Publications by authors named "Ryohei Kawabata"

Background: The prognosis of advanced gastric cancer (GC) with extensive lymph node (LN) metastasis treated with surgery alone remains poor. We conducted a multicenter phase II study to evaluate the efficacy and safety of perioperative capecitabine plus oxaliplatin (CapeOx) therapy in patients with advanced GC with extensive LN metastases.

Patients And Methods: Patients with histologically proven HER2-negative or unknown gastric adenocarcinoma with paraaortic LN (PALN) metastases and/or bulky LN metastases located at the celiac axis, common hepatic artery, and/or splenic artery were included in the study.

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Objective: Potential benefit of surgical resection for liver metastasis from gastric cancer (LMGC) remains controversial because most previous studies were retrospective. We evaluated the outcomes of surgical resection following chemotherapy for LMGC in a prospective single-arm multicenter interventional study.

Methods: Patients with synchronous or metachronous LMGC received 2-4 cycles of standard chemotherapy and proceeded to surgical resection if restaging showed a non-progressive disease with a chance of R0 resection.

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Article Synopsis
  • Robotic distal gastrectomy (RDG) with Billroth I (BI) reconstruction is enhanced by the Intracorporeal Triangular Anastomotic Technique (INTACT), which aims to minimize ischemic areas and improve surgical consistency and safety.
  • The surgical process involves precise dissection and anastomosis techniques using robotic arms to ensure a stable and effective reconstruction.
  • In a study of 81 patients, the procedure showed promising results with no significant complications, including no blood loss and a median hospital stay of 8 days, highlighting the technique's effectiveness and reliability.
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Background: Weight loss (WL) after gastrectomy for gastric cancer is associated with both decreased compliance with adjuvant chemotherapy and impaired survival. This study examined the effects of administering oral nutritional supplements (ONS) for 3 months after gastrectomy in terms of compliance with adjuvant chemotherapy and survival outcomes.

Methods: This large-scale, multicenter, open-label, randomized controlled trial enrolled 1,003 gastric cancer patients undergoing curative gastrectomy.

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Background: As the prevalence of gastric cancer rises in aging populations, managing surgical risks and comorbidities in elderly patients presents a unique challenge. The Comprehensive Preoperative Assessment and Support (CPAS) program, through comprehensive preoperative assessments, aims to mitigate surgical stress and improve outcomes by enhancing patient awareness and preparation. This study investigates the efficacy of a CPAS program, incorporating frailty and sarcopenia evaluations, to improve short-term outcomes in elderly gastric cancer patients.

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Background: This prospective observational study evaluated the real-world effectiveness of nivolumab monotherapy in previously treated advanced gastric cancer (GC). A preplanned 2-year final analysis was performed to confirm survival and tumor behavior with nivolumab monotherapy.

Patients And Methods: The primary endpoint was overall survival (OS).

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Background: Occupational cholangiocarcinoma is associated with exposure to organic solvents, such as dichloromethane (DCM) and 1,2-dichloropropane (DCP). This report describes a case of occupational cholangiocarcinoma detected through regularly imaging following the discovery of elevated serum γ-glutamyl trans peptidase (γ-GTP) levels revealed during regular checkup.

Case Presentation: A 43-year-old man who had been working in a printing company with 15 years of exposure to organic solvents presented to our hospital owing to abnormalities found during a routine checkup.

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Purpose: The NY-ESO-1 antigen is highly immunogenic and often spontaneously induces an immune response in patients with cancer. We conducted a large-scale multicenter cohort study to investigate the utility of serum NY-ESO-1 and p53 antibodies as predictive markers for the postoperative recurrence of gastric cancer. Here, we examined the usefulness of pre-treatment NY-ESO-1 and p53 antibodies as tumor markers for the diagnosis of gastric cancer in combination with carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9).

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Background: The increasing incidence of gastric cancer in the elderly underscores the need for an in-depth understanding of the challenges and risks associated with surgical interventions in this demographic. This study aims to investigate the risk factors and prognostic indicators for non-cancer-related mortality following curative surgery in elderly gastric cancer patients.

Methods: This retrospective analysis examined 684 patients with pathological Stage I-III gastric cancer who underwent curative resection between January 2012 and December 2021.

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Background: No reliable marker has been identified to predict postoperative recurrence of gastric cancer. We designed a clinical trial to investigate the utility of serum NY-ESO-1 antibody responses as a predictive marker for postoperative recurrence in gastric cancer.

Methods: A multicenter prospective study was conducted between 2012 and 2021.

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A 51-year-old woman presented to our hospital complaining of a lower abdominal mass and dysuria. She was diagnosed with advanced sigmoid colon cancer. The tumor was large, involving the bladder, and occupying the pelvic cavity.

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Aim: To compare the effects of open (OG) and laparoscopic gastrectomy (LG) on body composition and muscle strength.

Methods: This study performed a propensity score matching analysis using cases from a large-scale, multicenter, phase III randomized controlled trial concerning oral nutritional supplements after gastrectomy and analyzed both the whole and matched cohorts. Measurements of body composition and hand grip strength (HGS) were performed at baseline (preoperatively) and at 1, 2, 3, 6, and 12 months after gastrectomy.

