Publications by authors named "Kazuo Hara"
Background: JCOG1113 is a randomized phase III trial that showed non-inferiority of gemcitabine plus S-1 to gemcitabine plus cisplatin in patients with advanced biliary tract cancer. Assessment of inter-institutional heterogeneity in chemotherapy contributes to confirm generalizability and reliability of the study itself. However, there have been no studies conducted to assess the heterogeneity among participating centers in randomized phase III trials for biliary tract cancer.
View Article and Find Full Text PDFBackground/aims: Biliary obstruction drainage in patients with hepatocellular carcinoma (HCC) is associated with symptom palliation, improved access to chemotherapy, and improved survival. Stent placement and exchange via endoscopic retrograde cholangiopancreatography biliary drainage risk traversing the HCC, a hypervascular tumor and causing bleeding. Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) potentially prevents procedure-related bleeding.
View Article and Find Full Text PDFIntroduction: This analysis aimed to evaluate the long-term cost-effectiveness of tirzepatide 5 mg versus dulaglutide 0.75 mg (both administered once weekly) in people not achieving glycemic control on metformin, based on the results of the head-to-head SURPASS J-mono trial from a Japanese healthcare payer perspective.
Methods: A cost-utility analysis was performed over a 50-year time horizon using an implementation of the UKPDS Outcomes Model 2 developed in Microsoft Excel.
Background/aims: Hepatobiliary scintigraphy (HBS) is used to evaluate bile excretion. This study aimed to evaluate biliary excretion during endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) using HBS.
Methods: We retrospectively evaluated 78 consecutive patients with malignant extrahepatic biliary obstruction, who underwent HBS after EUS-HGS between April 2015 and July 2022.
Article Synopsis
- - The study investigates the levels of soluble αKlotho, a protein linked to aging, found in blood, particularly focusing on its origin from the kidneys.
- - Blood samples were taken from patients during adrenal venous catheterization to measure αKlotho levels in different sections of the inferior vena cava.
- - Results showed higher αKlotho concentrations above the kidneys (suprarenal) compared to below (infrarenal), indicating that the kidneys significantly contribute to αKlotho levels in the bloodstream.
Background And Study Aims: Endoscopic ultrasonography (EUS)-guided ethanol injection (EI) has recently been introduced as one of the management strategies for pancreatic neuroendocrine neoplasms (PNENs). However, its role as a surgical alternative is unclear. We evaluated the efficacy and safety of EUS-EI in treating small PNENs through a prospective multicentre study.
View Article and Find Full Text PDFArticle Synopsis
- Perforated esophageal cancer can lead to rare complications like mediastinal abscesses, which are difficult to treat.
- A 71-year-old man with this condition underwent endoscopic ultrasound-guided abscess drainage (EUS-AD) to manage the abscess before surgery, as traditional treatment was ineffective.
- After successfully draining the abscess and improving his condition, the patient received curative surgery followed by chemotherapy, remaining free of cancer recurrence two years later.
Article Synopsis
- The study investigates the effects of intraoperative frozen section analysis (FSA) of pancreatic transection margins on the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC).
- A total of 311 patients who underwent pancreaticoduodenectomy were analyzed, with findings categorized into three groups based on the first FSA results: negative (1FSA-R0), carcinoma in situ (1FSA-CIS), and invasive carcinoma (1FSA-IC).
- Results showed similar median survival rates for 1FSA-R0 and 1FSA-CIS, indicating that additional resections may be justified for 1FSA-CIS, while 1FSA-IC was significantly associated with poorer survival
Article Synopsis
- *The Subcommittee defined five types of I-EUS procedures based on their purpose and method: EUS-guided sampling, EUS-guided through-the-needle examination, EUS-guided drainage/anastomosis, ESCR procedures, and EUS-guided delivery.
- *The proposed classifications aim to clarify I-EUS procedures and will be updated as new techniques and concepts arise in the field.*
Article Synopsis
- EUS-guided pancreaticojejunostomy (EUS-PJS) is an effective procedure for treating strictures after Whipple surgery, showing a 100% technical success rate among 10 patients studied.
- The study, conducted at Aichi Cancer Center Hospital, found that while there were some minor adverse events like fever, overall safety was high with no serious complications.
- With a median follow-up of 9.5 months, some patients achieved a stent-free state, suggesting EUS-PJS may reduce the need for further interventions and create a permanent drainage solution.
A Phase II Placebo-Controlled Study of the Effect and Safety of Nanvuranlat in Patients with Advanced Biliary Tract Cancers Previously Treated by Systemic Chemotherapy.
