Publications by authors named "Shunsuke Doi"
Prognostic significance of creatine kinase in resected pancreatic cancer.
J Hepatobiliary Pancreat Sci
December 2024
Background: Creatine kinase (CK) levels decrease with cancer progression and muscle wasting, but its association with pancreatic ductal adenocarcinoma (PDAC) remains unclear. The aim of this study was to investigate CK as a prognostic biomarker and surrogate marker for muscle mass in patients with PDAC.
Methods: A retrospective analysis of 476 patients with PDAC was conducted.
Background: CD200, a negative regulator of T cells as well as a marker for cancer stem cells, represents a significant prognostic factor and potential therapeutic target in certain cancers. However, its clinical significance remains unknown in pancreatic ductal adenocarcinoma (PDAC).
Methods: CD200 was assessed in 220 resected PDAC patients who underwent surgery with or without neoadjuvant chemoradiotherapy (NACRT).
Article Synopsis
- The study investigates persistent acute kidney injury (AKI) in patients who undergo liver resection, focusing on identifying risk factors and its impacts on post-surgery recovery and long-term kidney health.
- Results showed that patients with persistent AKI experienced worse postoperative outcomes, such as higher rates of complications, longer hospital stays, and lower survival rates, especially in those with hepatocellular carcinoma (HCC).
- The research highlights that chronic kidney disease, high albumin-bilirubin grade, and anatomical resection are key predictors of persistent AKI, emphasizing the need for strategies to prevent this condition to enhance recovery and survival rates in these patients.
Article Synopsis
- Hepatocellular carcinoma (HCC) patients outside the Milan criteria who undergo liver surgery experience high rates of very early recurrence (VER) and poor outcomes, prompting this study to investigate predictive factors, including the CALLY index.
- The study analyzed patients who had liver resection for HCC beyond Milan criteria from 2000 to 2021, comparing those with VER (recurrence within 6 months) to those who recurred later or not at all, identifying key risk factors.
- Findings revealed that high alpha-fetoprotein levels, non-simple nodule types, and lower CALLY index significantly predicted poorer survival rates, indicating that patients with multiple risk factors may benefit from more aggressive treatment options.
Background: PDAC cells upregulate carbonic anhydrase 9 (CA9) expression in order to survive in hypoxic tumor environments, which plays a key role in tumor progression. However, the relationship between CA9 expression and preoperative treatment has not been clarified. We evaluated the clinical impact of CA9 expression on the efficacy of neoadjuvant chemoradiotherapy (NACRT) in pancreatic ductal adenocarcinoma (PDAC).
View Article and Find Full Text PDFBackground: Hyperglycemia is involved in malignant transformation of pancreatic cancer via the hexosamine biosynthetic pathway (HBP). However, few studies have verified this mechanism based on clinical data. This study investigated the complementary effects of hyperglycemia and HBP on pancreatic cancer prognosis using detailed clinical data.
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- The study evaluates the safety and effectiveness of Cell-free and concentrated ascites reinfusion therapy (CART) for patients with advanced pancreatic cancer experiencing malignant ascites.
- Analysis was conducted on 47 procedures involving 29 patients, revealing a 19% rate of adverse events, with only minor complications and no severe or lethal cases.
- Findings indicate that CART may enhance the efficacy of chemotherapy, leading to a significantly longer median survival time in patients receiving chemotherapy compared to those receiving only palliative care.
Background: Ehlers-Danlos syndrome (EDS) is a genetic disorder that causes fragility of the systemic connective tissues. Of the 13 subtypes, vascular EDS (vEDS) is associated with abnormalities in collagen production, resulting in arterial rupture and intestinal perforation. Herein, we report the case of a man with confirmed vEDS who survived a ruptured dissected splenic artery aneurysm triggered by perforation of the sigmoid colon.
View Article and Find Full Text PDFAim: This study aimed to evaluate the prognostic impact of total neoadjuvant therapy (TNT) for borderline resectable pancreatic cancer with arterial involvement (BR-A) pancreatic cancer.
