hosaka
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Hotta
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - S H Hwang
- Korea Research Institute of Standards and Science (KRISS), Daejeon 34113, Republic of Korea
| | - K Imai
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - T Ishikawa
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - K Joo
- Department of Physics, University of Connecticut, Storrs, Connecticut 06269-3046, USA
| | - Y Kato
- Kobayashi-Maskawa Institute, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - Y Kon
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H S Lee
- Rare Isotope Science Project, Institute for Basic Science, Daejeon 34047, Korea
| | - Y Maeda
- Proton Therapy Center, Fukui Prefectural Hospital, Fukui 910-8526, Japan
| | - T Mibe
- High Energy Accelerator Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - M Miyabe
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - Y Morino
- High Energy Accelerator Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - N Muramatsu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Nakano
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Nakatsugawa
- High Energy Accelerator Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - S I Nam
- Department of Physics, Pukyong National University (PKNU), Busan 608-737, Republic of Korea
| | - M Niiyama
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - H Noumi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Ohashi
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5143, Japan
| | - T Ohta
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Oka
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - J D Parker
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - C Rangacharyulu
- Department of Physics and Engineering Physics, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E2, Canada
| | - S Y Ryu
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Sawada
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
- Physics Department, University of Michigan, Michigan 48109-1040, USA
| | - H Shimizu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - E A Strokovsky
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
- Joint Institute for Nuclear Research, Dubna, Moscow Region 142281, Russia
| | - Y Sugaya
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Sumihama
- Department of Education, Gifu University, Gifu 501-1193, Japan
| | - T Tsunemi
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - M Uchida
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - M Ungaro
- Department of Physics, University of Connecticut, Storrs, Connecticut 06269-3046, USA
| | - S Y Wang
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - M Yosoi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
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Abstract
Two studies were conducted to check the effects of β-blocker eye drops, 2% carteolol (Mikelan®) and 0.5% timolol (Timoptol®), on regeneration of corneal epithelium in rabbit eyes. For the short-term study, epithelial deficiency was artificially induced in the cornea of albino rabbits. One of the β-blocker eye drops or 0.005% benzalkonium chloride was applied in the right eye and physiological saline solution was applied to the left eye four times a day, and wound healing rate was calculated. Two weeks later, images of the surface epithelium were analyzed by scanning electron microscopy and proliferative capacity was studied, using proliferating cell nuclear antigen as a marker. The long-term study was conducted similarly except that the eye drops were applied twice a day and epithelial deficiency was re-induced every two weeks. In the short-term study, epithelial wound healing rate was slowed in β-blocker groups. Significant differences were detected between the Mikelan® and Timoptol® groups, and the benzalkonium and physiological saline groups. The β-blocker groups had severe epithelial cell desquamation, as well as detachment. In the long-term study, the Mikelan® group had significantly delayed wound healing at first induction, the benzalkonium group showed delay up to the third induction and the Timoptol® group up to the fifth induction. These studies indicate that β-blocker eye drops delay corneal epithelial wound healing and supported the concept that corneal epithelial deficiency occurs clinically after the long-term administration of β-blocker eye drops.
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Affiliation(s)
- Y Haruta
- Department of Ophthalmology, National Osaka Minami Hospital, Japan
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Ohashi Y, Sato H, Kaihara S, Kiuchil T. Methodology for the Construction of a Disease Nomenclature and Classification System for Clinical Use. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1634625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract:The nature and problems of the linguistic representation of clinical data are discussed, using the linguistic theory of Ferdinand de Saussure. Based on the conclusions, a methodology for the construction of a disease nomenclature and a classification system, suitable for use in clinical information systems, is developed using set theory.
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Iwata H, Masuda N, Fujisawa T, Toyama T, Ohtani S, Yamamoto Y, Kashiwaba M, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Ohashi Y. Abstract P3-13-03: NEOS: A randomized, open label, phase 3 trial of adjuvant chemotherapy for postmenopausal breast cancer patients who responded to neoadjuvant letrozole: First report of long-term outcome and prognostic value of response to neoadjuvant endocrine therapy. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-13-03] [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: 11/16/2022]
Abstract
Abstract
Background: Whether adjuvant chemotherapy is required for patients (pts) with intermediate-risk endocrine-responsive postmenopausal breast cancer (BC) remains unknown. Sufficient data have not been available about the long-term prognosis of patients with neoadjuvant endocrine therapy (ET). NEOS is a randomized phase III study that assessed the long-term prognosis of estrogen receptor positive (ER+) primary breast cancer (PBC) pts who received neoadjuvant ET with/without adjuvant chemotherapy.
Methods: Postmenopausal BC pts with ER +/HER2 negative, T1c-2, clinically node negative, under 76 years old were enrolled at primary registration. Pts were treated by leterozole (LET) in weeks 24-28 after primary enrollment. Pts experienced progression (PD) during neoadjuvant phase were excluded at randomization and received any systemic therapy driven by investigators before or after surgery. The long-term prognosis was followed in all registered pts including PD pts. Response to neoadjuvant ET was evaluated as complete response (CR), partial response (PR) or stable disease (SD) using calipers, ultrasound and MRI (or CT) at the baseline and end of treatment before surgery. Pts who met eligibility criteria were randomized 1:1 to LET for 4.5-5 years after chemotherapy or LET alone for 4.5-5 years without chemotherapy after surgery. Pts excluded at second registration were treated any systemic therapies driven by investigators. The primary endpoint was disease-free survival (DFS) and secondary endpoints included overall survival (OS), clinical response rate in neoadjuvant phase, pathological response, and breast-conserving surgery rate. The randomization code have been blinded to the investigators.
Results: Between May 2008 and June 2013, 904 patients were enrolled at primary registration from 100 institutions in Japan (median follow-up: 4.0 years) and 24 pts were withdrawn during neoadjuvant phase. The median age was 63 years, T1c:37%, T2:63%, and PgR+:78%. Clinical response rates (CR, PR, SD and PD) were2% (16pts), 48% (421pts), 45% (400pts) and 5% (43pts), respectively and, in each response category, 0% (0/16), 5.5% (23/421), 7.8% (31/400), and 20.9% (9/43) experienced DFS events. DFS in PD pts to neoadjuvant ET were statistically significantly worse than CR, PR, SD pts (p<0.0001, hazard ratio 4.7 (95% CI:2.3-9.5). The prognosis after surgery in 669 randomized pts was good regardless with/without chemotherapy, forty four pts (6.6%) experienced DFS events after surgery. The predictive markers of PD for neoadjuvant ET were yet unclear among evaluated clinical factors.
