Publications by authors named "Kunisaki Chikara"
Aim: Gastric cancer is one of the leading causes of cancer-related mortalities worldwide. According to the pathological TNM classification, T3N0M0, Stage IIA gastric cancer has been excluded from the S-1 adjuvant chemotherapy trials. Thus, the clinical impact of S-1 adjuvant chemotherapy in patients with pathological T3N0M0 cancer and the associated prognostic factors have not been elucidated.
View Article and Find Full Text PDFBackground: Recent advances in cancer genome analysis and the practice of precision medicine have made it possible to identify fractions with rare genetic alterations. Among biliary tract cancers, EGFR-amplified cancers are known to be rare fractions across organs and have a poor prognosis. The use of anti-EGFR antibody for EGFR-amplified cancers has been promising; however, the evidence is not yet clear.
View Article and Find Full Text PDFBackground/aim: No clear treatment strategy for simultaneously detected liver and lung metastases (SLLM) of colorectal carcinoma has been established, to date. We aimed to identify the prognostic factors for SLLM and propose an appropriate treatment option.
Patients And Methods: This retrospective study included 64 patients with SLLM: 32 underwent pulmonary resection after hepatectomy in 32, while the other 32 underwent hepatectomy alone in 32.
Introduction: Indocyanine green fluorescence imaging (ICG-FI) reduces anastomotic leakage (AL) in rectal cancer surgery. However, no studies investigating risk factors for anastomotic leakage specific to the group using ICG-FI have ever previously been conducted. The purpose of this retrospective multicenter study was to ascertain the risk factors for AL in the group using ICG-FI.
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- A study evaluated the effectiveness and safety of immune-checkpoint inhibitor combination therapy in 71 patients with unresectable or metastatic esophageal cancer from March 2021 to December 2022.
- The therapy showed a 58% response rate in patients with measurable tumors and an 80% disease control rate overall, with some patients undergoing successful surgery afterward.
- Key factors influencing progression-free survival included patients' performance status and C-reactive protein levels, indicating that those with better health and lower inflammation might benefit most from this treatment.
Purpose: This study aimed to determine the clinicopathologic and prognostic significance of squamous cell carcinoma antigen (SCC-Ag) in patients with esophageal SCC who underwent radical surgery without neoadjuvant therapy.
Methods: This study included 566 patients with primary esophageal SCC who underwent radical resection without neoadjuvant therapy at 15 Japanese hospitals between 2008 and 2016. The cutoff value of SCC-Ag was 1.
Epithelial-mesenchymal transition (EMT) is a crucial mechanism that facilitates cancer cell metastasis. Despite its importance, the clinical significance of EMT in gastric cancer (GC) patients has yet to be clearly demonstrated. For gauging the extent of EMT in GC, we employed gene set variation analysis to score 807 patient samples from two large cohorts: TCGA and GSE84437.
View Article and Find Full Text PDF[A Case of Desmoid-Type Fibromatosis of the Mesentery of Small Intestine].
Gan To Kagaku Ryoho
March 2024
Article Synopsis
- Desmoid-type fibromatosis is a rare disease linked to familial adenomatous polyposis and past abdominal surgeries.
- A 43-year-old man experienced abdominal pain, and a CT scan revealed a 4×4×3 cm tumor in his lower abdomen, characterized by spindle-shaped cells.
- After surgery and a follow-up of six months, the patient showed no signs of tumor recurrence.
Purpose: Comprehensive genomic profiling is useful for patients with Thyroid carcinoma (TC) for whom standard treatment has become refractory. We analyzed the clinical and genomic characteristics of patients with TC using the Japanese nationwide Center for Cancer Genomics and Advanced Therapeutics (C-CAT) database.
Methods: This retrospective observational study used the data obtained from the C-CAT database.
Background: Abdominal surgical infectious complications (ASIC) after gastrectomy for gastric cancer impair patients' survival and quality of life. JCOG0912 was conducted to compare laparoscopy-assisted distal gastrectomy with open distal gastrectomy for clinical stage IA or IB gastric cancer. The present study aimed to identify risk factors for ASIC using prospectively collected data.
View Article and Find Full Text PDFAim: We evaluated the safety of robotic surgery for right-sided colon cancer in Japan.
Methods: This was a prospective, open-label, single-arm phase II trial conducted at two institutions. Patients ≥20 years old with stage I-III right-sided colon cancer and scheduled for radical resection with ≥D2 lymph node dissection were eligible.
Article Synopsis
- Ramucirumab combined with paclitaxel is used as second-line chemotherapy for older patients with advanced gastric cancer, but its effectiveness and safety in this demographic were previously unclear.
- In a study involving 25 patients aged 70 and above, treatment led to a high incidence of adverse events (84%), with neutropenia being the most common side effect.
- The chemotherapy resulted in a median progression-free survival of 6.9 months and an overall survival of 13.4 months, showing promising outcomes while highlighting the need for careful patient selection and treatment adjustments due to the side effects.
Background: A previous report confirmed the safety of laparoscopy-assisted total and proximal gastrectomies (LATG and LAPG) (JCOG1401). This report demonstrates the 5-year relapse-free survival (RFS) and overall survival (OS) after long-term follow-up to confirm the efficacy of these surgical methods as key secondary endpoints for cStage I gastric cancer.
Methods: This study enrolled patients who had histologically proven gastric adenocarcinoma and were diagnosed with clinical T1N0, T1N(+), or T2N0 tumors according to the 14th edition of the Japanese Classification of Gastric Carcinoma (3rd English edition).