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Article Synopsis
  • A study assessed the impact of a daily elemental diet (ED) on skeletal muscle mass loss in gastric cancer patients after surgery, following previous findings that it reduced body weight loss postoperatively.
  • The analysis utilized data from patients undergoing total or distal gastrectomy and compared changes in skeletal muscle mass index (%SMI) between those on the ED and control groups one year later.
  • Results showed that while the ED group had a lower median %SMI loss than the control group, the difference was not statistically significant, indicating no clear benefit of the diet in preventing muscle loss post-gastrectomy.
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Background: Although there is insufficient evidence for the treatment of older patients with advanced gastric cancer, fluorouracil combined with platinum chemotherapy has been recognized as a standard first-line treatment for such populations in Japan despite the lack of efficacy and toxicity data.

Methods: Patients aged 75 years or older with advanced gastric cancer were enrolled. S-1 plus docetaxel (docetaxel: 40 mg/m, day 1; S-1: 80 mg/m, days 1-14; q21 days) was repeated every 3 weeks.

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Malignant peripheral nerve sheath tumours (MPNSTs) are malignant tumours arising from a peripheral nerve or displaying nerve sheath differentiation. Most MPNSTs are found on the head, body trunk and extremities, whereas cases in the gastrointestinal are extremely rare. About half arise in neurofibromatosis type 1 patients and 10% arise post-irradiation.

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Intrahepatic splenosis (IHS) is a rare disease that is considered to result from heterotopic autotransplantation or implantation of splenic tissue after splenic trauma or surgery. A 46-year-old man with a treatment history of a left lateral liver segmentectomy and splenectomy for a road traffic injury 30 years earlier presented to Sakai City Medical Center (Sakai, Japan) with acute abdominal pain in November 2019. Physical examination showed no significant signs, and serum data were normal.

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Article Synopsis
  • A study was conducted to evaluate the effectiveness and safety of Capecitabine plus oxaliplatin (CapeOX) as a first-line treatment for advanced gastric cancer in patients aged 70 years and older.
  • The trial included 108 chemotherapy-naive patients, who were given either the original or reduced doses of CapeOX, with overall survival (OS) being the primary measurement.
  • Results showed a median OS of 12.9 months, with some patients experiencing significant side effects, mainly neutropenia and anemia, indicating that CapeOX is a viable treatment option for older patients with advanced gastric cancer.
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  • Adjuvant S-1 monotherapy is the standard post-surgery treatment for stage II gastric cancer in Japan, but its effectiveness for MSI-H tumors was previously unclear.
  • A study analyzed 184 out of 208 stage II gastric cancer patients treated with S-1 after surgery, finding that 13% had microsatellite instability-high (MSI-H) tumors.
  • While survival rates didn't significantly differ, MSI-H patients showed slightly better relapse-free and overall survival rates, suggesting different recurrence mechanisms between MSI-H and microsatellite-stable (MSS) tumors.
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Background: This study investigated whether schedule modification of bi-weekly nanoparticle albumin-bound paclitaxel (nab-PTX) plus ramucirumab (RAM) is efficacious against gastric cancer (GC) or gastroesophageal junction cancer (GJC).

Patients And Methods: Patients with unresectable GC or GJC who were previously treated with fluoropyrimidine-containing regimens received nab-PTX (100 mg/m) on days 1, 8, and 15 and RAM (8 mg/kg) on days 1 and 15 of a 28-day cycle. Based on the incidence of severe adverse events (AEs) during the first cycle, patients were modified to bi-weekly therapy from the second cycle.

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Background: The Cancer-VTE Registry was a large-scale, multicenter, prospective registry designed to investigate real-world data on venous thromboembolism (VTE) incidence and risk factors in adult Japanese patients with solid tumors. This pre-specified subgroup analysis aimed to estimate the incidence of VTE, including VTE types other than symptomatic VTE, and identify risk factors of VTE in stomach cancer from the Cancer-VTE Registry.

Methods: Stage II-IV stomach cancer patients who planned to initiate cancer therapy and underwent VTE screening within 2 months before registration were enrolled.

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Background: The clinical value of soluble forms of programmed cell death-1 (sPD-1), PD ligand 1 (sPD-L1) and cytotoxic T lymphocyte-associated protein-4 (sCTLA-4) for gastric cancer (GC) patients treated with nivolumab monotherapy has remained unknown.

Methods: Blood samples collected before nivolumab treatment from 439 GC patients enrolled in the DELIVER (Japan Clinical Cancer Research Organisation GC-08) trial were analysed for sPD-1, sPD-L1 and sCTLA-4. Corresponding baseline clinical data were also retrieved.

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Article Synopsis
  • Surgeons face challenges in optimal resection and reconstruction methods during laparoscopic gastrectomy for gastric cancer, particularly in the upper and middle stomach areas; the use of indocyanine green (ICG) marking and Billroth I (B-I) reconstruction can help.
  • A case involving a 51-year-old man with a clinical diagnosis of stage IA gastric cancer underwent laparoscopic distal gastrectomy, utilizing ICG fluorescence to accurately locate the tumor and preserve as much gastric function as possible.
  • The study concludes that the methods employed (ICG marking and gastric rotation) could expand the options for laparoscopic surgery in early-stage gastric cancer cases, potentially improving patient outcomes.
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We report a hepatocellular carcinoma(HCC)case with lung metastasis that was successfully treated with transarterial chemoembolization(TACE)and percutaneous radiofrequency ablation(RFA). A man in his 60s took right robe liver resection for HCC after TACE for its rupture. Lung metastasis occurred at S1+2 and S6 in the left lung, and an adverse event interrupted standard molecular target therapies.

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We present a case of a 72-year-old man diagnosed with rectal cancer invading the urinary bladder/prostate. Preoperative chemoradiotherapy substantially reduced the tumor size. In collaboration with urologists, robot-assisted low anterior resection with total cystectomy was performed using the da Vinci Xi system.

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