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Seto Y, Ishitobi M, Shien T, Oshiro C, Inoue H, Shima H, Kuba S, Watanabe N, Iwatani T, Nakayama T. Patient Preference for Surgical Methods for Ipsilateral Breast Tumor Recurrence. Ann Surg Oncol 2024:10.1245/s10434-024-15282-0. [PMID: 38594578 DOI: 10.1245/s10434-024-15282-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/27/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Mastectomy has been the standard surgical treatment for ipsilateral breast tumor recurrence (IBTR). Recently, there has been growing interest in repeat breast-conserving surgery (rBCS) for IBTR among breast surgeons; however, there is currently little information regarding patient preferences for surgical procedure for IBTR. The purpose of this study was to evaluate preference for surgical procedure (mastectomy vs. rBCS) among breast cancer patients who had undergone salvage surgery for IBTR. METHODS Overall, 100 breast cancer patients who had undergone salvage surgery for IBTR were asked about their preferred surgical methods for IBTR and the reason. The association of patient preference and the reasons related to various clinical and pathological factors were assessed. RESULTS Of the 100 respondents, only 11 patients (11%) preferred rBCS. Patients who had undergone rBCS and radiotherapy for IBTR were significantly more likely to prefer to undergo rBCS than other groups (p = 0.030). The most frequent reason for choosing rBCS was the patient's desire to minimize breast deformity and surgical wounds. CONCLUSIONS Our study revealed that there is a low rate of patients who opt to undergo rBCS among patients who had undergone salvage surgery for IBTR. Discrepancies in perceptions regarding the surgical procedure for IBTR between patients and their surgeons may exist.
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Affiliation(s)
- Yukiko Seto
- Department of Breast and Endocrine Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Makoto Ishitobi
- Department of Breast Surgery, Mie University School of Medicine, Tsu, Japan.
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Chiya Oshiro
- Department of Breast Surgery, Kaizuka City Hospital, Kaizuka, Japan
| | - Hiroaki Inoue
- Department of Thoracic, Endocrine Surgery and Oncology, Tokushima University Graduate School of Medical Sciences, Tokushima, Japan
| | - Hiroaki Shima
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Osaka, Japan
| | - Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Noriyuki Watanabe
- Department of Breast and Endocrine Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Tsuguo Iwatani
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Takahiro Nakayama
- Department of Breast and Endocrine Surgery, Osaka International Cancer Institute, Osaka, Japan
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Sako A, Matsuse M, Saenko V, Tanaka A, Otsubo R, Morita M, Kuba S, Nishihara E, Suzuki K, Ogi T, Kawakami A, Mitsutake N. TERT promoter mutations increase tumor aggressiveness by altering TERT mRNA splicing in papillary thyroid carcinoma. J Clin Endocrinol Metab 2024:dgae220. [PMID: 38576411 DOI: 10.1210/clinem/dgae220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/11/2024] [Accepted: 04/03/2024] [Indexed: 04/06/2024]
Abstract
CONTEXT Telomerase reverse transcriptase promoter (TERT-p) mutations, which upregulate TERT expression, are strongly associated with tumor aggressiveness and worse prognosis in papillary thyroid carcinomas (PTCs). TERT expression is also observed in a proportion of PTCs without TERT-p mutations, but such tumors show less aggressiveness and better prognosis compared with TERT-p mutation-positive tumors. OBJECTIVE TERT has multiple splicing variants whose relationships with the TERT-p status and clinicopathological characteristics remain poorly understood. We examined the relationship between the TERT-p mutational status, the TERT splicing pattern, and clinicopathological features. METHODS We investigated the expression of two major variants, α deletion (dA) and β deletion (dB), in a series of 207 PTCs operated between November 2001 and March 2020 in Nagasaki University Hospital and Kuma Hospital. RESULTS The TERT-p mutations were found in 33 cases, and among 174 mutation-negative cases, 24 showed TERT expression. All cases were classified into three groups: the TERT-p mutation-negative/expression-negative group (mut-/exp-), the TERT-p mutation-negative/expression-positive group (mut-/exp+), and the TERT-p mutation-positive group (mut+/exp+). The +A + B/dB ratio in mut+/exp + was significantly higher than that in mut-/exp + PTCs. Analysis with clinicopathological data revealed that +A + B expression was associated with higher PTC aggressiveness, whereas dB expression counteracted this effect. Functional in vitro study demonstrated that dB strongly inhibited cell growth, migration, and clonogenicity, suggesting its tumor suppressive role. CONCLUSION These results provide evidence that the TERT-p mutations alter the expression of different TERT splice variants, which, in turn, associates with different tumor aggressiveness.
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Affiliation(s)
- Ayaka Sako
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University
- Department of Endocrinology and Metabolism, Graduate School of Biomedical Sciences, Nagasaki University
| | - Michiko Matsuse
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University
| | - Vladimir Saenko
- Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University
| | - Aya Tanaka
- Department of Surgical Oncology, Graduate School of Biomedical Sciences, Nagasaki University
| | - Ryota Otsubo
- Department of Surgical Oncology, Graduate School of Biomedical Sciences, Nagasaki University
| | - Michi Morita
- Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University
| | - Sayaka Kuba
- Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University
| | | | - Keiji Suzuki
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University
| | - Tomoo Ogi
- Department of Genetics, Research Institute of Environmental Medicine, Nagoya University
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University
| | - Norisato Mitsutake
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University
- Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University
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Sakai T, Kutomi G, Shien T, Asaga S, Aruga T, Ishitobi M, Kuba S, Sawaki M, Terata K, Tomita K, Yamauchi C, Yamamoto Y, Iwata H, Saji S. The Japanese Breast Cancer Society Clinical Practice Guidelines for surgical treatment of breast cancer, 2022 edition. Breast Cancer 2024; 31:1-7. [PMID: 37843765 DOI: 10.1007/s12282-023-01510-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/01/2023] [Indexed: 10/17/2023]
Abstract
The 2022 revision of the Japanese Breast Cancer Society (JBCS) Clinical Practice Guidelines for surgical treatment of breast cancer was updated following a systematic review of the literature using the Medical Information Network Distribution Service (MINDS) procedure, which focuses on the balance of benefits and harms for various clinical questions (CQs). Experts in surgery designated by the JBCS addressed five areas: breast surgery, axillary surgery, breast reconstruction, surgical treatment for recurrent and metastatic breast cancer, and other related topics. The revision of the guidelines encompassed 4 CQs, 7 background questions (BQs), and 14 future research questions (FRQs). A significant revision in the 2022 edition pertained to axillary management after neoadjuvant chemotherapy in CQ2. The primary aim of the 2022 JBCS Clinical Practice Guidelines is to provide evidence-based recommendations to empower patients and healthcare professionals in making informed decisions regarding surgical treatment for breast cancer.
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Affiliation(s)
- Takehiko Sakai
- Department of Breast Surgical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
| | - Goro Kutomi
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Tadahiko Shien
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | - Sota Asaga
- Department of Breast Surgery, Keiyu Hospital, Yokohama, Japan
| | - Tomoyuki Aruga
- Department of Breast Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Makoto Ishitobi
- Department of Breast Surgery, Mie University School of Medicine, Mie, Japan
| | - Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masataka Sawaki
- Department of Breast Oncology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Kaori Terata
- Department of Breast and Endocrine Surgery, Akita University Hospital, Akita, Japan
| | - Koichi Tomita
- Department of Plastic and Reconstructive Surgery, Kindai University, Osaka, Japan
| | - Chikako Yamauchi
- Department of Radiation Oncology, Shiga General Hospital, Shiga, Japan
| | - Yutaka Yamamoto
- Department of Breast and Endocrine Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Shigehira Saji
- Department of Medical Oncology, Fukushima Medical University, Fukushima, Japan
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Kuba S, Maeda S, Shibata K, Soutome S, Yamanouchi K, Matsumoto M, Tanaka A, Morita M, Hatachi T, Otsubo R, Yano H, Kawashita Y, Sato S, Taniguchi H, Kanetaka K, Umeda M, Nagayasu T, Eguchi S. EFFICACY AND SAFETY OF A DEXAMETHASONE-BASED MOUTHWASH TO PREVENT CHEMOTHERAPY-INDUCED STOMATITIS IN WOMEN WITH BREAST CANCER: A MULTICENTRE, OPEN-LABEL, RANDOMISED PHASE 2 STUDY. J Evid Based Dent Pract 2023; 23:101896. [PMID: 37689451 DOI: 10.1016/j.jebdp.2023.101896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/17/2023] [Accepted: 05/17/2023] [Indexed: 09/11/2023]
Abstract
PURPOSE No standard approach other than oral care is available for preventing chemotherapy-induced stomatitis in patients with breast cancer. In this randomized, controlled phase 2 trial, we aimed to assess the efficacy and safety of a dexamethasone-based mouthwash in preventing chemotherapy-induced stomatitis in patients with early breast cancer. BASIC PROCEDURES Patients with breast cancer scheduled for epirubicin and cyclophosphamide (EC) or docetaxel and cyclophosphamide (TC) therapy were selected and allocated in a 1:1 ratio to the intervention and control groups. The intervention group received chemotherapy, oral care, and a dexamethasone-based mouthwash, whereas the control group received chemotherapy and oral care. The primary endpoint was the incidence of stomatitis. This was a phase 2 study, and the significance level for the analysis of the primary endpoint was set a priori at 0.2. MAIN FINDINGS Data pertaining to 58 patients in the control group and 59 patients in the intervention group were analyzed. Stomatitis incidence was 55% and 38% in the control and intervention groups, respectively (risk ratio, 0.68; 80% confidence interval, 0.52-0.88; P = .052). Stomatitis severity was lower in the intervention group than in the control group (P = .03). The proportion of patients who adhered to the mouthwash regimen was 87% (interquartile range, 67.8%-95.3%). No severe oral infections were observed. PRINCIPAL CONCLUSIONS The dexamethasone-based mouthwash safely reduced stomatitis incidence and severity in patients receiving chemotherapy for early breast cancer. Phase 3 clinical trials are warranted for validating our results.
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Affiliation(s)
- Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Shigeto Maeda
- Department of Breast and Endocrine surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Kenichiro Shibata
- Department of Surgery, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Sakiko Soutome
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Department of Surgery, Shimabara Hospital, Nagasaki, Japan
| | - Megumi Matsumoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Aya Tanaka
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshiko Hatachi
- Department of Surgery, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan; Department of Breast and Endocrine surgery, Ehime Prefectural Central Hospital, Ehime, Japan
| | - Ryota Otsubo
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Yano
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Department of Surgery, Sasebo City General Hospital, Nagasaki, Japan
| | - Yumiko Kawashita
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shuntaro Sato
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Hideki Taniguchi
- Department of Surgery, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masahiro Umeda
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Saeki S, Iwatani T, Kitano A, Sakurai N, Tanabe Y, Yamauchi C, Igarashi A, Kajimoto Y, Kuba S, Hara F, Sagara Y, Ohno S. Factors associated with financial toxicity in patients with breast cancer in Japan: a comparison of patient and physician perspectives. Breast Cancer 2023; 30:820-830. [PMID: 37310584 PMCID: PMC10404186 DOI: 10.1007/s12282-023-01476-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/05/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Financial toxicity (FT) is a notable concern for patients with breast cancer worldwide. The situation regarding FT in Japan, however, has not been well explored. This study examined FT in patients with breast cancer in Japan and presented an overview of the group study's overall findings. METHODS The survey used the Questant application and primarily targeted patients with breast cancer attending research facilities and physicians who are members of the Japanese Breast Cancer Society. The Japanese version of the Comprehensive Score for FT (COST) was used to quantify patients' FT. Multiple regression analysis was used to identify factors related to FT in patients with breast cancer in Japan and evaluate the sufficiency of information support level (ISL) for medical expenses. RESULTS We collected 1558 responses from patients and 825 from physicians. In terms of factors affecting FT, recent payments had the highest impact, followed by stage, and related departments positively affecting FT. Conversely, factors such as income, age, and family support were found to negatively affect FT. A significant discrepancy was identified between patients and physicians in perceived information support, with patients frequently feeling unsupported and physicians believing that they have provided adequate support. Furthermore, differences in the frequency of explanations and opportunities to ask questions about medical costs across FT grades were found. The analysis also showed that physicians with a better understanding of information support needs and greater knowledge of medical costs tended to provide more support that is comprehensive. CONCLUSION This study emphasizes the importance of addressing FT in patients with breast cancer in Japan and highlights the need for enhanced information support, deeper understanding by physicians, and collaborative efforts among professionals to mitigate financial burden and provide personalized, tailored support for individual needs.
