1
|
Imaoka K, Ohira M, Hattori M, Chogahara I, Sato S, Nakamura M, Bekki T, Sato K, Imaoka Y, Nakano R, Yano T, Sakai H, Kuroda S, Tahara H, Ide K, Kobayashi T, Tanaka Y, Ohdan H. Immunotherapy Using Activated Natural Killer Cells Improves Postoperative Neutrophil-to-Lymphocyte Ratio and Long-Term Prognosis of Living Donor Liver Transplant Recipients With Hepatocellular Carcinoma. Transplant Proc 2024; 56:634-639. [PMID: 38443302 DOI: 10.1016/j.transproceed.2024.02.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 02/02/2024] [Accepted: 02/13/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Preoperative neutrophil-to-lymphocyte ratio (NLR) is a well-known prognostic indicator in various malignancies; however, the impact of postoperative NLR on living donor liver transplant (LDLT) recipients is unknown. Immunotherapy with donor liver-derived activated natural killer (NK) cells may improve postoperative NLR by coactivating immune cells or suppressing activated neutrophils. This study aims to clarify the clinical significance of postoperative NLR in recipients after LDLT with HCC and assess whether immunotherapy improves postoperative NLR. METHODS We conducted a retrospective study of LDLT recipients between 2001 and 2022 to evaluate the clinical significance of postoperative NLR. Furthermore, the correlation between postoperative NLR and the activation marker of infused NK cells was also evaluated. The postoperative NLR was examined 4 weeks after LDLT. RESULTS The postoperative high NLR group (N = 78) had preoperative lower NLR and higher model for end-stage liver disease and a higher rate of postoperative infection within 30 days after LDLT than the postoperative low NLR group (N = 41). Postoperative high NLR (hazard ratio [HR], 2.62; 95% confidence interval [CI], 1.01-6.79; P = .047) and nontreatment of immunotherapy (HR, 3.10; 95% CI, 1.33-7.22; P < .01) were independent risk factors for poor overall survival in multivariate analysis. Furthermore, the activation marker of infused NK cells is inversely correlated with decreased postoperative NLR. CONCLUSIONS The higher level of postoperative NLR was independently associated with poor prognosis in patients after LDLT with HCC. Immunotherapy using activated NK cells may improve postoperative NLR and long-term prognosis.
Collapse
Affiliation(s)
- Kouki Imaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.
| | - Minoru Hattori
- Advanced Medical Skills Training Center, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ichiya Chogahara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Saki Sato
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mayuna Nakamura
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomoaki Bekki
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Koki Sato
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuki Imaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryosuke Nakano
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takuya Yano
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Sakai
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuka Tanaka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
2
|
Namba Y, Kobayashi T, Hashimoto M, Onoe T, Mashima H, Oishi K, Honmyo N, Abe T, Kuroda S, Ohdan H. The efficacy and safety of pure laparoscopic liver resection for hepatocellular carcinoma in super-elderly patients over 80 years: A multicenter propensity analysis. J Hepatobiliary Pancreat Sci 2024; 31:234-242. [PMID: 38009434 DOI: 10.1002/jhbp.1395] [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] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Very few reports have evaluated the safety of laparoscopic liver resection in super-elderly patients. We assessed the short-term outcomes of laparoscopic liver resection in patients with hepatocellular carcinoma aged ≥80 years, using propensity score matching. METHODS We retrospectively analyzed the data of 287 patients (aged ≥80 years) who underwent liver resection for hepatocellular carcinoma at eight hospitals belonging to Hiroshima Surgical study group of Clinical Oncology, between January 2012 and December 2021. The perioperative outcomes were compared between laparoscopic and open liver resection, using propensity score matching. RESULTS Of the 287 patients, 83 and 204 were included in the laparoscopic and open liver resection groups, respectively. Propensity score matching was performed, and 52 patients were included in each group. The operation (p = .68) and pringle maneuver (p = .11) time were not different between the groups. There were no significant differences in the incidences of bile leakage or organ failure. The laparoscopic liver resection group had significantly less intraoperative bleeding and a lower incidence of cardiopulmonary complications (both p < .01). CONCLUSIONS Laparoscopic liver resection can be safely performed in elderly patients aged ≥80 years.
Collapse
Affiliation(s)
- Yosuke Namba
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masakazu Hashimoto
- Department of Gastroenterological-Breast and Transplant Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Takashi Onoe
- Department of Surgery, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Hiroaki Mashima
- Department of Surgery and Endoscopic Surgery, JA Onomichi General Hospital, Hiroshima, Japan
| | - Koichi Oishi
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Naruhiko Honmyo
- Department of Surgery, Hiroshima City North Medical Center, Asa Citizens Hospital, Hiroshima, Japan
| | - Tomoyuki Abe
- Department of Surgery and Gastroenterological Surgery, East Hiroshima Medical Hospital, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
3
|
Namba Y, Kobayashi T, Kuroda S, Hashimoto M, Takei D, Fukuhara S, Oshita K, Matsubara K, Honmyo N, Nakano R, Sakai H, Tahara H, Ohira M, Ide K, Ohdan H. Protocol to evaluate the efficacy and safety of tolvaptan in patients with refractory ascites after liver resection: an open-label, single-arm phase I/II study. Int J Surg Protoc 2024; 28:1-5. [PMID: 38433869 PMCID: PMC10905494 DOI: 10.1097/sp9.0000000000000015] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/23/2023] [Indexed: 03/05/2024] Open
Abstract
Background In patients with chronic liver diseases such as cirrhosis, massive ascites after hepatic resection is the cause of prolonged hospitalization and worsening prognosis. Recently, the efficacy of tolvaptan in refractory ascites has been reported; however, there are no reports on the efficacy or safety of tolvaptan for refractory ascites after hepatic resection. This study aims to evaluate the efficacy of early administration of tolvaptan in patients with refractory ascites after hepatic resection. Materials and methods This is an open-label, single-arm phase I/II study. This study subject will comprise patients scheduled for hepatic resection of a liver tumor. Patients with refractory ascites after hepatic resection (drainage volume on postoperative day 1 ≥5 ml/body weight 1 kg/day) will be treated with tolvaptan. The primary endpoint will include the maximum change in body weight after hepatic resection relative to the preoperative baseline. The secondary endpoints will include drainage volume, abdominal circumference, urine output, postoperative complication rate (heart failure and respiratory failure), number of days required for postoperative weight gain because of ascites to decrease to preoperative weight, change in improvement of postoperative pleural effusion, total amount of albumin or fresh frozen plasma transfusion, type and amount of diuretics used, and postoperative hospitalization days. Conclusion This trial will evaluate the efficacy and safety of tolvaptan prophylaxis for refractory ascites after hepatic resection. As there are no reports demonstrating the efficacy of tolvaptan prophylaxis for refractory ascites after hepatic resection, the authors expect that these findings will lead to future phase III trials and provide valuable indications for the selection of treatments for refractory postoperative ascites.
