Improved Mortality, Morbidity, and Long-Term Outcome After Anatomical Hepatectomy With the Glissonean Pedicle Approach in Patients With Hepatocellular Carcinoma: 30 Years' Experience at a Single Institute.

Objective: We evaluated the morbidity and mortality after anatomical hepatectomy with the Glissonean pedicle approach, and long-term outcomes in relation to the morbidity in patients with hepatocellular carcinoma (HCC).

Summary Background Data: The mortality, morbidity, and long-term outcomes were evaluated retrospectively.

Methods: A total of 1953 patients with HCC underwent various anatomical hepatectomies with the Glissonean pedicle approach between 1985 and 2014.

Improved surgical outcomes for hilar cholangiocarcinoma: changes in surgical procedures and related outcomes based on 40 years of experience at a single institution.

Purpose: This study aimed to examine the changes in procedures for hilar cholangiocarcinoma (HC) surgery and patient survival following HC surgery over a 40-year period.

Methods: Between 1974 and 2014, 239 consecutive patients underwent surgery for HC. The changes in perioperative therapy and short- and long-term surgical outcomes were evaluated.

Surgical approaches to advanced gallbladder cancer : a 40-year single-institution study of prognostic factors and resectability.

Purpose: The aim was to evaluate prognostic factors and factors associated with the resectability of advanced gallbladder cancer (GBC).

Methods: This was a single-institution retrospective review of 274 consecutive surgically-treated cases of advanced GBC (excluding incidental GBC and early GBC). Univariate and multivariate analysis were performed to assess prognostic variables.

Postoperative dendritic cell vaccine plus activated T-cell transfer improves the survival of patients with invasive hepatocellular carcinoma.

The recurrence rate after surgery in patients with hepatocellular carcinoma (HCC) is very high, while prognosis is quite poor. However, there is no standard treatment to prevent recurrence of HCC after a curative operation. In this study, we investigated the clinical utilization of an autologous tumor lysate-pulsed dendritic cell vaccine plus ex vivo activated T cell transfer (ATVAC) in an adjuvant setting for postoperative HCC as a non-randomized controlled trial.

Clinical utilization of postoperative dendritic cell vaccine plus activated T-cell transfer in patients with intrahepatic cholangiocarcinoma.

Background: The prognosis of patients with intrahepatic cholangiocarcinoma (ICC) is extremely poor and the recurrence rate after curative operation is very high. There is no standard treatment to prevent recurrence of ICC. In this study, we investigated the clinical utilization of a dendritic cell vaccine plus activated T-cell transfer in an adjuvant setting for postoperative ICC.

A conundrum for randomized controlled trials: experience from a small hepatocellular carcinoma trial.

Objective: The aim of this study was to explore why patients accepted or declined to participate in a randomized clinical trial, which was subsequently discontinued because of a low recruitment rate.

Methods: Forty-one patients were invited to participate in a randomized clinical trial that aimed to compare local ablation therapies and surgery to treat small asymptomatic hepatocellular carcinomas. These patients were then asked to answer a questionnaire that assessed patient perception and reasons for accepting or declining to enroll in the randomized clinical trial.

Should the extrahepatic bile duct be resected or preserved in R0 radical surgery for advanced gallbladder carcinoma? Results of a Japanese Society of Biliary Surgery Survey: a multicenter study.

Purpose: We assessed the significance of an extra bile duct resection by comparing the survival of patients with advanced gallbladder carcinoma who had resected bile ducts with those who had preserved bile ducts. A radical cholecystectomy that includes extra bile duct resections has been performed without any clear evidence of whether an extra bile duct resection is preventive or curative.

Methods: We conducted a questionnaire survey among clinicians who belonged to the 114 member institutions of the Japanese Society of Biliary Surgery.

Right hepatectomy for hepatocellular carcinoma in patients with an indocyanine green retention rate at 15 minutes of 10% or higher.

Background/aims: Liver failure after right hepatectomy for hepatocellular carcinoma (HCC) in patients with an indocyanine green retention rate at 15 min (ICGR(15)) of 10% or higher remains a controversial issue.

Methods: Between 1995 and 2004, 98 patients with an ICGR(15) of 10% or higher were scheduled to undergo right hepatectomy or tri-sectionectomy for HCC. The hepatic resection volume (HR) excluding the tumor was measured using computed tomography.

Hepatic resection in 485 R0 pT2 and pT3 cases of advanced carcinoma of the gallbladder: results of a Japanese Society of Biliary Surgery survey--a multicenter study.

