Publications by authors named "Minoru Kitago"

Background/objectives: This study aimed to evaluate the safety, efficacy, and long-term outcomes of S-1-based neoadjuvant chemoradiotherapy (NACRT) in patients with resectable or borderline-resectable pancreatic ductal adenocarcinoma (PDAC).

Methods: This retrospective study included patients with PDAC who underwent S-1-based NACRT at our institute between 2010 and 2017.

Results: Forty patients were included in the study, including 15 (37.

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Background: Vessels encapsulating tumor clusters (VETC) pattern is tumor vasculature of HCC and is a predictor of prognosis and therapeutic efficacy. Recent radiological studies have demonstrated the predictability of VETC from preoperative images, but the mechanisms of image formation are not elucidated. This study aims to determine the relationship between VETC and intratumor heterogeneity in Gd-EOB-DTPA-enhanced magnetic resonance imaging (EOB-MRI) and to provide its pathological evidence.

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Background: The effect of "time to surgery (TTS)" on outcomes for curative-intent hepatectomy of hepatocellular carcinoma (HCC) remains debated. The interaction between tumor burden score (TBS) and TTS remains unclear. We sought to evaluate the effects of TBS and TTS on long-term HCC outcomes.

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Background: Despite recent medical advancements, surgery for hilar cholangiocarcinoma is associated with high complication and mortality rates. This may be partly attributed to the absence of established preoperative liver evaluation criteria for safe surgery. This study aimed to propose a reliable indicator for safe and well-planned management of major hepatectomy with extrahepatic bile duct resection.

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Introduction: There is no consensus on the optimal surveillance interval for patients undergoing resection of colorectal liver metastases (CRLM). We sought to assess the timing and intensity of recurrence following curative-intent resection of CRLM utilizing a recurrence-free survival (RFS) hazard function analysis.

Methods: Patients with CRLM who underwent curative-intent resection were identified from a multi-institutional database.

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Background: Lymph node metastasis (LNM) is among the most important predictors of poor prognosis after surgery for gallbladder cancer (GBC). Traditionally, staging has been based on the raw count of LNM, with a high risk of understaging patients who undergo inadequate lymph node dissection (LND). The log odds of metastatic lymph nodes (LODDS) may represent an alternative staging approach to stratify patients more accurately after resection of GBC.

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Background: The prognostic role of the fibrosis-4 (FIB-4) index relative to intrahepatic cholangiocarcinoma (ICC) after hepatectomy remains unclear. This study sought to characterize the impact of the FIB-4 index and tumor burden score (TBS) on recurrence and overall survival (OS).

Methods: ICC patients undergoing hepatectomy (2000-2020) were identified using a multi-institutional database.

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Article Synopsis
  • The advanced lung cancer inflammation index (ALI) combines inflammation and nutrition data to predict overall survival (OS) in patients with intrahepatic cholangiocarcinoma (ICC) who have undergone surgery.
  • In a study of 1,045 patients, low ALI was found to be an independent risk factor for worse OS, with those having low ALI showing significantly lower 5-year survival rates.
  • ALI performed comparably to other inflammatory markers in predicting survival while demonstrating slightly better model fit and accuracy, indicating the value of integrating nutritional and inflammatory data in prognostic assessments.
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  • A study was conducted to develop a machine learning (ML) model that predicts early extra-hepatic recurrence (EEHR) in patients who had colorectal liver metastasis (CRLM) surgery from 2000 to 2020.
  • The ML model, using eXtreme Gradient Boosting (XGBoost), successfully identified key factors influencing EEHR, achieving a c-index of 0.77, indicating good predictive power.
  • An online risk calculator was created to assist clinicians in evaluating patients' risks of EEHR post-surgery, potentially aiding in better treatment decisions for CRLM patients.*
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Purpose: Immunotherapies have led to a paradigm shift in the treatment of hepatocellular carcinoma (HCC). Studies have revealed the single-cell catalogs of tumor-infiltrating immune cells and the trajectories of their differentiation. Nevertheless, the spatial distribution of these immune cells with distinct phenotypes in the tumor microenvironment and their clinicopathologic significance in resectable and unresectable HCCs are still largely unclear.

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Background: Postoperative complications like remnant hepatic vein (HV) outflow block and liver torsion can occur after right hepatectomy. Hepatic falciform ligament fixation is typically used to prevent liver torsion. We report a novel procedure to manage outflow block.

