Publications by authors named "Akiharu Ishiyama"
Article Synopsis
- * An analysis of 3,575 patients showed that type 4 tumors had significantly lower overall survival rates compared to large type 3 tumors, but when comparing large type 3 undifferentiated tumors to type 4, their outcomes were similar.
- * The findings suggest that large type 3 tumors with an undifferentiated phenotype and type 4 tumors may be treated as a new category in future clinical trials, highlighting the need for more specific classifications.
Article Synopsis
- The study aimed to compare the postoperative quality of life (QOL) and body weight changes between two types of gastrectomies: pylorus-preserving gastrectomy (PPG) and distal gastrectomy (DG) for Stage I gastric cancer.
- Conducted on 295 patients, the research utilized questionnaires to assess QOL and found that DG had better scores for nausea, vomiting, and meal-related issues in the first month after surgery.
- Ultimately, the study concluded there was no significant difference in long-term QOL or body weight loss between the two surgical methods.
In Japan, systemic chemotherapy is the standard treatment for unresectable, advanced, or recurrent gastric cancer. However, numerous patients with gastric cancer do not receive late-line treatment because of the rapid progression of gastric cancer. Additionally, late-line treatments, such as nivolumab, trifluridine tipiracil (FTD/TPI), or irinotecan, have limited effects on improving clinical symptoms and delaying the onset of symptoms associated with cancer progression.
View Article and Find Full Text PDFBackground: Proximal gastrectomy (PG) has become an increasingly preferred procedure for treating early cancer in the upper third of the stomach. However, advantages of PG in postoperative quality of life (QOL) over total gastrectomy (TG) has not fully proven.
Methods: We conducted a multi-institutional prospective observational study (CCOG1602) of patients who undergo TG or PG for cStage I gastric cancer.
Introduction: Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 are widely used for treating various cancers, with cutoff values of 5.0 ng/mL and 37.0 IU/mL, respectively.
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- The albumin-bilirubin (ALBI) grade uses albumin and bilirubin levels to predict postoperative outcomes in gastric cancer patients.
- A study analyzed data from 3,571 patients who underwent gastrectomy, establishing modified ALBI (mALBI) grades with specific cutoff values to classify patients into three prognostic groups.
- Results showed that higher mALBI grades were linked to significantly lower disease-specific survival rates, with mALBI grade 3 identified as an independent risk factor for poor outcomes.
Background: The number of patients who die from causes other than gastric cancer after R0 resection is increasing in Japan, due in part to the aging population. However, few studies have comprehensively investigated the clinicopathological risks associated with deaths from other causes after gastrectomy. This study aimed to build a risk score for predicting such deaths.
View Article and Find Full Text PDFPurpose: Peritoneal dissemination is the key to the prognosis of gastric cancer (GC) and can be detected early with peritoneal lavage cytology. No studies have examined preoperative prognostic factors in GC patients who have positive cytology but no other non-curative factors.
Methods: We conducted a retrospective analysis using a multicenter database of 3575 patients who underwent gastrectomy between 2010 and 2014.
Purposes: This study aimed to evaluate the estimation of the physiological ability and surgical stress (E-PASS) scoring system for predicting the short- and long-term outcomes in gastric cancer (GC) surgery.
Methods: We analyzed a multi-institutional dataset to study patients who underwent gastrectomy with a curative intent between 2010 and 2014. This study evaluated the associations between the optimal E-PASS score cutoff value and the following outcomes: (1) the incidence of postoperative complications in stage I-III GC patients and (2) the prognosis in stage II-III GC patients.
Purpose: We analyzed the effect of a microscopic positive margin on survival outcomes after gastrectomy for gastric cancer METHODS: We analyzed a multi-institutional dataset to study patients who underwent gastrectomy with curative intent between 2010 and 2014. We used propensity score matching to strictly balance the patients' oncological features, backgrounds, and postoperative treatment to compare the survival outcomes of those with microscopic positive margins and those with negative margins.
Results: Among 3029 patients, 32 (1.
Background: Splenectomy for proximal gastric cancer was found to have no survival benefit in a randomized trial clarifying the role of splenectomy (JCOG0110 study). However, since tumor with invasion to the greater curvature and Type 4 tumor were excluded in JCOG0110, the benefit of splenectomy for these tumors is not known.
Methods: A multicenter dataset of patients with gastric cancer who underwent gastrectomy between 2010 and 2014 was created.
Background: The presence of chronic inflammation and nutritional status in cancer patients affects its prognosis. There is a clinical need for a prognostic predictor that is objective and accurate, and that can be easily evaluated by preoperative screening. We evaluated the importance and usefulness of the preoperative modified systemic inflammation score (mSIS) to predict the long-term outcome of patients undergoing curative resection for gastric cancer (GC).
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- A study assessed persistent sensory neuropathy (PSN) caused by oxaliplatin in colon cancer patients receiving adjuvant chemotherapy to see if an intermittent use of oxaliplatin would be more effective and safer than standard continuous use.
- Patients were randomly assigned to receive either continuous CAPOX (oxaliplatin plus capecitabine) or a regimen with intermittent oxaliplatin, with primary focus on PSN rates after one year and disease-free survival (DFS).