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Affiliation(s)
- Sumito Saeki
- Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
- Graduate School of Medicine, Department of Cancer Therapy and Surgery, Tohoku University, Sendai, Japan.
| | - Tsuguo Iwatani
- Department of Breast Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Atsuko Kitano
- Department of Medical Oncology, St Luke's International Hospital, Tokyo, Japan
| | | | - Yuko Tanabe
- Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan
| | - Chikako Yamauchi
- Radiation Therapy Center, Shiga General Hospital, Moriyama, Japan
| | - Ataru Igarashi
- Department of Pharmaceutical Policy, The University of Tokyo, Tokyo, Japan
| | - Yusuke Kajimoto
- Graduate School of Pharmaceutical Sciences, University of Tokyo, Tokyo, Japan
- Oncology Science Unit, MSD K.K, Tokyo, Japan
| | - Sayaka Kuba
- Graduate School of Biomedical Sciences, Department of Surgery, Nagasaki University, Nagasaki, Japan
| | - Fumikata Hara
- Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yasuaki Sagara
- Department of Breast and Thyroid Surgical Oncology, Hakuaikai Sagara Hospital, Kagoshima, Japan
| | - Shinji Ohno
- Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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Saeki S, Iwatani T, Kitano A, Sakurai N, Tanabe Y, Yamauchi C, Igarashi A, Kajimoto Y, Kuba S, Hara F, Sagara Y, Ohno S. Correction: Factors associated with financial toxicity in patients with breast cancer in Japan: a comparison of patient and physician perspectives. Breast Cancer 2023; 30:831. [PMID: 37395979 PMCID: PMC10404164 DOI: 10.1007/s12282-023-01479-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Affiliation(s)
- Sumito Saeki
- Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
- Graduate School of Medicine, Department of Cancer Therapy and Surgery, Tohoku University, Sendai, Japan.
| | - Tsuguo Iwatani
- Department of Breast Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Atsuko Kitano
- Department of Medical Oncology, St Luke's International Hospital, Tokyo, Japan
| | | | - Yuko Tanabe
- Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan
| | - Chikako Yamauchi
- Radiation Therapy Center, Shiga General Hospital, Moriyama, Japan
| | - Ataru Igarashi
- Department of Pharmaceutical Policy, The University of Tokyo, Tokyo, Japan
| | - Yusuke Kajimoto
- Graduate School of Pharmaceutical Sciences, University of Tokyo, Tokyo, Japan
- Oncology Science Unit, MSD K.K, Tokyo, Japan
| | - Sayaka Kuba
- Graduate School of Biomedical Sciences, Department of Surgery, Nagasaki University, Nagasaki, Japan
| | - Fumikata Hara
- Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Yasuaki Sagara
- Department of Breast and Thyroid Surgical Oncology, Hakuaikai Sagara Hospital, Kagoshima, Japan
| | - Shinji Ohno
- Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
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Meng X, Morita M, Kuba S, Hayashi H, Otsubo R, Matsumoto M, Yamanouchi K, Kobayashi K, Soyama A, Hidaka M, Kanetaka K, Nagayasu T, Eguchi S. Association of quantitative analysis of intratumoral reduced E-cadherin expression with lymph node metastasis and prognosis in patients with breast cancer. Sci Rep 2023; 13:10434. [PMID: 37369698 PMCID: PMC10300190 DOI: 10.1038/s41598-023-37012-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Loss of E-cadherin expression is a poor prognostic factor in patients with breast cancer. Breast cancer cells co-cultured with adipocytes reportedly promote E-cadherin attenuation and tumor progression. The current study aimed to investigate the association of reduced E-cadherin expression with adipose tissue invasion (ATI) and prognosis in breast cancer. Surgical specimens were collected from 188 women with invasive ductal carcinoma of the breast who had undergone surgery without neoadjuvant treatment. We compared E-cadherin expression in ATI and invasive front (IF) using immunohistochemistry with ImageJ. Reduced E-cadherin expression was detected not only in the ATI area but also in the IF, and the degree of reduced E-cadherin expression was positively correlated with both areas. In patients with lymph node metastasis compared to those without, E-cadherin expression was reduced and this reduction was associated with poor recurrence-free survival. We concluded that E-cadherin expression is reduced not only at the ATI area but also at the IF of the tumor. Reduced E-cadherin expression is a clear prognostic factor for breast cancer. Hence, future research is warranted for establishing an objective and quantitative E-cadherin staining assay that will allow clinical use of E-cadherin as a prognostic factor.
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Affiliation(s)
- Xiangyue Meng
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
| | - Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan.
| | - Hiroko Hayashi
- Department of Pathology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Ryota Otsubo
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Megumi Matsumoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
| | - Kazuma Kobayashi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
| | - Akihiko Soyama
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
| | - Masaaki Hidaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-Machi, Nagasaki, 852-8501, Japan
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Matsumoto M, Baba M, Tanaka A, Kuba S, Morita M, Kaseida F, Hayashi H, Maeda S, Yano H, Inamasu E, Ogiya A, Sekiya K, Nakashima M, Ikari H, Ohno S, Takei H, Yanagihara K, Eguchi S, Nagayasu T, Otsubo R. Abstract P5-01-03: Evaluation of novel diagnostic kits using the semi-dry dot-blot method combined with an automatic reader for detecting metastases in sentinel lymph nodes of patients with breast cancer: a multi-center prospective study. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p5-01-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Background: The semi-dry dot-blot (SDB) method, a diagnostic procedure for detecting lymph node (LN) metastases using an anti-cytokeratin (CK) antibody, is based on the theory that epithelial components, such as CK, are not found in normal LNs. Thus, metastases are diagnosed according to the presence of CK in the lavage fluid of sectioned LNs. We prospectively evaluated novel SDB kits that use a newly developed anti-CK19 antibody and an automatic reader for diagnosing sentinel LN metastases in patients with breast cancer as a multi-center study. Methods: We obtained 924 sentinel LNs dissected from 405 patients with breast cancer between January 2021 and December 2021 at six institutes in Japan. We excluded patients who underwent neoadjuvant chemotherapy and neoadjuvant endocrine therapy. LNs were sectioned at 2-mm intervals and washed with phosphate-buffered saline. Cells suspended in the lavage fluid of sectioned LNs were centrifuged and lysed to extract protein. The extracted protein was applied to the SDB kit to diagnose LN metastasis using an automatic absorbance reader. Hematoxylin and eosin (H&E) stained and washed LNs were blindly examined by pathologists using intraoperative and permanent histological examination. Diagnoses based on SDB kit and automatic reader findings were compared with diagnoses made by permanent histological examination of paraffin-embedded H&E-stained sections of LNs. Primary endpoints were the sensitivity, specificity, and overall agreement of the SDB kit for distinguishing macrometastases from non-macrometastases. Results: Ninety-four of the 924 LNs were assessed as macrometastases, 40 as micrometastases, and 790 as isolated tumor cells by histological examination. Compared with patients with non-macrometastases, those with macrometastases had significantly younger age (p< 0.01), larger primary tumor (p< 0.01), higher nuclear grade (p=0.04), increased lymphatic invasion (p< 0.01), and increased venous invasion (p=0.01). Using a borderline CK19 absorbance of 11.9 milli-absorbance for detecting macrometastases with an area under the curve of 0.989, the sensitivity, specificity, and overall agreement of the SDB kit were 94.7%, 98.3%, and 97.9%, respectively. Moreover, the sensitivity, specificity, and overall agreement of the intraoperative histological examination compared with permanent histological examination for distinguishing macrometastases from non-macrometastases were 91.4%, 99.1%, and 98.3%, respectively. Furthermore, the kits and automatic reader yielded diagnoses within approximately 20 min at a cost of < 30 USD for the SDB kit and < 3,000 USD for the automatic reader. Conclusions: The kits with an automatic reader used in our study were accurate, quick, and cost-effective in diagnosing LN metastases without the loss of LN tissue and were particularly useful for distinguishing macrometastases. We plan to make the SDB kit and automatic reader commercially available worldwide soon.
Citation Format: Megumi Matsumoto, Masaaki Baba, Aya Tanaka, Sayaka Kuba, Michi Morita, Fujiko Kaseida, Hiroko Hayashi, Shigeto Maeda, Hiroshi Yano, Eiko Inamasu, Akiko Ogiya, Kenta Sekiya, Masahiro Nakashima, Hideki Ikari, Shinji Ohno, Hiroyuki Takei, Katsunori Yanagihara, Susumu Eguchi, Takeshi Nagayasu, Ryota Otsubo. Evaluation of novel diagnostic kits using the semi-dry dot-blot method combined with an automatic reader for detecting metastases in sentinel lymph nodes of patients with breast cancer: a multi-center prospective study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-01-03.
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Affiliation(s)
| | | | | | | | | | | | | | - Shigeto Maeda
- 8National Hospital Organization Nagasaki Medical Center
| | | | | | - Akiko Ogiya
- 11The Cancer Institute Hospital Of JFCR, Koto-ku, Tokyo, Japan
| | | | | | | | - Shinji Ohno
- 15Breast Oncology Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Tokyo, Japan
| | | | | | - Susumu Eguchi
- 18Nagasaki University Graduate School of Biomedical sciences
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9
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Yamanouchi K, Kuba S, Matsumoto M, Yano H, Morita M, Sakimura C, Otsubo R, Hidaka M, Nagayasu T, Eguchi S. An Evaluation of the Efficacy of Compression Therapy Using Sleeves and Stockings to Prevent Docetaxel-induced Peripheral Neuropathy in Breast Cancer Patients. Acta Med Okayama 2022; 76:689-694. [PMID: 36549771 DOI: 10.18926/amo/64119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Taxanes are key drugs for patients with breast cancer. A major adverse effect of taxanes is peripheral neuropathy (PN). To investigate the ability of compression therapy using sleeves and stockings to prevent PN due to the taxane docetaxel, we conducted a single-center historical control trial. Patients receiving docetaxel at 75 mg/m2 every 3 weeks for 4 cycles as first-line chemotherapy for breast cancer were eligible. PN was evaluated using the common terminology criteria for adverse events version 4.0. The primary endpoint was the incidence of allgrade PN until 3 weeks after the fourth docetaxel administration. We evaluated 26 patients in the intervention group and compared their data to those collected retrospectively from 52 patients treated with docetaxel without compression. Neither the incidence of all-grade PN until 3 weeks after the fourth docetaxel administration (63.5% in the control group vs. 76.9% in the intervention group, p=0.31) nor that of PN grade ≥ 2 (13.5% vs. 15.4%, p=0.99) differed between the groups. In this study, the efficacy of compression therapy using sleeves and stockings to prevent PN induced by docetaxel was not demonstrated. Further clinical studies including medications or intervention are needed to reduce the incidence and severity of PN induced by chemotherapy.
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Affiliation(s)
- Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science.,Department of Surgery, Nagasaki Prefecture Shimabara Hospital
| | - Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science
| | - Megumi Matsumoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science
| | - Hiroshi Yano
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science.,Department of Breast Surgery, Sasebo City General Hospital
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science
| | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science.,Department of Breast and Endocrine Surgery, Nagasaki Harbor Medical Center
| | - Ryota Otsubo
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science
| | - Masaaki Hidaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science
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10
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Hara Y, Otsubo R, Shinohara S, Morita M, Kuba S, Matsumoto M, Yamanouchi K, Yano H, Eguchi S, Nagayasu T. Lymphedema After Axillary Lymph Node Dissection in Breast Cancer: Prevalence and Risk Factors-A Single-Center Retrospective Study. Lymphat Res Biol 2022; 20:600-606. [PMID: 35357959 PMCID: PMC9810350 DOI: 10.1089/lrb.2021.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: Lymphedema may develop when axillary lymph node dissection (ALND) injures and obstructs the lymph ducts in the upper limb. In patients with breast cancer, lymphedema is difficult to treat and can cause arm swelling, heaviness, and restricted movement. We aimed to identify the prevalence and risk factors for lymphedema after ALND in patients with breast cancer. Methods and Results: This retrospective study included 175 patients with breast cancer who underwent ALND in the Nagasaki University Hospital, Japan, between 2005 and 2018. Lymphedema was defined as symptomatic arm swelling with a >2-cm difference in the arm circumference between the affected and contralateral arms. Patients were divided into two groups according to the presence or absence of lymphedema. Surgical and pathological findings were compared between the two groups. Univariate and multivariate analyses were performed, including the chi-square test, Student's t-test, and logistic regression analysis. Lymphedema was prevalent in 20% of the study participants, and the mean time interval from surgery to development of lymphedema was 479 days. In the univariate analysis, a body mass index of >26 kg/m2, smoking, radiotherapy (RT), and dissection of >18 axillary lymph nodes (ALNs) significantly increased the risk of lymphedema. In the multivariate analysis, smoking, RT, and dissection of >18 ALNs significantly increased the risk of lymphedema. Conclusions: The prevalence of lymphedema in our study was 20%. Our findings suggest that smoking, RT, and dissection of >18 ALNs are risk factors for lymphedema. Aggressive and empiric ALND might be associated with axillary lymph duct damage.
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Affiliation(s)
- Yuki Hara
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryota Otsubo
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Address correspondence to: Ryota Otsubo, MD, PhD, Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
| | - Shota Shinohara
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Hospital, Nagasaki, Japan
| | - Sayaka Kuba
- Department of Surgery, Nagasaki University Hospital, Nagasaki, Japan
| | - Megumi Matsumoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroshi Yano
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Hospital, Nagasaki, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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11
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Kawaguchi Y, Kuba S, Morita M, Meng X, Hayashi H, Kobayashi K, Adachi T, Hidaka M, Itoh S, Kanetaka K, Eguchi S. Bilateral Inflammatory Breast Cancer That Developed Two Years after Treatment for Triple-negative Breast Cancer. Intern Med 2022; 61:2387-2391. [PMID: 35022341 PMCID: PMC9424078 DOI: 10.2169/internalmedicine.7786-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A 66-year-old woman underwent partial mastectomy and a sentinel lymph node biopsy for left breast cancer; the pathological diagnosis was invasive ductal carcinoma (pT1aN0, pStage I, triple-negative subtype). Postoperative radiotherapy was performed. Two years later, she developed redness and induration at both breasts. The diagnosis was bilateral inflammatory breast cancer. After four cycles of dose-dense epirubicin and cyclophosphamide followed by 12 weekly paclitaxel cycles, bilateral total mastectomy and axillary lymph node dissection were performed. At the one-year follow-up after undergoing operation and radiotherapy, she remained alive without recurrence. Dose-dense treatment regimens may help patients achieve complete resection without short-term recurrence.