Conclusion: This is the first report of DFS in the largest neoadjuvant ET trial (NEOS). The DFS of postmenopausal, ER+/HER2-, PBC pts excluding PD pts to neoadjuvant ET is highly good regardless with/without chemotherapy. Neoadjuvant ET with utilization of PD response as a prognostic marker can be considered as a standard treatment option for these patients. Clinical trial information: UMIN000001090.
Citation Format: Iwata H, Masuda N, Fujisawa T, Toyama T, Ohtani S, Yamamoto Y, Kashiwaba M, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Ohashi Y. NEOS: A randomized, open label, phase 3 trial of adjuvant chemotherapy for postmenopausal breast cancer patients who responded to neoadjuvant letrozole: First report of long-term outcome and prognostic value of response to neoadjuvant endocrine therapy [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-13-03.
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Affiliation(s)
- H Iwata
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - N Masuda
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Fujisawa
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Toyama
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - S Ohtani
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Yamamoto
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - M Kashiwaba
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - N Taira
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Sakai
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Hasegawa
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - R Nakamura
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - H Akabane
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Shibahara
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - H Sasano
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - T Yamaguchi
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
| | - Y Ohashi
- Aichi Cancer Center Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Kumamoto University, Kumamoato, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Chuo University, Tokyo, Japan
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Yamamoto Y, Iwata H, Masuda N, Fujisawa T, Toyama T, Kashiwaba M, Ohtani S, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Sakamaki K, Chao C, McCullough D, Sugiyama N, Ohashi Y. Abstract PD5-03: TransNEOS: Validation of the oncotype DX recurrence score (RS) testing core needle biopsy samples from NEOS as predictor of clinical response to neoadjuvant endocrine therapy for postmenopausal estrogen receptor positive (ER+), HER2 negative (HER2-) breast cancer patients. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd5-03] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Neoadjuvant therapy for locally advanced breast cancer has the potential to improve surgical therapeutic outcomes without sacrificing the survival advantages of adjuvant therapy. However, determining whether ER+ patients (pts) will respond to neoadjuvant (NA) chemotherapy (CT) or hormone therapy (HT) can be difficult. Not all ER+ pts respond to NACT, while response to NAHT can vary across ER+ pts. Thus, the ability to select pts more likely to benefit from NAHT would represent progress in clinical management of breast cancer. NEOS is a randomized phase III study assessinglong-term prognosis of ER+ primary breast cancer with/without adjuvant CT following NAHT (UMIN 000001090, http://www.umin.ac.jp/). We used archived core biopsy tumor samples from the NEOS study to validate the RS result as a predictor of clinical response and its association with successful breast conserving surgery (BCS) in pts treated with 6 months of NAHT.
Methods: NEOS enrolled 904 postmenopausal pts with ER+, HER2-, clinically node negative (cN0) breast cancer to evaluate whether adjuvant CT was necessary for pts who responded to NAHT. In this current study, we enrolled pts with tumors ≥2cm from the NEOS study. Biopsy samples of 333 pts were assessed for the Oncotype DX assay. Response to NAHT was recorded as complete/partial response (CR/PR), or stable/progressive disease (SD/PD).
Primary endpoint of this study was to evaluate clinical response (CR/PR) to NA letrozole between pts with low (<18) and high (≥31) RS result. Secondary endpoints include evaluating the relationships between clinical response and continuous RS results, and other covariates including age, tumor size, grade, Ki67 by IHC, ER and PR single gene scores, and ER and proliferation gene group scores by RT-PCR.
Results: The analysis included 294 pts with median age of 63 yrs, median tumor size of 25mm, and 66% were nuclear grade 1. 156 (53.0%), 83 (28.6%) and 54(18.4%) cases were low, intermediate, and high RS groups by Oncotype DX, respectively. Six (2%), 126 (42.8%), 149 (50.3%), 13 (4.4%) cases experienced CR, PR, SD, PD as clinical response, respectively, similar to that of all NEOS pts. Clinical response rate was 54%, 42% and 22% in low, intermediate, and high RS groups, respectively. The proportion of pts with clinical response was significantly higher in the low RS group vs the high RS group (p<0.001). In univariate analyses, continuous RS was significantly associated with clinical response (p<0.001), along with ER (p=.02), PR (p<0.001), and ER gene group score (p<0.001). Other covariates were not associated with clinical response.
Conclusion: The Oncotype DX RS test in core biopsy samples is validated as a predictive assay for clinical response of NAHT in postmenopausal, ER+/HER2-, cN0, primary early breast cancer pts. Further results on the association of RS results with BCS outcomes following NAHT will be presented. These results when combined with previously published data on RS in NACT studies help guide pts with ER+, HER2- breast cancer with NAHT vs NACT treatment options to maximize clinical response.
Citation Format: Yamamoto Y, Iwata H, Masuda N, Fujisawa T, Toyama T, Kashiwaba M, Ohtani S, Taira N, Sakai T, Hasegawa Y, Nakamura R, Akabane H, Shibahara Y, Sasano H, Yamaguchi T, Sakamaki K, Chao C, McCullough D, Sugiyama N, Ohashi Y. TransNEOS: Validation of the oncotype DX recurrence score (RS) testing core needle biopsy samples from NEOS as predictor of clinical response to neoadjuvant endocrine therapy for postmenopausal estrogen receptor positive (ER+), HER2 negative (HER2-) breast cancer patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD5-03.