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Article Synopsis
  • Postoperative pancreatic fistula (POPF) is a common complication after distal pancreatectomy (DP), prompting a study (WRAP study) to assess new prevention strategies during minimally invasive DP (MIDP).
  • The trial involves 172 patients at 14 centers in Japan, randomly assigning them to either a control group or an intervention group that uses polyglycolic acid (PGA) mesh and fibrin glue to reinforce the pancreatic stump.
  • The primary goal is to evaluate whether this reinforcement can reduce the occurrence of clinically relevant POPF, potentially establishing a new best practice in MIDP surgery.
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  • Gallbladder cancer (GBC) typically has a high risk of recurrence and poor outcomes even after surgery aimed at curing it, and the effectiveness of the modified ALBI (mALBI) score in predicting patient prognosis after surgery hadn’t been fully explored.
  • A study examined the mALBI scores of 269 patients who had radical resection for GBC, finding that those with higher mALBI scores (grades 2b/3) had significantly worse 5-year overall survival (OS) and recurrence-free survival (RFS) compared to those with lower scores (grades 1/2a).
  • The mALBI score may serve as a valuable tool for assessing liver function and predicting
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Objective: We sought to identify patients at risk of "futile" surgery for intrahepatic cholangiocarcinoma using an artificial intelligence (AI)-based model based on preoperative variables.

Methods: Intrahepatic cholangiocarcinoma patients who underwent resection between 1990 and 2020 were identified from a multi-institutional database. Futility was defined either as mortality or recurrence within 12 months of surgery.

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Positive peritoneal washing cytology is an indicator of poor prognosis in patients with pancreatic ductal adenocarcinoma (PDAC); however, its sensitivity is relatively low. This study evaluated the performance of peptide nucleic acid (PNA)-directed PCR clamping as a molecular-based peritoneal washing cytology for sensitive detection of KRAS mutation in PDAC. Intraoperative peritoneal washing fluid (IPWF) obtained from patients with PDAC who underwent surgery was analyzed.

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Background And Objectives: Among patients undergoing liver resection for intrahepatic cholangiocarcinoma (ICC), perioperative bleeding requiring blood transfusion is a common complication, yet preoperative identification of patients at risk for transfusion remains challenging. The objective of this study was to develop a preoperative risk score for blood transfusion requirement during surgery for ICC.

Methods: Patients undergoing curative-intent liver surgery for ICC (1990-2020) were identified from a multi-institutional database.

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Article Synopsis
  • Pancreatic ductal adenocarcinoma (PDAC) is a deadly cancer that is hard to diagnose and has a poor outlook, highlighting the need for better biomarkers for diagnosis and prognosis.
  • A study identified extracellular vesicles (EVs) marked by O-glycan-binding lectins (ACA) as a promising diagnostic tool for PDAC, using a system called ExoCounter.
  • Analysis of serum samples from 44 patients showed that an increase in ACA-positive EVs post-surgery was linked to shorter overall survival and recurrence-free survival, making it a potential independent predictor of poor prognosis in PDAC.
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Human pancreatic cancer is characterized by the molecular diversity encompassing native duct-like and squamous cell-like identities, but mechanisms underlying squamous transdifferentiation have remained elusive. To comprehensively capture the molecular diversity of human pancreatic cancer, we here profiled 65 patient-derived pancreatic cancer organoid lines, including six adenosquamous carcinoma lines. H3K27me3-mediated erasure of the ductal lineage specifiers and hijacking of the TP63-driven squamous-cell programme drove squamous-cell commitment, providing survival benefit in a Wnt-deficient environment and hypoxic conditions.

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Hepatocellular carcinoma (HCC) in the caudate lobe presents surgical challenges due to the lack of distinct anatomical landmarks. This case report introduces a novel surgical approach combining Takasaki's classification and indocyanine green negative counterstaining for precise anatomical caudate lobectomy. A 78-year-old patient with hepatocellular carcinoma in the caudate lobe underwent surgery following preoperative volumetric assessment.

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Article Synopsis
  • Elevated platelet counts in patients undergoing liver surgery for intrahepatic cholangiocarcinoma (ICC) can indicate more severe disease and poor outcomes.
  • A study of 825 patients revealed that those with high platelet counts (>300 *10/L) had worse cancer-specific survival (CSS) and overall survival (OS) compared to those with lower counts.
  • High platelet count remained an independent predictor of worse outcomes even after accounting for other clinical factors, suggesting it may help in preoperative risk assessment for surgery.
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Background: We sought to assess the impact of various perioperative factors on the risk of severe complications and post-surgical mortality using a novel maching learning technique.

Methods: Data on patients undergoing resection for HCC were obtained from an international, multi-institutional database between 2000 and 2020. Gradient boosted trees were utilized to construct predictive models.

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Patients with pancreatic neuroendocrine tumors (pNETs) have limited access to effective targeted agents and invariably succumb to progressive disease. MUC1-C is a druggable oncogenic protein linked to driving pan-cancers. There is no known involvement of MUC1-C in pNET progression.

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