Publications by authors named "Kozo Kataoka"
Background: Fluoropyrimidine remains the key agent of adjuvant chemotherapy for stage III colorectal cancer (CRC). Western studies have shown that female sex is a favorable prognostic factor after surgery, but it is also a risk factor for adverse events (AEs) during adjuvant chemotherapy with fluoropyrimidine. However, little is known about whether sex differences in treatment outcomes exist in this setting in the Asian population.
View Article and Find Full Text PDFRisk Factors for Adhesive Small Bowel Obstruction After Liver Cancer Surgery.
Cancer Diagn Progn
November 2024
Background/aim: Although the frequency of small bowel obstructions after liver surgery is generally considered low, previous studies have followed-up patients for less than a year, thus the incidence of small bowel obstructions several years after surgery is unknown. Furthermore, the rise in laparoscopic surgeries and the use of adhesion prevention materials may influence the occurrence of small bowel obstructions. This study aimed to assess the incidence of small bowel obstructions within a five-year period following liver surgery and identify the associated risk factors.
View Article and Find Full Text PDFThe interim analysis of the CIRCULATE-Japan GALAXY observational study demonstrated the association of circulating tumor DNA (ctDNA)-based molecular residual disease (MRD) detection with recurrence risk and benefit from adjuvant chemotherapy (ACT) in resectable colorectal cancer (CRC). This updated analysis with a 23-month median follow-up, including 2,240 patients with stage II-III colon cancer or stage IV CRC, reinforces the prognostic value of ctDNA positivity during the MRD window with significantly inferior disease-free survival (DFS; hazard ratio (HR): 11.99, P < 0.
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- In May 2022, Hyogo Medical University Hospital implemented a new pharmacotherapy management system (PBPM) for cancer treatments, involving collaborative planning between doctors and pharmacists.
- A study comparing colorectal cancer patients before and after the introduction of PBPM showed significant improvements, including an increase in the proportion of clinical examinations performed from 93.2% to 98.8%.
- The number of prescription questions from pharmacists decreased significantly from an average of 64.7 to 29.5 per month, suggesting improved efficiency, while the time taken to address these questions remained statistically unchanged.
Background: The survival benefit of adjuvant chemotherapy after surgical resection of oligometastases from colorectal cancer (CRC) remains unclear. The prognostic role of circulating-tumor DNA (ctDNA) was reported recently and a risk stratification strategy based on monitoring minimal/molecular residual disease (MRD) has been proposed, however, which drug regimen is most effective for ctDNA-positive patients is unknown.
Methods/design: Oligometastatic CRC patients planning to undergo surgery were registered in this study.
Article Synopsis
- The study focuses on developing a predictive model to diagnose anorectal cancer in patients with Crohn's disease (CD), which is often diagnosed at advanced stages and is challenging to treat.
- Utilizing T2-weighted and T1-weighted MRI images, the research analyzed lesions in CD patients from Hyogo Medical University between 2009 and 2022.
- The best-performing model was the Regularized Greedy Forest (RGF), achieving an impressive AUC of 0.944, with significant predictive features related to the texture and structure of the lesions identified through SHAP analysis.
Article Synopsis
- The study compares lymph node spread patterns in young (≤45 years) and elderly (≥80 years) patients with stage III colon cancer who underwent extensive lymphadenectomy in Japan between 1998 and 2018.
- Results showed that younger patients had significantly more lymph nodes harvested and a higher rate of positive central lymph nodes compared to elderly patients.
- The findings suggest that younger patients face a higher risk of central lymph node invasion, which is linked to poorer recurrence-free survival outcomes, indicating a potentially more aggressive form of the disease.
Background: Spatial and temporal heterogeneities of RAS and other molecular genes should be considered in the treatment of metastatic colorectal cancer (mCRC) treated with anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (mAbs); acquired RAS mutation is sometimes observed at disease progression of treatment with the anti-EGFR mAb. At the same time, discrepancy of RAS status from tissues and circulating tumor DNA (ctDNA) in the same patient is sometimes observed. Based on this, we commenced two observational studies to clarify these heterogeneities of RAS and BRAF in mCRC, using next generation sequencing from liquid biopsy.
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- Phase III randomized controlled trials (RCTs) are essential for clinical research but are costly and time-consuming to conduct fully.
- The Colorectal Cancer Study Group (CCSG) of the Japan Clinical Oncology Group (JCOG) has created a comprehensive database that integrates data from four RCTs to explore factors affecting pStage II/III colorectal cancer.
- This database will continue to grow by including additional trial data, facilitating ongoing and future analyses to improve treatment strategies for localized colorectal cancer.
Purpose: This study assessed the feasibility of using three-dimensional (3D) models of intrapelvic vascular patterns constructed using computed tomography (CT) and magnetic resonance imaging (MRI) fusion data for preoperative planning in patients with locally recurrent rectal cancer.
Methods: Eleven patients scheduled for pelvic exenteration were included. The 3D fusion data of the intrapelvic vessels constructed using CT and MRI with true fast imaging with steady-state precession sequence (True FISP) were evaluated preoperatively.
Introduction: Laparoscopic surgery (LAP) is now recognized as the standard procedure for colorectal surgery. However, the standard surgery for ulcerative colitis (UC) is total proctocolectomy with ileal pouch anal anastomosis (IPAA), which may be an overly complex procedure to complete laparoscopically. We conducted this systematic review and meta-analysis to evaluate the efficacy as well as the advantages and disadvantages of LAP-IPAA in patients with UC stratified by the outcome of interest.
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- Subcutaneous emphysema (SCE) occurs frequently in laparoscopic surgeries, affecting about 23.1% of patients, with diagnosis mostly confirmed through X-ray.
