Publications by authors named "Kazuaki Shimada"

Background: Lymph node dissection is required for many pancreatic neuroendocrine neoplasms. However, the need for such dissection has rarely been examined in detail by the tumor size, tumor location, or World Health Organization grading. The objective is to determine which characteristics of pancreatic neuroendocrine neoplasms require lymph node dissection, and to what extent lymph node dissection should be performed.

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Background: While liver resection remains the best curative option for hepatocellular carcinoma (HCC), it is unclear whether the consistent progress of multidisciplinary approaches in managing HCC over several decades has influenced the outcomes of liver resection.

Methods: Patients undergoing liver resection for HCC from 1993 to 2022 in our institution were retrospectively assessed and stratified into three periods according to the year of liver resection, P1 (1993-2000), P2 (2001-2009), and P3 (2010-2022), and tumor status using the Barcelona Clinic Liver Cancer (BCLC) staging system.

Results: A total of 1257 patients were included (P1:P2:P3 = 385:490:382, BCLC stage 0/A:B:C = 908:214:135).

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Background And Purpose: Definitive radiotherapy for patients with scalp angiosarcoma has a poor prognosis, often resulting in severe skin adverse events. Additionally, malignant melanoma is known for its radioresistant nature. Boron neutron capture therapy (BNCT) may address these challenges due to the high uptake capacity of boron drugs in these cancer types.

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Background: Postoperative pancreatic fistula (POPF) is a major complication of distal pancreatectomy (DP). Although the visceral fat area (VFA) is a risk factor for POPF in DP, its measurement is complicated. This study aimed to identify a simple marker as a predictive indicator of POPF.

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Background: The optima preoperative biliary drainage before pancreaticoduodenectomy in patients with biliary tract and pancreatic cancer remains controversial.

Methods: A total of 898 patients who underwent preoperative biliary drainage via endoscopic retrograde biliary drainage, endoscopic transnasal biliary drainage, or percutaneous transhepatic biliary drainage before pancreaticoduodenectomy for biliary tract and pancreatic cancer were included. Perioperative and long-term outcomes were analyzed.

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Background: The incidence of non-hepatitis B and non-hepatitis C hepatocellular carcinoma (NBNC-HCC) is increasing in our country. This study assesses the feasibility of employing an identical surgical treatment strategy for resectable NBNC-HCC as that for hepatitis virus-associated HCC (HV-HCC).

Methods: A retrospective analysis (1993-2023) of 1321 curative liver resections for HCC at a single institution was performed.

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Purpose: Whether surgical intervention for patients with oligometastatic recurrence can improve their post-recurrent prognosis is unclear. In this study, we introduce a novel concept of oligometastasis in post-surgical pancreatic ductal adenocarcinoma (PDAC) patients with hepatic recurrence, which we call "oligo-like liver metastasis (OLLM)." Patients with OLLM have better post-recurrence prognosis and could therefore be eligible for surgical intervention.

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Article Synopsis
  • Patients with distal cholangiocarcinoma (DCC) often have high recurrence rates and poor survival outcomes, prompting this study to examine the effect of surgical margin status on these factors.
  • A retrospective analysis of 133 patients showed that while 21.8% had R1cis and 17.3% had R1inv margins, surgical margin status did not significantly affect overall and recurrence-free survival rates.
  • However, R1 status was associated with a higher likelihood of isolated distant recurrence, suggesting that comprehensive treatment approaches are crucial for improving patient outcomes.
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Article Synopsis
  • Peptide receptor radionuclide therapy (PRRT) proves effective in treating unresectable liver metastases from pancreatic neuroendocrine tumors (PNETs), leading to rare surgical opportunities.
  • A case study of a 52-year-old man shows that after PRRT treatment and the use of somatostatin analogs (SSAs), previously unresectable liver metastases became operable, resulting in no viable tumor cells post-surgery.
  • The findings emphasize the potential of combining PRRT and SSAs as a promising multimodal treatment for patients with difficult-to-operate PNETs.
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Introduction: Major hepatectomy (MH) may produce the impaired liver function and affect the feasibility of adjuvant chemotherapy in terms of early period after the surgery, but there have not been detailed investigations. JCOG1202 (UMIN000011688) is a randomized phase III trial demonstrating the superiority of adjuvant S-1 chemotherapy for biliary tract cancer (BTC). The aim of this study is to examine the influence of MH for BTC on adjuvant S-1.

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Intrahepatic cholangiocarcinoma (iCCA) is an aggressive cancer composed of large-duct and small-duct types. Understanding the tumor immune microenvironment and its related vascular system is important for developing novel and efficient therapies. We focused on tertiary lymphoid structure (TLS) as a hallmark of antitumor immunity and investigated the clinicopathologic significance of TLSs and the influence of vascular microenvironment on TLS formation in iCCAs.

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Article Synopsis
  • This study presents the first case of using a linear accelerator-based boron neutron capture therapy (BNCT) system to treat a patient with cutaneous malignant melanoma in a clinical trial that started in November 2019.
  • A patient with a localized melanoma who opted out of surgery and chemotherapy received BNCT after being administered boronophenylalanine (BPA), leading to a gradual improvement in their condition over 12 months.
  • While the patient experienced some mild side effects, there were no serious adverse events, indicating that accelerator-based BNCT could be a promising new treatment option for this type of cancer.
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Background: This substudy of the Cancer-VTE Registry estimated venous thromboembolism (VTE) incidence and risk factors in pancreatic cancer patients.

