Publications by authors named "Yujin Kudo"

Objective: Although recent trials on intentional segmentectomy have made mediastinal lymph node dissection (MLND) mandatory, the necessity of MLND in segmentectomy remains uncertain. We conducted a retrospective study to evaluate the necessity of MLND in segmentectomy for patients with peripheral stage IA (≤2 cm) non-small cell lung cancer.

Methods: Of the 5222 surgical cases for non-small cell lung cancer from 3 institutions between 2010 and 2021, 1457 patients met the JCOG0802 trial eligibility criteria.

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Objectives: To determine the feasibility of segmentectomy in patients with central, whole tumor size ≤2 cm and radiologically solid-dominant cN0 non-small cell lung cancer (NSCLC).

Methods: We retrospectively reviewed 1240 patients who underwent lobectomy or segmentectomy for small and radiologically solid-dominant cN0 NSCLC between January 2010 and December 2022. The inclusion criteria encompassed centrally located tumors, defined as tumors located in the inner two-thirds of the pulmonary parenchyma.

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Purpose: This study aimed to assess the efficiency of artificial intelligence (AI) in the detection of visceral pleural invasion (VPI) of lung cancer using high-resolution computed tomography (HRCT) images, which is challenging for experts because of its significance in T-classification and lymph node metastasis prediction.

Methods: This retrospective analysis was conducted on preoperative HRCT images of 472 patients with stage I non-small cell lung cancer (NSCLC), focusing on lesions adjacent to the pleura to predict VPI. YOLOv4.

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Article Synopsis
  • The study addresses the challenge of distinguishing solid nodules from ground-glass lesions in lung cancer, particularly for tumors smaller than or equal to 2 cm, due to high variability in human assessments.
  • It utilizes artificial intelligence (AI) to analyze and classify these nodules from a dataset of 246 patients, aiming to improve the accuracy of preoperative assessments by correlating AI findings with pathological results.
  • The AI system successfully identified solid nodules with high confidence that were associated with a significant likelihood of malignancy and lymph node metastasis, suggesting that this approach could enhance surgical decision-making for lung cancer patients.
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Background: The purpose of this study was to determine the optimal extent of lymph node dissection required in patients with small (≤3 cm) radiologically ground-glass opacity-dominant, peripheral, non-small cell lung cancer tumors.

Methods: The study analyzed the clinicopathologic findings and surgical outcomes of 988 patients with radiologic, ground-glass opacity-dominant non-small cell lung cancer without lymph node involvement who underwent complete resection of the primary tumor between 2010 and 2020. Patients were followed up for 54.

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Introduction: Lung squamous cell carcinoma (LUSC) usually shows expansive growth with large tumor nests; few reports on invasive growth patterns (INF) in LUSC have been associated with poor prognosis in gastrointestinal and urothelial cancers. In this study, we examine the association between INF and the prognosis of LUSC.

Materials And Methods: We analyzed INF as a potential prognostic factor in 254 consecutive patients with LUSC who underwent complete surgical resection at our hospital between 2008 and 2017.

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Article Synopsis
  • Lung cancer, specifically lung adenocarcinoma (LUAD), has poor prognosis, prompting a study to create an immune-related gene prognostic index (IRGPI) to assess patient outcomes and responses to immune checkpoint inhibitors (ICI).
  • By utilizing data from the TCGA database, researchers identified differentially expressed immune-related genes (DEIRGs) and constructed the IRGPI model using Cox regression analyses, grouping patients into high- and low-risk categories for further survival analysis.
  • Results indicated that patients with a high-risk IRGPI had a significantly lower overall survival rate and were associated with unfavorable immune characteristics, but interestingly, they may still respond better to ICI treatment.
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Background: The recurrence site that influences post-recurrence survival (PRS) in patients with non-small cell lung cancer (NSCLC) undergoing surgery and the preoperative predictors of recurrence remain unclear.