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Affiliation(s)
- Y Yamamoto
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - H Iwata
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - N Masuda
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Fujisawa
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Toyama
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - M Kashiwaba
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - S Ohtani
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - N Taira
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Sakai
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - Y Hasegawa
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - R Nakamura
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - H Akabane
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - Y Shibahara
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - H Sasano
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - T Yamaguchi
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - K Sakamaki
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - C Chao
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - D McCullough
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - N Sugiyama
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
| | - Y Ohashi
- Kumamoto University, Kumamoto, Japan; Aichi Cancer Ceter Hospital, Nagoya, Japan; NHO Osaka National Hospital, Osaka, Japan; Gunma Prefectural Cancer Center, Maebashi, Japan; Nagoya City University Graduate School of Medical Science, Nagoya, Japan; Breastopia Miyazaki Hospital, Miyazaki, Japan; Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Hirosaki Municipal Hospital, Hirosaki, Japan; Chiba Cancer Center, Chiba, Japan; Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, Asahikawa, Japan; Tohoku University Graduate School of Medicine, Sendai, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Genomic Health, Inc.; Chuo University, Tokyo, Japan
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Mikami T, Ohashi Y, Bologna-Molina R, Mosqueda-Taylor A, Fujiwara N, Tsunoda N, Yamada H, Takeda Y. Primordial Odontogenic Tumor: A case report with histopathological analyses. Pathol Int 2017; 67:638-643. [PMID: 29090496 DOI: 10.1111/pin.12601] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 09/20/2017] [Indexed: 02/05/2023]
Abstract
Primordial odontogenic tumor (POT) is a benign mixed epithelial and mesenchymal odontogenic tumor included into the current World Health Organization (WHO) classification of Head and Neck tumours in 2017. As far as the authors have confirmed, only eight cases of this tumor have been reported so far. This paper reports a case of POT that occurred in the right mandible of a 5-year-old patient. Panoramic radiograph showed a well-defined homogeneous radiolucency displacing the unerupted second deciduous molar to the deep part of the mandible. Histopathologically, the tumor was composed of cell-rich mesenchymal tissue with myxoid areas, surrounded by columnar epithelium and non-keratinized cuboidal epithelium in the outer layers. The histopathological diagnosis was POT. The expression patterns of cytokeratins (CK) 14, 18, 19, vimentin and CD34 suggested that the grade of differentiation of the POT was approximately equivalent to that of normal primary tooth germ tissues in cap stage to late bell stage.
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Affiliation(s)
- Toshinari Mikami
- Division of Anatomical and Cellular Pathology, Department of Pathology, Iwate Medical University, 2-1-1 Nishitokuta Yahaba Shiwa-gun, Iwate 028-3694, Japan
| | - Yu Ohashi
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, 19-1 Uchimaru Morioka, Iwate 020-8505, Japan
| | - Ronell Bologna-Molina
- Molecular Pathology Area, Faculty of Dentistry, Universidad de la República, Montevideo, Uruguay
| | | | - Naoki Fujiwara
- Division of Developmental Biology and Regenerative Medicine, Department of Anatomy, Iwate Medical University, 2-1-1 Nishitokuta Yahaba Shiwa-gun, Iwate 028-3694, Japan
| | - Naoko Tsunoda
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, 19-1 Uchimaru Morioka, Iwate 020-8505, Japan
| | - Hiroyuki Yamada
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, 19-1 Uchimaru Morioka, Iwate 020-8505, Japan
| | - Yasunori Takeda
- Division of Clinical Pathology, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, 19-1 Uchimaru Morioka, Iwate 020-8505, Japan
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Yokoyama T, Naka G, Ishida H, Kishi K, Ohashi Y, Kunitoh H. P3.01-055 The Usefulness of Liquid Biopsy for ctDNA in Patients with EGFR-Mutant NSCLC During and After Treatment with EGFR-TKIs. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tanaka S, Kawasaki R, Tanaka-Mizuno S, Iimuro S, Matsunaga S, Moriya T, Ishibashi S, Katayama S, Ohashi Y, Akanuma Y, Sone H, Yamashita H. Severe hypoglycaemia is a major predictor of incident diabetic retinopathy in Japanese patients with type 2 diabetes. Diabetes Metab 2017; 43:424-429. [PMID: 28720342 DOI: 10.1016/j.diabet.2017.06.002] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 06/14/2017] [Accepted: 06/14/2017] [Indexed: 12/16/2022]
Abstract
AIM Hypoglycaemia is a common complication in diabetes patients. However, its relationship with retinopathy has not been well documented in patients with type 2 diabetes (T2D). This study aimed to investigate the associations between hypoglycaemia and the incidence and progression of diabetic retinopathy (DR). METHODS In this longitudinal cohort study, which was part of the Japan Diabetes Complications Study (JDCS), adult patients with T2D were recruited at 59 diabetes clinics across Japan. Their history of hypoglycaemia was assessed by standardized self-reported questionnaires. Severe hypoglycaemia was defined as having at least one episode with coma requiring an outpatients visit or hospitalization. Adjusted hazard ratios (HRs) for incidence and progression of DR over 8 years of follow-up were determined. RESULTS Of 1221 patients without DR, 127 (10.4%) had experienced non-severe hypoglycaemia within the previous year, whereas 10 (0.8%) reported severe hypoglycaemia episodes. During the 8-year follow-up involving 8492 person-years, 329 patients developed DR. In 410 patients with prevalent DR, the adjusted HRs for incident DR were 4.35 (95% CI: 1.98-9.56; P<0.01) and, for progression of DR, 2.29 (95% CI: 0.45-11.78; P=0.32) with severe hypoglycaemia. CONCLUSION Having a history of severe hypoglycaemia was one of the strongest predictors of incident DR in patients with T2D, with a fourfold increased risk. Identifying patients with greater risks of DR based on their history of hypoglycaemia may help to personalize risk evaluation in patients with diabetes.
