Publications by authors named "Toru Beppu"
: Preoperative recurrence risk stratification for colorectal liver metastases (CRLM) undergoing hepatectomy is essential when designing a treatment strategy. We developed a Beppu classification system consisting of three risk groups and found that the mutation increased risk in low- and moderate-risk patients. : A total of 173 patients undergoing initial hepatectomy for CRLM between 2004 and 2020 were analyzed.
View Article and Find Full Text PDFThermal ablation has been widely used for patients with small colorectal liver metastases (CRLMs), even for resectable cases; however, solid evidence has been scarce. Some propensity-score matching studies using patients with balanced baseline characteristics have confirmed less invasiveness and the comparable survival benefits of thermal ablation to liver resection. A more recent pivotal randomized controlled trial comparing thermal ablation and liver resection was presented during the American Society of Clinical Oncology 2024 meeting.
View Article and Find Full Text PDFBackground/aim: Enlarged polypoid gallbladder lesions should first be evaluated to rule out gallbladder cancer. Gallbladder lymphoma rarely develops, and gallbladder follicular lymphoma is seldom observed.
Case Report: The case of a 70-year-old man with an enlarged polypoid gallbladder lesion and stable-sized multiple enlarged mesenteric lymph nodes is reported.
Partial splenic embolization (PSE) has developed as an alternative to surgical splenectomy, mainly to improve hypersplenism and esophagogastric varices in cirrhotic patients. We proposed the novel concept that splenic infarction volume, rather than the splenic infarction ratio, is essential for patients receiving PSE. A splenic infarction volume between 388 and 540 mL is suitable for a sufficient increase in platelet count and less severe PSE-related complications.
View Article and Find Full Text PDFThe Joint Committee for Nationwide Survey on colorectal liver metastasis (CRLM) was established to improve treatment outcomes in patients with CRLM. The aim of this study was to evaluate the transition in the characteristics and treatment strategies of patients with CRLM and to analyze the prognostic factors. The data of 5085 patients newly diagnosed between 2013 and 2017 were compared with those of 3820 patients from 2005 and 2007.
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- A study investigated the impact of the rs16906115 polymorphism in the interleukin-7 gene on immune-related adverse events (irAEs) and treatment response to immune checkpoint inhibitors within a Japanese population.
- Conducting a comparison between participants with severe irAEs and those with none, as well as hepatocellular carcinoma patients categorized by treatment response, researchers found no significant association between the polymorphism and irAEs, but identified a link to poorer treatment outcomes in responders.
- The findings suggest that while the rs16906115 minor allele does not predict irAEs, its homozygosity may indicate a reduced likelihood of effective treatment results in this Japanese cohort.
Article Synopsis
- Two-stage hepatectomy (TSH) is a surgery that helps patients with colorectal liver metastasis (CRLM) when one surgery isn't enough.
- Researchers in Japan used a huge database to study the outcomes of TSH in patients with CRLM over several years.
- They found that while TSH is safe and offers good survival rates, having more than 10 liver nodules can make it harder for patients to survive after surgery.
Article Synopsis
- The study aimed to assess a new CT imaging protocol that uses low radiation and iodinated contrast medium doses while maintaining image quality through deep-learning reconstruction (DLR).
- It involved 148 patients, comparing two different voltage protocols (120-kVp and 80-kVp) in relation to the radiation dose, iodine dose, image noise, and overall image quality.
- Results showed that the 80-kVp protocol with DLR provided better image quality and significantly lower radiation and iodine doses compared to the higher voltage protocol.
Background: Follow-up is recommended for an asymptomatic unilocular hepatic cystic lesion without wall-thickness and nodular components. A few liver cystic lesions represent biliary cystic neoplasms, which are difficult to differentiate from simple cysts with benign mural nodules on imaging alone.
Case Presentation: An 84-year-old woman with a history of simple liver cyst diagnosed one year prior was admitted for evaluation of a developed mural nodule in the cystic lesion.
We report a patient with hemophilia A who underwent partial splenic embolization (PSE) for severe thrombocytopenia secondary to portal hypertension-induced splenomegaly, resulting in a stable long-term quality of life. The patient was diagnosed with hemophilia A and unfortunately contracted human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) from blood products. He subsequently developed progressive splenomegaly due to portal hypertension from chronic HCV, resulting in severe thrombocytopenia.
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- * A study focused on 20 high-risk, unresectable CRLM patients treated with hepatectomy and optional local ablation; outcomes showed that all patients responded positively to chemotherapy, with low recurrence rates after surgery.
- * The findings indicate that the treatment approach for high-risk patients is effective, achieving a 3-year disease-free survival rate of 57.4% and a 5-year overall survival rate of 56.2%, regardless of whether local ablation was included.
Article Synopsis
- Hepatic artery pseudoaneurysms are rare, occurring in about 1% of cases after metal stenting for malignant biliary issues, with fewer instances following plastic stenting for benign conditions.
- A case is presented involving a 61-year-old man who developed hemobilia following the placement of plastic biliary stents, despite lacking common risk factors.
- Successful treatment of the pseudoaneurysm was achieved through superselective transarterial embolization, and monitoring with imaging techniques is advised if hemobilia occurs post-stenting.
