Publications by authors named "Hakamada K"

Objectives: To clarify the risk factors affecting prognosis after primary tumor resection (PTR) in patients with metastatic colorectal cancer with synchronous peritoneal metastasis (mCRC-SPM).

Methods: Patients were enrolled prospectively in the JSCCR project "Grading of Peritoneal Seeding in Colorectal Cancer." Factors that may influence overall survival-age, sex, location of the primary tumor, lymph node metastasis, presence of liver metastasis, degree of peritoneal metastasis, peritoneal cancer index (PCI), cancer cure, and postoperative chemotherapy-in the PTR group were examined using multivariate analysis.

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Background: Vascular endothelial growth factor-A (VEGFA) is a key inducer of angiogenesis, responsible for generating new blood vessels in the tumor microenvironment (TME) and facilitating metastasis. Notably, Avastin, which targets VEGFA, failed to demonstrate any significant benefit in clinical trials for breast cancer (BC). This study aimed to investigate the clinical relevance of gene expression in BC.

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We conducted this study to evaluate the efficacy of robot-assisted minimally invasive esophagectomy (RAMIE) on cadavers in the prone position, utilizing telesurgical support through the double-surgeon cockpit (double SC) of the novel Japanese-made surgical robot system, hinotori (Medicaroid, Kobe, Japan). The Cadaveric Anatomy and Surgical Training Laboratory (CAST Lab) at Hokkaido University and Kushiro City General Hospital (KCGH) are interconnected by a dedicated 1 Gbps internet line, spanning 300 km. An operation unit and double SC were installed at CAST Lab, whereas the double SC proctor was installed at KCGH.

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The increasing global incidence of breast cancer underscores the significance of breast reconstruction in enhancing patients' quality of life. Breast reconstruction primarily falls into two categories: implant-based techniques and autologous tissue transfers. In this study, we present a comprehensive review of various aspects of implant-based reconstruction, including different types of implants, surgical techniques, and their respective advantages and disadvantages.

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Purpose: Chemoradiotherapy (CRT) for rectal cancer is limited by its harmful side effects and its insufficient benefit on lateral lymph node metastases. The purpose of this study was to evaluate the long-term outcomes of S-1 and oxaliplatin with total mesorectal excision (TME) and lateral lymph node dissection (LLND) without radiation for rectal cancer.

Methods: The inclusion criteria were patients with stage II or III rectal cancer located within 10 cm from the anal verge.

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Intratumoral genomic heterogeneity (ITGH), the existence of genotypic and phenotypic variation within an individual tumor, is known to be a key mechanism in treatment resistance. Deviating gene Expression Profiling Tumor Heterogeneity 2 (DEPTH2) algorithm was developed to estimate ITGH using solely RNA expression data unlike the others that require both DNA- and RNA-expression data. Total of 6,500 breast cancer patients from multiple independent cohorts were analyzed using DEPTH2.

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Article Synopsis
  • * Japan began researching telesurgery in 2002, but implementation was slow due to insufficient telecommunications and a lack of support for robotic surgery.
  • * Recently, the Japan Surgical Society is leading feasibility studies for telesurgery amid growing demand for online medical services, with other countries like China, India, and the U.S. also exploring similar clinical studies, indicating a shift towards broader adoption of telesurgery.
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  • * Liquid biopsy has the potential for detecting these mutations, but current methods struggle with sensitivity and accuracy.
  • * The study explored oligoribonucleotide interference-PCR (ORNi-PCR) coupled with real-time PCR or droplet digital PCR (ddPCR), finding that ORNi-PCR methods are more effective at detecting mutant DNA for early diagnosis and monitoring of recurrent PDAC.
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  • - Edoxaban, a factor Xa inhibitor, is usually metabolized into an active metabolite called M-4, which has minimal antithrombotic effects in healthy individuals; however, certain conditions can elevate its plasma concentration significantly.
  • - A 68-year-old man with pancreatic cancer was prescribed edoxaban along with rifampin and clarithromycin for lung disease but developed acute kidney injury after surgery, leading to unusually high levels of M-4 in his system.
  • - This case highlights the potential for increased M-4 levels in patients with kidney issues who are taking edoxaban alongside drugs that affect its metabolism, suggesting that these combinations could be more clinically impactful than previously understood.
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Background: The aim of this study was to determine the optimal treatment for patients with pancreatic cancer (PaCa) having positive peritoneal cytology (PPC).

Methods: This multicenter retrospective study included patients with PPC treated at 78 high-volume centers between January 2012 and December 2020. Prognoses after resection (S-group) and initiation of nonsurgical treatment (N-group) were compared.

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  • * Analyzing data from 1183 patients, it found that completing 6 months of postoperative adjuvant therapy significantly improved overall, disease-specific, and recurrence-free survival, especially for high-risk patients.
  • * Additionally, neoadjuvant therapy showed benefits for those with borderline resectable IPMC, and any treatment for recurrence after surgery was linked to longer survival compared to no treatment.
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The patient was a 35-year-old man who saw his first doctor with the chief complaint of painful urination. A contrast- enhanced CT scan of the abdomen revealed a diagnosis of abscess-forming appendicitis with inflammatory spread to the bladder, and conservative treatment was decided. Since antibiotic treatment failed to reduce the size of the abscess, he underwent surgery.