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Affiliation(s)
- S Tanaka
- Department of pharmacoepidemiology, graduate longitudinal school of medicine and public health, Kyoto university, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, Japan
| | - R Kawasaki
- Department of public health, Yamagata university graduate school of medical science, 2-2-2 Iida-Nishi, Yamagata, Japan.
| | - S Tanaka-Mizuno
- Division of medical statistics, Shiga university of medical science, Tsukinowa Seta-cho, Ohtsu, Shiga, Japan
| | - S Iimuro
- Teikyo academic research centre, Teikyo university, Kaga, Itabashi-ku, Tokyo, Japan
| | - S Matsunaga
- Department of haematology, endocrinology and metabolism, faculty of medicine, Niigata university, 1-757 Asahi-machi, Chuo-ku, Niigata, Japan
| | - T Moriya
- Health care centre, Kitasato university, 1-15-1 Kitasato, Minami-ku, Sagamihara-shi, Kanagawa, Japan
| | - S Ishibashi
- Division of endocrinology and metabolism, school of medicine, Jichi medical university, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan
| | - S Katayama
- Kawagoe clinic, Saitama medical university, 21-7 Wakitahonchou, Kawagoe, Saitama, Japan
| | - Y Ohashi
- Department of integrated science and engineering for sustainable society, Chuo university, 1-13-27, Kasuga, Bunkyo-ku, Tokyo, Japan
| | - Y Akanuma
- The institute for adult diseases Asahi life foundation, 1-6-1 Marunouchi Chiyoda-ku, Tokyo, Japan
| | - H Sone
- Department of haematology, endocrinology and metabolism, faculty of medicine, Niigata university, 1-757 Asahi-machi, Chuo-ku, Niigata, Japan
| | - H Yamashita
- Department of ophthalmology and visual sciences, school of medicine, Yamagata university, 2-2-2 Iida-Nishi, Yamagata, Japan
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Watanabe T, Kamata K, Hasan S, Shibusawa S, Kamada M, Yonekura T, Yamada M, Ohashi Y. Design and Implementation of an Antagonistic Exercise Support System Using a Depth Image Sensor. EAI Endorsed Transactions on Pervasive Health and Technology 2017. [DOI: 10.4108/eai.13-7-2017.152887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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40
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Itabashi Y, Ohashi Y, Muramatsu M, Kawamura T, Hyodo Y, Hamasaki Y, Shishido S, Sakai K, Maemura T, Morita M, Aikawa A. Association Between the Fertile Period and Live Birth Post-Kidney Transplantation: A Retrospective Single-Center Cohort Study. Transplant Proc 2017; 49:1068-1072. [PMID: 28583529 DOI: 10.1016/j.transproceed.2017.03.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite restoration of fertility after kidney transplantation, the benefit is limited in female kidney recipients. Our objective is to determine the reasons for this discrepancy. METHODS We evaluated 315 women who underwent kidney transplantation from 1983 to 2015 (a median of age at transplantation [10th-90th percentile] of 32 years [7-55 years]); 230 recipients between the ages of 15 to 49 years old as of March 2016 were observed. RESULTS We experienced 10 abortions and 21 live births from our 23 recipients and 2 abortions and 7 live births in 7 recipients from other transplant center. The live birth rate was 8.9 per 1000 female transplant recipients of childbearing age. Seven recipients received either treatments of artificial insemination or in vitro fertilization. Average age at pregnancy was 33.2 ± 3.2 years old, and the fertile period post-transplantation was longer in recipients with live births than those without live births (14.1 ± 7.1 vs 9.9 ± 7.3 years, P < .05). In 42.9% of recipients with live birth, pregnancy-induced hypertension was observed in the last trimester. The gestational age and the average birth weight were 32.8 ± 5.0 months and 2184 ± 632 g, respectively. During follow-up of 14.5 years, there was one case of graft loss, which is a rate of 2.5 per 1000 female recipients. CONCLUSION Although pregnancy complications are often observed in kidney recipients, graft survival is less influenced by pregnancy. Importantly, kidney disease at childbearing age disrupts pregnancy even after kidney transplantation.
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Affiliation(s)
- Y Itabashi
- Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Y Ohashi
- Department of Nephrology, Sakura Medical Center, School of Medicine, Toho University, Chiba, Japan.
| | - M Muramatsu
- Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - T Kawamura
- Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Y Hyodo
- Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Y Hamasaki
- Department of Pediatric Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo, Japan
| | - S Shishido
- Department of Pediatric Nephrology, Omori Medical Center, School of Medicine, Toho University, Tokyo, Japan
| | - K Sakai
- Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - T Maemura
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - M Morita
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - A Aikawa
- Department of Nephrology, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
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Okusaka T, Miyakawa H, Fujii H, Nakamori S, Satoh T, Hamamoto Y, Ito T, Maguchi H, Matsumoto S, Ueno H, Ioka T, Boku N, Egawa S, Hatori T, Furuse J, Mizumoto K, Ohkawa S, Yamaguchi T, Yamao K, Funakoshi A, Chen JS, Cheng AL, Sato A, Ohashi Y, Tanaka M. Updated results from GEST study: a randomized, three-arm phase III study for advanced pancreatic cancer. J Cancer Res Clin Oncol 2017; 143:1053-1059. [PMID: 28210843 PMCID: PMC5427167 DOI: 10.1007/s00432-017-2349-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 01/24/2017] [Indexed: 01/05/2023]
Abstract
PURPOSE The GEST study showed non-inferiority of S-1 but not superiority of gemcitabine plus S-1 (GS) to gemcitabine alone for overall survival with the data by the cut-off date of 31st July in 2010 for chemo-naïve patients with advanced pancreatic cancer. We considered it important to determine whether S-1 maintains non-inferiority after a long-term follow-up in the GEST study and to obtain a firm positive conclusion. In addition, it may be an interesting challenge to explore the efficacious profile of GS in the long-term follow-up study. Using the data from the follow-up period, background and efficacy in patients from Taiwan and Japan, as well as the rates of tumor shrinkage in locally advanced and metastatic patients (Waterfall plot) were also analyzed. METHODS The results of the primary analysis were reconfirmed, and subset analysis of overall survival and progression-free survival was performed based on the overall survival data updated by the cut-off date of 31st July in 2011. RESULTS The median follow-up period was 29.8 months, and 795 deaths occurred (95.6%). The median overall survival was 8.8 months for gemcitabine, 9.7 months for S-1 (hazard ratio [HR], 0.96; 97.5% confidence interval [CI], 0.79-1.17), and 9.9 months for GS (HR 0.91; 97.5% CI 0.75-1.11). In patients with performance status (PS) 0, the median overall survival was 9.8 months for gemcitabine, 10.9 months for S-1, and 10.5 months for GS. In patients with PS 1, the median overall survival was 6.2 months for gemcitabine, 6.3 months for S-1, and 9.6 months for GS. CONCLUSION Our survey reconfirmed the non-inferiority of S-1 to gemcitabine and showed S-1 can be used as one of the standard treatment options for advanced pancreatic cancer. TRIAL REGISTRATION ClinicalTrials.gov: NCT00498225.