Collapse
Affiliation(s)
- Yosuke Namba
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Masakazu Hashimoto
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
- Department of Gastroenterological-Breast and Transplant Surgery, Hiroshima Prefectural Hospital
| | - Daisuke Takei
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
- Department of Surgery and Endoscopic Surgery, JA Onomichi General Hospital, Hiroshima, Japan
| | - Sotaro Fukuhara
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Ko Oshita
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Keiso Matsubara
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Naruhiko Honmyo
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Ryosuke Nakano
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Hiroshi Sakai
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| |
Collapse
|
4
|
Okada K, Kobayashi T, Kuroda S, Mashima H, Hashimoto M, Tahara H, Ohira M, Uemura K, Takahashi S, Ohdan H. Prognostic impact of pre- and postoperative tumor markers in patients with intrahepatic cholangiocarcinoma. Surg Today 2024; 54:177-185. [PMID: 37340141 DOI: 10.1007/s00595-023-02715-8] [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: 12/13/2022] [Accepted: 05/29/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE The present study assessed the impact of pre- and postoperative tumor markers on the survival of patients with intrahepatic cholangiocarcinoma. METHODS Medical records of 73 patients with intrahepatic cholangiocarcinoma were reviewed retrospectively. The pre- and postoperative carcinoembryonic antigen and carbohydrate antigen 19-9 levels were assessed. Patient characteristics, clinicopathological factors, and prognostic factors were analyzed. RESULTS The median recurrence-free survival and overall survival were 30.0 and 90.9 months, respectively. A multivariate survival analysis revealed that elevated postoperative carbohydrate antigen 19-9 (p = 0.023) was the only independent poor prognostic factor. The median overall survival of patients with normal and elevated postoperative carbohydrate antigen 19-9 levels was 101.4 and 15.7 months (p < 0.001), respectively. Multivariate logistic regression identified elevated preoperative carbohydrate antigen 19-9 as an independent preoperative risk factor for elevated postoperative carbohydrate antigen 19-9. The optimal cutoff value of preoperative carbohydrate antigen 19-9 for predicting elevated postoperative carbohydrate antigen 19-9 was 40 U/mL, with a sensitivity and specificity of 92% and 87%, respectively (area under curve = 0.915). CONCLUSIONS Elevated postoperative carbohydrate antigen 19-9 was an independent poor prognostic factor. Preoperative predictors, such as elevated preoperative carbohydrate antigen 19-9, may indicate the need for neoadjuvant therapies to improve the survival.
Collapse
Affiliation(s)
- Kenjiro Okada
- Department of Gastroenterological Surgery, Division of Gastroenterology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
- Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological Surgery, Division of Gastroenterology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan.
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan.
| | - Shintaro Kuroda
- Department of Gastroenterological Surgery, Division of Gastroenterology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Hiroaki Mashima
- Department of Gastroenterological Surgery, Division of Gastroenterology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Masakazu Hashimoto
- Department of Gastroenterological Surgery, Division of Gastroenterology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological Surgery, Division of Gastroenterology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Masahiro Ohira
- Department of Gastroenterological Surgery, Division of Gastroenterology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Kenichiro Uemura
- Department of Gastroenterological Surgery, Division of Gastroenterology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
- Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Shinya Takahashi
- Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Hideki Ohdan
- Department of Gastroenterological Surgery, Division of Gastroenterology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan
| |
Collapse
|
5
|
Imaoka K, Ohira M, Shimomura M, Hattori M, Bekki T, Sato K, Imaoka Y, Akabane S, Nakano R, Yano T, Sakai H, Hirata F, Kuroda S, Tahara H, Ide K, Ishiyama K, Kobayashi T, Tanaka Y, Ohdan H. Effect of Abdominal Aortic Calcification on Recurrence Following Initial Hepatectomy for Colorectal Liver Metastases. Anticancer Res 2024; 44:649-658. [PMID: 38307553 DOI: 10.21873/anticanres.16854] [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: 12/23/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND/AIM The aim of the study was to analyze the association between abdominal aortic calcification (AAC) and patient prognosis following resection of colorectal liver metastases (CRLM). AAC potentially reflects intrahepatic immunity and is involved in tumor development and progression. However, the clinical effects of AAC on colorectal cancer (CRC) prognosis after curative-intent liver resection for CRLM remain unclear. PATIENTS AND METHODS We evaluated the effect of AAC on the clinical prognosis and metastatic patterns in 99 patients who underwent hepatectomy for CRLM between 2010 and 2019. RESULTS The high-AAC group had significantly worse overall survival (OS) and remnant liver recurrence rate (RR) after propensity score matching to adjust for differences in baseline characteristics of patients and tumors. In multivariate Cox regression analyses, high AAC volume was an independent risk factor for poor OS and liver RR, but not poor lung RR. The expression of tumor necrosis factor-related apoptosis-inducing ligand, known as an anti-tumor marker, in liver natural killer (NK) cells was lower in the high-AAC group than in the low-AAC group. CONCLUSION High AAC volume showed a strong relationship with remnant liver RR after curative resection of CRLM. High AAC volume may be responsible for the suppression of anti-tumor activity of liver NK cells, which results in an increased risk of liver recurrence and poor prognosis.
Collapse
Affiliation(s)
- Kouki Imaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Manabu Shimomura
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Minoru Hattori
- Advanced Medical Skills Training Center, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomoaki Bekki
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Koki Sato
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuki Imaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Akabane
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryosuke Nakano
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takuya Yano
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Sakai
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Fumihiro Hirata
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kohei Ishiyama
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Renal Transplant Surgery, Aichi Medical School Medicine, Nagoya, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuka Tanaka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
6
|
Hashimoto M, Kobayashi T, Ohira M, Okimoto S, Abe T, Inoue M, Onoe T, Honmyo N, Kuroda S, Ohdan H. Comparison of postoperative outcomes in cases achieving sustained virological response with direct-acting antiviral and interferon therapy. J Hepatobiliary Pancreat Sci 2023. [PMID: 38135908 DOI: 10.1002/jhbp.1406] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/23/2023] [Accepted: 11/15/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND/PURPOSE The effect of direct-acting antiviral agents (DAAs) on hepatocellular carcinoma (HCC) recurrence after curative hepatectomy remains uncertain. This retrospective study aimed to evaluate the effect of sustained virological response (SVR) with DAAs or interferon (IFN) therapy on recurrence and overall survival (OS) after hepatectomy. METHODS We enrolled 593 patients who underwent curative resections between January 2010 and December 2017. Among them, 186 achieved SVR before hepatectomy: a total of 51 (27.4%) in the DAA-SVR group and 132 (72.6%) in the IFN-based SVR group. RESULTS SVR before hepatectomy was an independent predictor of OS, and the 5-year OS rate was significantly higher in the SVR group than that in the non-SVR group (82.2% vs. 63.9%). There were no significant differences in the recurrence rates or OS between DAA and IFN treatments in achieving SVR before hepatectomy, regardless of poor hepatic function in the DAA therapy group. CONCLUSIONS There was no significant difference in OS and recurrence-free survival (RFS) between the preoperative SVR achieved with DAA and IFN groups in this study, although liver function was significantly worse at the time of surgery in the DAA group compared to the IFN group.