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Affiliation(s)
- Yuta Kawaguchi
- Department of Surgery, Yamaguchi Prefectural Grand Medical Center, Japan
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Xiangyue Meng
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Hiroko Hayashi
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Kazuma Kobayashi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Tomohiko Adachi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Masaaki Hidaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Shinichiro Itoh
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
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12
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Kobayashi K, Fujita T, Inoue Y, Okada S, Adachi T, Kuba S, Morita M, Kosaka T, Tanaka T, Kobayashi S, Maruya Y, Soyama A, Adachi T, Fukuda M, Honda T, Ito S, Hidaka M, Kanetaka K, Eguchi S. P74-4 FOLFOXIRI+a is an ideal regimen for conversion in the treatment of advanced/recurrent colorectal cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.05.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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13
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Maeda S, Kuba S, Shibata K, Soutome S, Yamanouchi K, Matsumoto M, Tanaka A, Morita M, Hatachi T, Baba M, Otsubo R, Yano H, Kawashita Y, Sato S, Kanetaka K, Taniguchi H, Umeda M, Nagayasu T, Eguchi S. Efficacy and safety of dexamethasone-based mouthwash to prevent chemotherapy-induced stomatitis in women with breast cancer: A multicenter, open-label, randomized phase II study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.12103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
12103 Background: Stomatitis, a frequent adverse event in patients undergoing chemotherapy, can lead to pain, ulcers, bleeding, and malnutrition due to reduced oral intake, which not only deteriorates quality of life but may also result in dose reduction or interruption of chemotherapy. However, there is currently no standard approach for preventing chemotherapy-induced stomatitis. Therefore, this study aimed to assess the efficacy and safety of a dexamethasone-based mouthwash for preventing chemotherapy-induced stomatitis in patients with early breast cancer. Methods: We conducted a multicenter, randomized, controlled phase II trial. Patients with early-stage breast cancer scheduled for epirubicin and cyclophosphamide (EC) or docetaxel and cyclophosphamide (TC) therapies were allocated in a 1:1 ratio to the intervention and control groups. The sample size was set to 120 cases based on the following assumptions: stomatitis incidence of 50% in the control group and 30% in the intervention group, alpha error of 0.2, one-sided power of 0.9, and dropout proportion of 10%. The intervention group received chemotherapy, oral care, and a dexamethasone-based mouthwash (10 mL, 0.1 mg/mL; swish for 2 min and spit, 4 times daily for 9 weeks), and the control group received chemotherapy and oral care. The primary endpoint was the incidence of stomatitis that was compared between the two groups. Results: There were 60 patients in the control group and 61 in the intervention group. One patient in the control group and two in the study group withdrew consent; one patient in the control group was excluded because of discontinuation of the first cycle of chemotherapy and unavailability of data related to the incidence of stomatitis. Finally, the data of 58 patients in the control group and 59 in the intervention group were analyzed. There were no differences in age and chemotherapy regimens between the groups. The incidence of stomatitis was 55% in the control group and 38% in the intervention group (risk ratio 0.68; 80% confidence interval, 0.52 – 0.88; p = 0.052). The grade of stomatitis (0/1/2/3) was significantly lower in the study group (intervention group vs. control group: 37/13/7/2 vs. 26/16/7/9, p = 0.03). There were no differences in the duration of stomatitis between the groups. Moreover, the percentage of patients who adhered to the mouthwash regimen was 87% (range, 14% – 100%). There were no significant differences in the occurrence of other adverse events between the groups, and only one case of oral candidiasis was observed in the intervention group. Conclusions: Dexamethasone-based mouthwash safely reduced the incidence and severity of stomatitis in patients receiving chemotherapy (EC/TC) for early breast cancer. Clinical trial information: UMIN000030489.
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Affiliation(s)
- Shigeto Maeda
- National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Sayaka Kuba
- Nagasaki University Graduate school of biomedical Science, Nagasaki, Japan
| | - Kenichi Shibata
- Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Sakiko Soutome
- Perioperative Oral Management Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Kosho Yamanouchi
- National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Megumi Matsumoto
- Surgical Oncology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Aya Tanaka
- Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | | | - Toshiko Hatachi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masayuki Baba
- Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Hiroshi Yano
- Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Shuntaro Sato
- Departments of Clinical Research Center, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-Shi, Japan
| | | | - Masahiro Umeda
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takeshi Nagayasu
- Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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14
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Kuba S, Maeda S, Minami S, Moriuchi H, Tanaka A, Akashi M, Morita M, Sakimura C, Baba M, Otsubo R, Matsumoto M, Yamanouchi K, Yano H, Kanetaka K, Nagayasu T, Eguchi S. Post-recurrence survival in asymptomatic compared with symptomatic metastatic breast cancer: A multicenter retrospective study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.1049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1049 Background: Asymptomatic metastatic breast cancer (mBC) is often detected using tumor marker or imaging tests in Japan. At the ASCO 2019, we reported on mBC detection, the distribution of symptomatic and asymptomatic disease by subtype (abstract e12568). We aimed to determine whether there are differences in post-recurrence survival (PRS), and treatment between asymptomatic and symptomatic MBCs, and identify factors associated with PRS. Methods: We performed a multicenter, retrospective analysis of patients with mBC treated in our hospitals from 2008 to 2018. Patients were divided into asymptomatic and symptomatic MBCs to compare their prognosis by breast cancer (BC) subtypes: luminal (hormone receptor positive/human epidermal growth factor 2 [HER2] negative), HER2 (any hormone receptor/HER2 positive), and triple-negative (TN) (hormone receptor negative/HER2 negative). Results: Of 204 patients with mBC (114 asymptomatic, 90 symptomatic), PRS was longer in asymptomatic mBC than in symptomatic mBC (median survival: 55 months vs. 29 months; p < 0.001) and tended to have longer overall survival (OS) (110 months vs 72 months, respectively; p = 0.09). In multivariate analysis, TN, recurrence-free survival (RFS), multiple metastasis sites, and symptomatic disease were independently predictive of PRS (Table). In luminal and HER2, PRS trended higher in the asymptomatic group than in the symptomatic group (luminal: 54 months vs. 41 months; p = 0.08, HER2: 71 months vs. 27 months; p = 0.09), but without significant difference in OS (luminal: 112 months vs. 124 months; p = 0.91, HER2: 113 months vs. 72 months; p = 0.40). In the luminal group, 13 patients (11%) were treated with cyclin-dependent kinase 4/6 (CDK4/6) inhibitors. The median PRS was 80 months for luminal patients with three factors — longer than 4 years of RFS, a single metastasis site, and asymptomatic disease. The duration of endocrine therapy did not differ between groups; however, the patients with luminal BC in the asymptomatic group had longer chemotherapy than those in the symptomatic group. In TN, PRS was very short (asymptomatic, 28 months; symptomatic, 10.5 months; p = 0.01). Conclusions: We demonstrated that asymptomatic MBC and symptomatic MBC differed in terms of subtypes, prognosis, and duration of chemotherapy in the luminal group. Therefore, unique treatment strategy for asymptomatic or symptomatic MBC should be developed. [Table: see text]
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Affiliation(s)
- Sayaka Kuba
- Nagasaki University Graduate school of biomedical Science, Nagasaki, Japan
| | - Shigeto Maeda
- National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | | | | | - Aya Tanaka
- Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Momoko Akashi
- Nagasaki Harbor Medical Center, Nagasaki Harbor Medical Center, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki Habor Hospital, Nagasaki, Japan
| | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masayuki Baba
- Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
| | | | - Megumi Matsumoto
- Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
| | - Kosho Yamanouchi
- National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Hiroshi Yano
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-Shi, Japan
| | - Takeshi Nagayasu
- Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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15
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Kuba S, Watanabe K, Chiba K, Matsumoto M, Yamanouchi K, Fukushima A, Meng X, Morita M, Otsubo R, Yano H, Kanetaka K, Osaki M, Nagayasu T, Eguchi S. Adjuvant endocrine therapy effects on bone mineral density and microstructure in women with breast cancer. J Bone Miner Metab 2021; 39:1031-1040. [PMID: 34191126 DOI: 10.1007/s00774-021-01239-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Although aromatase inhibitors (AIs) are typical drugs for cancer treatment-induced bone loss, their effects on the bone microstructure remain unclear. In this study, we evaluated changes in the bone mineral density (BMD) and bone microstructure associated with AI treatment using high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients with early breast cancer. MATERIALS AND METHODS This prospective, single-arm, observational study included non-osteoporotic, postmenopausal women with hormone receptor-positive breast cancer. Patients underwent dual-energy X-ray absorptiometry (DXA), HR-pQCT, and tartrate-resistant acid phosphatase-5b (TRACP-5b) or procollagen type-I N-terminal propeptide measurements at baseline and 6 and 12 months after AI therapy. The primary endpoint was changes in the total volumetric BMD (Tt.vBMD), trabecular vBMD (Tb.vBMD), and cortical vBMD (Ct.vBMD) longitudinally at the distal radius and tibia. RESULTS Twenty women were included (median age 57.5 years; range 55-72 years). At 12 months, HR-pQCT indicated a significant decrease in the Tt.vBMD (median distal radius - 5.3%, p < 0.01; distal tibia - 3.2%, p < 0.01), Tb.vBMD (- 3.2%, p < 0.01; - 1.0%, p < 0.05, respectively), and Ct.vBMD (- 3.2%, p < 0.01; - 2.7%, p < 0.01, respectively). Estimated bone strength was also significantly decreased. The DXA BMD value in the total hip (p < 0.01) and femoral neck (p = 0.03), but not in the lumbar spine, was significantly decreased. The TRACP-5b levels was significantly negatively associated with changes in the Tt.vBMD in both the distal radius and tibia (r = - 0.53, r = - 0.47, respectively) CONCLUSION: Postmenopausal women who received AIs for early breast cancer experienced significant trabecular and cortical bone deterioration and a decrease in estimated bone strength within only 1 year.
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Affiliation(s)
- Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-machi, Nagasaki, 852-8501, Japan.
| | - Kounosuke Watanabe
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Ko Chiba
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Megumi Matsumoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-machi, Nagasaki, 852-8501, Japan
| | - Ayako Fukushima
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Xiangyue Meng
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-machi, Nagasaki, 852-8501, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-machi, Nagasaki, 852-8501, Japan
| | - Ryota Otsubo
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Hiroshi Yano
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-machi, Nagasaki, 852-8501, Japan
| | - Makoto Osaki
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-machi, Nagasaki, 852-8501, Japan
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Kobayashi K, Fujita T, Sato A, Ito S, Inoue Y, Okada S, Kuba S, Morita M, Kobayashi S, Maruya Y, Fukumoto M, Kosaka T, Soyama A, Fukuda M, Honda T, Adachi T, Hidaka M, Kanetaka K, Eguchi S. P4-3 A reevaluation of adjuvant chemotherapy for colon cancer in our department. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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17
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Maeda S, Anan K, Koga K, Kuba S, Yano H, Kai Y, Nishimura R, Toh U, Yamaguchi M, Mashino K, Mitsuyama S, Tamura K, Tanaka T, Iwase H. Baseline neutrophil-to-lymphocyte ratio and absolute lymphocyte count in patients with HER2-negative breast cancer treated with eribulin may predict overall survival. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e13005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13005 Background: In Japan, eribulin has been approved for inoperative or recurrent breast cancer, following treatment with an anthracyclines and a taxanes. We reported the efficacy and safety of eribulin as a first-line to third-line treatment in patients with advanced/metastatic breast cancer (MBC) previously treated with anthracylinsanthracyclines and taxanes (Breast 2017). Briefly, the main inclusion criteria were as follows: no history of eribulin administration; an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 to 2,; human epidermal growth factor receptor 2 (HER2)-negative,; 20–75 years; ≥4 weeks from the last dose of chemotherapy, or ≥2 weeks from the last dosing of endocrine or radiation therapy; measurable lesion based on Response Evaluation Criteria in Solid Tumors (RECIST) ver. 1.1; sufficient organ function; life expectancy of ≥3 months; and no significant abnormalities on electrocardiogram. Patients in this clinical trial were enrolled between December 1, 2011, and November 30, 2013. Eribulin was administered intravenously at a dose of 1.4 mg/m2 during a 2-5 min infusion on days 1 and 8 every 3 weeks. In contrast, baseline neutrophil-to-lymphocyte ratio (NLR) and absolute lymphocyte count (ALC) were reported to predict progression-free survival (PFS) or overall survival (OS). However, these reports were mainly retrospective analysis. Therefore, retrospective evaluation of NLR/ALC in a prospective clinical trial is important to understand the association between NLR/ALC and OS/PFS. Methods: Of 47 prospectively enrolled patients in a previous trial, 45 patients were retrospectively evaluated for baseline NLR/ACL and at the time of 3 cycles of eribulin. The association between NLR/ALC and OS/PFS was also were analyzed for association with OS/PFS. The Kaplan-Meier method was used to estimate the OS/PFS distribution. The cut-off values for baseline NLR and ALC were set at 3 and 1500 /ul, respectively. Results: The median OS of patients with a baseline NLR < 3 was significantly longer than that of patients with a baseline NLR ≥ ≧3 (769 days vs. 409 days; log-rank test p = 0.0333). The median OS of patients with a baseline ALC ≥ ≧1500 was also significantly longer than that of patients with a baseline ALC < 1500 (964 days vs.vs 427 days; log-rank test p = 0.0425). Association between baseline NLR/ALC and PFS were not seen, and also association between at the time of 3 cycles of NLR/ALC and OS/PFS were not seen neither. Conclusions: Baseline NLR and ALC in the patients with HER2- negative breast cancer who plan to treat eribulin may predict overall survival. Clinical trial information: UMIN000007121.