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Affiliation(s)
- Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - H Miyakawa
- Division of Biliopancreatology, Sapporo Kosei General Hospital, Sapporo, Japan
| | - H Fujii
- Division of Clinical Oncology, Jichi Medical University, Tochigi, Japan
| | - S Nakamori
- Hepato-Biliary-Pancreatic Surgery, Osaka National Hospital, Osaka, Japan
| | - T Satoh
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Hamamoto
- Keio Cancer Center, Keio University Hospital, Tokyo, Japan
| | - T Ito
- Department of Medicine and Bioreguratory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - H Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - S Matsumoto
- Department of Medical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - H Ueno
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - T Ioka
- Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - N Boku
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - S Egawa
- Department of Surgery, Tohoku University, Sendai, Japan
| | - T Hatori
- Department of Surgery and Digestive Diseases Center, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - J Furuse
- Department of Medical Oncology, Kyorin University School of Medicine, Tokyo, Japan
| | - K Mizumoto
- Kyushu University Hospital Cancer Center, Fukuoka, Japan
| | - S Ohkawa
- Division of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - T Yamaguchi
- Department of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - K Yamao
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - A Funakoshi
- Division of Pancreatology, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - J S Chen
- Division of Hematology-Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan, Republic of China
| | - A L Cheng
- Department of Oncology, National Taiwan University Hospital, and National Taiwan University Cancer Center, Taipei, Taiwan, Republic of China
| | - A Sato
- Department of Medical Oncology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Y Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan
| | - M Tanaka
- Department of Surgery, Shimonoseki City Hospital, Shimonoseki, Japan
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Yamazaki K, Sakai K, Ohashi Y, Nihei H, Itabashi T, Muramatsu M, Kawamura T, Shishido S, Aikawa A. Similar Anemic Control Between Chronic Kidney Diseases in Patients With and Without Transplantation on Entry to Dialysis. Transplant Proc 2017; 49:57-60. [PMID: 28104159 DOI: 10.1016/j.transproceed.2016.11.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Transplant recipients are supposedly in a more anemic, catabolic, and even inflammatory state at re-entering hemodialysis due to chronic rejection. The goal of this study was to clarify how transplant recipients can re-enter dialysis safely by focusing on control of anemia. METHODS From 2012 to 2014, a total of 29 transplant recipients re-entered hemodialysis because of chronic rejection (ie, the chronic kidney disease with transplant [CKDT] group). At the same time, in 2014, a total of 30 patients with chronic kidney disease without transplantation entered dialysis as the control group (ie, the CKD group). CKDT recipients (mean ± standard deviation age, 41.9 ± 11.8 years; 18 male subjects, 10 female subjects; frequency of diabetes, 10%; duration of graft survival, 12.5 ± 4.3 years) were younger and fewer had diabetes compared with the CKD group (age, 53.2 ± 10.5 years; 21 male subjects, 9 female subjects; frequency of diabetes, 36%). Patient characteristics at entering dialysis in both groups were analyzed according to retrospective chart review. RESULTS At entering dialysis, there were no significant differences between the CKD and CKDT groups in terms of the following: dose of darbepoetin; concentrations of hemoglobin, albumin, and C-reactive protein; cardiothoracic ratio; blood urea nitrogen and creatinine levels; estimated glomerular filtration rate; initial ultrafiltration; and duration of hospitalization for initiation of dialysis. The only difference between groups was mean weight at entry to dialysis (CKDT group, 58.5 ± 15.1 kg; CKD group, 67.1 ± 14.8 kg; P = .03). The darbepoetin dose per kilogram of weight did not differ between groups (CKDT, 2.28 ± 2.03 μg/kg; CKD, 2.12 ± 1.6 μg/kg; P = .95) in the final month before entry to dialysis. CONCLUSIONS Safe re-initiation of dialysis is important for recipient survival. Although anemia is supposedly higher in transplant recipients due to immunosuppression, this single-center analysis found no difference in anemia in CKD with or without transplantation, caused by good use of erythropoietin-stimulating agents in both groups.
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Affiliation(s)
- K Yamazaki
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - K Sakai
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan.
