Publications by authors named "Shinno N"
Aim: To compare minimally invasive and open surgery for older patients with gastric cancer.
Methods: This study included 464 consecutive patients with gastric cancer aged ≥75 years who underwent open or laparoscopic gastrectomy at our institution from January 2004 to December 2018. We performed propensity score-matching and compared short- and long-term outcomes between the two groups.
Background And Study Aims: Diffuse infiltrative gastric cancer can be difficult to diagnose owing to a lack of endoscopic features in the superficial mucosa. Moreover, a forceps biopsy may not reveal a pathological diagnosis. We aimed to evaluate the diagnostic yield and safety of endoscopic mucosal resection (EMR) and 'open-lid submucosal biopsy', a technique wherein EMR followed by biopsy of the ulcer floor is performed for a pathological diagnosis.
View Article and Find Full Text PDFBackground: Laparoscopic surgery for gastric cancer has become widely used; minimally invasive surgery has become the mainstream of treatment. This randomized controlled trial (RCT) aimed to compare long-term quality of life (QoL) and weight loss rates in patients who underwent single-port laparoscopic gastrectomy (SLG) or multi-port laparoscopic gastrectomy (MLG) for gastric cancer.
Methods: This single-center RCT compared MLG and SLG in patients with clinical stage I gastric cancer, all of which underwent distal gastrectomy between April 2016 and September 2018.
Article Synopsis
- The study explores the importance of the lymph node ratio (LNR) in determining prognosis for patients with ampullary cancer who underwent surgical treatment between 1980 and 2018.
- Analysis of data from 106 patients revealed that higher LNR values correlated with worse outcomes, specifically linking a higher LNR to increased recurrence and lower survival rates.
- Findings suggest that LNR, particularly with an identified cut-off value of 0.07, serves as a critical independent prognostic marker for recurrence and survival in ampullary cancer patients.
Article Synopsis
- The study examined changes in body composition after esophagectomy in esophageal cancer patients, focusing on weight, muscle mass, and fat mass over time.
- It involved 528 patients, measuring their body composition before and at various points after the surgery, with significant findings at 3 months post-op.
- Results showed that significant losses in skeletal muscle mass and body fat correlated with poorer overall and recurrence-free survival, indicating these changes could be important for patient prognosis.
Article Synopsis
- Identifying patients who won't benefit from invasive pancreatic cancer surgery is important to preserve quality of life, especially after neoadjuvant therapy for resectable cases.
- The study analyzed 609 patients, categorizing them into poor-prognosis (those with rapid recurrence or no surgery) and good-prognosis groups (those without recurrence or longer recurrence intervals).
- Key findings showed that elevated levels of carbohydrate antigen 19-9 (specifically >200 U/mL) after treatment were strongly linked to poor survival rates, indicating that patients with such levels should avoid radical surgery due to low chances of benefit.
Article Synopsis
- The study investigates the importance of reinforcing the duodenal stump to prevent leakage after radical gastrectomy in gastric cancer patients, as the effectiveness of different reinforcement methods was not well understood.
- Conducted across 57 medical centers in Japan, the research analyzed data from over 16,000 patients from 2012 to 2021 and found that 0.93% experienced duodenal stump leakage, with lower incidence rates linked to reinforcement methods like seromuscular sutures and reinforced staplers.
- Results highlighted that duodenal stump reinforcement is crucial, as leakage rates were lower in higher-volume hospitals and specific patient demographics were identified as risk factors for leakage-related mortality.
Pembrolizumab plus chemotherapy has been indicated as the first-line treatment for metastatic or unresectable locally advanced esophageal cancer. However, pretreatment biomarkers for predicting clinical outcomes remain unclear. We investigated the predictive value of inflammation-based prognostic scores in patients treated with pembrolizumab and chemotherapy.
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- * A study involving 488 patients with esophageal squamous cell carcinoma found that factors like tumor depth, nodal status, and lymphovascular (LV) invasion significantly affect overall survival, with nodal status and LV invasion being strong independent predictors.
- * The research suggests using both nodal status and LV invasion to better guide treatment decisions for adjuvant therapy, as patients with LV invasion showed poorer outcomes across various nodal stages.
Introduction: The prognostic nutritional index (PNI) and D-dimer level are two useful measures for gastric cancer prognosis. As they each comprise different factors, it is possible to employ a more useful combined indicator. This study therefore aimed to establish a PNI-D score - which combines the PNI and D-dimer level - and validate its usefulness as a prognostic marker.
View Article and Find Full Text PDFBackground/aim: CheckMate 577 evaluated adjuvant nivolumab therapy after neoadjuvant chemoradiotherapy and surgery for esophageal cancers. However, the efficacy of this treatment in patients who received neoadjuvant chemotherapy remains unknown. This study investigated the short-term outcomes of adjuvant nivolumab therapy in patients with advanced esophageal squamous cell carcinoma post-neoadjuvant chemotherapy.
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- The study focuses on the high mortality rates of metastatic or unresectable locally advanced oesophageal cancer and looks into the effectiveness of pembrolizumab plus chemotherapy as the first-line treatment.
- Researchers measured early tumour shrinkage (ETS) and depth of response (DpR) in 53 patients to assess treatment efficacy, with specific cut-off values determined for these metrics.
- Results indicated that patients with an ETS of 20% or more had significantly better progression-free and overall survival rates, suggesting ETS could be a valuable early marker for treatment sensitivity.