Clin Cancer Res
September 2024
Article Synopsis
- The study aimed to assess the effectiveness and safety of nanvuranlat, an L-type amino acid transporter 1 inhibitor, as a treatment for advanced biliary tract cancers that are hard to treat.
- Conducted across 14 Japanese medical centers, the trial involved 211 patients, with 105 eligible participants randomly assigned to receive either nanvuranlat or a placebo, focusing on progression-free survival (PFS) as the main measure of success.
- Results showed that nanvuranlat significantly improved PFS compared to placebo, although overall survival rates were similar, suggesting the need for further research, especially in specific cancer subtypes like intrahepatic and extrahepatic cholangiocarcinoma.
Background/aims: Dilation of the tract before stent deployment is a challenging step in endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD). In this study, we examined the effectiveness and safety of a novel spiral dilator, Tornus ES (Asahi Intec), for EUS-PDD.
Methods: This was a retrospective, single-arm, observational study at Aichi Cancer Center Hospital.
Article Synopsis
- The TOKYO criteria, initially proposed for standardized reporting of endoscopic transpapillary biliary drainage outcomes, face limitations in newer techniques like endoscopic ultrasound and device-assisted endoscopy.
- A new committee is updating these criteria to better reflect current clinical practices in managing various biliary conditions, recognizing the need for comprehensive outcome evaluations beyond just stent patency.
- The revised TOKYO criteria 2024 aim to enhance the design and reporting of clinical studies by introducing a "stent-demanding time" concept for a more thorough assessment of endoscopic biliary drainage outcomes.
Aims: The utilization of long-term effect of internet of things (IoT) on glycemic control is controversial. This trial aimed to examine the effect of an IoT-based approach for type 2 diabetes.
Materials And Methods: This randomized controlled trial enrolled 1,159 adults aged 20-74 years with type 2 diabetes with a HbA1c of 6.
Case Presentation: A 61-year-old female was referred to our hospital with a neoplastic lesion in the duodenum. Computed tomography with contrast enhancement revealed a 10-mm tumor in the duodenum. Upper gastrointestinal endoscopy revealed a submucosal tumor-like lesion in the descending part of the duodenum.
View Article and Find Full Text PDFBackground/aims: Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (EUS-HGS) performed at the intrahepatic bile duct segment 3 (B3) is widely used for biliary drainage. Although performing post-puncture procedures is easier in the intrahepatic bile duct segment 2 (B2) when using a conventional oblique-viewing (OV) EUS scope, this method may cause transesophageal puncture and severe adverse events. We evaluated the safety and efficacy of B2 puncture using a novel OV-EUS scope.
View Article and Find Full Text PDFObjectives: This consensus was developed by the Asian EUS Group (AEG), who aimed to formulate a set of practice guidelines addressing various aspects of endoscopic ultrasound-guided tissue acquisition (EUS-TA).
Methods: The AEG initiated the development of consensus statements and formed an expert panel comprising surgeons, gastroenterologists, and pathologists. Three online consensus meetings were conducted to consolidate the statements and votes.
Therapeutic endoscopic ultrasonography (EUS) procedures using the forward-viewing convex EUS (FV-EUS) have been reviewed based on the articles reported to date. The earliest reported procedure is the drainage of pancreatic pseudocysts using FV-EUS. However, the study on drainage of pancreatic pseudocysts focused on showing that drainage is possible with FV-EUS rather than leveraging its features.
View Article and Find Full Text PDFObjective Adverse events such as bile leakage and bleeding are among the issues that need to be resolved in EUS-guided choledochoduodenostomy (EUS-CDS). To overcome this problem, we developed a new EUS-CDS technique using a 19-G Franseen needle without tract dilation. This study aimed to evaluate the safety and efficacy of the new EUS-CDS technique.
View Article and Find Full Text PDFIntroduction: Obesity prevalence has increased in Japan in recent years. Given the strong association of obesity with poor glycemic control, and increased risk of type 2 diabetes (T2D) with central obesity, this study describes the current trends and relationships between glycated hemoglobin (HbA1c), body mass index (BMI), and waist circumference in the Japanese people with T2D.
Methods: This was a retrospective, cross-sectional study of people with T2D who had at least one recorded HbA1c and BMI (or waist circumference) value in the Japan Medical Data Center Claims database.
Aims: The beneficial effects of exercise on reducing the risk of cardiovascular disease are established. However, the potential interaction between genetic risk for type 2 diabetes and physical activity on cardiovascular outcomes remains elusive. We aimed to investigate the effect of type 2 diabetes genetic risk-physical activity interaction on cardiovascular outcomes in individuals with diabetes.
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