Collapse
Affiliation(s)
- Masakazu Hashimoto
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
- HiSCO: Hiroshima Surgical study group of Clinical Oncology, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
- HiSCO: Hiroshima Surgical study group of Clinical Oncology, Hiroshima, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
- HiSCO: Hiroshima Surgical study group of Clinical Oncology, Hiroshima, Japan
| | - Sho Okimoto
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
- HiSCO: Hiroshima Surgical study group of Clinical Oncology, Hiroshima, Japan
| | - Tomoyuki Abe
- Department of Surgery, JA Onomichi General Hospital, Onomichi, Japan
- HiSCO: Hiroshima Surgical study group of Clinical Oncology, Hiroshima, Japan
| | - Masashi Inoue
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan
- HiSCO: Hiroshima Surgical study group of Clinical Oncology, Hiroshima, Japan
| | - Takashi Onoe
- Department of Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan
- HiSCO: Hiroshima Surgical study group of Clinical Oncology, Hiroshima, Japan
| | - Naruhiko Honmyo
- Department of Surgery, Hiroshima City North Medical Center, Asa Citizens Hospital, Hiroshima, Japan
- HiSCO: Hiroshima Surgical study group of Clinical Oncology, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
- HiSCO: Hiroshima Surgical study group of Clinical Oncology, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
- HiSCO: Hiroshima Surgical study group of Clinical Oncology, Hiroshima, Japan
| |
Collapse
|
7
|
Takei D, Kuroda S, Kobayashi T, Mashima H, Tahara H, Ohira M, Aikata H, Chosa K, Baba Y, Ohdan H. Prospective Exploratory Phase I Clinical Trial Assessing the Safety of Preoperative Marking for Small Liver Tumors. Cureus 2023; 15:e50603. [PMID: 38226110 PMCID: PMC10788183 DOI: 10.7759/cureus.50603] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/17/2024] Open
Abstract
Background Small tumors in liver cirrhosis are difficult to distinguish using intraoperative ultrasonography. In addition, preoperative chemotherapy for metastatic liver cancer may diminish tumor size, thus making tumors difficult to identify intraoperatively. To address such difficulties, we devised a method to mark liver tumors preoperatively to facilitate intraoperative identification. This study aimed to investigate the safety of a preoperative liver tumor marking method. Methodology This exploratory prospective clinical trial included patients with liver tumors measuring ≤20 mm requiring resection. Preoperative marking was performed by placing a coil for embolization of blood vessels near the tumor using either the transcatheter or percutaneous approach. The tumor was identified and resected by intraoperative ultrasonography based on the marker. The study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000028608). Results Overall, 19 patients (9 with primary liver cancer and 10 with metastatic tumors) were recruited. The transcatheter and percutaneous methods were used in 13 and 6 patients, respectively. Marking was not possible in two patients in the transcatheter group because the catheter could not be guided to the vicinity of the tumor. There were no marking-related complications. Hepatectomy was performed in all but one patient who was not fit for hepatectomy owing to the development of a metastatic liver tumor. The markers were adequately identified during hepatectomy. Additionally, there were no difficulties in the surgical procedure or postoperative complications. Conclusions Preoperative marking with embolization coils can be performed safely for intraoperative identification of liver nodules.
Collapse
Affiliation(s)
- Daisuke Takei
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Hiroaki Mashima
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Hiroshi Aikata
- Department of Gastroenterology and Metabolism, Hiroshima University, Hiroshima, JPN
| | - Keigo Chosa
- Department of Diagnostic Radiology, Hiroshima University, Hiroshima, JPN
| | - Yasutaka Baba
- Department of Diagnostic Radiology, Saitama Medical University International Medical Center, Hidaka, JPN
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| |
Collapse
|
8
|
Oshita KO, Kobayashi T, Tadokoro T, Namba Y, Fukuhara S, Matsubara K, Takei D, Honmyo N, Kuroda S, Kawaoka T, Aikata H, Ohdan H. Outcomes and Prognostic Analysis of Surgical Resection for Oligometastasis from Hepatocellular Carcinoma. Anticancer Res 2023; 43:5189-5196. [PMID: 37909959 DOI: 10.21873/anticanres.16720] [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: 09/08/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND/AIM This study aimed to evaluate the outcomes of patients who underwent resection for oligometastasis from hepatocellular carcinoma (HCC) and identify the prognostic factors associated with poor survival. PATIENTS AND METHODS Patients who underwent resection for oligometastasis from HCC between January 2000 and April 2021 were retrospectively investigated. Oligometastasis was defined as 1-5 single organ metastases that were detected preoperatively in this study. Clinical characteristics and treatment outcomes were analyzed, and independent risk factors for poor prognosis were identified using cox proportional hazards model. RESULTS A total of 33 patients were included in this study. Eleven oligometastases were located in the intraabdominal lymph node, 8 in the adrenal gland, 5 in the lung, 4 in the peritoneum, 3 in the pleura, and 1 each in the supraclavicular lymph node and abdominal wall. No re-operation or operative death occurred in this study. The median OS was 44.6 months (range=5.1-150.6 months), and the median survival after primary HCC diagnosis was 116.5 months (range=7.1-253.6 months). The median cumulative incidence of recurrent HCC was 7.2 months (range=0.3-94.7 months). The multivariate analysis showed that an alpha-fetoprotein level ≥20 ng/ml and multiple primary HCC tumors were independent poor prognostic factors. CONCLUSION Clinical characteristics and treatment outcomes of patients who underwent resection for oligometastasis from HCC were demonstrated. A high alpha-fetoprotein level and multiple primary HCC tumors were independent poor prognostic factors. Surgical resection can be one of the treatment options for oligometastasis from HCC.
Collapse
Affiliation(s)
- K O Oshita
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;
| | - Takeshi Tadokoro
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yosuke Namba
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Sotaro Fukuhara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keiso Matsubara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Daisuke Takei
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naruhiko Honmyo
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomokazu Kawaoka
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
- Department of Gastroenterology and Metabolisms, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Aikata
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
- Department of Gastroenterology and Metabolisms, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
9
|
Imaoka Y, Ohira M, Chogahara I, Bekki T, Imaoka K, Sato K, Doskali M, Nakano R, Yano T, Hirata F, Kuroda S, Tahara H, Ide K, Ishiyama K, Kobayashi T, Tanaka Y, Ohdan H. Impact of a new liver immune status index among patients with hepatocellular carcinoma after initial hepatectomy. Ann Gastroenterol Surg 2023; 7:987-996. [PMID: 37927921 PMCID: PMC10623950 DOI: 10.1002/ags3.12702] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/05/2023] [Accepted: 05/14/2023] [Indexed: 11/07/2023] Open
Abstract
Aim The anti-tumor effects of natural killer (NK) cells vary among individuals. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) expressed on liver NK cells is a marker of anti-tumor cytotoxicity against hepatocellular carcinoma (HCC) in immune cell therapy. This study aimed to develop a liver immune status index (LISI) that predicts low TRAIL expression and validates its ability to predict recurrence after initial hepatectomy for primary HCC. Methods A functional analysis of liver NK cells co-cultured with interleukin-2 for 3 days was performed of 40 liver transplant donors. The LISI, which predicted low TRAIL expression (25% quartile: <33%) in liver NK cells, was calculated using multiple logistic regression analysis. Next, 586 initial hepatectomy cases were analyzed based on the LISI. Results Our model was based on the Fibrosis-4 index+0.1 (odds ratio [OR], 1.33), body mass index (OR, 0.61), and albumin levels+0.1 (OR, 0.54). The area under the receiver operating characteristic curve (AUC) of the LISI for low TRAIL expression was 0.89. Stratification of the recurrence rates (RR) revealed that LISI was an independent predictive factor of RR (moderate risk: hazard ratio, 1.44; high risk: hazard ratio, 3.02). The AUC was similar for the LISI, albumin-indocyanine green evaluation grade, albumin-bilirubin score, and geriatric nutritional risk index for predicting RR. Among the vascular invasion cases, the LISI was more useful than the other indexes. Conclusion Our model facilitates the prediction of RR in high-risk patients by providing LISI to predict the anti-tumor effects of NK cells.