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Affiliation(s)
- Shigeto Maeda
- National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Keisei Anan
- Kitakyushu Municipal Medical Center, Kitakyushu, Fukuoka, Japan
| | | | - Sayaka Kuba
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaski, Japan
| | - Hiroshi Yano
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Reiki Nishimura
- Breast Center, Kumamoto Shinto General Hospital, Kumamoto, Japan
| | - Uhi Toh
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | | | | | | | - Kazuo Tamura
- Division of Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Toshihiro Tanaka
- Division of Oncology, Hematology and Infectious Diseases, Department of Internal Medicine, Fukuoka University, Fukuoka, Japan
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18
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Kuba S, Watanabe K, Matsumoto M, Chiba K, Yamanouchi K, Fukushima A, Morita M, Otsubo R, Yano H, Kanetaka K, Osaki M, Nagayasu T, Eguchi S. Abstract PS9-23: Second-generation HR-pQCT analysis of bone mineral density and microstructure in women with breast cancer who underwent adjuvant endocrine therapy. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ps9-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Adjuvant endocrine therapy for 5-10 years reduces breast cancer (BC) mortality in women with hormone receptor-positive BC. However, aromatase inhibitors (AIs) decrease bone mineral density (BMD), and increase fractures, joint stiffness, and joint pain. Although dual energy X-ray absorptiometry (DXA) is widely used to assess BMD, it is a two-dimensional method and thus cannot analyze trabecular and cortical bone microstructure. High-resolution peripheral quantitative computed tomography (HR-pQCT) allows in vivo analysis of peripheral bone microarchitecture with high spatial resolution and low radiation exposure. We used HR-pQCT to evaluate changes in volumetric bone density and microstructure consisting of trabecular and cortical bone associated with AI treatment in patients with early BC. Methods: This was a prospective single-center observational study of nonosteoporotic, postmenopausal women with hormone receptor-positive BC, whose baseline DXA lumber spine and femoral neck T-scores were > −2.5. All patients were scheduled to receive DXA and HR-pQCT at baseline and at 6 and 12 months after starting AI therapy. The primary endpoint was to examine changes in total volumetric BMD (Tt. vBMD), trabecular volumetric BMD (Tb. vBMD), cortical volumetric BMD (Ct. vBMD) change at the distal radius and the distal radius between baseline and 6 and 12 months after starting endocrine therapy. Results: Of the 20 women in the study (median age: 57.5 years; range: 55-72 years), 8 had undergone chemotherapy before registration. Their mean change in Tt. vBMD between baseline and 1 year were distal radius: −5.7% (SD: 2.5%, P<0.01); distal tibia: −3.8% (SD: 1.8%, P<0.01), Tb. vBMD distal radius: −4.0% (SD: 3.9%, P<0.01); distal tibia: −0.9% (SD: 2.4%, P<0.05), Ct. vBMD distal radius: −3.1% (SD: 1.6%, P<0.01); distal tibia: −2.9% (SD: 1.7%, P<0.01). Furthermore, at 1 year in trabecular bone, mean trabecular bone volume fraction (p<0.01), trabecular thickness (p<0.05), and trabecular number (p<0.01) were significantly decreased, and trabecular separation (p<0.01) increased, in both the distal radius and tibia. At 1 year in cortical bone, mean changes in cortical thickness (p<0.01) and cortical bone area (p<0.01) were significantly decreased in both the distal radius and tibia; however, the endocortical perimeter of cortical bone did not significantly change and cortical porosity (p<0.05) was significantly greater than that at baseline. At 1 year, DXA decreased at the total hip (−4.4%, P<0.01) and femoral neck (−0.6%, P=0.03) compared with baseline. However, no significant difference was seen in median values for lumbar spine BMD at 1 year, or for tartrate-resistant acid phosphatase-5b (TRACP-5b) or procollagen type-I N-terminal propeptide (PINP). Conclusion: Postmenopausal women who took AIs for early BC experience volumetric bone density decline and both trabecular and cortical bone deterioration. A decade of AI treatment is a standard treatment for early BC; however, healthcare professionals should monitor bone health during and after these treatments.
Citation Format: Sayaka Kuba, Konosuke Watanabe, Megumi Matsumoto, Ko Chiba, Kosho Yamanouchi, Ayako Fukushima, Michi Morita, Ryota Otsubo, Hiroshi Yano, Kengo Kanetaka, Makoto Osaki, Takeshi Nagayasu, Susumu Eguchi. Second-generation HR-pQCT analysis of bone mineral density and microstructure in women with breast cancer who underwent adjuvant endocrine therapy [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-23.
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Affiliation(s)
| | | | | | - Ko Chiba
- Nagasaki University, Nagasaki, Japan
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Otsubo R, Yano H, Matsumoto M, Tanaka A, Fukushima A, Kuba S, Morita M, Uno N, Yoon HS, Yanagihara K, Eguchi S, Nagayasu T. Abstract PS1-39: Evaluation of novel diagnostic kits using the semi-dry dot-blot method combined with an automatic reader for detecting metastases in lymph nodes of patients with breast cancer : A single-center prospective study. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ps1-39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The semi-dry dot-blot (SDB) method, a diagnostic procedure for detecting lymph node (LN) metastases using anti-cytokeratin (CK) antibody, is based on the theory that epithelial components such as CK are not found in normal LNs. Thus, metastases are diagnosed on basis of the presence of CK in lavage fluid of sectioned LNs. We prospectively evaluated novel SDB kits that use a newly developed anti-CK19 antibody and an automatic reader for diagnosing LN metastases in patients with breast cancer. Methods: We obtained 117 LNs dissected from 58 patients with breast cancer between January 2020 and June 2020 at Nagasaki University Hospital. These were sliced at 2-mm intervals and washed with phosphate-buffered saline. Cells suspended in the lavage fluid of sliced LNs were centrifuged and lysed to extract protein. The extracted protein was applied to the SDB kit to diagnose LN metastasis using an automatic reader that evaluates absorbance. Hematoxylin and eosin (H&E) stained washed LNs were blindly examined by pathologists. Diagnoses based on SDB kit and automatic reader findings were compared with diagnoses made by histological examination of paraffin-embedded H&E stained sections of the LNs. Results: Six of the 117 LNs were assessed as positive and 111 as negative by histological examination. With a borderline CK19 absorbance of 50 milli-absorbance (mAbs) for detecting LN metastases excluding isolated tumor cells, the sensitivity, specificity, and overall agreement of the SDB kit were 66.7%, 99.1%, and 97.4%, respectively. Two patients with false-negatives had micrometastases of 0.6 and 0.5 mm in diameter. There was contamination by breast epithelial tissue in one false-positive case. With a borderline CK19 absorbance of 100 mAbs for distinguishing macrometastases from micrometastases, the sensitivity, specificity, and overall agreement of the SDB kit were 100%, 100%, and 100%, respectively. Furthermore, the kits and the automatic reader yielded diagnoses in approximately 20 min at a cost of less than 30 USD. Conclusions: The kits with an automatic reader used in our study were accurate, quick, and cost-effective in diagnosing LN metastases without loss of LN tissue, and were especially useful for detecting distinguish macrometastases. We plan to start a prospective multi-center study to evaluate clinical performance soon.
Citation Format: Ryota Otsubo, Hiroshi Yano, Megumi Matsumoto, Aya Tanaka, Ayako Fukushima, Sayaka Kuba, Michi Morita, Naoki Uno, Han-Seung Yoon, Katsunori Yanagihara, Susumu Eguchi, Takeshi Nagayasu. Evaluation of novel diagnostic kits using the semi-dry dot-blot method combined with an automatic reader for detecting metastases in lymph nodes of patients with breast cancer : A single-center prospective study [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS1-39.
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Affiliation(s)
| | | | | | - Aya Tanaka
- Nagasaki University Hospital, Nagasaki, Japan
| | | | - Sayaka Kuba
- Nagasaki University Hospital, Nagasaki, Japan
| | | | - Naoki Uno
- Nagasaki University Hospital, Nagasaki, Japan
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Kuba S, Moriuchi H, Yamanouchi K, Shibata K, Yano H, Oikawa M, Maeda S, Meng X, Morita M, Hatachi T, Otsubo R, Matsumoto M, Miyamoto J, Kanetaka K, Taniguchi H, Nagayasu T, Eguchi S. Protocol for studying the efficiency of ChemoCalc software in helping patients to understand drug treatment costs for breast cancer: A multicenter, open-label, randomized phase 2 study. Contemp Clin Trials Commun 2021; 21:100739. [PMID: 33718655 PMCID: PMC7921475 DOI: 10.1016/j.conctc.2021.100739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/22/2020] [Accepted: 02/04/2021] [Indexed: 11/28/2022] Open
Abstract
Survival of patients with breast cancer can be prolonged by treatment with drugs, particularly new molecular-targeted drugs. However, these agents can be expensive and such treatments can be “an economic burden.” In this ongoing trial, we aim to assess the usefulness of ChemoCalc, a software package for calculating drug costs, to help patients understand the financial outlays. In this multicenter, randomized controlled phase 2 trial, 106 patients with advanced breast cancer will be assigned to either the “ChemoCalc” or “Usual Explanation” group. Treatment using ChemoCalc will be discussed with patients in the ChemoCalc group, whereas standard treatments, without using ChemoCalc, will be discussed with patients in the Usual Explanation group. Subsequently, the participants will decide the treatment and complete a five-grade evaluation questionnaire; those in the Usual Explanation group will receive information about ChemoCalc. Investigators will report if patients subsequently decide to change treatments. The primary endpoint will be the scores of two key questions compared between the groups: “Did you understand the cost of treatment in today's discussion?” and “Do you think the cost of treatment is important in choosing a treatment?“. The secondary endpoints will be to compare discrepancies between treatments recommended by physicians and those selected by patients, the time required for discussion, other questionnaire factors, and the relationship between Comprehensive Score for Financial Toxicity tool and treatment selection. This will be the first randomized controlled trial to assess the efficacy of software to help patients understand drug cost estimates and whether it subsequently affects treatment choice. This study will be conducted according to the CONSORT statement. All participants will sign a written consent form. The study protocol was reviewed and approved by the Clinical Research Review Board of Nagasaki University (19070801). The protocol (version 1) was designed and will be conducted in accordance with the Declaration of Helsinki (1964) and the Ethical Guidelines for Medical and Health Research Involving Human Subjects (2017). The findings will be disseminated through scientific and professional conferences, and in peer-reviewed journals. Trial registration UMIN Clinical Trials Registry, UMIN000039904. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000041968 We aim to verify the efficiency of the drug cost estimation software ChemoCalc We will demonstrate whether knowing drug costs will change treatment choice We will elucidate whether ChemoCalc will enable patient–physician discussions
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Affiliation(s)
- Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Hiroki Moriuchi
- Department of Surgery, National Hospital Organization Saga Hospital, Saga, Japan
| | - Kosho Yamanouchi
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Kenichiro Shibata
- Department of Surgery, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Hiroshi Yano
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Masahiro Oikawa
- Department of Breast Surgery, Oikawa Hospital, Fukuoka, Japan
| | - Shigeto Maeda
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Xiangyue Meng
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Toshiko Hatachi
- Department of Surgery, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Ryota Otsubo
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Megumi Matsumoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Junya Miyamoto
- Clinical Research Center of Nagasaki University Hospital, Nagasaki, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Hideki Taniguchi
- Department of Surgery, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
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Kuba S, Yamanouchi K, Morita M, Sakimura C, Inamasu E, Hatachi T, Otsubo R, Matsumoto M, Yano H, Miyamoto J, Sato S, Nakagawa H, Kanetaka K, Takatsuki M, Nagayasu T, Eguchi S. The Efficacy of Software to Help Patients Understand Drug for Adjuvant Treatment for Breast Cancer: A Pilot Randomized Controlled Trial. Acta Med Okayama 2021; 74:95-101. [PMID: 32341582 DOI: 10.18926/amo/58266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We assessed the usefulness of ChemoCalc, a software package for calculating drug costs, in helping patients understand these costs. We randomly assigned, in a 1 : 1 ratio, 20 women who had undergone surgery for early breast cancer to a group that discussed adjuvant treatment with their physicians using the ChemoCalc software (ChemoCalc group) or a group that discussed adjuvant treatment without ChemoCalc (Usual Explanation group). The participants completed a five-grade evaluation questionnaire after these discussions. The primary endpoint was the intergroup comparison of the questionnaire scores regarding participants' understanding of their treatment-associated drug costs. Median age was not significantly different between the ChemoCalc group and Usual Explanation group (57 vs. 50, respectively; p=0.27). Patients in the ChemoCalc group had a significantly higher perceived level of understanding of the drug cost than those in the Usual Explanation group (5 [4-5] vs. 2.5 [1-5], respectively; p=0.002). Scores related to the patients' perception that understanding drug costs is an important part of breast cancer treatment were also higher in the ChemoCalc group than the Usual Explanation group (5 [2-5] vs. 3 [1-5], respectively; p=0.049). ChemoCalc was found to be useful for understanding drug costs.
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Affiliation(s)
- Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501,
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Eiko Inamasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Toshiko Hatachi
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Ryota Otsubo
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Megumi Matsumoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Hiroshi Yano
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Junya Miyamoto
- Department of Clinical Research Center, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Shuntaro Sato
- Department of Clinical Research Center, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Hiroo Nakagawa
- Department of Pharmacy, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Mitsuhisa Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
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Matsuzaka Y, Hamaguchi Y, Nishino A, Muta K, Sagara I, Ishii H, Noguchi I, Kuba S, Shiotani Y, Mine T, Ichikawa T, Ozawa H, Yasutake T, Kawarai Lefor A, Honda S, Maeda T, Nagata Y. The linkage between medical student readiness for interprofessional learning and interest in community medicine. Int J Med Educ 2020; 11:240-244. [PMID: 33170147 PMCID: PMC7883804 DOI: 10.5116/ijme.5f89.83ae] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 10/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The purpose of this study is to investigate the relationship between medical student readiness for interprofessional learning and interest in community medicine prior to incorporating community-oriented interprofessional education into the curriculum. METHODS A questionnaire was administered to students at Nagasaki University School of Medicine in Japan during each of three consecutive years (N=2244). The Readiness for Interprofessional Learning Scale (RIPLS) was administered in addition to a questionnaire to evaluate interest in community medicine. The Kruskal-Wallis and Steel-Dwass tests were used to determine differences between school years. Correlation between the RIPLS score and interest in community medicine was evaluated with Spearman's rank correlation coefficient. Relationships between RIPLS score and demographic parameters, and interest in community medicine were evaluated with multiple linear regression analysis. RESULTS Eighty-four percent (1891/2244) of students responded. The RIPLS score was highest in school year 1, followed by year 6, year 5, year 3, and years 4 and 2. Interest in community medicine correlated with the RIPLS score (rs = 0.332, p < 0.001), but less in year 1 (rs = 0.125, p = 0.002) than in other years. RIPLS score was significantly associated with gender, age, school year, interest in community medicine, but not the year that the survey was conducted. CONCLUSIONS Community-oriented interprofessional education has the potential to improve attitudes towards interprofessional learning. When introducing this promising education into the curriculum from year 1, attracting students' interest in community medicine should be considered.