| | - Y Ohashi
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - H Nihei
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - T Itabashi
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - M Muramatsu
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - T Kawamura
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - S Shishido
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
| | - A Aikawa
- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
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Nakashima T, Ohashi Y, Oki S, Saito R, Koido K, Ogawa C, Sato N, Seto K, Negishi Y, Kondo N, Kikuchi M, Yokoyama A, Ueno H, Koinuma M, Yachi Y, Terakado H. 349P A retrospective multicenter survey of hepatitis B virus infection (HBV) screening and HBV-DNA monitoring in patients receiving hematopoietic stem cell transplantation and rituximab-based chemotherapy. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00507-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ohashi Y, Okamura M, Fang S, Tsutsui S, Tamaki N, Akatsuka A, Yoshimatsu K, Shiina I, Yamori T, Dan S. M-COPA, a new Golgi disruptor, inhibited growth of RTK-addicted human cancer cells. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)33051-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Nakashima T, Ohashi Y, Oki S, Saito R, Koido K, Ogawa C, Sato N, Seto K, Negishi Y, Kondo N, Kikuchi M, Yokoyama A, Ueno H, Koinuma M, Yachi Y, Terakado H. 349P A retrospective multicenter survey of hepatitis B virus infection (HBV) screening and HBV-DNA monitoring in patients receiving hematopoietic stem cell transplantation and rituximab-based chemotherapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw586.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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46
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Ichikawa W, Uehara K, Minamimura K, Tanaka C, Takii Y, Miyauchi H, Sadahiro S, Shinozaki K, Fukumoto K, Otsuji T, Kambara T, Morita S, Ando Y, Arai M, Sugihara M, Sugiyama T, Ohashi Y, Sakata Y. A nomogram for predicting overall survival (OS) in Japanese patients (pts) with advanced colorectal cancer (aCRC) treated with irinotecan (IRI)-based regimens. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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47
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Shiroiwa T, Fukuda T, Shimozuma K, Mouri M, Hagiwara Y, Doihara H, Akabane H, Kashiwaba M, Watanabe T, Ohashi Y, Mukai H. Long-term health status as measured by EQ-5D among patients with metastatic breast cancer: comparison of first-line oral S-1 and taxane therapies in the randomized phase III SELECT BC trial. Qual Life Res 2016; 26:445-453. [PMID: 27517267 PMCID: PMC5288429 DOI: 10.1007/s11136-016-1388-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2016] [Indexed: 12/29/2022]
Abstract
Purpose The goal of chemotherapy for metastatic breast cancer (MBC) is to prolong survival and maintain health-related quality of life. This study aimed to evaluate long-term health status of patients with MBC who participated in the phase III randomized SELECT BC trial. Methods In the SELECT BC trial, patients were randomly allocated to the S-1 or taxane (paclitaxel or docetaxel) arm. Health status was assessed by EQ-5D at pre-treatment, 3 and 6 months after randomization, and every 6 months thereafter to the extent possible. Least square mean scores were assessed to compare EQ-5D index values between groups. Time to deterioration analysis was also performed by defining the minimally important difference of EQ-5D as 0.05 or 0.1. Results The number of patients for EQ-5D analysis was 175 and 208 in the taxane and S-1 arms, respectively. Least square mean EQ-5D index values up to 60 months were 0.741 (95 % CI [0.713–0.769]) in the taxane arm and 0.748 [0.722–0.775] in the S-1 arm. The EQ-5D index value during PFS up to 12 months in the S-1 was superior to the corresponding index value in the taxane (0.812 [0.789–0.834] vs. 0.772 [0.751–0.792], P = 0.009). Time to deterioration analysis also revealed that S-1 significantly delayed the deterioration of EQ-5D index value during the period before progression (P = 0.002 and 0.003). Conclusions Our findings suggest that the EQ-5D index value was higher in patients treated with S-1 during first-line chemotherapy. Considering non-inferiority of S-1 in terms of OS, obtained quality-adjusted life years may be greater in the S-1 arm.
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Affiliation(s)
- T Shiroiwa
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - T Fukuda
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - K Shimozuma
- Department of Biomedical Sciences, College of Life Sciences, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - M Mouri
- Kanagawa Academy of Science and Technology (KAST), 3-2-1 Sakado, Takatsu-ku, Kawasaki, Kanagawa, 213-0012, Japan
| | - Y Hagiwara
- Department of Biostatistics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - H Doihara
- Breast and Endocrine Surgery Department, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - H Akabane
- Department of Surgery, Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, 24-111 Ichijo dori, Asahikawa, Hokkaido, 078 8211, Japan
| | - M Kashiwaba
- Department of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - T Watanabe
- Department of Breast Surgery, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan
| | - Y Ohashi
- Department of Integrated Science and Engineering, Chuo University, 1-13-27 Kasuga, Bunkyo-ku, Tokyo, 112-8551, Japan
| | - H Mukai
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
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Shinkoda Y, Shirahata A, Fukutake K, Takamatsu J, Shima M, Hanabusa H, Mugishima H, Takedani H, Kawasugi K, Taki M, Matsushita T, Tawa A, Nogami K, Higasa S, Kosaka Y, Fujii T, Sakai M, Migita M, Uchiba M, Kawakami K, Sameshima K, Ohashi Y, Saito H. A phase III clinical trial of a mixture agent of plasma-derived factor VIIa and factor X (MC710) in haemophilia patients with inhibitors. Haemophilia 2016; 23:59-66. [DOI: 10.1111/hae.13050] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Y. Shinkoda
- Department of Paediatrics; Kagoshima City Hospital; Kagoshima Japan
| | - A. Shirahata
- Kitakyushu Yahata Higashi Hospital; Kitakyushu Fukuoka Japan
| | - K. Fukutake
- Department of Laboratory Medicine; Tokyo Medical University; Tokyo Japan
| | - J. Takamatsu
- Japanese Red Cross Tokai-Hokuriku Block Blood Center; Seto Aichi Japan
| | - M. Shima
- Department of Paediatrics; Nara Medical University; Kashihara Nara Japan
| | - H. Hanabusa
- Department of Haematology; Ogikubo Hospital; Tokyo Japan
| | - H. Mugishima
- Department of Paediatrics; Nihon University Itabashi Hospital; Tokyo Japan
| | - H. Takedani
- Department of Joint Surgery; Research Hospital of the Institute of Medical Science; the University of Tokyo; Tokyo Japan
| | - K. Kawasugi
- Department of Internal Medicine; Teikyo University Hospital; Tokyo Japan
| | - M. Taki
- Department of Paediatrics; St. Marianna University School of Medicine; Kawasaki Kanagawa Japan
| | - T. Matsushita
- Department of Transfusion Medicine; Nagoya University Hospital; Nagoya Aichi Japan
| | - A. Tawa
- Department of Paediatrics; National Hospital Organization Osaka National Hospital; Osaka Japan
| | - K. Nogami
- Department of Paediatrics; Nara Medical University; Kashihara Nara Japan
| | - S. Higasa
- Division of Haematology; Department of Internal Medicine; Hyogo College of Medicine; Nishinomiya Hyogo Japan
| | - Y. Kosaka
- Department of Haematology and Oncology; Kobe Children's Hospital; Kobe Hyogo Japan
| | - T. Fujii
- Division of Blood Transfusion; Hiroshima University Hospital; Hiroshima Japan
| | - M. Sakai
- Department of Paediatrics; University of Occupational and Environmental Health; Kitakyushu Fukuoka Japan
| | - M. Migita
- Department of Paediatrics; Kumamoto Red Cross Hospital; Kumamoto Japan
| | - M. Uchiba
- Department of Blood Transfusion and Cell Therapy; Kumamoto University Hospital; Kumamoto Japan
| | - K. Kawakami
- Department of Paediatrics; Kagoshima City Hospital; Kagoshima Japan
| | - K. Sameshima
- Department of Paediatrics; Kagoshima City Hospital; Kagoshima Japan
| | - Y. Ohashi
- Department of Biostatistics; School of Public Health; the University of Tokyo; Tokyo Japan
| | - H. Saito
- National Hospital Organization Nagoya Medical Center; Nagoya Aichi Japan