Methods: We analyzed 81 patients initially diagnosed as BR-A who received initial treatments between 2007 and 2021. Among them, 18 patients who received upfront surgery were classified as the UFS group, while 30 patients who were treated with neoadjuvant chemoradiotherapy were classified as the NACRT group.
Background: When administering an infusion to a patient, it is necessary to verify that the infusion pump settings are in accordance with the injection orders provided by the physician. However, the infusion rate entered into the infusion pump by the health care provider cannot be automatically reconciled with the injection order information entered into the electronic medical records (EMRs). This is because of the difficulty in linking the infusion rate entered into the infusion pump by the health care provider with the injection order information entered into the EMRs.
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- - This study explored how sarcopenia, a condition characterized by loss of muscle mass, affects the long-term outcomes of patients with early-stage intrahepatic recurrent hepatocellular carcinoma (HCC) after treatments like surgery or radiofrequency ablation.
- - Results showed that patients with sarcopenia had significantly lower overall survival and recurrence-free survival rates compared to those without sarcopenia, making it a critical independent prognostic factor.
- - The research also found that patients with sarcopenia had reduced levels of important immune cells, suggesting that weakened immune response may contribute to their poor outcomes regardless of treatment type.
Article Synopsis
- The study investigates early recurrence in patients with resectable pancreatic cancer who underwent neoadjuvant chemoradiotherapy and pancreatectomy from January 2009 to June 2021.
- Out of 203 patients, 22 had early recurrence (within 6 months of surgery), with these patients showing significantly lower median survival rates compared to those with late recurrence or no recurrence.
- High carbohydrate antigen 19-9 levels (>100 units/mL) and T status (≥T2) were identified as independent predictors of early recurrence, suggesting the need for stronger preoperative treatment for at-risk patients.
Article Synopsis
- - The study investigated how prolonged intermittent Pringle maneuver (IPM) affects post-hepatectomy liver failure (PHLF) in patients who had either open or laparoscopic liver surgery, involving 546 patients in total.
- - Results showed that in patients undergoing open surgery, the risk of PHLF increased with Pringle times over 120 minutes; however, laparoscopic surgery did not show a significant risk of PHLF related to Pringle times.
- - The findings suggest that laparoscopic hepatectomy has a lower rate of PHLF even with longer IPM durations compared to open hepatectomy, indicating a potential benefit for laparoscopic procedures.
Article Synopsis
- Pancreatic lipomas (PLs) are rare tumors arising from fat tissue in the pancreas, and this is the first reported case of a pancreatic ductal adenocarcinoma (PDAC) coexisting with a PL.
- The 69-year-old male patient, who had a 12 cm PL diagnosed 12 years prior, experienced complications related to liver damage and elevated inflammatory markers, leading to a differential diagnosis that included various types of pancreatic tumors.
- After treatment and surgery, histological analysis confirmed that the patient had PDAC complicated by chronic pancreatitis, while the lipoma was identified as benign and not indicative of liposarcoma.
Background: This study aimed to evaluate the significance of multiple tumor markers (TMs) measurements in determining the indications for conversion surgery (CS) in the management of unresectable locally advanced pancreatic cancer (UR-LAPC).
Methods: A total of 103 patients with UR-LAPC, treated between 2008 and June 2021, were enrolled in this study. Three TMs, including carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), and Duke pancreatic monoclonal antigen type 2 (DUPAN-2), were measured.
Aim: To investigate the impact of the COVID-19 pandemic and its preventive measures on the glycemic and lipid control in people with diabetes mellitus (DM).
Materials And Methods: We conducted this retrospective cohort study from April 2019 to March 2021; we termed the period from April 2019 to March 2020 as the pre-COVID-19 period, and the period from April 2020 to March 2021 as the COVID-19 period, and divided each of these two periods into four quarters.