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Affiliation(s)
- Yusuke Matsuzaka
- Center for Comprehensive Community Care Education, Nagasaki University Graduate School of Biomedical Sciences
| | - Yuko Hamaguchi
- Center for Comprehensive Community Care Education, Nagasaki University Graduate School of Biomedical Sciences
| | - Ayako Nishino
- Center for Comprehensive Community Care Education, Nagasaki University Graduate School of Biomedical Sciences
| | - Kumiko Muta
- Center for Comprehensive Community Care Education, Nagasaki University Graduate School of Biomedical Sciences
| | - Ikuko Sagara
- Center for Comprehensive Community Care Education, Nagasaki University Graduate School of Biomedical Sciences
| | - Hiroyuki Ishii
- Center for Comprehensive Community Care Education, Nagasaki University Graduate School of Biomedical Sciences
| | - Ikue Noguchi
- Center for Comprehensive Community Care Education, Nagasaki University Graduate School of Biomedical Sciences
| | - Sayaka Kuba
- Center for Comprehensive Community Care Education, Nagasaki University Graduate School of Biomedical Sciences
| | - Yuji Shiotani
- Department of Comprehensive Community Care Service, Nagasaki Junshin Catholic University
| | - Takashi Mine
- Department of Comprehensive Community Care Systems, Nagasaki University Graduate School of Biomedical Sciences
| | - Tatsuki Ichikawa
- Department of Comprehensive Community Care Systems, Nagasaki University Graduate School of Biomedical Sciences
| | - Hiroki Ozawa
- Department of Neuropsychiatry, Nagasaki University Graduate School of Biomedical Sciences
| | - Toru Yasutake
- Advanced Medical Education Center, School of Medicine, Nagasaki University
| | | | - Sumihisa Honda
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences
| | - Takahiro Maeda
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Yasuhiro Nagata
- Center for Comprehensive Community Care Education, Nagasaki University Graduate School of Biomedical Sciences
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Yamanouchi K, Kuba S, Matsumoto M, Yano H, Morita M, Sakimura C, Otsubo R, Kanetaka K, Nagayasu T, Eguchi S. Study Protocol for Assessing the Efficacy of Compression Therapy Using Stockings and Sleeves to Prevent Docetaxel-Induced Peripheral Neuropathy in Breast Cancer Patients. Acta Med Okayama 2020; 74:455-459. [PMID: 33106704 DOI: 10.18926/amo/60808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Taxanes are key drugs for patients with breast cancer. A major adverse effect associated with the administration of the taxane docetaxel is chemotherapy-induced peripheral neuropathy (CIPN). We are conducting a singlecenter, single-arm, open-label historical control trial to evaluate the ability of compression therapy using stockings or sleeves to prevent CIPN due to docetaxel treatment. The primary endpoint is the incidence of all-grade CIPN according to patients' records until 3 weeks after the fourth docetaxel administration. This study's results will clarify whether compression therapy using stockings or sleeves can prevent CIPN in breast cancer patients.
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Affiliation(s)
- Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501,
| | - Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Megumi Matsumoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Hiroshi Yano
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Ryota Otsubo
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki 852-8501, Japan
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Kobayashi K, Morita M, Fukui S, Ito S, Inoue Y, Yamaguchi I, Mine Y, Kosaka T, Kuba S, Sakimura C, Yamanouchi K, Soyama A, Ono S, Adachi T, Natsuda K, Okada S, Tetsuo H, Ikebe A, Yamaguchi S, Enjoji T, Okada K, Haraguchi M, Taniguchi K, Fujioka H, Kuroki T, Matsuo M, Azuma T, Kamohara Y, Hashimoto T, Moriuchi H, Kitajima T, Kawakami S, Enjoji A, Suto R, Hidaka M, Torashima Y, Hayashida N, Kanetaka K, Takatsuki M, Eguchi S. S-1 and CPT-11 Plus Ramucirumab (IRIS+Rmab) as Second-Line Chemotherapy for Patients with Oxaliplatin-Refractory Metastatic Colorectal Cancer (mCRC): A Multicenter Phase II Study in Japan (N-DOCC-F-C-1701). Kurume Med J 2020; 66:43-47. [PMID: 32378536 DOI: 10.2739/kurumemedj.ms661007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This multicenter phase II N-DOCC-F-C-1701 trial is being planned in order to investigate the efficacy and safety of CPT-11+S-1 +Ramucirumab (IRIS+Rmab), which is anticipated to have a stronger anti-tumor effect than IRIS+Bmab in patients with metastatic colorectal cancer (mCRC) previously treated with oxaliplatin (L-OHP) containing regimen, in consideration of the result of RAISE, FIRIS and some phase II trials of IRIS+Bevacicizumab (Bmab). The number of patients is set at 38 for the statistical analysis, assuming an expected median PFS of 5.0 months (threshold: 3.0 months). The primary endpoint of the study is the progression free survival (PFS), and the secondary endpoints are the overall response rate (ORR), overall survival (OS), adverse events (AE), quality of life (QOL) and review of nausea and vomiting. This trial is registered in the UMIN Clinical Trials Registry as UMIN000028170. We intend to start conducting the trial in September 1, 2017. If this trial meets the endpoint, IRIS+Rmab might be supported as a new optional standard regimen for mCRC.
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Affiliation(s)
- Kazuma Kobayashi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Saeko Fukui
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Shinichiro Ito
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Yusuke Inoue
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Izumi Yamaguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Yuka Mine
- Department of Surgery, Koseikai Hospital
| | - Taiichiro Kosaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Akihiko Soyama
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Shinichiro Ono
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Tomohiko Adachi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Koji Natsuda
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Satomi Okada
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Hanako Tetsuo
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Ayaka Ikebe
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Shun Yamaguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Takahiro Enjoji
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | | | | | - Ken Taniguchi
- Department of Surgery, National Hospital Organization Nagasaki Medical Center
| | - Hikaru Fujioka
- Department of Surgery, National Hospital Organization Nagasaki Medical Center
| | - Tamotsu Kuroki
- Department of Surgery, National Hospital Organization Nagasaki Medical Center
| | | | | | - Yukio Kamohara
- Department of Surgery, Nagasaki Prefecture Shimabara Hospital
| | | | | | | | | | - Akihito Enjoji
- Department of Surgery, National Hospital Organization Saga Hospital
| | - Ryuichiro Suto
- Department of Surgery, Yamaguchi Prefectural Grand Medical Center
| | - Masaaki Hidaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Yasuhiro Torashima
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Naomi Hayashida
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Mitsuhisa Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
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Fukui S, Kobayashi K, Morita M, Ito S, Inoue Y, Kuba S, Sakimura C, Kosaka T, Abe K, Yamanouchi K, Kanetaka K, Takatsuki M, Eguchi S. A Complete Response Achieved in a Patient with Hepatic Metastasis from Sigmoid Colon Cancer by a Regimen Containing Ramucirumab: a Case Report. J Gastrointest Cancer 2020; 51:624-627. [PMID: 31482405 DOI: 10.1007/s12029-019-00304-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Saeko Fukui
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki city, Nagasaki, 852-8501, Japan
| | - Kazuma Kobayashi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki city, Nagasaki, 852-8501, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki city, Nagasaki, 852-8501, Japan
| | - Shinichiro Ito
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki city, Nagasaki, 852-8501, Japan
| | - Yusuke Inoue
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki city, Nagasaki, 852-8501, Japan
| | - Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki city, Nagasaki, 852-8501, Japan
| | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki city, Nagasaki, 852-8501, Japan
| | - Taiichiro Kosaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki city, Nagasaki, 852-8501, Japan
| | - Kuniko Abe
- Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki city, Nagasaki, 852-8501, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki city, Nagasaki, 852-8501, Japan
| | - Mitsuhisa Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki city, Nagasaki, 852-8501, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki city, Nagasaki, 852-8501, Japan.
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Kobayashi K, Yamaguchi S, Ito S, Torashima Y, Inoue Y, Okada S, Enjoji T, Tetsuo H, Kuba S, Kosaka T, Adachi T, Hidaka M, Yamanouchi K, Kanetaka K, Takatsuki M, Eguchi S. Efficacy and Safety of Modified FOLFOXIRI+α in the Treatment of Advanced and Recurrent Colorectal Cancer: A Single-center Experience. Intern Med 2020; 59:1239-1245. [PMID: 32074573 PMCID: PMC7303458 DOI: 10.2169/internalmedicine.3274-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 12/23/2019] [Indexed: 11/12/2022] Open
Abstract
Objective In the treatment of advanced and recurrent colorectal cancer (ARCC), FOLFOXIRI regimens have been proven to be significantly superior to FOLFIRI in terms of the progression-free survival (PFS), response rate (RR), and overall survival (OS). Furthermore, the Tribe trial showed that the RR and PFS rates in patients who received bevacizumab (Bmab) +FOLFOXIRI were superior to those in patients treated with Bmab+FOLFIRI. A phase III trial of panitumumab (Pmab) +FOLFOXIRI is currently ongoing. A modified FOLFOXIRI regimen is also widely used to reduce adverse events. In our department, we introduced modified FOLFOXIRI+α (mFOLFOXIRI+α) in 2015. The present study reviewed the efficacy and safety of mFOLFOXIRI+α. Methods Eligible patients were retrospectively reviewed, and their results were compared to those of patients treated with other regimens (OTHERS) (n=134) to demonstrate the efficacy of this treatment. Patients: Between February 2015 and November 2018, 12 patients with ARCC (male/female=6/6; average age, 60.7 years old) received mFOLFOXIRI+α (Bmab: 10, Pmab: 1, alone: 1). Results The median PFS in the mFOLFOXIRI+α and OTHERS groups was 565 and 322 days, respectively (p=0.0544). The RR in the mFOLFOXIRI+α and OTHERS groups was 66.7% and 31.3%, respectively (p=0.0135). The conversion rate (Conv R) in the mFOLFOXIRI+α and OTHERS groups was 50.0% and 12.7%, respectively (p=0.0007). While 58% of patients treated with FOLFOXIRI+α developed grade ≥3 leukopenia, the incidence of febrile neutropenia (FN) was only 17%. In all patients with symptoms due to the tumor burden, the symptoms subsided with mFOLFOXIRI+α treatment. Conclusion Based on the RR, Conv R, and symptom palliation ability, mFOLFOXIRI+α was suggested to be a viable candidate for first-line treatment for patients with ARCC, especially those with a high tumor burden.
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Affiliation(s)
- Kazuma Kobayashi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Shun Yamaguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Shinichiro Ito
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Yasuhiro Torashima
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Yusuke Inoue
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Satomi Okada
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Takahiro Enjoji
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Hanako Tetsuo
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Taiichiro Kosaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Tomohiko Adachi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Masaaki Hidaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Mitsuhisa Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Kuba S, Maeda S, Matsumoto M, Yamanouchi K, Iwata T, Morita M, Sakimura C, Otsubo R, Yano H, Sato S, Kanetaka K, Nagayasu T, Eguchi S. Optimal Tumor Reduction Rate and Modalities for Predicting pCR in Women With Breast Cancer. Anticancer Res 2020; 40:2303-2309. [PMID: 32234930 DOI: 10.21873/anticanres.14196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM To predict pCR during neoadjuvant chemotherapy is still difficult. The aim of this study was to evaluate the optimal tumor reduction rate and modalities for predicting pCR after two cycles of docetaxel. PATIENTS AND METHODS We analyzed 52 patients with HER2-positive or triple-negative breast cancer. The tumor reduction rate was evaluated after two 3-week cycles of docetaxel (plus trastuzumab for HER2-positive cancer patients). Patients without progression completed two additional cycles of docetaxel and four cycles of an anthracycline-containing regimen. RESULTS Twenty-eight patients achieved pCR. The optimal tumor reduction rates for predicting pCR were 23, 39, 32, and 40% for US, caliper, MMG, and MRI measurements, respectively. The AUC was highest for caliper measurements. The optimal modality for predicting pCR differed among subtypes. CONCLUSION Although tumor reduction rate after two cycles of chemotherapy is highly predictive of pCR, the optimal cutoff value differed among the modalities and breast cancer subtype.