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Ryu SY, Ahn JK, Nakano T, Ahn DS, Ajimura S, Akimune H, Asano Y, Chang WC, Chen JY, Daté S, Ejiri H, Fujimura H, Fujiwara M, Fukui S, Hasegawa S, Hicks K, Horie K, Hotta T, Hwang SH, Imai K, Ishikawa T, Iwata T, Kato Y, Kawai H, Kino K, Kohri H, Kon Y, Kumagai N, Lin PJ, Maeda Y, Makino S, Matsuda T, Matsuoka N, Mibe T, Miyabe M, Miyachi M, Morino Y, Muramatsu N, Murayama R, Nakatsugawa Y, Nam SI, Niiyama M, Nomachi M, Ohashi Y, Ohkuma H, Ohta T, Ooba T, Oshuev DS, Parker JD, Rangacharyulu C, Sakaguchi A, Sawada T, Shagin PM, Shiino Y, Shimizu H, Strokovsky EA, Sugaya Y, Sumihama M, Tokiyasu AO, Toi Y, Toyokawa H, Tsunemi T, Uchida M, Ungaro M, Wakai A, Wang CW, Wang SC, Yonehara K, Yorita T, Yoshimura M, Yosoi M, Zegers RGT. Interference Effect between ϕ and Λ(1520) Production Channels in the γp→K^{+}K^{-}p Reaction near Threshold. Phys Rev Lett 2016; 116:232001. [PMID: 27341225 DOI: 10.1103/physrevlett.116.232001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Indexed: 06/06/2023]
Abstract
The ϕ-Λ(1520) interference effect in the γp→K^{+}K^{-}p reaction has been measured for the first time in the energy range from 1.673 to 2.173 GeV. The relative phases between ϕ and Λ(1520) production amplitudes were obtained in the kinematic region where the two resonances overlap. The measurement results support strong constructive interference when K^{+}K^{-} pairs are observed at forward angles but destructive interference for proton emission at forward angles. Furthermore, the observed interference effect does not account for the sqrt[s]=2.1 GeV bump structure in forward differential cross sections for ϕ photoproduction. This fact suggests possible exotic structures such as a hidden-strangeness pentaquark state, a new Pomeron exchange, or rescattering processes via other hyperon states.
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Affiliation(s)
- S Y Ryu
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - J K Ahn
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - T Nakano
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - D S Ahn
- RIKEN, The Institute of Physical and Chemical Research, Wako, Saitama 351-0198, Japan
| | - S Ajimura
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Akimune
- Department of Physics, Konan University, Kobe, Hyogo 658-8501, Japan
| | - Y Asano
- XFEL Project Head Office, RIKEN, Sayo, Hyogo 679-5143, Japan
| | - W C Chang
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - J Y Chen
- Light Source Division, National Synchrotron Radiation Research Center, Hsinchu 30076, Taiwan
| | - S Daté
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5143, Japan
| | - H Ejiri
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Fujimura
- Wakayama Medical College, Wakayama 641-8509, Japan
| | - M Fujiwara
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - S Fukui
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - S Hasegawa
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - K Hicks
- Department of Physics and Astronomy, Ohio University, Athens, Ohio 45701, USA
| | - K Horie
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Hotta
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - S H Hwang
- Korea Research Institute of Standards and Science (KRISS), Daejeon 34113, Republic of Korea
| | - K Imai
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - T Ishikawa
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - T Iwata
- Department of Physics, Yamagata University, Yamagata 990-8560, Japan
| | - Y Kato
- Kobayashi-Maskawa Institute, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - H Kawai
- Department of Physics, Chiba University, Chiba 263-8522, Japan
| | - K Kino
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - H Kohri
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Kon
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - N Kumagai
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5143, Japan
| | - P J Lin
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - Y Maeda
- Proton Therapy Center, Fukui Prefectural Hospital, Fukui 910-8526, Japan
| | - S Makino
- Wakayama Medical College, Wakayama 641-8509, Japan
| | - T Matsuda
- Department of Applied Physics, Miyazaki University, Miyazaki 889-2192, Japan
| | - N Matsuoka
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Mibe
- High Energy Accelerator Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - M Miyabe
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - M Miyachi
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - Y Morino
- High Energy Accelerator Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - N Muramatsu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - R Murayama
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - Y Nakatsugawa
- High Energy Accelerator Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - S I Nam
- Department of Physics, Pukyong National University, Busan 48513, Republic of Korea
| | - M Niiyama
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - M Nomachi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - Y Ohashi
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5143, Japan
| | - H Ohkuma
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5143, Japan
| | - T Ohta
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - T Ooba
- Department of Physics, Chiba University, Chiba 263-8522, Japan
| | - D S Oshuev
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - J D Parker
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - C Rangacharyulu
- Department of Physics and Engineering Physics, University of Saskatchewan, Saskatoon, Saskatchewan S7N 5E2, Canada
| | - A Sakaguchi
- Department of Physics, Osaka University, Toyonaka, Osaka 560-0043, Japan
| | - T Sawada
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - P M Shagin
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - Y Shiino
- Department of Physics, Chiba University, Chiba 263-8522, Japan
| | - H Shimizu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - E A Strokovsky
- Joint Institute for Nuclear Research, Dubna, Moscow Region, 142281, Russia
| | - Y Sugaya
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Sumihama
- Department of Education, Gifu University, Gifu 501-1193, Japan
| | - A O Tokiyasu
- Research Center for Electron Photon Science, Tohoku University, Sendai, Miyagi 982-0826, Japan
| | - Y Toi
- Department of Applied Physics, Miyazaki University, Miyazaki 889-2192, Japan
| | - H Toyokawa
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5143, Japan
| | - T Tsunemi
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - M Uchida
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - M Ungaro
- Department of Physics, University of Connecticut, Storrs, Connecticut 06269-3046, USA
| | - A Wakai
- Akita Research Institute of Brain and Blood Vessels, Akita 010-0874, Japan
| | - C W Wang
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - S C Wang
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - K Yonehara
- Department of Physics, Konan University, Kobe, Hyogo 658-8501, Japan
| | - T Yorita
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - M Yoshimura
- Institute for Protein Research, Osaka University, Suita, Osaka 565-0871, Japan
| | - M Yosoi
- Research Center for Nuclear Physics, Osaka University, Ibaraki, Osaka 567-0047, Japan
| | - R G T Zegers
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
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Sagara Y, Sawaki M, Taira N, Saito T, Kashiwaba M, Iwata H, Kobayashi K, Nakayama T, Bando H, Mizuno T, Yamamoto Y, Tsuneizumi M, Takahashi M, Yamaguchi M, Kawashima H, Takashima T, Uemura Y, Hozumi Y, Sagawa N, Mukai H, Ohashi Y. Abstract P5-18-01: A randomized clinical trial of postoperative adjuvant therapy for elderly breast cancer patients: Conditions of obtaining informed consent and reasons for declining participation. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-18-01] [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: 11/16/2022]
Abstract
Abstract
Background: There are few randomized clinical trials examining adjuvant treatment in elderly breast cancer patients. While obtaining informed consent is essential for participation in clinical studies, there is little information on the frequency of agreement to participate among elderly patients. Furthermore, elderly patients might have specific reasons to decline participation.