Collapse
Affiliation(s)
- Yuki Imaoka
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical ResearchHiroshima University HospitalHiroshimaJapan
| | - Ichiya Chogahara
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| | - Tomoaki Bekki
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| | - Kouki Imaoka
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| | - Koki Sato
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| | - Marlen Doskali
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| | - Ryosuke Nakano
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| | - Takuya Yano
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| | - Fumihiro Hirata
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| | - Kohei Ishiyama
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
- Department of Renal Transplant SurgeryAichi Medical University School of MedicineNagakuteJapan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| | - Yuka Tanaka
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima UniversityHiroshimaJapan
| |
Collapse
|
10
|
Oshita K, Kuroda S, Kobayashi T, Aoki G, Mashima H, Onoe T, Shigemoto N, Hirata T, Tashiro H, Ohdan H. A Multicenter, Open-Label, Single-Arm Phase I Trial of Dual-Wield Parenchymal Transection: A New Technique of Liver Resection Using the Cavitron Ultrasonic Surgical Aspirator and Water-Jet Scalpel Simultaneously (HiSCO-14 Trial). Cureus 2023; 15:e49028. [PMID: 38116351 PMCID: PMC10728581 DOI: 10.7759/cureus.49028] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2023] [Indexed: 12/21/2023] Open
Abstract
PURPOSE This study evaluated the safety and feasibility of a technique of liver resection named dual-wield parenchymal transection technique (DWT), using cavitron ultrasonic surgical aspirator (CUSA) and water-jet scalpel simultaneously. METHODS This multicenter, prospective, open-label, and single-arm phase I trial included patients aged 20 years or older with hepatic tumors indicated for surgical resection and scheduled for open radical resection. This study was conducted at two institutions affiliated with the Hiroshima Surgical Study Group of Clinical Oncology (HiSCO). The primary endpoint was the proportion of massive intraoperative blood loss (≥ 1000 mL). The secondary endpoints were the amount of blood loss, operative time, parenchymal transection speed, postoperative complications, and mortality. The safety endpoints were device failure and adverse events associated with devices. RESULTS From June 2022 to May 2023, 20 patients were enrolled; one was excluded and 19 were included in the full analysis set (FAS). In the FAS, segmentectomy was performed in nine cases, sectionectomy in four cases, and hemihepatectomy in six cases. Radical resection was achieved in all patients. Intraoperative blood loss greater than 1000 mL was observed in five patients (26.3%). The median amount of blood loss was 545 mL (range, 180-4413), and blood transfusions were performed on two patients (10.5%). The median operative time was 346 minutes (range, 238-543) and the median parenchymal transection speed was 1.2 cm2/minute (range, 0.5-5.1). Postoperative complications of Clavien-Dindo classification ≥ Grade 3 occurred in four patients (21.1%). No mortalities occurred in this study. In the safety analysis, there were no device failures or adverse events associated with devices. CONCLUSIONS This study demonstrated the safety and feasibility of DWT for liver resection. The efficacy of the DWT will be evaluated in future clinical trials.
Collapse
Affiliation(s)
- Ko Oshita
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Gaku Aoki
- Department of Biostatistics, Clinical Research Center, Hiroshima University, Hiroshima, JPN
| | - Hiroaki Mashima
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, JPN
| | - Takashi Onoe
- Department of Surgery, Kure Medical Center and Chugoku Cancer Center, National Hospital Organization, Kure, JPN
| | | | - Taizo Hirata
- Translational Research Center, Hiroshima University, Hiroshima, JPN
| | - Hirotaka Tashiro
- Department of Surgery, Kure Medical Center and Chugoku Cancer Center, National Hospital Organization, Kure, JPN
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| |
Collapse
|
11
|
Fukuhara S, Kuroda S, Kobayashi T, Takei D, Namba Y, Oshita K, Matsubara K, Honmyo N, Nakano R, Sakai H, Tahara H, Ohira M, Kawaoka T, Tsuge M, Chosa K, Awai K, Ohdan H. Preoperative percutaneous or transvascular marking for curative resection of small liver tumours with potential for missing during hepatectomy: a study protocol for an open-label, single-arm phase II study. BMJ Open 2023; 13:e075891. [PMID: 37890974 PMCID: PMC10619086 DOI: 10.1136/bmjopen-2023-075891] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
INTRODUCTION Small liver tumours are difficult to identify during hepatectomy, which prevents curative tumour excision. Preoperative marking is a standard practice for small, deep-seated tumours in other solid organs; however, its effectiveness for liver tumours has not been validated. The objective of this study is to evaluate the effectiveness of preoperative markings for curative resection of small liver tumours. METHODS AND ANALYSIS This is an open-label, single-arm, single-centre, phase II study. Patients with liver tumours of ≤15 mm requiring hepatectomy will be enrolled and will undergo preoperative marking by placing a microcoil near the tumour using either the percutaneous or transvascular approach. The tumours, including the indwelling markers, will be excised. The primary endpoint will be the successful resection rate of liver tumours, defined as achieving a surgical margin of ≥5 mm and ≤15 mm. Secondary endpoints will include the results of preoperative marking and hepatectomy. ETHICS AND DISSEMINATION Ethical approval for this trial was obtained from the Ethical Committee for Clinical Research of Hiroshima University, Japan. The results will be published at an academic conference or by submitting a paper to a peer-reviewed journal. TRIAL REGISTRATION NUMBER jRCTs062220088.
Collapse
Affiliation(s)
- Sotaro Fukuhara
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Daisuke Takei
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Yosuke Namba
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Ko Oshita
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Keiso Matsubara
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Naruhiko Honmyo
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Ryosuke Nakano
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Sakai
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Masahiro Ohira
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Tomokazu Kawaoka
- Gastroenterology and Metabolism, Hiroshima University, Hiroshima, Japan
| | - Masataka Tsuge
- Gastroenterology and Metabolism, Hiroshima University, Hiroshima, Japan
| | - Keigo Chosa
- Diagnostic Radiology, Hiroshima University, Hiroshima, Japan
| | - Kazuo Awai
- Diagnostic Radiology, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
12
|
Oshita K, Kobayashi T, Namba Y, Fukuhara S, Matsubara K, Takei D, Nakano R, Okamoto W, Sakai H, Tanimine N, Nakahara T, Kuroda S, Tahara H, Ohira M, Kawaoka T, Ide K, Imamura M, Aikata H, Ohdan H. Efficacy and safety of lenvatinib-transcatheter arterial chemoembolisation sequential therapy followed by surgical resection for intermediate-stage hepatocellular carcinoma beyond Up-to-7 criteria: a study protocol for a multicentre, single-arm, prospective study. BMJ Open 2023; 13:e073797. [PMID: 37798025 PMCID: PMC10565137 DOI: 10.1136/bmjopen-2023-073797] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION The feasibility and efficacy of surgical resection following systemic therapy for intermediate-stage hepatocellular carcinoma (HCC) beyond the Up-to-7 criteria is unclear. The combination of lenvatinib (LEN) and transcatheter arterial chemoembolisation (TACE), termed LEN-TACE sequential therapy, has shown a high response rate and survival benefit in patients with intermediate-stage HCC. This trial aims to evaluate the efficacy and safety of LEN-TACE sequential therapy and the feasibility of surgical resection for intermediate-stage HCC beyond the Up-to-7 criteria. METHODS AND ANALYSIS This is a multicentre, single-arm, prospective clinical trial. Thirty patients with intermediate-stage HCC beyond the Up-to-7 criteria will be enrolled. Patients eligible for this study will undergo LEN-TACE sequential therapy in which LEN is administered for 4 weeks, followed by TACE, and then further LEN for another 4 weeks. Patients will be assessed for efficacy of LEN-TACE sequential therapy and resectability, and surgical resection will be performed if the HCC is considered radically resectable. The primary outcome of this study is the resection rate after LEN-TACE sequential therapy. The secondary outcomes are the objective response rate of LEN-TACE sequential therapy, safety, curative resection rate, overall survival and recurrence-free survival. ETHICS AND DISSEMINATION This trial was approved by the Institutional Review Board of Hiroshima University, Japan (approval no. CRB210003), and has been registered with the Japan Registry of Clinical Trials (jRCTs061220007). The results of this study will be submitted for publication in a peer-reviewed journal and shared with the scientific community at international conferences. TRIAL REGISTRATION NUMBER jRCTs061220007 (https://jrct.niph.go.jp/latest-detail/jRCTs061220007).