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Affiliation(s)
- Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Shigeto Maeda
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Megumi Matsumoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Kosho Yamanouchi
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Toru Iwata
- Department of Surgery, Nagasaki Rosai Hospital, Nagasaki, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Ryota Otsubo
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Hiroshi Yano
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Shuntaro Sato
- Clinical Research Center of Nagasaki University Hospital, Nagasaki, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
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Kuba S, Yamanouchi K, Matsumoto M, Maeda S, Hatachi T, Sakiko S, Kawashita Y, Morita M, Sakimura C, Inamasu E, Shibata K, Otsubo R, Yano H, Nose S, Miyamoto J, Sato S, Kanetaka K, Taniguchi H, Umeda M, Nagayasu T, Eguchi S. Study protocol for efficacy and safety of steroid-containing mouthwash to prevent chemotherapy-induced stomatitis in women with breast cancer: a multicentre, open-label, randomised phase 2 study. BMJ Open 2020; 10:e033446. [PMID: 32060155 PMCID: PMC7045258 DOI: 10.1136/bmjopen-2019-033446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Stomatitis is a frequent adverse event in patients undergoing chemotherapy for breast cancer. Stomatitis can hamper oral nutrition resulting in malnutrition, reduce quality of life and introduce the need for dose reductions and interruption of chemotherapy; however, there is currently no standard approach for preventing chemotherapy-induced stomatitis. We aimed to assess the safety and efficacy of a dexamethasone-based elixir mouthwash for preventing chemotherapy-induced stomatitis in patients with early breast cancer. METHODS AND ANALYSIS In this multicenter, randomised, controlled phase 2 trial, we will randomly assign 120 women with early breast cancer undergoing chemotherapy to use of a dexamethasone-based elixir or standard oral care, to compare their preventive effects on chemotherapy-induced stomatitis. Patients will be assigned in a 1:1 ratio. Patients in the intervention group will receive chemotherapy, oral care and a dexamethasone-based elixir (10 mL 0.1 mg/mL; swish for 2 min and spit, four times daily for 9 weeks), and patients in the control group will receive chemotherapy and oral care. The primary endpoint is the difference in incidence of stomatitis between the two groups. The sample size allows for the detection of a minimum difference of 20% in the incidence of stomatitis between the two groups. Secondary endpoints are severity of stomatitis, duration of stomatitis, completion rate of chemotherapy and adverse events. ETHICS AND DISSEMINATION All participants signed a written consent form, and the study protocol has been reviewed and approved by the Clinical Research Review Board of Nagasaki University (CRB7180001). TRIAL REGISTRATION NUMBER UMIN Clinical Trials Registry (UMIN000030489).
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Affiliation(s)
- Sayaka Kuba
- Surgery, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kosho Yamanouchi
- Surgery, National Hospital Organisation Nagasaki Medical Center, Omura, Nagasaki, Japan
| | - Megumi Matsumoto
- Surgical Oncology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shigeto Maeda
- Surgery, National Hospital Organisation Nagasaki Medical Center, Omura, Nagasaki, Japan
| | - Toshiko Hatachi
- Surgery, Japanese Red Cross Nagasaki Atomic Bomb Hospital, Nagasaki, Japan
| | - Soutome Sakiko
- Oral Management Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Yumiko Kawashita
- Oral Management Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Michi Morita
- Surgery, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Chika Sakimura
- Surgery, Nagasaki Harbor Medical Center City Hospital, Nagasaki, Japan
| | - Eiko Inamasu
- Hakujujikai Sasebo Chuo Hospital, Sasebo, Nagasaki, Japan
| | - Kenichiro Shibata
- Surgery, Japanese Red Cross Nagasaki Atomic Bomb Hospital, Nagasaki, Japan
| | - Ryota Otsubo
- Surgical Oncology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Yano
- Surgical Oncology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Seiichi Nose
- Pharmacy, Nagasaki University Hospital, Nagasaki, Japan
| | - Junya Miyamoto
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Shuntaro Sato
- Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Kengo Kanetaka
- Surgery, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hideki Taniguchi
- Surgery, Japanese Red Cross Nagasaki Atomic Bomb Hospital, Nagasaki, Japan
| | - Masahiro Umeda
- Clinical Oral Oncology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takeshi Nagayasu
- Surgical Oncology, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Surgery, Nagasaki University School of Medicine Graduate School of Biomedical Sciences, Nagasaki, Japan
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Kobayashi K, Kanetaka K, Yoneda A, Kobayashi S, Yamaguchi S, Tetsuo H, Okada S, Enjoji T, Kuba S, Sakimura C, Kosaka T, Inoue Y, Ono S, Natsuda K, Adachi T, Hidaka M, Torashima Y, Ito S, Yamanouchi K, Takatsuki M, Eguchi S. Down-staging and histological effects might be predictive factors for DOC+CDDP+5-FU for esophageal cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz343.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Meng X, Yamanouchi K, Kuba S, Sakimura C, Morita M, Matsuguma K, Kanetaka K, Takatsuki M, Abe K, Eguchi S. Giant fibroadenoma of the breast: A rare case in a mature woman. Int J Surg Case Rep 2019; 63:36-39. [PMID: 31561187 PMCID: PMC6796725 DOI: 10.1016/j.ijscr.2019.09.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/31/2019] [Accepted: 09/09/2019] [Indexed: 11/16/2022] Open
Abstract
We experienced giant fibroadenoma of breast, a rare case in a mature woman. We suspected a malignant tumor, due to the size and ulceration and bleeding. Total mastectomy and skin grafting were needed for complete resection. An early diagnosis and treatment could prevent total mastectomy.
Introduction Fibroadenomas are common benign lesions of the breast that are usually found young patients. Giant fibroadenomas are uncommon benign lesions, defined as fibroadenomas of >5 cm in size, which are usually found in patients of less than 20 years of age. Presentation of case A 39-year-old premenopausal woman presented with a right breast tumor that had rapidly increased in size and which showed ulceration and bleeding. Needle biopsy showed mixed connective tissue and an epithelial tumor without a leaf-like pattern, but indeterminate. Total mastectomy and skin grafting were performed. Histopathology confirmed the diagnosis of giant fibroadenoma. Discussion In comparison to all previous reports on patients with giant fibroadenoma, this patient was relatively old and the etiology was unknown. Although rare, an appropriate therapeutic strategy should be decided according to the results of a histopathological examination. Conclusion Early treatment could allow breast preserving surgery and patients should be recommended to undergo reexamination with awareness of progression.
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Affiliation(s)
- Xiangyue Meng
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
| | - Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Kunihito Matsuguma
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Mitsuhisa Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Kuniko Abe
- Department of Pathology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan; Department of Pathology, Nagasaki Genbaku (Atomic Bomb) Hospital, 3-15 Mori-machi, Nagasaki, 852-8511, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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Huang Y, Yamanouchi K, Sakai Y, Kuba S, Sakimura C, Morita M, Kanetaka K, Takatsuki M, Eguchi S. Fabrication of Functional Cell Sheets with Human Thyrocytes from Non-Tumorous Thyroid Tissue. Tissue Eng Regen Med 2019; 16:491-499. [PMID: 31624704 DOI: 10.1007/s13770-019-00198-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 04/26/2019] [Accepted: 06/03/2019] [Indexed: 11/29/2022] Open
Abstract
Background Engineered cell sheet transplantation has been considered an alternative physiological therapy for endocrine disorders. In this study, we attempted to fabricate functional human thyroid cell sheets using the engineering technology by culturing primary thyrocytes in free-feeder monolayers and assessed their proliferation and function in two different media. Methods The non-tumorous tissues (approximately 2 g) were dissected during surgery. Primary human thyroid cells were isolated by mechanical dispersion and treatment with isolation solution. The cells were cultured on tissue culture dishes or temperature-responsive culture dishes to induce the formation of detached cell sheets. Results Primary thyroid cells isolated from nine patients were positive for thyroid transcription factor 1, thyroglobulin (TG) and cytokeratin 7. Cell sheets with follicles were fabricated by cells incubated in both Dulbecco's Modified Eagle Medium (DMEM) and hepatocyte-defined medium (HDM) culture medium. The diameter and thickness of sheets fabricated in HDM were larger and thicker than those fabricated from DMEM. Furthermore, the cells incubated in HDM secreted higher levels of fT3 and fT4 than those incubated in DMEM. The thyroid peroxidase and TG mRNA of cells maintained in HDM were higher than those in cells maintained in DMEM. Conclusion HDM appears suitable as a culture medium for maintaining primary thyrocytes and fabricating functional cell sheets. These in vitro findings may contribute to the development of appropriate culture conditions for human thyrocytes as well as engineered functional cell sheets.
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Affiliation(s)
- Yu Huang
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Yusuke Sakai
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Mitsuhisa Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan
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Kuba S, Yamanouchi K, Maeda S, Yano H, Minami S, Moriuchi H, Matsumoto M, Otsubo R, Morita M, Sakimura C, Inamasu E, Yamaguchi J, Kanetaka K, Takatsuki M, Nagayasu T, Eguchi S. Asymptomatic versus symptomatic metastatic breast cancer: Potential effects on prognosis and treatment strategies. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e12568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e12568 Background: Early breast cancer (BC) patients in Japan can receive a follow-up CT scan, which can diagnose asymptomatic metastatic (M)BC. How symptomatic and asymptomatic MBC differ regarding prognosis and whether treatment strategies should differ is unclear. Methods: A retrospective, multicenter, cohort study was performed. We reviewed records of MBC women treated at four institutions between 2008 and 2018. Follow-up CTs were not routinely performed. Patients were divided into three BC subtypes: Luminal (ER+, PgR+, or both, but HER2-), HER2 (HER2+), and triple negative (TN) (ER-, PgR-, HER2-). Results: Of 205 MBC patients, 120 were luminal, 51 HER2, and 34 TN. Ninety were diagnosed with symptomatic and 115 with asymptomatic MBC. Symptomatic MBC patients had the following symptoms: locoregional metastasis (43%), bone pain (25%), cough or dyspnea (16%), and brain-related symptoms (10%). Diagnosis of asymptomatic MBC was based on follow-up imaging (71%) and elevated tumor markers (27%). The proportion of the patients with symptomatic MBC were different in each subtype: 38% luminal, 45% HER2, and 65% TN (p = 0.02). Among luminal patients, median overall survival (OS) after metastasis was longer for those with asymptomatic versus symptomatic MBC (62 vs 41 M, respectively; p = 0.04), although disease-free interval (48 vs 54 M, respectively; p = 0.40) and OS after breast surgery (119 vs 126 M, respectively; p = 0.93) did not differ significantly. Conversely, among TN patients, those with asymptomatic MBC had significantly longer median OS after metastasis and after breast surgery. Although the median period of cumulative endocrine therapy after metastasis did not differ between groups, luminal BC patients with asymptomatic MBC received chemotherapy longer than those with symptomatic MBC (20 vs 12 M, respectively; p = 0.02). Most patients switched to chemotherapy because of endocrine resistance without life threatening disease. To diagnose asymptomatic MBC might lead to longer use chemotherapy. Conclusions: Physicians should take symptomatic versus asymptomatic MBC into consideration in predicting prognosis to optimize treatment strategies.
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Affiliation(s)
- Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Hiroshi Yano
- Department of Surgery, Nagasaki University Hospital, Nagasaki, Japan
| | - Shigeki Minami
- Department of Surgery, Nagasaki Harbor Medical Center, Nagasaki, Japan
| | | | - Megumi Matsumoto
- Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
| | - Ryota Otsubo
- Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki Habor Hospital, Nagasaki, Japan
| | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Eiko Inamasu
- Department of Surgical Oncology, Nagasaki University, Fukuoka, Japan
| | | | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-Shi, Japan
| | - Mitsuhisa Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takeshi Nagayasu
- Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Hara Y, Otsubo R, Inamasu E, Matsumoto M, Yano H, Sakimura C, Kuba S, Yamanouchi K, Eguchi S, Nagayasu T. Abstract P3-03-35: Prevalence and risk factors associated with development of lymphedema after axillary lymph node dissection among breast cancer patients: Single center retrospective study. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-03-35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Lymphedema in breast cancer is one of the most important complications, and causes symptoms of arm swelling, heaviness and limited movement. Once lymphedema has occurred, it is difficult to cure. Nowadays, treatment with axillary lymph node dissection (ALND) has been decreasing among breast cancer patients as a result of the ACOSOG Z0011, AMAROS and IBCSG 23-01 trials. However, some cases require ALND for ALN metastasis. ALND increases the risk of lymphedema and detracts from quality of life, but the surgical procedure based on anatomical landmarks has not been changed for several decades. The upper borderline for ALND might cause injury to lymph ducts from arms, and incidence and risk factors for lymphedema after ALND are still unclear. Our aim was to identify prevalence and risk factors associated with development of lymphedema after ALND among breast cancer patients.
Methods: This retrospective study was based on data collected from 178 breast cancer patients who underwent ALND in Nagasaki University Hospital, Japan, between 2005 and 2017. Lymphedema was defined as symptomatic arm swelling with >2 cm difference in circumference of the arm compared with that of the contralateral arm. We classified the patients with and without lymphedema, and compared them regarding surgical and pathological findings. Univariate and multivariate analyses were performed to evaluate the risk factors, using the χ2 test, Student's t-test and Cox logistic regression analysis.
Results: Prevalence of lymphedema was 16% (28/178 patients) and mean time interval from surgery to development of lymphedema was 463 days. In univariate analysis, there was a significant difference in postmastectomy radiation therapy (PMRT) (p = 0.02) and the number of patients with >18 dissected ALNs (p = 0.02). Body mass index (p = 0.6), administration of docetaxel (p = 0.2), and smoking (p = 0.07) did not significantly increase lymphedema. In multivariate analysis, PMRT (p = 0.01) and dissection of >18 ALNs (p = 0.001) significantly increased the risk of lymphedema, whereas smoking did not (p = 0.4).
Conclusion: Our study suggested that PMRT and number of dissected ALNs were risk factors for lymphedema. Aggressive and empiric ALND might be associated with axillary lymph duct damage. Therefore, we plan to introduce axillary reverse mapping using indocyanine green to reduce the risk of lymphedema in breast cancer patients who undergo ALND.
Citation Format: Hara Y, Otsubo R, Inamasu E, Matsumoto M, Yano H, Sakimura C, Kuba S, Yamanouchi K, Eguchi S, Nagayasu T. Prevalence and risk factors associated with development of lymphedema after axillary lymph node dissection among breast cancer patients: Single center retrospective study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-03-35.
