Publications by authors named "Yuichiro Kohara"
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.
Is multidisciplinary treatment effective for invasive intraductal papillary mucinous carcinoma?
Ann Gastroenterol Surg
September 2024
Article Synopsis
- * Analyzing data from 1183 patients, it found that completing 6 months of postoperative adjuvant therapy significantly improved overall, disease-specific, and recurrence-free survival, especially for high-risk patients.
- * Additionally, neoadjuvant therapy showed benefits for those with borderline resectable IPMC, and any treatment for recurrence after surgery was linked to longer survival compared to no treatment.
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.
Article Synopsis
- - 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.
Article Synopsis
- A gene panel consisting of 9 nectin family genes (NFGP) was identified to help predict oncologic outcomes for patients undergoing surgery for pancreatic ductal adenocarcinoma (PDAC).
- Comprehensive analyses in multiple cohorts showed that NFGP can effectively stratify overall survival (OS) and relapse-free survival (RFS) rates for these patients.
- The study concluded that NFGP serves as a valuable biomarker for improving patient selection and treatment planning in PDAC cases.
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.
Oligometastatic disease has been proposed as an intermediate state between localized and polymetastatic disease that can benefit from multimodal treatment, including surgery. There is a growing concern about performing surgery for oligometastatic pancreatic ductal adenocarcinoma, although there is still little evidence. We reviewed articles published between 2021 and 2022, focusing mainly on surgical outcomes.
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- 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.*
We report a case of laparoscopic mucosectomy for gastric duplication cysts that communicated with the spleen. A 10-year-old girl visited a local hospital with a chief complaint of intermittent left abdominal pain that had lasted for about 2 months. We diagnosed two gastric duplication cysts by ultrasonography and planned a laparoscopic extirpation.
View Article and Find Full Text PDFBackground: Gastric artery aneurysms are rarely caused by segmental arterial mediolysis (SAM), a condition that often involves multiple vessels. The clinical course of SAM after vessel rupture may vary depending on the involved vessels. For example, the "double-rupture phenomenon" observed following the rupture of the splenic artery aneurysm manifests as a biphasic and relatively slow clinical course.
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