Collapse
Affiliation(s)
- Ko Oshita
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yosuke Namba
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Sotaro Fukuhara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keiso Matsubara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Daisuke Takei
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryosuke Nakano
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Wataru Okamoto
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
- Cancer Treatment Center, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Sakai
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoki Tanimine
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takashi Nakahara
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomokazu Kawaoka
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Michio Imamura
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Aikata
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
13
|
Imaoka Y, Ohira M, Imaoka K, Bekki T, Nakano R, Kuroda S, Tahara H, Ide K, Kobayashi T, Tanaka Y, Ohdan H. Correction: Surgery‑related disseminated intravascular coagulation predicts postoperative complications. BMC Surg 2023; 23:170. [PMID: 37355568 DOI: 10.1186/s12893-023-02073-9] [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] [Accepted: 06/08/2023] [Indexed: 06/26/2023] Open
Affiliation(s)
- Yuki Imaoka
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences, Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences, Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
- Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
| | - Kouki Imaoka
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences, Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Tomoaki Bekki
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences, Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Ryosuke Nakano
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences, Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences, Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences, Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences, Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences, Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Yuka Tanaka
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences, Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences, Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| |
Collapse
|
14
|
Imaoka K, Ohira M, Bekki T, Sato K, Imaoka Y, Nakano R, Yano T, Sakai H, Tanimine N, Shimizu S, Doskali M, Kuroda S, Tahara H, Ide K, Kobayashi T, Tanaka Y, Ohdan H. Arteriosclerosis Decreases Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand Expression on Liver Natural Killer Cells in Living Donor Liver Transplantation. Transplant Proc 2023:S0041-1345(23)00235-X. [PMID: 37095010 DOI: 10.1016/j.transproceed.2023.03.066] [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] [Received: 12/30/2022] [Revised: 03/21/2023] [Accepted: 03/29/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is critical for natural killer (NK) cell-mediated anti-tumor and anti-microbe killing. The TRAIL expression on the donor's liver NK cells from the liver perfusate after interleukin-2 stimulation varies between individuals and is unpredictable. This study aimed to clarify the risk factors for low TRAIL expression by analyzing perioperative donor characteristics. METHODS This retrospective study of living donor liver transplant (LDLT) donors between 2006 and 2022 was performed to analyze low TRAIL expression risk factors. Seventy-five donors who had undergone hepatectomy for LDLT were divided into 2 groups, low and high TRAIL, according to their TRAIL expression on liver NK cells, using median values. RESULTS The low TRAIL group (N = 38) was older and had lower nutrition and a higher low-density lipoprotein/high-density lipoprotein (LDL/HDL) cholesterol ratio, related to arteriosclerosis, than the high TRAIL group (N = 37). In multivariate analysis, the geriatric nutritional risk index (GNRI) (odds ratio, 0.86; 95% CI, 0.76-0.94; P < .001) and LDL/HDL cholesterol ratio (odds ratio, 2.32; 95% CI, 1.10-4.86; P = .005) were independent predictive factors for low TRAIL expression on liver NK cells. Furthermore, the TRAIL expression of liver NK cells decreased in donors who already had atherosclerosis and in donors at risk of potentially developing atherosclerosis. CONCLUSIONS The TRAIL expression on liver NK cells in donors had a strong relationship with atherosclerosis and GNRI. Atherosclerosis can reflect the TRAIL expression on liver NK cells.
Collapse
Affiliation(s)
- Kouki Imaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan; Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Minami-ku, Hiroshima, Japan.
| | - Tomoaki Bekki
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Koki Sato
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Yuki Imaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Ryosuke Nakano
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Takuya Yano
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Hiroshi Sakai
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Naoki Tanimine
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Seiichi Shimizu
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Marlen Doskali
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Yuka Tanaka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan
| |
Collapse
|
15
|
Ide R, Ohira M, Imaoka Y, Sato K, Kuroda S, Tahara H, Ide K, Kobayashi T, Ohdan H. Impact of Abdominal Aortic Calcification on Chronic Kidney Disease After Liver Transplantation: A Retrospective Study. Transplant Proc 2023:S0041-1345(23)00136-7. [PMID: 37085382 DOI: 10.1016/j.transproceed.2023.03.014] [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] [Received: 01/31/2023] [Accepted: 03/13/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND With improved graft and patient survival after liver transplantation (LT), the onset of late complications, such as renal dysfunction, has become a problem. In this study, we aimed to investigate abdominal aortic calcification (AAC), a potential indicator of systemic atherosclerosis, and evaluate the relationship between preoperative AAC and postoperative chronic kidney disease (CKD), as the latter might be a long-term complication after LT. METHODS Among the 184 LTs performed at our center between 2008 and 2021, 110 LTs with normal renal function (estimated glomerular filtration rate [eGFR] 60 mL/min per 1.73 m2) before surgery were included. These were divided into high- (≥100 mm3) and low-AAC groups (<100 mm3) consisting of 51 and 59 patients, respectively. The AAC volume was automatically calculated for calcifications located in the abdominal aorta using the Agatston method. RESULTS The high-AAC group was older, consisted of more men, and had lower preoperative creatinine and eGFR levels. No significant difference in the onset of postoperative CKD was found between the 2 groups. However, the cumulative incidence of postoperative CKD was significantly higher in the high-AAC group compared with the low-AAC group. Multivariate analysis of postoperative CKD using the Cox proportional hazards model showed significant differences in preoperative AAC ≥100 mm3, recipient age ≥50 years, and preoperative eGFR <75 mL/min per 1.73 m2. CONCLUSIONS The development of postoperative CKD should be monitored in liver transplant recipients despite normal preoperative renal function. Our study suggests that preoperative AAC may influence postoperative renal dysfunction.
Collapse
Affiliation(s)
- Ryuta Ide
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.
| | - Yuki Imaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kouki Sato
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
16
|
Imaoka Y, Ohira M, Imaoka K, Bekki T, Nakano R, Kuroda S, Tahara H, Ide K, Kobayashi T, Tanaka Y, Ohdan H. Surgery-related disseminated intravascular coagulation predicts postoperative complications. BMC Surg 2023; 23:86. [PMID: 37041491 PMCID: PMC10091651 DOI: 10.1186/s12893-023-01986-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 04/04/2023] [Indexed: 04/13/2023] Open
Abstract
PURPOSE The rate of postoperative morbidity, including infectious complications, is still high after major hepatobiliary pancreatic (HBP) surgery. Although surgery-related disseminated intravascular coagulation (DIC) occurs in some cases, its significance has not been elucidated in HBP surgery. This study aimed to evaluate the influence of surgery-related DIC on the complication severity after HBP surgery. METHODS We analyzed the records of 100 patients with hepatectomy in two or more segments, hepatectomy with biliary tract reconstruction, and pancreaticoduodenectomy. The baseline characteristics and complications were compared between patients with and without surgery-related DIC on postoperative day 1 (POD1) after HBP surgery between 2010 and 2018. Complication severity was assessed using the Comprehensive Complication Index (CCI). RESULTS The DIC group (surgery-related DIC on POD1) had predictive factors, such as larger bleeding volume and higher liver enzyme levels. The DIC group exhibited significantly elevated rates of surgical site infection, sepsis, prolonged intensive care unit stay, more frequent blood transfusions, and higher CCI. Furthermore, compared with and without adjustment of DIC, odds ratio (OR) of AST level and operation time for the risk of high CCI decreased (OR of AST level: 1.25 to 1.19 and OR of operation time: 1.30 to 1.23) and the significant differences had vanished. CONCLUSIONS Surgery-related DIC on POD1 could be a partial mediator between AST level, operation time and higher CCI. The prevention or proper management of surgery-related DIC on POD1 can be an important target to reduce the severity of postoperative complications.