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Affiliation(s)
- Y Hara
- Nagasaki University Hospital, Nagasaki, Japan
| | - R Otsubo
- Nagasaki University Hospital, Nagasaki, Japan
| | - E Inamasu
- Nagasaki University Hospital, Nagasaki, Japan
| | - M Matsumoto
- Nagasaki University Hospital, Nagasaki, Japan
| | - H Yano
- Nagasaki University Hospital, Nagasaki, Japan
| | - C Sakimura
- Nagasaki University Hospital, Nagasaki, Japan
| | - S Kuba
- Nagasaki University Hospital, Nagasaki, Japan
| | | | - S Eguchi
- Nagasaki University Hospital, Nagasaki, Japan
| | - T Nagayasu
- Nagasaki University Hospital, Nagasaki, Japan
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Kinoe H, Yamanouchi K, Kuba S, Morita M, Sakimura C, Kanetaka K, Takatsuki M, Abe K, Yano H, Matsumoto M, Otsubo R, Hayashida N, Nagayasu T, Eguchi S. Discordance of hormone receptor, human epidermal growth factor receptor-2, and Ki-67 between primary breast cancer and synchronous axillary lymph node metastasis. J BUON 2018; 23:60-66. [PMID: 30722113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE We herein report the discordance rate between primary breast cancer and synchronous axillary node metastasis, its characteristics and its prognostic impact. METHODS One hundred and four patients with invasive breast cancer with synchronous axillary node metastasis who underwent surgery were included. Estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor-2 (HER2), and Ki-67 were stained by immunohistochemistry in both primary and node metastasis. The cut-off values of the ER/PgR and Ki-67 labeling index were set at 10% and 14%, respectively. HER2 was classified according to the ASCO/CAP guidelines. RESULTS Cases positive for ER, PgR, and HER2 were 65.4%, 51.0%, and 27.9% and those with a high Ki-67 labeling index were 47.1% in primary breast cancer, respectively, while they were 47.1%, 30.8%, 16.3%, and 75.0% in node metastasis, respectively. The discordance rates between primary and node were 28.8% for ER (positive in primary→negative in node/negative→positive 22.1%/6.7%), 31.7% for PgR (26.9%/4.8%), 13.5% for HER2 (12.5%/1.0%), and 43.3% for Ki-67 (high in primary→low in node/low→high 12.5%/30.8%). The proportions of labeled cells in primary/node were as follows: ER 42.7%/25.2%, PgR 32.1%/14.0%, Ki-67 20.3%/37.1% (p<0.01 each). Regarding the cut-off value of Ki-67 in node metastasis as defined by a receiver operating characteristic (ROC) analysis, the patients with values >33.2% tended to have a poor recurrence-free survival (RFS) (p=0.08). CONCLUSIONS The expression of hormone receptors tended to weaken while the proliferative status remained strong in axillary metastasis. A high Ki-67 labeling index in axillary lymph node metastasis may be a risk factor for recurrence.
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Affiliation(s)
- Hiroko Kinoe
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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Kobayashi K, Sakimura C, Kanetaka K, Kobayashi S, Morita M, Kuba S, Kosaka T, Inoue Y, Soyama A, Hidaka M, Honda T, Fukuda M, Ito S, Yamanouchi K, Takatsuki M, Eguchi S. A review of S-1 and S-1+Platinum for late-stage elderly patients with metastatic gastric cancer as a first-line regimen. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy375.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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36
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Yamanouchi K, Kinoe H, Kuba S, Morita M, Sakimura C, Kobayashi K, Kanetaka K, Takatsuki M, Hayashida N, Eguchi S. Discordance of Hormonal Receptor, Human Epidermal Growth Factor Receptor-2, and Ki-67 between Primary Breast Cancer and Synchronous Axillary Node Metastasis. J Am Coll Surg 2018. [DOI: 10.1016/j.jamcollsurg.2018.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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37
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Kuba S, Fujiyama R, Yamanouchi K, Morita M, Sakimura C, Hatachi T, Matsumoto M, Yano H, Takatsuki M, Hayashida N, Nagayasu T, Eguchi S. Awareness of dysgeusia and gustatory tests in patients undergoing chemotherapy for breast cancer. Support Care Cancer 2018; 26:3883-3889. [PMID: 29754211 DOI: 10.1007/s00520-018-4256-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 05/06/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE We analyzed the prevalence of gustatory test abnormalities in breast cancer (BC) patients undergoing chemotherapy. METHODS We enrolled 43 BC patients undergoing chemotherapy and 38 BC patients who had never undergone chemotherapy (control group). Two gustatory tests were conducted: an instillation method examining the threshold for four basic taste stimuli and an electrogustometry method measuring the threshold for perception with electric stimulation at the front two-thirds of the tongue (cranial nerve VII) and at the back third of the tongue (cranial nerve IX). The results of the two gustatory tests and clinicopathological factors were compared between the chemotherapy and control groups and between patients with and without awareness of dysgeusia in the chemotherapy group. RESULTS In the chemotherapy group, 19 (44%) patients were aware of dysgeusia and 8 (19%) had hypogeusia using the instillation method. Although more patients had parageusia in the chemotherapy than control group, no significant differences in the results of the two gustatory tests were observed. Patients with dysgeusia awareness had a higher threshold at cranial nerve IX using the electrogustometry method than those without dysgeusia awareness; no significant differences in hypogeusia were observed using the instillation method. In fact, 74% (14/19) of patients with dysgeusia awareness could identify the four tastes accurately using the instillation method. Similar results were observed for the instillation and electrogustometry methods at cranial nerve VII. CONCLUSIONS While approximately half of the chemotherapy patients were aware of dysgeusia, 81% (35/43) of them could accurately identify the four basic tastes using the instillation method.
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Affiliation(s)
- Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-machi, Nagasaki, Nagasaki, 852-8501, Japan.
| | - Rie Fujiyama
- Department of Oral Physiology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-machi, Nagasaki, Nagasaki, 852-8501, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-machi, Nagasaki, Nagasaki, 852-8501, Japan
| | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-machi, Nagasaki, Nagasaki, 852-8501, Japan
| | - Toshiko Hatachi
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Megumi Matsumoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Hiroshi Yano
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Mitsuhisa Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-machi, Nagasaki, Nagasaki, 852-8501, Japan
| | - Naomi Hayashida
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-machi, Nagasaki, Nagasaki, 852-8501, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto-machi, Nagasaki, Nagasaki, 852-8501, Japan
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Kuba S, Maeda S, Matsumoto M, Yamanouchi K, Yano H, Morita M, Sakimura C, Hatachi T, Tokai Y, Takatsuki M, Fujioka H, Hayashida N, Nagayasu T, Eguchi S. Adherence to Adjuvant Endocrine Therapy in Women With Breast Cancer: A Prospective Observational Study in Japanese Women. Clin Breast Cancer 2017; 18:150-156. [PMID: 29290564 DOI: 10.1016/j.clbc.2017.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 11/13/2017] [Accepted: 12/03/2017] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Nonadherence to adjuvant endocrine therapy has been poorly studied in Asian patients with breast cancer. We therefore assessed adherence to endocrine therapy among women with breast cancer in Japan. PATIENTS AND METHODS We conducted a prospective observational study among Japanese women with hormone receptor-positive breast cancer. Patients brought their pill packets to visits for 1 year and answered a questionnaire. We also examined prescription records during the study period. Adherence to endocrine therapy was defined as patients who had taken > 80% of the pills according to the packets during the study. Clinicopathologic features and questionnaires were compared between adherent and nonadherent patients. RESULTS A total of 234 patients completed the trial, of whom 85% demonstrated adherence based on pill packets, and 98% demonstrated adherence based on prescription records. Mastectomy, higher stage, nodal metastasis and adjuvant chemotherapy were correlated with adherence based on pill packets. Adjuvant chemotherapy was an independent factor associated with adherence. According to the questionnaire, adherent patients were more likely to consult a nurse when they had trouble with their medication. These patients also emphasized the efficacy rather than the side effects of the medication. Nonadherent patients were aware that they were being nonadherent. CONCLUSION The results of this study revealed that 85% of patients were adherent to endocrine therapy, but physicians were unaware of the nonadherent patients. Raised awareness of nonadherence and information sharing between patients and medical teams might increase adherence to endocrine therapy.
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Affiliation(s)
- Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
| | - Shigeto Maeda
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Megumi Matsumoto
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Hiroshi Yano
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Toshiko Hatachi
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Yukiko Tokai
- Departments of Surgery, Nagasaki University, Japan
| | - Mitsuhisa Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Hikaru Fujioka
- Department of Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Naomi Hayashida
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
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Yamanouchi K, Kuba S, Sakimura C, Morita M, Kanetaka K, Kobayashi K, Takatsuki M, Hayashida N, Eguchi S. The Relationship Between Peripheral Neuropathy Induced by Docetaxel and Systemic Inflammation-based Parameters in Patients with Breast Cancer. Anticancer Res 2017; 37:6947-6951. [PMID: 29187478 DOI: 10.21873/anticanres.12160] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 09/21/2017] [Accepted: 09/25/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Docetaxel often induces peripheral neuropathy (PN). The aim of this study was to elucidate the relationship between PN and systemic inflammation parameters, namely the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR). PATIENTS AND METHODS We retrospectively evaluated 67 patients with breast cancer who were treated with docetaxel. Thirty patients (44.8%) had received previous chemotherapy including anthracycline. RESULTS Overall, 51 patients (76.1%) experienced PN. All the parameters increased with the number of administered courses of docetaxel. In an analysis of patients without previous chemotherapy, those suffering from PN had a significantly higher NLR at the first and third cycles than those not suffering from PN (2.9 vs. 2.0, and 3.1 vs. 2.6, respectively, both p<0.05), and the MLR at the first cycle was also significantly higher in those with PN than in those without (0.18 vs. 0.15, p<0.05). CONCLUSION Systemic inflammation appears to contribute to the occurrence of PN induced by docetaxel.
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Affiliation(s)
- Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Michi Morita
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kengo Kanetaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuma Kobayashi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mitsuhisa Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naomi Hayashida
- Division of Strategic Collaborative Research, Center for Promotion of Collaborative Research on Radiation and Environment Health Effects, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Kobayashi K, Morita M, Ito S, Inoue Y, Yamaguchi I, Kosaka T, Kuba S, Sakimura C, Soyama A, Adachi T, Ohno S, Kobayashi S, Hara T, Hidaka M, Hayashida N, Yamanouchi K, Kanetaka K, Takatsuki M, Eguchi S. S-1 and CPT-11 plus ramucirumab (IRIS+Rmab) as second-line chemotherapy for patients with oxaliplatin-refractory metastatic colorectal cancer: A multicenter phase II study in Japan (N-DOCC-F-C-1701). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx659.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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41
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Kuba S, Fujiyama R, Yamanouchi K, Sakimura C, Hatachi T, Matsumoto M, Yano H, Kobayashi K, Takatsuki M, Hayashida N, Nagayasu T, Eguchi S. Assessment of dysgeusia and taste identification in patients undergoing chemotherapy for breast cancer. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e21668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21668 Background: Dysgeusia is a common side effect of chemotherapy (CT) and often impacts negatively on QOL. This study analyzed the prevalence of gustatory test abnormalities in breast cancer (BC) patients undergoing CT. Methods: We enrolled 33 BC patients who were undergoing CT (26 adjuvant CT and 7 CT for advanced BC) and conducted 2 gustatory tests on CT day. In the test of sensitivity using the instillation method (IM), 4 basic taste stimuli (sweet, salty, sour, and bitter) at 5 concentrations were applied to the entire oral cavity. For the electrogustometry method (EM), we measured the amount of current for perception of metallic tastes, examining the front two thirds of the tongue (cranial nerve VII) and the back third of the tongue (cranial nerve IX). We compared awareness of dysgeusia with results of the 2 gustatory tests. Results: Median CT duration was 83 days (12–1,353). Fifteen (45%) patients had awareness of dysgeusia (Grade 1: 11, Grade 2: 4). IM revealed 8 (24%) patients with abnormalities, 7 in a single taste species and 1 in 3 taste species. EM revealed 20 (61%) patients withabnormalities, 7 in the cranial nerve VII and 20 in the cranial nerve IX innervation area. All patients with abnormalities in the cranial nerve VII innervation area also had abnormalities in the cranial nerve IX innervation area. Among 15 patients with awareness of dysgeusia, there were 5 (33%) IM abnormalities and 12 (80%) EM abnormalities (4 in the cranial nerve VII and 12 in the cranial nerve IX innervation area). Among 18 patients without awareness of dysgeusia, there were 3 (16%) IM abnormalities and 8 (44%) EM abnormalities (3 in the cranial nerve VII and 8 in the cranial nerve IX nerve innervation area). Patients with IM abnormalities had a higher frequency of abnormalities in the cranial nerve VII innervation area than the normal range (50% and 12%, respectively; p = 0.04); there was no significant difference in the cranial nerve IX innervation area. Conclusions: Nearly half of the patients reporteddysgeusia, but most of these could correctly identify the four basic tastes. Further studies to clarify the discrepancy between subjective and objective observations could lead to effective prevention and treatment of dysgeusia.