Article Synopsis
- The Beppu score is a tool used to estimate postoperative disease-free survival for patients with colorectal liver metastases based on six preoperative clinical parameters.
- It categorizes patients into three risk groups: low (≤6 points), moderate (7-10 points), and high (≥11 points), guiding treatment options.
- Recommended treatments include hepatectomy alone for low-risk, hepatectomy plus adjuvant chemotherapy for moderate-risk, and hepatectomy plus preoperative chemotherapy for high-risk patients.
It has been reported that patients with macroscopic vascular invasion accompanying hepatocellular carcinoma have a poor prognosis. Modern molecular therapy with multitargeted tyrosine kinase inhibitors and immune checkpoint inhibitors has shown promising results in patients with metastatic hepatocellular carcinoma; however, molecular therapy is limited to patients with Child-Pugh class A disease. This review summarizes the present status of surgical therapies, including conversion hepatectomy, for patients with MVI in the developing era of novel molecular therapy.
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- Patients with bilateral lung metastases from hepatocellular carcinoma (HCC) typically receive molecular therapy, with atezolizumab and bevacizumab showing potential for long-term survival.
- A 67-year-old woman treated for HCC experienced metastases in her lungs and underwent multiple therapies, including lenvatinib, atezolizumab plus bevacizumab, and later cabozantinib and dual immune checkpoint inhibitors.
- Despite limited response from some treatments, she maintained stable disease for extended periods while preserving liver function and quality of life.
Aim: Laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) located in the posterosuperior segments (PS) have generally been considered more difficult than those for HCC in anterolateral segments (AL), but may be safe and feasible for selected patients with accumulated experience. In the present study, we investigated the effectiveness of LLR for single nodular HCCs ≤3 cm located in PS.
Methods: In total, 473 patients who underwent partial liver resection for single nodular HCCs ≤3 cm at the 18 institutions belonging to the Kyusyu Study Group of Liver Surgery from January 2010 to December 2018 were enrolled.
Article Synopsis
- This study investigates the risk factors and short-term outcomes associated with central bisectionectomy (CB) for liver cancer (HCC) by analyzing data from 142 surgical patients.
- A significant 37% of patients faced complications like liver failure and bile leakage, with factors like high blood loss and tumor characteristics increasing this risk.
- The study found that tumor size and compression of blood vessels were key independent risk factors, and 50% of patients experienced cancer recurrence post-surgery, with good overall survival rates.
Background/aim: Operable peritoneal dissemination from distal cholangiocarcinoma after pancreaticoduodenectomy is rare. Furthermore, peritoneal dissemination mimicking liver metastasis has scarcely been reported.
Case Report: An 81-year-old woman received pancreaticoduodenectomy for distal cholangiocarcinoma.
As for resection for colorectal liver metastasis (CRLM), securing an adequate surgical margin is important for achieving a better prognosis. However, it is often difficult to achieve adequate margins for the resection of CRLM. So the current survival impact of sub-centi/millimeter surgical margins in hepatectomy for CRLM should be evaluated.
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- Hepatocellular carcinoma (HCC) associated with bile duct tumor thrombus (BDTT) is aggressive, requiring ongoing, multidisciplinary treatment approaches for effective management.
- The study presented two cases of elderly men with advanced HCC and BDTT, who underwent complex surgical and interventional therapies, including extended liver surgeries and transarterial chemoembolization (TACE).
- Both patients achieved complete remission without viable tumors and maintained good health nearly two years post-treatment, highlighting the effectiveness of the Vater papilla-preserving strategy for long-term survival in such cases.
Article Synopsis
- Scientists created a tool called the JSHBPS nomogram to help predict how long patients with liver cancer can stay healthy after surgery.
- They studied two groups of patients: one that had surgery right away and another that had chemotherapy before surgery.
- The results showed that the nomogram works well for patients who had surgery first, but not as well for those who had chemotherapy first, especially if their risk score was high.
To improve treatment outcomes in patients with colorectal liver metastasis (CRLM), the Joint Committee for Nationwide Survey on CRLM was established by the Japanese Society for Cancer of the Colon and Rectum and the Japanese Society of Hepato-Biliary-Pancreatic Surgery. The aim of the study was to evaluate transition in the characteristics and treatment strategy in CRLM patients and analyze prognostic factors using large-scale data. The present study summarizes the data of patients newly diagnosed between 2015 and 2017 and presents prognostic data of patients newly diagnosed in 2013 and 2014.
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- - The study aimed to identify risk factors for nonalcoholic fatty liver disease (NAFLD) in patients after undergoing pancreaticoduodenectomy (PD), focusing on the remnant pancreatic volume (RPV) as assessed by CT scans.
- - Out of 101 patients studied, 39.6% developed NAFLD three months post-surgery, with significant differences in RPV ratios between reconstruction methods: pancreaticogastrostomy (PG) had lower ratios compared to pancreaticojejunostomy (PJ).
- - The research found key risk factors for NAFLD to be female sex, PG reconstruction, and an RPV ratio of 60% or less, suggesting that maintaining better pancreatic function (as seen