Methods: The Cancer-VTE Registry was an observational study that collected VTE data from patients with solid tumors across Japan. We measured baseline VTE prevalence, and at 1-year follow-up, the cumulative incidence of symptomatic and composite VTE (symptomatic VTE and incidental VTE requiring treatment), bleeding, cerebral infarction/transient ischemic attack (TIA)/systemic embolic event (SEE), and all-cause death.

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Background: Extrahepatic cholangiocarcinoma (eCCA) is a rare and aggressive disease and consisted of conventional eCCA and intraductal papillary neoplasm of the bile duct (IPNB). Intraepithelial spread (IES) of cancer cells beyond the invasive area is often observed in IPNBs; however, the prevalence of IES remains to be examined in conventional eCCAs. Here, we evaluated the clinicopathological features of eCCAs according to tumor location, with a focus on the presence of IES.

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Objective Primary hepatobiliary neuroendocrine neoplasms (NENs) are rare tumors exhibiting several morphological and behavioral characteristics. Considering the lack of relevant data on this topic, we evaluated the clinicopathological features and treatment outcomes of patients with primary hepatobiliary NENs. Methods/Patients We examined 43 consecutive patients treated at the National Cancer Center Hospital with pathological diagnoses of primary hepatobiliary NEN between 1980 and 2016.

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Background: The prognostic benefit of preoperative chemotherapy leading to conversion surgery for unresectable colorectal liver metastases (CRLM) is well recognized, while that of neoadjuvant chemotherapy (NAC) compared with upfront surgery (UFS) for resectable CRLM is negligible. This study aims to assess the prognostic benefit and search for optimal indication of NAC for resectable advanced CRLM by establishing an objective definition of biologically borderline resectable (bBR) CRLM.

Methods: A bicentric retrospective analysis of patients with CRLM undergoing curative-intent initial liver resection between 2007 and 2021 was performed.

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Postoperative delirium is an important issue in cancer patients, affecting surgical outcomes and the quality of life. Ramelteon is a melatonin receptor agonist with high affinity for MT1 and MT2 receptors. Clinical trials and observational studies in Japan, including in surgical cancer patients, have shown efficacy of ramelteon in delirium prevention, with no serious safety concerns.

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This report summarizes the presentations and discussions in the first Asian Clinical Trials Network for Cancers (ATLAS) international symposium that was held on 24 April 2022, in Bangkok, Thailand, and hosted by the National Cancer Center Hospital (NCCH), co-hosted by the Pharmaceuticals and Medical Devices Agency (PMDA), Clinical Research Malaysia (CRM) and the Thai Society of Clinical Oncology (TSCO), and supported by Embassy of Japan in Thailand. Since 2020, the NCCH has conducted the ATLAS project to enhance research environments and infrastructures to facilitate international clinical research and cancer genomic medicine in the Asian region. The purpose of the symposium was to discuss what we can achieve under the ATLAS project, to share the latest topics and common issues in cancer research and to facilitate mutual understanding.

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Acinar cell carcinoma (ACC) is a rare and highly malignant pancreatic tumor. Owing to histologic similarity, ACC is often difficult to distinguish from other solid medullary pancreatic tumors, particularly neuroendocrine neoplasm (NEN) and intraductal tubulopapillary neoplasm (ITPN). We aimed to identify new immunohistochemical markers commonly expressed in tumor cells with acinar cell differentiation and useful for both surgical and small biopsy specimens.

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Objectives: Real-time virtual sonography (RVS) is an artificial-intelligence-assisted ultrasonographic navigation system that displays synchronized preoperative computed tomography (CT) images corresponding to real-time intraoperative ultrasonograms (IOUS). This study aimed to investigate whether RVS can enhance IOUS identification of small intrahepatic targets found in preoperative CT.

Methods: Patients with small intrahepatic targets detected by preoperative thin-slice dynamic CT before liver resection were included.

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Article Synopsis
  • A study evaluated the effectiveness of the drug S-1 as an adjuvant treatment for patients with resected biliary tract cancer, comparing it with observation alone.
  • This phase 3 trial involved 440 patients across 38 Japanese hospitals and aimed to measure overall survival rates after treatment.
  • Results indicated that after 3 years, patients receiving S-1 had a 77.1% survival rate, compared to 67.6% in the observation group, showing a significant survival benefit associated with S-1 treatment.
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Background: Noninvasive detection of early stage cancers with accurate prediction of tumor tissue-of-origin could improve patient prognosis. Because miRNA profiles differ between organs, circulating miRNomics represent a promising method for early detection of cancers, but this has not been shown conclusively.

Methods: A serum miRNA profile (miRNomes)-based classifier was evaluated for its ability to discriminate cancer types using advanced machine learning.

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Background: Progress of non-surgical treatments in the last decade has improved the prognosis of pancreatic neuroendocrine neoplasms (PanNEN). However, the improvement of surgery for advanced PanNEN remains unknown. This study aimed to investigate the chronological changes of the clinical impact of pancreatectomy for PanNEN.

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