Collapse
Affiliation(s)
- Yuki Imaoka
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
- Division of Regeneration and Medicine,, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
| | - Kouki Imaoka
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Tomoaki Bekki
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Ryosuke Nakano
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Yuka Tanaka
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, School of Biomedical and Health Sciences Hiroshima University, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| |
Collapse
|
17
|
Ohira M, Kobayashi T, Tanaka Y, Imaoka Y, Sato K, Imaoka K, Nakano R, Doskali M, Piao J, Nakamura M, Yoshida T, Ichinohe T, Kawano R, Yoshimura K, Ueda K, Tamura N, Hirata T, Imamura M, Aikata H, Tanimine N, Kuroda S, Tahara H, Ide K, Ohdan H. Adoptive immunotherapy with natural killer cells from peripheral blood CD34 + stem cells to prevent hepatocellular carcinoma recurrence after curative hepatectomy: a study protocol for an open-label, single-arm phase I study. BMJ Open 2022; 12:e064526. [PMID: 36410831 PMCID: PMC9680173 DOI: 10.1136/bmjopen-2022-064526] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Hepatocellular carcinoma (HCC) remains a major clinical problem as more than half of these cases recur after radical resection. Natural killer (NK) cells are at the forefront of the innate immune system and attack microcarcinomas and circulating tumour cells. The objective of this study was to evaluate the feasibility and toxicity of peripheral blood CD34+ stem cell-derived NK cell infusion after radical hepatectomy for HCC. METHODS AND ANALYSIS This is an open-label, single-arm, single-centre phase I study. Patients who have undergone initial hepatectomy for HCC with three or more risk factors for recurrence (≥10 ng/mL of Alpha fetoprotein (AFP), ≥360 mAU/mL of PIVKA-II, multiple tumours and ≥3 peripheral blood circulating tumour cells) will be enrolled and be treated with three peripheral blood CD34+ stem cell-derived NK cell infusions every 3 months. The primary endpoint will be safety assessment including the type and severity of adverse events, frequency of occurrence and duration of occurrence. The secondary endpoints will include survival, effect of immune response and clinical laboratory test results. ETHICS AND DISSEMINATION Ethical approval of the trial was obtained from the Certified Committee for Regenerative Medicine Hiroshima University in Japan. The trial results will be shared with the scientific community at international conferences and by publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER jRCTb060200020.
Collapse
Affiliation(s)
- Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
- Medical Center for Translational and Clinical Research, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
| | - Yuka Tanaka
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
| | - Yuki Imaoka
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
| | - Koki Sato
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
| | - Koki Imaoka
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
| | - Ryosuke Nakano
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
| | - Marlen Doskali
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
| | - Jinlian Piao
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
| | - Mayuna Nakamura
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
| | - Tetsumi Yoshida
- Department of Hematology and Oncology, Hiroshima University Hospital, Hiroshima, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Hiroshima University Hospital, Hiroshima, Japan
| | - Reo Kawano
- Clinical Research Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Kenichi Yoshimura
- Medical Center for Translational and Clinical Research, Hiroshima University, Hiroshima, Japan
| | - Keiko Ueda
- Clinical Research Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Natsuko Tamura
- Clinical Research Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Taizo Hirata
- Clinical Research Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Michio Imamura
- Department of Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Aikata
- Department of Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Naoki Tanimine
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima, Japan
- Clinical Research Center, Hiroshima University Hospital, Hiroshima, Japan
| |
Collapse
|
18
|
Shimizu S, Ohira M, Tanaka Y, Ide K, Tahara H, Kuroda S, Tanimine N, Doskali M, Hotta R, Yano T, Nakano R, Imaoka Y, Sato K, Imaoka K, Kobayashi T, Ohdan H. Adoptive immunotherapy overcomes genetic susceptibility to bloodstream infections due to fc-gamma receptor polymorphisms after liver transplantation. Am J Transplant 2022; 22:2392-2400. [PMID: 35670552 DOI: 10.1111/ajt.17113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/31/2022] [Revised: 06/03/2022] [Accepted: 06/03/2022] [Indexed: 01/25/2023]
Abstract
Single nucleotide polymorphisms (SNPs) in FCGR3A can predict the susceptibility of liver transplant (LT) recipients to bloodstream infections (BSI) and clinical outcomes following living-donor LT (LDLT). Here, we retrospectively analyzed the relationship of adoptive immunotherapy with activated natural killer (NK) cells from perfusate effluents of liver allografts against BSI following LDLT. Higher BSI incidence and lower survival were observed in LT recipients with FcγRIIIa (158F/F or F/V) (n = 81) who did not receive adoptive immunotherapy (n = 55) than in those who did (n = 26) (BSI frequency, 36.4% vs. 11.5%; p = .033; log-rank p = .047). After matching patient background using propensity score, similar results were obtained (BSI ratio, 41.7% vs. 12.5%; p = .049; log-rank p = .039). The predominant BSI pathogens in patients who did and did not receive adoptive immunotherapy were gram-negative rods (n = 3, 100%) and gram-positive cocci (GPC) (n = 15, 65.2%), respectively. The proportion of NK cells administered to patients with BSI was significantly lower than that administered to patients without BSI (Number: 80.3 (29.9-239.2) × 106 cells vs. 37.1 (35.6-50.4) × 106 ; p = .033, percentage; 14.1 (13.3-17.8)% vs. 34.6 (16.5-47)%, p = .0078). Therefore, adoptive immunotherapy with NK cells was associated with the reduced post-transplant BSI related to GPCs due to FcγRIIIa SNP in LT recipients.