Methods: Cohorts 1 and 2 had 4520 (who underwent complete resection for p-stage 0-IIIA NSCLC) and 727 (who experienced recurrence after surgery) patients, respectively. The initial sites of recurrence were the lungs (309 cases), thoracic lymph nodes (225 cases), pleura (112 cases), bone (110 cases), central nervous system (86 cases), adrenal gland (25 cases), abdomen (60 cases), cervical and axillary lymph nodes (38 cases), chest wall (13 cases), skin (5 cases), and eye and tongue (3 cases).

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Background: Pulmonary sequestration is a rare pulmonary malformation, with intralobar pulmonary sequestration being the most common subtype. Lobectomy has generally been performed for its treatment, owing to unclear boundaries of the lesion. However, recent reports have introduced lung resection using intravenous indocyanine green (ICG) as a treatment for pulmonary sequestrations.

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Objectives: We aimed to clarify the differences in prognosis between wedge resection and segmentectomy performed for cN0 non-small cell lung cancer (NSCLC) measuring ≤ 2 cm, with consolidation tumor ratio (CTR) > 0.25.

Methods: This multicenter study included 570 patients with cN0 NSCLC (tumor size ≤ 2 cm, CTR > 0.

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Lymphovascular invasion (LVI) is a fundamental step toward the spread of cancer. Extracellular vesicles (EVs) promote cellular communication by shuttling cargo, such as microRNAs (miRNAs). However, whether EV-associated miRNAs serve as biomarkers for LVI remains unclear.

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In recent years, the number of cases of small-size lung cancer(<2 cm) has increased with the widespread of computed tomography (CT) in medical checkup and comprehensive medical checkup. Although lobectomy has been the standard surgical treatment for early-stage small-size lung cancer, it has become possible to evaluate the CT findings of small tumors in terms of ground-glass areas and solid areas, and it has become clear that the former has a low histological malignancy while the latter has a high malignancy. Lung cancers with high ground-glass opacity have low malignant potential and are therefore being aggressively treated by limited resection.

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We aimed to investigate the value of computed tomography (CT)-based radiomics with artificial intelligence (AI) in predicting pathological lymph node metastasis (pN) in patients with clinical stage 0-IA non-small cell lung cancer (c-stage 0-IA NSCLC). This study enrolled 720 patients who underwent complete surgical resection for c-stage 0-IA NSCLC, and were assigned to the derivation and validation cohorts. Using the AI software Beta Version (Fujifilm Corporation, Japan), 39 AI imaging factors, including 17 factors from the AI ground-glass nodule analysis and 22 radiomics features from nodule characterization analysis, were extracted to identify factors associated with pN.

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Article Synopsis
  • Researchers investigated how CT imaging and AI can predict early recurrence of non-small cell lung cancer (NSCLC) in patients after surgery.
  • A study with 642 patients showed specific CT features and factors like male sex and solid part size were linked to recurrence-free survival (RFS).
  • The findings suggest that AI-enhanced CT radiomics can effectively noninvasively identify patients at risk for early cancer recurrence, with significant differences in 5-year RFS rates based on solid part size and volume ratios.
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Purpose: Sarcopenia influences postoperative outcomes of patients with non-small cell lung cancer (NSCLC). Imaging tools for evaluating and diagnosing sarcopenia have developed, and a novel method of psoas volume index (PVI) obtained by measuring bilateral psoas major muscle volume has been reported. However, the relationship between sarcopenia based on PVI and clinical outcomes has not been fully investigated for patients with early-stage NSCLC.

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Background: Sarcopenia is associated with prognostic outcomes for patients with various solid tumors, whereas the clinical significance of sarcopenia 1 year after surgery (post-sarcopenia) for non-small cell lung cancer (NSCLC) has not been investigated. This study aimed to clarify the clinical impact of post-sarcopenia and factors associated with post-sarcopenia in NSCLC patients without preoperative sarcopenia.