Patients and Method: The National Surgical Adjuvant Study of Breast Cancer 07 (N-SAS BC 07) is a randomized clinical trial in women over 70 years with HER2-positive primary breast cancer. The primary aim was to investigate the benefit of trastuzumab monotherapy compared with the combination of trastuzumab and chemotherapy. Key inclusion criteria were as follows: women between 70 and 80 years old with HER2-positive breast cancer; underwent curative operation; stage I to IIIA; with sufficient organ function. Patients were randomized to receive either trastuzumab plus chemotherapy or trastuzumab monotherapy. The primary endpoint was disease-free survival, and the secondary endpoints were overall survival, relapse-free survival, safety, health-related quality of life, and cost effectiveness (NCT01104935). It was not possible to predict the number of patients who would agree to participate. In order to comprehensively assess the effect of postoperative adjuvant therapy, we evaluated the reasons why eligible patients declined to participate. The patients were registered in a cohort study to prospectively evaluate the subsequent treatment options and prognosis (07-Cohort). This study examined the obtaining of informed consent for N-SAS BC 07 and the reasons for declining participation, and compared the clinicopathological backgrounds between the N-SAS BC 07 and 07-Cohort groups.
Results: 398 eligible patients have been recruited. Informed consent to participate in N-SAS BC 07 has been obtained from 275 patients (69%) and 123 patients (31%) who declined to participate in the RCT have been registered in the 07-Cohort. The common reasons to decline participation in the RCT were "cannot choose the treatment option (55%)", "refused chemotherapy (16%)", "wanted chemotherapy (9%)", "anxious about clinical studies (9%)" and "family opposition (8%)". The mean ages of the patients in N-SAS BC 07 and 07-Cohort were 73.9 and 74.6 years old, respectively. There were no differences in stage, surgical procedure, lymph node metastasis, or co-morbidities between the groups. ER-positive rate was higher in 07-Cohort group compared with N-SAS BC 07 group (53% vs. 37%, p=0.017, χ2 test).
Conclusion: While we expected the number of registrants to be small, since N-SAS BC 07 investigated whether elderly patients with HER2-positive breast cancer should undergo chemotherapy, almost 70% of the patients accepted informed consent. The most common reason to decline participation in N-SAS BC 07 was "cannot choose the treatment option" and the majority refused chemotherapy. Furthermore, ER-positivity was higher in the 07-Cohort group, which suggested that ER expression in the patients with HER2-positive breast cancer might influence their decision to participate in the study or to choose the treatment option.
Citation Format: Sagara Y, Sawaki M, Taira N, Saito T, Kashiwaba M, Iwata H, Kobayashi K, Nakayama T, Bando H, Mizuno T, Yamamoto Y, Tsuneizumi M, Takahashi M, Yamaguchi M, Kawashima H, Takashima T, Uemura Y, Hozumi Y, Sagawa N, Mukai H, Ohashi Y. A randomized clinical trial of postoperative adjuvant therapy for elderly breast cancer patients: Conditions of obtaining informed consent and reasons for declining participation. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-18-01.
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Affiliation(s)
- Y Sagara
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - M Sawaki
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - N Taira
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - T Saito
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - M Kashiwaba
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - H Iwata
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - K Kobayashi
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - T Nakayama
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - H Bando
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - T Mizuno
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - Y Yamamoto
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - M Tsuneizumi
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - M Takahashi
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - M Yamaguchi
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - H Kawashima
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - T Takashima
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - Y Uemura
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - Y Hozumi
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - N Sagawa
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - H Mukai
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
| | - Y Ohashi
- Hakuaikai Social Cooperation, Kagoshima, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Saitama Red Cross Hospital, Saitama, Japan; Iwate Medical University, Morioka, Iwate, Japan; Okayama University Hospital, Okayama, Japan; Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan; Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan; University of Tsukuba, Tsukuba, Ibaraki, Japan; Mie University Hospital, Tsu, Mie, Japan; Kumamoto University, Kumamoto, Japan; Shizuoka General Hospital, Shizuoka, Japan; Hokkaido Cancer Center, Sapporo, Hokkaido, Japan; Kurume General Hospital, Kurume, Fukuoka, Japan; Aomori City Hospital, Aomori, Japan; Osaka City University Graduate School of Medicine, Osaka, Japan; Tokyo University Hospital, Tokyo, Japan; Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan; Chuo University, Tokyo, Japan
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