- Factors increasing the risk of SCE include being female, older age (≥ 80), low body mass index, lengthy operation times (over 360 minutes), use of robotic surgery, and elevated intraabdominal pressures.
- While SCE can lead to mild complications, careful monitoring during and after surgery is essential to manage potential risks effectively.
Aim: Multidisciplinary management of metastatic colorectal liver metastases (CRLM) is still challenging. To assess postoperative complications in initially unresectable or borderline resectable CRLM, the prospective EORTC-1409 ESSO 01-CLIMB trial capturing 'real-life data' of European centres specialized in liver surgery was initiated.
Material And Methods: A total of 219 patients were registered between May 2015 and January 2019 from 15 centres in nine countries.
Article Synopsis
- The study compared ulcerative colitis (UC) patients who had surgery for cancer/dysplasia with those who had surgery for refractory disease, examining their clinical characteristics and preoperative preparation for surgery.
- Out of 443 UC surgical cases, 188 were for cancer/dysplasia, showing a rising trend (about 40% recently) in such cases; these patients also had longer disease duration and better nutritional status than those with refractory disease.
- Findings revealed that cancer/dysplasia patients had lower severity of inflammation and significantly better nutritional factors, including weight, body mass index, serum albumin level, and prognostic nutrition index, compared to refractory UC patients.
Article Synopsis
- Comprehensive genomic profiling (CGP) has been covered by health insurance since June 2019, but its clinical impact on metastatic colorectal cancer (mCRC) patients is still not well understood, with limited reports on patient outcomes.
- A questionnaire was sent to 51 mCRC patients who received CGP results after April 2021, with 21 patients responding about their satisfaction and the timing of their tests.
- While 66.7% of respondents were satisfied with CGP, half were unaware of it before their doctors discussed it, highlighting the need for better patient education early in the treatment process.
Article Synopsis
- Understanding the branch patterns of internal iliac vessels, particularly veins, is crucial for safely performing minimally-invasive pelvic surgeries.
- A study of 30 patients examined the anatomical variations of these vessels using surgical videos and 3D simulations, focusing on several key arteries and veins.
- Results showed a dominant branch pattern for the internal iliac vein, with high correlation between the arteries and veins, which can improve surgical outcomes and safety in procedures.
Transanal Minimally Invasive Surgical Approach to Total Pelvic Exenteration.
Dis Colon Rectum
September 2023
Article Synopsis
- Total pelvic exenteration is a complex surgical procedure for advanced rectal cancer, and researchers are exploring a new approach using transanal minimally invasive surgery.
- A two-team surgical method combines laparoscopic and transanal techniques to effectively remove pelvic organs while minimizing complications.
- Preliminary results from eight patients show manageable blood loss and operation time, with no severe complications, suggesting this method is a promising alternative for complex cases.
Article Synopsis
- Fluorouracil infusion requires patients with advanced colorectal cancer to self-remove a needle from a central venous port; initial outpatient instructions led to low success rates.
- A study compared results of self-removal instructions given in outpatient settings vs. in-hospital patient wards, finding similar initial success rates but higher overall success in the ward with family involvement.
- Involving patients' families during hospital stays significantly improved needle self-removal rates, especially for elderly patients, suggesting that family support plays a critical role in the process.
Background: The role of recurrence-free survival (RFS) as a valid surrogate endpoint for overall survival (OS) in patients who underwent upfront surgery for colorectal liver metastases remains uncertain. The aim of the study was to compare the two survival measures in a nationwide cohort of upfront resected colorectal liver metastasis.
Methods: Data from patients with colorectal liver metastases without extrahepatic metastases who underwent curative surgery for liver metastases were retrieved from the Japanese nationwide database (data collection 2005-2007 and 2013-2014).
Article Synopsis
- - This study aimed to explore the risk factors for recurrence in colorectal cancer associated with ulcerative colitis (UC-CRC) by analyzing 210 patients over 17 years, focusing on the 144 with stages I to III cancer.
- - The findings revealed an overall recurrence rate of 12.5%, with a 5-year recurrence-free survival rate of 87.5%. Significant risk factors for recurrence included younger age at surgery, undifferentiated carcinoma, lymph node metastasis, and vascular invasion.
- - It was concluded that young adult patients with advanced stage III UC-CRC tend to have a poorer prognosis compared to older adults, highlighting the importance of age as a risk factor in recurrence situations.
Article Synopsis
- The article addresses the need to correct previously published errors related to document identifier DOI: 10.23922/jarc.2022-060.
- It highlights the importance of maintaining accurate and reliable information in academic research.
- The corrections aim to enhance the clarity and validity of the findings presented in the original article.
Total Neoadjuvant Chemotherapy in Rectal Cancer: Current Facts and Future Strategies.
J Anus Rectum Colon
January 2023
Article Synopsis
- Preoperative chemoradiotherapy (CRT) and total mesorectal excision improve local control for locally advanced rectal cancer (LARC), but do not significantly enhance survival due to distant metastasis being the main issue.
- Total neoadjuvant chemotherapy (TNT) is a newer strategy aimed at enhancing treatment effectiveness, showing better outcomes in several studies compared to standard CRT.
- Recent trials like PAPIDO and PRODIGE 23 have significantly demonstrated that TNT improves disease-free survival in LARC patients, highlighting promising advancements in cancer treatment approaches.
Article Synopsis
- Despite standard treatments, over 30% of colorectal cancer patients experience relapse after surgery.
- The GALAXY study analyzed presurgical and postsurgical circulating tumor DNA (ctDNA) in 1,039 patients with stage II-IV resectable colorectal cancer and found that postsurgical ctDNA positivity significantly correlates with higher recurrence risk.
- The findings suggest that ctDNA testing could help identify patients who may benefit from adjuvant chemotherapy after surgery, particularly those with stage II or III disease.