Results: In the 1st quarter of the COVID period, when the Japanese government declared the first public health emergency, 3,465 people with diabetes mellitus were receiving treatment, which was 10.
Article Synopsis
- The study aimed to establish effective biomarkers for monitoring the treatment of pancreatic ductal adenocarcinoma (PDAC) by evaluating the combined use of three tumor markers: CA19-9, CEA, and DUPAN-2.
- Researchers analyzed the impact of these markers on overall survival (OS) and recurrence-free survival (RFS) in two patient groups: those undergoing upfront surgery and those receiving neoadjuvant chemoradiation.
- Findings indicated that patients with elevated levels of these markers had significantly worse prognoses, suggesting that combining these tumor markers could serve as essential prognostic tools for better treatment strategies in PDAC patients.*
Purpose: We investigated the detailed recurrent sites after wedge liver resection for primary hepatocellular carcinoma (HCC).
Methods: We retrospectively reviewed 278 patients with primary HCC who underwent curative liver resection between 2000 and 2016. Recurrent sites were divided into four groups: around the initial HCC (segmental recurrence), within the same section as the primary HCC (sectional recurrence), within the same lobe as the primary HCC (lobar recurrence), and contralateral or extrahepatic recurrence (extra recurrence).
Article Synopsis
- Organ/space surgical site infections (SSIs) are common complications after liver surgery, affecting patient recovery and mortality, hence identifying high-risk patients early is crucial.
- This study analyzed hospital records of patients who had liver surgeries between 2008 and 2015 to see if pre- and postoperative C-reactive protein (CRP) levels could predict SSIs.
- Results showed that higher preoperative CRP levels and a significant increase in CRP from postoperative day 3 to 5 were linked to a greater risk of SSIs, with specific factors like bile leakage and preoperative cholangitis playing important roles.
Aims/introduction: To evaluate the impact of the COVID-19 pandemic on the glycemic control, eating habits, and body composition of people with diabetes mellitus; to identify the determinants of worsening glycemic control in people with diabetes mellitus.
Materials And Methods: This retrospective, longitudinal observational study was performed in outpatients with diabetes mellitus who visited our hospital between April 2019 and March 2020 (pre-COVID-19 period) and continued for follow up from April 2020 to March 2021 (COVID-19 period). We compared the glycemic control, nutritional intakes, and body composition of people with diabetes mellitus between the two periods.
Background: Splenic artery aneurysms usually rupture into the free peritoneal space and rarely into the gastrointestinal tract. We report the case of a patient with a giant splenic artery aneurysm that ruptured in to the stomach with hemorrhagic shock and was successfully treated with emergency surgery.
Case Presentation: A 59-year-old man presented to the emergency department with chest pain and syncope.
Background: Late-onset biliary complications (LBC) after pancreatoduodenectomy (PD) can be serious. This study aimed to clarify the frequency and risk factors of severe LBC after PD.
Methods: We defined LBC as biliary complications occurring 3 months after PD and severe LBC as cases that required intensive care.
Article Synopsis
- The study investigates how laparoscopic liver resection (LLR) and open liver resection (OLR) affect liver regeneration after surgery for liver cancers.
- It included 72 patients, comparing regeneration and recovery rates between LLR (29 patients) and OLR (43 patients) groups over 1 and 6 months post-surgery.
- The results show that both types of surgery led to similar liver regeneration and recovery rates, indicating the surgical method does not significantly influence liver healing.
Article Synopsis
- Patients with lung metastases from pancreatic cancer show a better prognosis compared to those with metastases in other organs, prompting an in-depth study of the immune characteristics of this subgroup.
- The analysis involved immunohistochemistry on various tumor samples, revealing a significant increase in immune cells like CD4+ and CD8+ in lung metastases compared to peritoneal and liver metastases.
- The findings indicate that lung metastases exhibit a more favorable immune environment, suggesting that these patients may benefit from targeted immunotherapy, particularly immune checkpoint inhibitors.