Brain metastases develop in 0.5-0.7% of patients with gastric/gastroesophageal junction (G/GEJ) cancer.
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- - The study assessed preoperative sarcopenia in 115 elderly patients with esophageal cancer by measuring muscle mass, strength, and physical function to understand its impact on patient outcomes.
- - Out of the participants, 20% were diagnosed with sarcopenia, which was linked to older age and more advanced cancer stages, while slow gait speed was associated with higher risk of serious postoperative complications.
- - Patients with preoperative sarcopenia had significantly worse overall survival than those without, suggesting that a comprehensive assessment of muscle health might be important in predicting cancer prognosis.
Introduction: Curative esophagectomy is not always possible in patients with locally advanced esophageal cancer. However, few studies have investigated patients who underwent non-curative surgery with intraoperative judgment. This study aimed to investigate patient characteristics and clinical outcomes for patients undergoing non-curative surgery and compare them between non-resectional and non-radical surgery.
View Article and Find Full Text PDFBackground/aim: The Japanese Gastric Cancer Treatment Guidelines recommend doublet chemotherapy (S-1 plus another chemotherapy) over S-1 alone for patients with pStage III gastric cancer who underwent radical gastrectomy. However, no consensus exists on adjuvant regimens for patients with pStage III gastric cancer. Therefore, we conducted a comparative study to evaluate the tolerability, safety, and survival outcomes of docetaxel plus S-1 (DS) and S-1 plus oxaliplatin (SOX) therapies as adjuvant chemotherapy for patients with pStage III gastric cancer.
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- The study assessed the impact of a new Enhanced Recovery After Surgery (ERAS) program on patients with thoracic esophageal cancer, focusing on postoperative outcomes and body composition.
- The new program resulted in reduced hospital stay, fewer complications, and improved body weight and composition at discharge compared to the old program.
- Factors like age and male sex were identified as independent risks for non-compliance with the new program, suggesting tailored ERAS approaches for older patients may enhance recovery outcomes.
Article Synopsis
- The study aimed to examine long-term changes in bone mineral density (BMD) in esophageal cancer patients after esophagectomy and identify factors influencing postoperative osteoporosis and survival outcomes.
- Results showed a consistent annual decrease in BMD over five years, with a significant rise in osteoporosis rates post-surgery, particularly in older patients and those with a history of smoking.
- The research concluded that esophageal cancer survivors have an increased risk of developing osteoporosis after surgery, and preoperative osteoporosis may negatively impact their prognosis.
The anastomotic technique after esophagectomy is of great interest in the prevention of anastomotic complications that adversely affect postoperative recovery. This study aimed to compare the clinical outcomes of modified Collard (MC) and circular stapled (CS) anastomoses after esophagectomy. A total of 504 consecutive patients with thoracic esophageal cancer who underwent esophagectomy and cervical esophagogastric CS or MC anastomosis from January 2013 to December 2019 were enrolled.
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- The study examines the prognostic significance of tumor deposits in gastric cancer by analyzing data from 1012 patients who underwent surgery at the Osaka International Cancer Institute from 2010 to 2017.
- Findings reveal that only 6.3% of patients had tumor deposits, which were linked to various clinical factors and resulted in significantly lower 5-year disease-free (32.60% vs. 92.45%) and overall survival rates (41.22% vs. 89.37%) compared to those without deposits.
- The research concludes that tumor deposits are independent predictors of tumor recurrence and poor survival, showing outcomes comparable to more advanced cancer stages.
The gastrointestinal stromal tumor(GIST)guidelines state that the use of neoadjuvant chemotherapy(NAC)for curable GIST is not apparent. However, NAC is performed for massive rectal GIST at our hospital to reduce surgical invasion and improve surgical results. The cases were a 39-year-old man, a 48-year-old man, and a 78-year-old man.
View Article and Find Full Text PDFBackground: Duke pancreatic mono-clonal antigen type 2 (DUPAN-II) is a famous tumour maker for pancreatic cancer (PC) as well as carbohydrate antigen 19-9 (CA19-9). We evaluated the clinical implications of DUPAN-II levels as a biological indicator for PC during preoperative chemoradiation therapy (CRT).
Methods: This retrospective analysis included data from 221 consecutive patients with resectable and borderline resectable PC at diagnosis who underwent preoperative CRT between 2008 and 2017.
Pulmonary tumor thrombotic microangiopathy is a rare and fatal complication of cancer that features widespread tumor cell-derived embolisms in the small arteries and arterioles of the lung and is often associated with thrombus formation. We describe the case of a 43-year-old woman who was hospitalized with cough and respiratory distress that lasted for 2 months. Computed tomography findings demonstrated multiple areas of interlobular septal thickening and ground-glass opacities in both lungs.
View Article and Find Full Text PDFBackground: Surgical site infections are common after pancreaticoduodenectomy. Our institution routinely performs intraoperative bile culture with pancreaticoduodenectomy. Herein we examined whether antibiotic selection based on bile culture analysis reduced the surgical site infection risk after pancreaticoduodenectomy.
View Article and Find Full Text PDFPurpose: The incidence of adenocarcinoma of the esophagogastric junction (AEG) and proximal gastric cancer (PGC) is rising worldwide. Recently, the use of indocyanine green (ICG) tracer-guided surgery has been reported; however, its efficacy for total/proximal gastrectomy has not been clarified. We evaluated the feasibility and safety of ICG fluorescent marking for tumor localization in AEG/PGC treatment by laparoscopic surgery.
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