Purpose: We conducted this study to evaluate the optimal hepatic resection for pT2 and pT3 advanced carcinoma of the gallbladder without invasion of the hepatoduodenal ligament.

Methods: We conducted a questionnaire survey regarding 4,243 cases of carcinoma of the gallbladder treated during the recent 10-year period at 112 institutions belonging to the Japanese Society of Biliary Surgery. The questionnaires included questions on preoperative-diagnosis, complications, treatment, and surgical treatment, procedures of resection, surgical result, path histological findings, mode, and site of recurrence, additional post-operative treatment.

Graft size and donor age are independent factors for graft loss in adult-to-adult living-donor liver transplantation using the left liver.

Background/purpose: Graft survival is affected by various factors, such as preoperative state and the ages of the recipient and donor, as well as graft size. The objective of this study was to analyze the risk factors for graft survival.

Methods: From September 1997 to July 2005, 24 patients who had undergone living-donor liver transplantation (LDLT) were retrospectively analyzed.

Surgery versus radiochemotherapy for resectable locally invasive pancreatic cancer: final results of a randomized multi-institutional trial.

Purpose: Although the outcome of surgery for locally advanced pancreatic cancer remains poor, it is improving, with 5-year survival up to about 10% in Japan. The preliminary results of our multi-institutional randomized controlled trial revealed better survival after surgery than after radiochemotherapy. We report the final results of this study after 5 years of follow-up.

Non-coding MicroRNAs hsa-let-7g and hsa-miR-181b are Associated with Chemoresponse to S-1 in Colon Cancer.

BACKGROUND: MicroRNAs (miRNAs) are small non-coding RNAs (~22 nucleotides) that regulate gene expression at a post-transcriptional level via imperfect base pairing to the 3'-UTR of their target mRNAs. Previous studies from our group identified a number of deregulated miRNAs due to the loss of p53 tumor suppressor in colon cancer cell lines. To further investigate the in vivo biological significance of these miRNAs, the expressions of hsa-let-7g, hsa-miR-143, hsa-miR-145, hsa-miR-181b and hsa-miR-200c were investigated using formalin-fixed paraffin-embedded (FFPE) colon cancer specimens to evaluate the potential relationship with chemosensitivity and tumorigenesis.

[Usefulness of transcatheter arterial embolization (TAE) for large hepatocellular carcinoma using a lecithin-added Lipiodol emulsion].

This study was to retrospectively compare the effectiveness of transarterial embolization (TAE) using a lipidol emulsion for large lesion of hepatocellular carcinoma (HCC). average survival time was retrospectively compared in patients with HCC larger then 3 cm in diameter. Twenty patients were treated with conventional transarterial embolization (TAE)(group A), 27 with transarterial embolization using a lipidol emulsion (TAE-L) (group B).

[Usefulness of hepatic arterial infusion chemotherapy using lecithin-added lipiodol emulsion in hepatocellular carcinoma].

After implanting a reservoir in the hepatic artery, we performed intra-arterial chemotherapy with a smaller particle size lipiodol emulsion and examined its therapeutic effect. Subjects were 21 patients with advanced/recurrent hepatocellular carcinoma (HCC). Arterial infusion was performed once every 2 weeks on an outpatient basis using 2 mL lipiodol emulsion with lecithin added as a surface active agent and 10 mg doxorubicin hydrochloride.

Hepatopancreatoduodenectomy could be allowed for patients with advanced intrahepatic cholangiocarcinoma.

Background/aims: Patients with advanced intrahepatic cholangiocarcinoma (ICC) have a poor outcome even if they undergo extended radical surgery. Hepatopancreatoduodenectomy (HPD; hepatectomy with pancreatoduodenectomy) for ICCs may be expected to provide a favorable outcome if curative resection is reasonable and patients can tolerate the radical major procedure.

Methodology: Between January 1981 and March 2002, 152 hepatic resections were performed for ICC.

Status of surgical treatment of biliary tract cancer.

Complete surgical resection of biliary tract carcinoma remains the best treatment. The Japanese Society of Biliary Surgery has organized a registry project and established a classification of biliary tract carcinoma. We report here the status of biliary surgery in Japan.

Liver metastases with massive portal venous tumor thrombi from colorectal cancer: can be treated by surgical resection?

Background/aims: The surgical treatments for liver metastases from colorectal cancer with massive portal venous tumor thrombi were evaluated.

Methodology: Five patients, among the 142 patients who underwent hepatic resection for liver metastases from colorectal cancer from 1989 to 1998, were included in this study. The tumor thrombi in the main portal vein were removed by the following procedures; (1) the circumferential incision of the first branch of the portal vein and removal of the exposed tumor thrombi with ring forceps and suction, (2) temporary clamping of the distal end, (3) dilatation of the round ligament and the venous cannula was inserted into the umbilical portion, (4) washing out of the residual tumor thrombi, (5) declamping of the distal end and closing suture of the cut end of the portal branch.