Collapse
Affiliation(s)
- Seiichi Shimizu
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Yuka Tanaka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoki Tanimine
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Marlen Doskali
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryuichi Hotta
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takuya Yano
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryosuke Nakano
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuki Imaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Koki Sato
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kouki Imaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
19
|
Yamaguchi M, Tashiro H, Kuroda S, Okimoto S, Kobayashi T, Hinoi T, Ohdan H. Downregulation of thrombomodulin contributes to ischemia-reperfusion injury in mice with steatotic liver. Hepatol Res 2022; 52:762-772. [PMID: 35714128 DOI: 10.1111/hepr.13802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/24/2021] [Revised: 06/03/2022] [Accepted: 06/13/2022] [Indexed: 02/08/2023]
Abstract
AIM Ischemia-reperfusion (IR) injury is one of the most critical complications commonly associated with liver surgery, including liver transplantation. Steatotic livers are particularly vulnerable to IR injury. However, the underlying mechanisms of this increased susceptibility have not fully been understood. In the present study, we used heterogeneous thrombomodulin (TM)-knockout (KO) (TM+/- ) mice, which express about 50% functional activity of TM as compared with wild type, to investigate whether dysregulation of TM enhances IR injury in steatotic livers. METHODS Steatotic livers were induced using choline-deficient diets (CDD) in mice. The biological activity of TM was assessed using the productivity of protein C. Susceptibility to IR injury was compared between steatotic livers and non-steatotic livers and also assessed in TM-KO mice. We investigated whether recombinant TM (rTM) and the lectin-like domain of TM (rTM-D1) ameliorated IR injury in steatotic livers. RESULTS Protein C activity was significantly decreased to less than 20% in CDD-fed mice compared with mice with non-steatotic livers. Steatotic livers showed exaggerated IR injury compared with non-steatotic livers. Recombinant TM (rTM) and the lectin-like domain of TM (rTM-D1), which has anti-inflammatory effects, ameliorated IR injury in steatotic livers. TM+/- mice showed increased susceptibility to IR injury, and rTM ameliorated the increased IR injury in TM+/- mice. CONCLUSION We conclude that downregulation of TM increases susceptibility to hepatic IR injury in steatotic livers and that rTM ameliorates hepatic IR injury through anti-inflammatory action.
Collapse
Affiliation(s)
- Megumi Yamaguchi
- Department of Surgery, Kure Medical Center, National Hospital Organization, Hiroshima, Japan.,Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Hirotaka Tashiro
- Department of Surgery, Kure Medical Center, National Hospital Organization, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Sho Okimoto
- Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Takao Hinoi
- Department of Clinical and Molecular Genetics, Hiroshima University Hospital, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, Hiroshima, Japan
| |
Collapse
|
20
|
Kodama K, Kawaoka T, Kosaka M, Johira Y, Shirane Y, Miura R, Yano S, Murakami S, Amioka K, Naruto K, Ando Y, Kosaka Y, Uchikawa S, Fujino H, Nakahara T, Murakami E, Okamoto W, Yamauchi M, Miki D, Imamura M, Kuroda S, Kobayashi T, Ohdan H, Aikata H, Chayama K. Calcium channel blockers improve the prognosis of patients with intrahepatic cholangiocarcinoma after resection. J Gastroenterol 2022; 57:676-683. [PMID: 35849192 DOI: 10.1007/s00535-022-01887-3] [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: 10/27/2021] [Accepted: 05/28/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Intrahepatic cholangiocarcinoma is the second most common primary cancer of the liver. It is highly malignant and its prognosis is very poor. Although there have been various reports on the effects of calcium channel blockers on cancer, the effects of calcium channel blockers on intrahepatic cholangiocarcinoma have not been reported so far. METHODS Seventy-nine patients diagnosed with intrahepatic cholangiocarcinoma by hepatectomy between January 2002 and May 2019 were retrospectively evaluated. We compared prognosis and time to recurrence between patients treated with calcium channel blockers (CCBs) (n = 29) and those not treated with CCBs (n = 50). Propensity score matching reduced confounding biases and yielded 25 matched patient pairs. Survival between groups was compared using Kaplan-Meier analyses, logrank tests, and Cox proportional hazard regression models. RESULTS Overall survival and recurrence-free survival of the CCBs group were significantly longer than those of the non-CCBs group OS in the original cohort and matched cohort (98 months vs 45 months, p = 0.010; 96 months vs 22 months, p = 0.020, respectively). Multivariate analyses showed that CCBs treatment was independently associated with overall survival (HR, 0.37; 95% CI 0.16-0.85; p = 0.019) and recurrence-free survival (HR, 0.39; 95% CI 0.17-0.90; p = 0.020) in the original cohort and matched cohort, respectively. CONCLUSION CCBs treatment might improve prognosis of patients with intrahepatic cholangiocarcinoma.
Collapse
Affiliation(s)
- Kenichiro Kodama
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Tomokazu Kawaoka
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Masanari Kosaka
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Yusuke Johira
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Yuki Shirane
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Ryoichi Miura
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Shigeki Yano
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Serami Murakami
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Kei Amioka
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Kensuke Naruto
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Yuwa Ando
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Yumi Kosaka
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Shinsuke Uchikawa
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Hatsue Fujino
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Takashi Nakahara
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Eisuke Murakami
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Wataru Okamoto
- Cancer Treatment Center, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Masami Yamauchi
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Daiki Miki
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Michio Imamura
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Hiroshi Aikata
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan.
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan.,Collaborative Research Laboratory of Medical Innovation, Hiroshima University, Hiroshima, 734-8551, Japan.,Collaborative Research Laboratory of Medical Innovation, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
21
|
Shimizu T, Kawashiri SY, Morimoto S, Kawazoe Y, Kuroda S, Kawasaki R, Ito Y, Sato S, Yamamoto H, Kawakami A. AB0157 EFFICACY AND SAFETY OF FILGOTINIB IN ACTIVE RHEUMATOID ARTHRITIS PATIENTS WITH INADEQUATE RESPONSE TO METHOTREXATE: COMPARATIVE STUDY WITH FILGOTINIB AND TOCILIZUMAB EXAMINED BY CLINICAL INDEX AS WELL AS MUSCULOSKELETAL ULTRASOUND ASSESSMENT (TRANSFORM STUDY): STUDY PROTOCOL. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe administration of Janus kinase (JAK) inhibitors as well as biological disease-modifying anti-rheumatic drugs has dramatically improved even the clinical outcomes in rheumatoid arthritis (RA) patients with inadequate response to methotrexate (MTX). The dysregulation of JAK- signal transducer and activator of transcription (STAT) pathways via overproduction of cytokines, such as interleukin-6 (IL-6) is involved in the pathogenesis of RA (1). Filgotinib, a preferential JAK1 inhibitor, is effective in suppressing disease activity and preventing the progression of joint destruction due to inhibition of the JAK-STAT pathway. IL-6 inhibitors such as tocilizumab also inhibit the JAK-STAT pathways due to inhibition of IL-6 signaling. Thus, it should be desirable to investigate whether the effectiveness of filgotinib monotherapy is non-inferior to those of tocilizumab monotherapy in RA patients with inadequate response to MTX. In addition, it is important to accurately evaluate disease activity at the joint level by using musculoskeletal ultrasound (MSUS) and clinical disease activity indices, including subjective parameters (2).ObjectivesThis study’s principal objective is to evaluate the effects of filgotinib monotherapy is non-inferior to those of tocilizumab monotherapy in RA patients with inadequate response to MTX. In addition, we will evaluate changes in patients’ parameters, including clinical disease activity indices, MSUS scores, serum biomarkers, patient-reported outcome (PRO), and modified total Sharp score (mTSS) after the administration of filgotinib or tocilizumab. Herein, we describe the study protocol for this study.MethodsThis study is an interventional, multicenter, randomized, open-label, parallel-group and non-inferiority clinical trial with a 52-week follow-up. In total, 400 RA patients with at least moderate disease activity during treatment with MTX will be included. Patients will be randomized in a 1:1 ratio to administration of filgotinib 200mg/day monotherapy or subcutaneous tocilizumab 162mg/biweekly monotherapy switched from MTX (Figure 1). We will evaluate disease activity by measuring clinical disease activity indices and by using MSUS. The primary endpoint is the proportion of patients who achieve an American College of Rheumatology 50 response at week 12. Important secondary endpoints are the changes from the baseline of the MSUS scores, PRO, and mTSS. We will also comprehensively analyze the serum levels of multiple biomarkers such as cytokines and chemokines.Figure 1.ResultsAlthough the study results cannot be shown because the research entry is in progress, they are expected to show the non-inferiority of filgotinib monotherapy to tocilizumab monotherapy in RA patients with inadequate response to MTX.ConclusionThe strength of this study is its prospective evaluation of therapeutic efficacy using not only clinical disease activity indices but also MSUS, which accurately and objectively evaluate disease activity at the joint level among patients drawn from multiple centers with a standardized evaluation by MSUS. In addition, we will evaluate the effectiveness of both drugs by integrating multilateral assessments, i.e., clinical disease activity indices, MSUS findings, and serum biomarkers.References[1]Gadina M, Le MT, Schwartz DM, Silvennoinen O, Nakayamada S, Yamaoka K, et al. Janus kinases to jakinibs: from basic insights to clinical practice. Rheumatology (Oxford). 2019;58(Suppl 1):i4-i16.[2]Colebatch AN, Edwards CJ, Ostergaard M, van der Heijde D, Balint PV, D’Agostino MA, et al. EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis. 2013;72(6):804-14.Disclosure of InterestsToshimasa Shimizu: None declared, Shin-ya Kawashiri: None declared, Shimpei Morimoto: None declared, Yurika Kawazoe: None declared, Shohei Kuroda: None declared, Rina Kawasaki: None declared, Yasuko Ito: None declared, Shuntaro Sato: None declared, Hiroshi Yamamoto: None declared, Atsushi Kawakami Grant/research support from: Gilead Sciences, Inc.