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Affiliation(s)
- Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Rie Fujiyama
- Department of Integrative Sensory Physiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toshiko Hatachi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Megumi Matsumoto
- Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroshi Yano
- Department of Surgery, Nagasaki University Hospital, Nagasaki, Japan
| | - Kazuma Kobayashi
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mitsuhisa Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naomi Hayashida
- Division of Strategic Collaborative Research Center for Promotion of Collaborative Research on Radiation and Environment Health Effects, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Takeshi Nagayasu
- Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Yamanouchi K, Hayashida N, Kuba S, Sakimura C, Kuroki T, Togo M, Katayama N, Takamura N, Eguchi S. Increase in Operator's Sympathetic Nerve Activity during Complicated Hepatobiliary Surgery: Evidence for Surgeons' Mental Stress. TOHOKU J EXP MED 2016; 237:157-62. [PMID: 26466520 DOI: 10.1620/tjem.237.157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Surgeons often experience stress during operations. The heart rate variability (HRV) is the variability in the beat-to-beat interval, which has been used as parameters of stress. The purpose of this study was to evaluate mental stress of surgeons before, during and after operations, especially during pancreaticoduodenectomy (PD) and living donor liver transplantation (LDLT). Additionally, the parameters were compared in various procedures during the operations. By frequency domain method using electrocardiograph, we measured the high frequency (HF) component, representing the parasympathetic activity, and the low frequency (LF)/HF ratio, representing the sympathetic activity. In all 5 cases of PD, the surgeon showed significantly lower HF component and higher LF/HF during operation, indicating predominance of sympathetic nervous system and increased stress, than those before the operation (p < 0.01) and these did not return to the baseline level one hour after the operation. Out of the 4 LDLT cases, the value of HF was decreased in two and the LF/HF increased in three cases (p < 0.01) during the operation compared to those before the operation. In all cases, the value of HF was decreased and/or the LF/HF increased significantly during the reconstruction of the vessels or bile ducts than during the removal of the liver. Thus, sympathetic nerve activity increased during hepatobiliary surgery compared with the level before the operation, and various procedures during the operations induced diverse changes in the autonomic nervous activities. The HRV analysis could assess the chronological changes of mental stress by measuring the autonomic nervous balances.
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Affiliation(s)
- Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences
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Kuba S, Yamanouchi K, Hayashida N, Maeda S, Sakimura C, Kawakami F, Yano H, Matsumoto M, Otsubo R, Sato S, Fujioka H, Kuroki T, Nagayasu T, Eguchi S. Total thyroidectomy versus thyroid lobectomy for papillary thyroid cancer: Comparative analysis after propensity score matching—A multicenter study. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e17556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naomi Hayashida
- Division of Strategic Collaborative Research Center for Promotion of Collaborative Research on Radiation and Environment Health Effects,Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | | | - Chika Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Fusako Kawakami
- Departments of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | | | - Megumi Matsumoto
- Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
| | - Ryota Otsubo
- Division of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
| | - Shuntaro Sato
- Departments of Clinical Research Center, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | | | - Tamotsu Kuroki
- Departments of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan
| | - Takeshi Nagayasu
- Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Sakimura C, Eguchi S, Yamanouchi K, Minami S, Kuba S, Hayashida N, Soyama A, Hidaka M, Takatsuki M, Maeda S, Kuroki T. The first report of the thyroid function of haemophilic patients with HIV/HCV co-infection in Japan. Haemophilia 2016; 22:e130-3. [PMID: 27167093 DOI: 10.1111/hae.12930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION A high incidence of thyroid dysfunction is reported in patients with HIV or HCV mono-infection. We have conducted a periodic medical examination including the thyroid function for haemophilic patients with HIV/HCV co-infection due to contaminated blood products. METHODS We examined the thyroid function (as assessed by the FT3, FT4 and TSH levels) in 45 haemophilic patients, including thyroglobulin and auto-antibody, antithyroglobulin antibody, antithyroid peroxidase antibody and anti-TSH receptor antibody in 28 patients. RESULTS All the patients were males (median age: 42 years; range: 29-66). The median values of thyroid function were FT3 3.36 pg mL(-1) , FT4 1.125 ng mL(-1) and TSH 1.65 μIU mL(-1) . Five patients (11.1%) had high TSH levels. In 28 patients in whom the presence of auto-antibodies was examined, the median age was 47 years of age. The median value of thyroglobulin was 16 ng mL(-1) and two patients showed high levels of thyroglobulin. The presence of anti-TSH receptor antibody of all the patients was negative, but one patient (3.5%) was positive of antithyroid peroxidase antibody and antithyroglobulin antibody. CONCLUSIONS Since 0.68-3.6% of the general healthy population is reported to show hypothyroidism, our data showed that the proportion of hypothyroidism in haemophilic patients with HIV/HCV co-infection was more frequent than that of the normal population.
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Affiliation(s)
- C Sakimura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - K Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S Minami
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - N Hayashida
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - A Soyama
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - M Hidaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - M Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S Maeda
- National Hospital Nagasaki Medical Center, Omura, Japan
| | - T Kuroki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Yamanouchi K, Kinoe H, Kuba S, Hayashida N, Kawakami F, Sakimura C, Fujita F, Kuroki T, Eguchi S, Kanetaka K. Discordance of biomarkers between primary breast cancer and synchronous axillary node metastasis; pilot study. J Am Coll Surg 2015. [DOI: 10.1016/j.jamcollsurg.2015.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Yamanouchi K, Minami S, Kuba S, Sakimura C, Hayashida N, Kawakami F, Kuroki T, Eguchi S. Evaluation of the operative methods for Graves' disease. MINERVA CHIR 2015; 70:77-81. [PMID: 25312017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM In Japan, surgery for Graves' disease (GD), which is considered to be a radical therapy, has been restricted by various guidelines. Nevertheless, some patients benefit from surgery. We sought to identify a reasonable operative method for GD by comparing the efficacy and safety among patients undergoing different extents of thyroidectomy. METHODS A total of 162 patients underwent thyroidectomy for GD between 2003 and 2012 in our department. We compared the clinical factors among those who underwent subtotal thyroidectomy (ST), near-total thyroidectomy (NTT), and total thyroidectomy (TT). RESULTS The ST, NTT, and TT groups included 111, 21, and 30 patients, respectively. The patient sex, period between disease onset and surgery, and preoperative thyroidal function were not substantially different among the three groups. With regard to surgical variables, the duration of surgery, amount of blood loss, and postoperative length of hospitalization were not substantially different among the three groups. Postoperative recurrent laryngeal nerve (RLN) palsy was transient in all cases, but the rate was significantly higher in the TT group compared to the other two groups (P<0.001). The incidences of transient hypocalcemia and permanent hypoparathyroidism were not substantially different among the groups. The proportion of patients who required the postoperative administration of levothyroxine was significantly lower in the ST group compared to the TT and NTT groups. Hyperthyroidism recurrence was noted in eight patients in the ST group (7.2%). CONCLUSION NTT for GD is thus considered to be a reasonable operative method regarding both efficacy and safety.
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Affiliation(s)
- K Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan -
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Kuba S, Yamanouchi K, Sakimura C, Kawakami F, Minami S, Fujita F, Takatsuki M, Kobayashi K, Kanetaka K, Kuroki T, Eguchi S. Total Versus Hemithyroidectomy for Well Differentiated Thyroid Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu340.49] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kuba S, Ishida M, Nakamura Y, Yamanouchi K, Minami S, Taguchi K, Eguchi S, Ohno S. Treatment and prognosis of breast cancer patients with brain metastases according to intrinsic subtype. Jpn J Clin Oncol 2014; 44:1025-31. [PMID: 25156682 DOI: 10.1093/jjco/hyu126] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE How breast cancer subtypes should affect treatment decisions for breast cancer patients with brain metastases is unclear. We analyzed local brain metastases treatments and their outcomes according to subtype in patients with breast cancer and brain metastases. METHODS We reviewed records and database information for women treated at the National Kyushu Cancer Center between 2001 and 2010. Patients were divided into three breast cancer subtype groups: Luminal (estrogen receptor positive and/or progesterone receptor positive, but human epidermal growth factor receptor 2 negative); human epidermal growth factor receptor 2 positive and triple negative (estrogen receptor negative, progesterone receptor negative and human epidermal growth factor receptor 2 negative). RESULTS Of 524 advanced breast cancer patients, we reviewed 65 (12%) with brain metastases and records showing estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 status, as well as outcome data; there were 26 (40%) Luminal, 26 (40%) had human epidermal growth factor receptor 2 and 13 (20%) had triple negative subtypes. There was no statistical difference in the number of brain metastases among subtypes; however, rates of stereotactic radiosurgery or surgery for brain metastases differed significantly by subtype (human epidermal growth factor receptor 2: 81%, Luminal: 42% and triple negative: 47%; P = 0.03). Patients having the human epidermal growth factor receptor 2 subtype, a performance status of ≤1 and ≤4 brain metastases, who underwent systemic therapy after brain metastases and underwent stereotactic radiosurgery or surgery, were predicted to have longer overall survival after brain metastases. Multivariate analysis demonstrated that not having systemic therapy and not having the human epidermal growth factor receptor 2 subtype were independent factors associated with an increased risk of death (hazard ratio 2.4, 95% confidence interval 1.01-5.6; P = 0.05 and hazard ratio 2.9, 95% confidence interval 1.5-5.8; P = 0.003, respectively). CONCLUSION Our study showed that local brain treatments and prognosis differed by subtype in breast cancer patients with brain metastases.
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Affiliation(s)
- Sayaka Kuba
- Department of Breast Oncology, National Hospital Organization, Kyushu Cancer Center, Fukuoka Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Mayumi Ishida
- Department of Breast Oncology, National Hospital Organization, Kyushu Cancer Center, Fukuoka
| | - Yoshiaki Nakamura
- Department of Breast Oncology, National Hospital Organization, Kyushu Cancer Center, Fukuoka
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Shigeki Minami
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Kenichi Taguchi
- Department of Pathology, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki
| | - Shinji Ohno
- Department of Breast Oncology, National Hospital Organization, Kyushu Cancer Center, Fukuoka
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Kuba S, Ishida M, Nakamura Y, Taguchi K, Yamanouchi K, Minami S, Eguchi S, Ohno S. Treatment and prognosis of breast cancer patients with brain metastases according to intrinsic subtype. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.1087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sayaka Kuba
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mayumi Ishida
- Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan
| | - Yoshiaki Nakamura
- Department of Breast Oncology, National Kyushu Cancer Center, Fukuoka, Japan
| | - Kenji Taguchi
- Department of Pathology, National Kyushu Cancer Center, Fukuoka, Japan
| | - Kosho Yamanouchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shigeki Minami
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shinji Ohno
- Department of Clinical Oncology, National Kyushu Cancer Center, Fukuoka, Japan
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Yoshiyama T, Nakamura Y, Igawa A, Saruwatari A, Shigechi T, Ueda N, Kuba S, Ishida M, Nishimura S, Nishiyama K, Ohno S. Abstract P3-06-26: Serum anti-p53 antibody titers predict pathological response to preoperative chemotherapy in women with HER2 positive or triple negative breast cancer. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p3-06-26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In SABCS 2009, we reported that the high level of serum anti-p53 antibody titers was associated with response to preoperative chemotherapy in cases with primary breast cancer (SABCS 2009). Prognostic meaning of pathological complete response (pCR) after preoperative chemotherapy differs among various subtype, and there is a close relationship between pCR and prognosis in cases with HER2 positive or triple negative disease. The aim of this study is to evaluate the association between the high level of serum anti-p53 antibody titers and pCR in patients with HER2-positive or triple negative breast cancer.
Patients and Methods: In this study, we analyzed 196 women with operable early stage breast cancer (T1-T3, N0-1) treated with preoperative chemotherapy and definitive curative surgery since 2002 to 2011. All of the patients received four cycles of FEC (fluorouracil 500 mg/m2, epirubicin 100 mg/m2, cyclophosphamide 500 mg/m2 q3w) followed by four cycles of docetaxel (75 mg/m2 q3w). The serum anti-p53 antibody titers were assessed by ELISA with the anti-p53 EIA Kit II (MESACUP anti-53 Test: MBL) in the pre-treatment serum samples. The test's cut-off value was determined to be 1.3 IU/ml based on reference distribution in healthy control individuals. The association between serum anti-p53 antibody titers and pCR was analyzed.
Results: The subtype of tumors of 196 patients were classified to 86 of ER+/HER2−, 24 of ER+/HER2+, 29 of ER−/HER2+ and 57 of ER−/HER2−. The pCR was achieved 49 of 196 patients (25%). The pCR rate were 7%(6/86), 33%(8/24), 48%(14/29) and 37%(21/57) in the subtype of ER+/HER2−, ER+/HER2+, ER−/HER2+ and ER−/HER2− respectively. The range of serum anti-p53 antibody titers in the serum samples of 196 patients was between 0.40 and 5610 (the median was 0.40 and the average was 85.2). Excluding 86 cases with ER+/HER2−, relationship between serum anti-p53 antibody titers and pCR was evaluated. According to serum anti-p53 antibody titers with the patients of pCR, cut-off value of serum anti-p53 antibody titers was set to be 6 IU/ml. The pCR was observed in nine of 12 cases (75%) with high serum anti-p53 antibody titers, which was significantly higher than those with low titers (35%: 34/98; p = 0.01). Multivariate analysis showed that the only high anti-p53 antibody titer was an independent predictive factor for pCR due to preoperative chemotherapy (p = 0.01).
Conclusion: p53 mutation analysis using serum anti-p53 antibody titers might be a useful predictive test for response to preoperative chemotherapy in patients especially with HER2 positive or triple negative breast cancer.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-06-26.
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Affiliation(s)
- T Yoshiyama
- National Kyushu Cancer Center, Fukuoka, Japan
| | - Y Nakamura
- National Kyushu Cancer Center, Fukuoka, Japan
| | - A Igawa
- National Kyushu Cancer Center, Fukuoka, Japan
| | | | - T Shigechi
- National Kyushu Cancer Center, Fukuoka, Japan
| | - N Ueda
- National Kyushu Cancer Center, Fukuoka, Japan
| | - S Kuba
- National Kyushu Cancer Center, Fukuoka, Japan
| | - M Ishida
- National Kyushu Cancer Center, Fukuoka, Japan
| | - S Nishimura
- National Kyushu Cancer Center, Fukuoka, Japan
| | - K Nishiyama
- National Kyushu Cancer Center, Fukuoka, Japan
| | - S Ohno
- National Kyushu Cancer Center, Fukuoka, Japan
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