Operative outcome and problems of right hepatic lobectomy with pancreatoduodenectomy for advanced carcinoma of the biliary tract.

From 1979 to 1996, 32 patients underwent at least right hepatic lobectomy with pancreatoduodenectomy (right HPD) for advanced carcinoma of the biliary tract at our institute. Twelve of the 32 patients underwent hepatoligamentopancreatoduodenectomy (HLPD). Curative resection was achieved in 20 (63%) of the 32 patients, but the operative outcomes were not satisfactory.

OK432-activated natural killer cells enhanced trastuzumab (Herceptin)-mediated antibody-dependent cellular cytotoxicity in patients with advanced cancer.

Background: Adoptive immunotherapy using natural killer (NK) cells from cancer patients yielded only modest success. Whether Herceptin and OK432-activated NK cells (NK cells obtained by stimulating peripheral blood mononuclear cells with OK432 and interleukin-2) improve the outcome of adoptive immunotherapy against HER-2/neu positive tumor cells via antibody-dependent cellular cytotoxicity, was examined in vitro.

Materials And Methods: A 51Cr release assay was performed to assess cytotoxicity.

Chemoradiotherapy with and without esophagectomy for advanced esophageal cancer.

Background/aims: To evaluate the impact of surgery on survival after chemoradiotherapy, we analyzed the long-term outcome of patients with advanced esophageal cancer.

Methodology: Data on 92 consecutive patients with T3 or T4 esophageal cancer who were initially treated by chemoradiotherapy were reviewed retrospectively. Of 82 patients who completed the planned schedule, 35 patients underwent esophagectomy (CRT+E Group) and 47 patients received definitive chemoradiotherapy (CRT Group).

Hepatocellular carcinoma with a central scar and a scalloped tumor margin resembling focal nodular hyperplasia in macroscopic appearance.

Background: We sometimes encounter hepatocellular carcinoma (HCC) with a central scar and a scalloped tumor margin resembling focal nodular hyperplasia (FNH) in macroscopic appearance. The fibrolamellar variant sometimes shows this appearance; however, this type of HCC can be clearly differentiated from fibrolamellar variants on the basis of clinical and histopathological findings. The clinical features of patients with this type of HCC need to be clarified.

Intrahepatic cholangiocarcinoma with lymph node metastasis successfully treated by immunotherapy with CD3-activated T cells and dendritic cells after surgery: report of a case.

Intrahepatic cholangiocarcinoma (ICC) with lymph node (LN) metastasis is generally associated with a poor prognosis. However, we treated ICC with LN metastasis successfully by surgery and postoperative immunotherapy in a 59-year-old woman. The immunotherapy consisted of CD3-activated T cells and tumor lysate- or peptide-pulsed dendritic cells.

Pancreaticojejunostomy using duct-to-mucosa anastomosis without a stenting tube.

Background Purpose: There is a high risk of anastomotic leakage after pancreaticojejunostomy following pancreaticoduodenectomy in patients with a normal soft pancreas because of the high degree of exocrine function. Therefore, pancreaticojejunostomy is generally performed using a stenting tube (stented method). However, pancreaticojejunostomy with a certain duct-to-mucosa anastomosis does not always require a stenting tube, even in patients with a normal soft pancreas.

Clinicopathologic features of patients with intrahepatic cholangiocarcinoma who are seropositive for alpha-fetoprotein-L3 and those with combined hepatocellular and cholangiocarcinoma.

Background: Some patients who are seropositive for lectin-reactive alpha-fetoprotein (AFP-L3) have intrahepatic cholangiocarcinoma (ICC). There have been no studies regarding the features of ICC patients seropositive for AFP-L3. Thus, the purpose of the present paper was to compare the features of ICC patients from the viewpoint of two different tumor markers, AFP-L3 and carbohydrate antigen (CA) 19-9.

5-fluorouracil-related gene expression levels in primary colorectal cancer and corresponding liver metastasis.

Gene expression levels of thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), thymidine phosphorylase (TP) and orotate phosphoribosyl transferase (OPRT) have been shown to be associated with response to 5-fluorouracil-based therapies. Analyzing these gene expression levels in liver metastases is important to obtain the best prediction of therapy. Our aim was to determine how TS, DPD, TP and OPRT gene expression levels in primary colorectal cancer (CRC) were related to those in liver metastases.