- Results showed a significantly lower PSN rate (16% vs. 60%) and higher treatment completion rate (89% vs. 65%) in the intermittent group, with similar DFS rates, indicating that intermittent oxaliplatin use could
Purpose: Preoperative chemotherapy for gastric cancer may be effective from the standpoint of compliance, although there is insufficient evidence of its efficacy. We analyzed a multicenter database to clarify whether preoperative chemotherapy influenced the short-term outcomes of gastrectomy.
Methods: We analyzed, retrospectively, 3571 patients who underwent gastrectomy between January, 2010 and December, 2014.
Background: We aimed to clarify the utility of lymph node ratio (LNR) for assessing the prognosis of patients with node-positive gastric cancer after curative gastrectomy.
Methods: We retrospectively analyzed data of 973 patients with node-positive gastric cancer who had undergone curative gastrectomy at nine institutions from 2010 to 2014. Survival analysis was performed by comparing LNR low and high groups according to the optimal cutoff value of LNR, which was determined using receiver operating characteristic curve analysis.
Article Synopsis
- The study examined recurrence patterns of gastric cancer in 313 patients who underwent gastrectomy, focusing on peritoneal, hematogenous, and nodal recurrences.
- The analysis revealed that while patients with peritoneal recurrence had longer recurrence-free survival, they experienced shorter post-recurrence survival compared to the other groups.
- Overall, the prognosis after curative resection was found to be similar across all types of recurrence, with median disease-specific survival times being relatively close.
Article Synopsis
- Researchers investigated the benefits of D2 lymphadenectomy in elderly gastric cancer patients (aged ≥ 80).
- The study analyzed data from 3484 patients, focusing on 87 who underwent D2 dissection and 87 who did not, revealing that the D2 group had longer surgery times and higher complication rates.
- Overall, D2 lymphadenectomy showed minimal survival advantages for older patients while increasing the risk of complications, suggesting it may not be the best option for this age group.
Article Synopsis
- * Of the 1,415 patients analyzed, 3.0% developed grade II or higher pneumonia, with the preoperative systemic inflammation score (SIS) showing the strongest correlation with pneumonia risk.
- * The findings suggest that a high SIS can serve as an independent risk factor, particularly in female patients, helping doctors implement preventive strategies for at-risk individuals after surgery.
Purpose: Patients with pathological stage T1N+ or T2-3N0 gastric cancer may experience disease recurrence following curative gastrectomy. However, the current Japanese Gastric Cancer Treatment Guidelines do not recommend postoperative adjuvant chemotherapy for such patients. This study aimed to identify the prognostic factors for patients with pT1N+ or pT2-3N0 gastric cancer using a multi-institutional dataset.
View Article and Find Full Text PDFBackground: Few well-controlled studies have compared postoperative complications between Billroth I (B-I) and Roux-en-Y (R-Y). The aim of the present study was to compare the incidence of overall and severe postoperative complications by reconstruction method after distal gastrectomy.
Methods: We performed a multi-institutional dataset study of patients who underwent distal gastrectomy with B-I or R-Y reconstruction from 2010 to 2014.
Background: Little is known about the changes in prognostic factors after adjuvant S-1 monotherapy has become widespread as a standard of care for patients with gastric cancer (GC) in East Asia. The present study compared prognostic factors of patients with stage II/III GC treated with or without S-1 adjuvant to formulate appropriate risk stratification strategies.
Methods: We designed a large multicenter dataset and retrospectively analyzed 847 patients with GC stage II or III, who underwent curative gastrectomy between 2010 and 2014.
Background: Laparoscopic gastrectomy (LG) is a standard approach for patients with clinical stage I gastric cancer in East Asia; however, following surgery, these patients may be pathologically diagnosed with stage II or III cancer. The prognosis of patients with gastric cancer migration from clinical stage I to pathological stage II or III after LG has not been completely clarified.
Methods: To compare the prognosis following LG and open gastrectomy (OG) in patients with pathological stage II or III gastric cancer who were preoperatively diagnosed with stage I cancer, we conducted a retrospective analysis using a multicenter dataset comprising details of 3480 patients who underwent gastrectomy between 2010 and 2014 at nine participating institutions.
Background: Insufficient data are available on the prognostic significance of complications after resection of gastric cancer. Therefore, we aimed to assess this gap in our knowledge by studying patients with resectable gastric cancer.
Methods: A multi-institutional retrospective database comprising clinical information of 3575 patients who received resection of gastric cancer from 2010 to 2014 at nine institutions.
Aim: To evaluate the prognostic significance of perioperative carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels in stage II/III gastric cancer.
Methods: From a multi-institutional retrospective database compiled by integrating clinical data from nine institutions, data of 998 patients who underwent curative resection for stage II/III gastric cancer between 2010 and 2014 were retrieved and analyzed. The prognostic impact of the preoperative and postoperative levels and chronological changes in CEA, CA19-9 and their combination were evaluated.
Background: This study aimed to evaluate whether the timing of initiating postoperative chemotherapy with S-1 monotherapy affects gastric cancer patients' prognosis.
Methods: A multi-institution dataset identified patients with pStage II or III gastric cancer who received S-1 monotherapy for over 6 months after curative resection between 2010 and 2014. Patients were divided into three groups based on the timing of S-1 monotherapy initiation.