Article Synopsis
- Endoscopic full-thickness resection (EFTR) is a minimally invasive approach for treating gastrointestinal stromal tumors (GISTs), particularly for gastric tumors, and this study explored a modified technique called endoscopic resection with one-port placement (EROPP).
- The retrospective study included 17 patients who underwent EROPP, involving a specific procedure to excise tumors while maintaining intra-abdominal pressure through a port, allowing for possible conversion to laparoscopic surgery if necessary.
- Results showed that all procedures were successful, with high rates of complete resection and efficient recovery times, indicating EROPP is effective and safe for treating gastric GISTs without the need for more invasive surgery.
Key Clinical Message: A rare missense mutation was identified as a reversion mutation using cancer genomic profiling and a suspected mechanism underlying resistance to olaparib in breast cancer.
Abstract: A 34-year-old woman with breast cancer and : p.Gln3047Ter was treated with olaparib.
Article Synopsis
- The study evaluated the long-term effectiveness of neoadjuvant chemotherapy (NAC) with the DCS regimen in patients with clinical stage III gastric cancer, focusing on relapse-free survival (RFS) and overall survival (OS).
- Results showed 5-year RFS and OS rates of 69.8% and 74.3% respectively, with better outcomes for patients who underwent R0 gastrectomy.
- It was found that poorer immune-nutritional status before and after NAC significantly negatively impacted long-term survival, suggesting the need for a randomized control study to assess immune-nutritional support in conjunction with the DCS treatment.
Article Synopsis
- A retrospective study assessed the safety and short-term outcomes of redo laparoscopic colorectal resection (Re-LCRR) for colorectal cancer using a matched case-control design.
- The study included 29 patients who underwent Re-LCRR, compared to 58 patients who had primary laparoscopic colorectal resection, revealing no significant differences in operative time, blood loss, or complications between the two groups.
- Although the short-term outcomes were similar, the RCRR group had a significantly lower number of harvested lymph nodes, which is important for oncological assessment.
Purpose: The purpose of this study is to evaluate the effect of preoperative endoscopic tattooing using India ink (ETI) on the number of retrieved lymph nodes (LNs) dissected during laparoscopic surgery for stage I right-sided colon cancer (RCC).
Methods: This single-center, retrospective study included stage I RCC patients who underwent laparoscopic surgery between January 2010 and December 2021. The clinicopathological background and number of LNs retrieved were compared between patients managed with and without ETI.
Article Synopsis
- Current evidence is limited regarding laparoscopic gastrectomy's effectiveness in treating locally advanced gastric cancer, particularly with follow-up predominantly around 3 years; more data is needed to confirm its noninferiority.* -
- A randomized trial compared 5-year survival rates between laparoscopy-assisted distal gastrectomy (LADG) and open distal gastrectomy (ODG), involving 502 patients from 37 Japanese institutions, with results assessed via interim and final analyses through various years.* -
- No significant differences in severe postoperative complications were noted between ODG (4.7%) and LADG (3.5%), and the average follow-up duration for patients was about 67.9 months.*
Background: OpClear® is a newly developed laparoscopic lens-cleaning device that can be attached to a laparoscope. The present study determined whether or not the use of a OpClear® reduces the multidimensional surgery-specific workload of the operator during laparoscopic colorectal surgery for colorectal cancer compared with the reference technique (warm saline) by a randomized controlled trial.
Methods: Patients diagnosed with colorectal cancer and scheduled for laparoscopic colorectal surgery were randomly allocated to the warm saline arm or Opclear® arm.
Article Synopsis
- The study investigates the Glasgow Prognostic Score (GPS) and its impact on survival outcomes for patients undergoing liver resection for hepatocellular carcinoma (HCC).
- 480 patients were analyzed, categorized into three GPS groups based on C-reactive protein and serum albumin levels, with results indicating that higher GPS correlates with poorer overall survival (OS) and disease-free survival (DFS).
- The findings suggest that the preoperative GPS is a valuable tool for predicting patient outcomes and recurrence patterns after liver surgery for HCC.
Purpose: The purpose of this study was to clarify the usefulness of indocyanine green fluorescence imaging (ICG-FI) in the assessment of intestinal vascular perfusion in patients who receive intracorporeal anastomosis (IA) in colon cancer surgery.
Methods: This was a single-center, retrospective study using propensity score matching. We compared the surgical outcomes of colon cancer patients who underwent laparoscopic colonic resection with IA or external anastomosis (EA) with the intraoperative evaluation of anastomotic perfusion using ICG-FI from January 2019 to July 2021.
Background: Late complications following gastric cancer surgery, including postgastrectomy syndromes, are complex problems requiring a solution. Reported risk factors for developing late complications include surgery-related factors, such as the surgical approach and the extent of resection and reconstruction. However, this has not been assessed in a prospective study with a large sample size.
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- - The debate over surgeries for proximal gastric cancer continues, with total gastrectomy (TG) as the standard approach, while alternatives like proximal gastrectomy (PG) and subtotal esophagectomy are also used in practice.
- - A study involving 1909 patients examined the types of gastrectomy performed, reconstruction techniques, and factors like stomach size and anti-reflux methods, revealing TG was most common (63.0%), followed by PG (33.4%).
- - Findings suggest that TG remains the preferred choice in Japanese clinical practice, but the size of the remnant stomach and the location of the esophageal stump significantly influence the reconstruction method after PG.