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Introduction: Esophageal achalasia is a typical esophageal motility disorder (EMD). Although viral infections have been hypothesized to play a role in the pathogenesis of esophageal achalasia, its etiology remains unclear. This study used esophageal muscle layer specimens collected during per-oral endoscopic myotomy (POEM) procedures to investigate the association between esophageal achalasia and esophagogastric junction outflow obstruction (EGJOO) and pattern recognition receptors.

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Introduction: Small fibre neuropathy (SFN) is an early manifestation of diabetic polyneuropathy. Although oxidative stress, inflammation and change of intestinal bacterial population are assumed to be their pathogenesis, the effects of dietary nutrition have not been evaluated. The relationship between dietary nutrition intake and pain sensation was evaluated in the Japanese population.

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  • NAD + is crucial for various cellular functions and lower levels may be linked to cancer, sparking interest in how it changes in cancer patients undergoing surgery.
  • This study analyzed NAD + dynamics in 99 patients with different digestive cancers by measuring blood samples and found that while NAD + levels stayed stable post-surgery, nicotinamide mononucleotide (NMN) levels dropped and recovered differently based on cancer type.
  • The research suggests that understanding individual NAD + levels could lead to personalized supplementation strategies for cancer patients during treatment.
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Objective: This study aimed to clarify the molecular mechanism of remnant pancreatic cancer (PC) development after primary PC resection.

Summary Background Data: Molecular mechanisms of the development of remnant PCs following primary PC resection are largely unknown.

Methods: Forty-three patients undergoing remnant PC resection after primary PC resection between 2001 and 2017 at 26 institutes were retrospectively analyzed.

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Purpose: While comprehensive research exists on the mutation of the DNA repair gene BRCA1, limited information is available regarding the clinical significance of BRCA1 gene expression. Given that cancer cell proliferation is aggrevated by DNA repair, we hypothesized that high BRCA1 gene expression breast cancer (BC) might be linked with aggressive tumor biology and poor clinical outcomes.

Methods: The cohorts: The Cancer Genome Atlas (TCGA, n = 1069), METABRIC (n = 1903), and SCAN-B (n = 3273) were utilzed to obtain data of 6245 BC patients.

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  • * Advances in technology and new surgical robots have mitigated previous challenges, leading to a legal framework in Japan since 2019 that supports remote surgical assistance under a surgeon's supervision.
  • * The Japan Surgical Society developed "Telesurgery Guidelines" in June 2022, outlining standards for medical teams, communication protocols, robotic systems, and addressing issues like responsibility and adverse events, with plans for ongoing updates.
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Since its development in 1943, lidocaine has been one of the most commonly used local anesthesia agents for surgical procedures. Lidocaine alters neuronal signal transmission by prolonging the inactivation of fast voltage-gated sodium channels in the cell membrane of neurons, which are responsible for action potential propagation. Recently, it has attracted attention due to emerging evidence suggesting its potential antitumor properties, particularly in the in vitro setting.

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Small nerve fibres located in the epidermis sense pain. Dysfunction of these fibres decreases the pain threshold known as small fibre neuropathy. Diabetes mellitus is accompanied by metabolic changes other than glucose, synergistically eliciting small fibre neuropathy.

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Acute normovolemic hemodilution (ANH) is a useful intraoperative blood conservation technique. However, the impact on long-term outcomes in pancreatic ductal adenocarcinoma (PDAC) remains unclear. The present study investigated the impact of ANH on long-term outcomes in patients with PDAC undergoing radical surgery.

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  • - Metaplastic breast carcinoma (MBC) is a diverse type of breast cancer comprised of various histological types, often exhibiting a mix of different cancer cell characteristics, which is important for understanding tumor behavior and managing recurrence.
  • - In a study of 25 MBC tumors, the predominant components were found to be squamous cell carcinoma (SCC) and spindle cell carcinoma (SpCC), each exhibiting distinct immunohistochemical markers that could aid in identification and treatment.
  • - Analysis revealed that SCC had notable PTEN gene mutations and specific marker expressions compared to SpCC, indicating that these components have unique molecular profiles that could influence prognosis and therapeutic strategies.
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A 72-year-old man was referred to our hospital for the examination of a pancreatic head mass. Abdominal computed tomography revealed a contrasted 8-cm-diameter tumor extending from the dorsal pancreatic head to the porta hepatis. The preoperative diagnosis was challenging due to the absence of specific imaging findings and the inability to perform a biopsy.

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Background: Peripancreatic bacterial contamination (PBC) is a critical factor contributing to the development of clinically relevant postoperative pancreatic fistula (CR-POPF) following pancreaticoduodenectomy (PD). Controlling pathogenic bacteria is essential in preventing CR-POPF; however, the precise relationship between specific bacteria and CR-POPF remains unclear. This study aimed to investigate the relationship between PBC and CR-POPF after PD, with a focus on identifying potentially causative bacteria.

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A 68-year-old woman underwent neoadjuvant chemotherapy for left breast cancer(triple negative type), cT2N3cM0, cStage ⅢC, and Bt+Ax(Ⅲ). The pathological diagnosis was ypT1aN2aM0, ypStage ⅢA, ER-, PgR-, HER2 score 1+, Ki- 67 25%. Adjuvant radiotherapy(50 Gy/25 Fr)was then administered, followed by capecitabine as adjuvant chemotherapy.

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