Methods: This study enrolled 443 patients with clinical stage 1 or 2 NSCLC (234 patients without preoperative sarcopenia [NS group] and 209 patients with preoperative sarcopenia [S group]) who underwent computed tomography (CT) at two time points (before surgery and a year afterward) or more.

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Introduction: The size of the solid part of a tumor, as measured using thin-section computed tomography, can help predict disease prognosis in patients with early-stage lung cancer. Although three-dimensional volumetric analysis may be more useful than two-dimensional evaluation, measuring the solid part of some lesions is difficult using this methods. We developed an artificial intelligence-based analysis software that can distinguish the solid and non-solid parts (ground-grass opacity).

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Introduction: In Japan, adjuvant tegafur-uracil (UFT) chemotherapy is recommended for patients with completely resected, stage I NSCLC. This treatment requires real-world re-evaluation because of recent advances in target-based and immuno-oncological treatments and refinement of lung cancer staging.

Methods: The Japan Clinical Oncology Group (JCOG) 0707, a phase 3 trial comparing the benefits of UFT and S-1 (tegafur-gimeracil-oteracil) in patients with completely resected stage I NSCLC (T1 >2 cm and T2 in the TNM sixth edition), was conducted in Japan.

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RNA activation (RNAa) is an uncharacterized mechanism of transcriptional activation mediated by small RNAs, such as microRNAs (miRNAs). A critical issue in RNAa research is that it is difficult to distinguish between changes in gene expression caused indirectly by post-transcriptional regulation and direct induction of gene expression by RNAa. Therefore, in this study, we seek to identify a key factor involved in RNAa, using the induction of ZMYND10 by miR-34a as a system to evaluate RNAa.

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Background: Part-solid lung adenocarcinoma appears as a heterogeneous subgroup, and its surgical management is controversial. This study aimed to elucidate whether preoperative carcinoembryonic antigen, a time-honored tumor marker, can be used as a prognostic factor that contributes to its management.

Methods: We retrospectively reviewed consecutive patients with clinical-T1a-cN0M0 part-solid adenocarcinoma who underwent surgical resection between January 2011 and December 2015 at two institutions.

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Objectives: Indications of limited resection, such as segmentectomy, have recently been reported for patients with solid-predominant lung cancers ≤2 cm. This study aims to identify unfavourable prognostic factors using three-dimensional imaging analysis with artificial intelligence (AI) technology.

Methods: A total of 157 patients who had clinical N0 non-small cell lung cancer with a radiological size ≤2 cm, and a consolidation tumour ratio > 0.

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Background: Even if lung cancer is detected at an early stage, surgery may be difficult in patients with severe comorbidities, like interstitial pneumonia (IP). Radiation therapy cannot be performed due to the high risk of acute IP exacerbation. Therefore, an effective alternative, such as photodynamic therapy (PDT), is required.

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Article Synopsis
  • PD-L1 expression is a key biomarker for predicting how effective immunotherapy will be in patients with non-small cell lung cancer (NSCLC), where CD8+ tumor-infiltrating lymphocytes (TILs) contribute significantly to treatment efficacy.
  • The study analyzed the relationship between tumor PD-L1 expression, exosomal PD-L1 in serum, and CD8+ TILs in 120 NSCLC patients to better understand anti-PD-1 therapy responses and related clinical outcomes.
  • Results showed a strong correlation between serum exosomal PD-L1 and tumor PD-L1 levels, indicating that higher exosomal PD-L1 levels could signal worse recurrence-free survival, suggesting that serum exosomal PD-L1 could improve
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Background: Mediastinal teratomas occasionally rupture into the thoracic cavity, which induces mediastinitis or various other severe complications. Surgical treatment is crucial for ruptured teratomas; however, few literature reviews to date have addressed the characteristics of ruptured mediastinal teratomas.

Case Presentation: We report a 29-year-old woman with severe mediastinitis owing to a mediastinal mature teratoma that ruptured into the mediastinum and right pleural cavity.

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