Collapse
|
22
|
Imaoka Y, Ohira M, Sato K, Imaoka K, Kuroda S, Tahara H, Kobayashi T, Ide K, Tanaka Y, Ohdan H. Impact of abdominal aortic calcification on clinical outcomes following initial hepatectomy for hepatocellular carcinoma: A retrospective cohort study. Ann Gastroenterol Surg 2022; 6:149-158. [PMID: 35106425 PMCID: PMC8786692 DOI: 10.1002/ags3.12508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/22/2021] [Accepted: 09/02/2021] [Indexed: 01/13/2023] Open
Abstract
AIM The clinical impact of abdominal aortic calcification (AAC) in patients who undergo hepatectomy for hepatocellular carcinoma (HCC) is unknown. METHODS To evaluate the impact of AAC on clinical outcomes, we analyzed 203 patients who underwent hepatectomy for HCC between 2010 and 2013. RESULTS Kaplan-Meier survival curve analysis showed significantly worse overall survival (OS) in the high AAC group than in the low AAC group. The recurrence-free survival (RFS) was also significantly worse in the high AAC group. In the multivariate analysis, high AAC (hazard ratio [HR], 2.51; 95% confidence interval [CI], 1.24-5.09; P = .01) was an independent risk factor for poor OS after hepatectomy for HCC. High AAC was also an independent risk factor for poor RFS (HR, 1.69; 95% CI, 1.04-2.76; P = .04). CONCLUSIONS Abdominal aortic calcification had a strong relationship with poor OS and RFS after hepatectomy for HCC. We suggest that AAC had a relationship with smoking and diabetes; therefore, AAC could reflect a surrogate for older age, worse health status, and inflammatory score.
Collapse
Affiliation(s)
- Yuki Imaoka
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
- Division of Regeneration and MedicineMedical Center for Translational and Clinical ResearchHiroshima University HospitalHiroshimaJapan
| | - Koki Sato
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Kouki Imaoka
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Yuka Tanaka
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| |
Collapse
|
23
|
Johira Y, Kawaoka T, Kosaka M, Shirane Y, Miura R, Murakami S, Yano S, Amioka K, Naruto K, Ando Y, Kosaka Y, Kodama K, Uchikawa S, Fujino H, Ono A, Nakahara T, Murakami E, Okamoto W, Yamauchi M, Imamura M, Sentani K, Oue N, Arihiro K, Kuroda S, Kobayashi T, Ohdan H, Chayama K, Aikata H. Pathological Complete Response to Lenvatinib after Failure of Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma. Liver Cancer 2021; 11:174-177. [PMID: 35634428 PMCID: PMC9109072 DOI: 10.1159/000520898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/11/2021] [Indexed: 02/04/2023] Open
Affiliation(s)
- Yusuke Johira
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Tomokazu Kawaoka
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Masanari Kosaka
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Yuki Shirane
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Ryoichi Miura
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Serami Murakami
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Shigeki Yano
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Kei Amioka
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Kensuke Naruto
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Yuwa Ando
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Yumi Kosaka
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Kenichiro Kodama
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Shinsuke Uchikawa
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Hatsue Fujino
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Atsushi Ono
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Takashi Nakahara
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Eisuke Murakami
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Wataru Okamoto
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Masami Yamauchi
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Michio Imamura
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazuhiro Sentani
- Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naohide Oue
- Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Koji Arihiro
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Hiroshi Aikata
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan,*Hiroshi Aikata,
| |
Collapse
|
24
|
Ishikawa S, Kuroda S, Chosa K, Okada K, Tanimine N, Tahara H, Ohira M, Ide K, Kobayashi T, Ohdan H. Treatment of multiple huge liver cysts in a hybrid operating room: a case report. Surg Case Rep 2021; 7:232. [PMID: 34714449 PMCID: PMC8556466 DOI: 10.1186/s40792-021-01320-6] [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: 09/22/2021] [Accepted: 10/21/2021] [Indexed: 11/19/2022] Open
Abstract
Background Liver cysts are common, with most cases being asymptomatic. In symptomatic cases, the disease is amenable to treatment. However, huge or multiple liver cysts with vascular narrowing and associated systemic symptoms are extremely rare. Furthermore, the performance of a reliable and effective surgery in such cases remains a major problem. Here, we report a case of multiple giant liver cysts with impaired blood flow surgically treated in a hybrid operating room. Case presentation A 73-year-old male presented to a previous doctor with leg edema and dyspnea on exertion; computed tomography revealed that the cause complaint was right lung and heart compression and inferior vena cava (IVC) stenosis due to huge liver cysts in the caudal lobe. The patient was referred to our hospital because of disease recurrence despite percutaneous aspiration of the cyst. Multiple liver cysts were observed in addition to the drained cysts, two of which were located on both sides of the IVC and caused IVC stenosis. We performed open surgery for the liver cysts and used the hybrid operating room for intraoperative IVC angiography and measuring the hepatic vein and portal vein (PV) pressure. We performed unroofing of the hepatic cyst and cauterization of the cyst wall on the hepatic side. Angiography was performed before and after unroofing of the liver cysts, and IVC stenosis release was confirmed. IVC pressure measured at the peripheral side of the stenosis and PV pressures were continuously measured during surgery and were confirmed to have decreased during the opening of the liver cysts. The patient had a good postoperative course and was discharged on the 10th postoperative day. No recurrence was observed 6 months postoperatively. Conclusions Cyst unroofing surgery using angiography in a hybrid operating room is a useful treatment for deep hepatic lesions in that vascular stenosis improvement can be intraoperatively confirmed. Moreover, in cases wherein the cyst compresses the vasculature, intraoperative monitoring of IVC and PV pressures can be used to prove that the liver cyst is hemodynamically involved.
Collapse
Affiliation(s)
- Sho Ishikawa
- Department of Surgery, Kure City Medical Association Hospital, 15-24, Asahimachi, Kure-City, Hiroshima, 737-0056, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Keigo Chosa
- Department of Diagnostic Radiology, Hiroshima University Hospital, Hiroshima, Japan
| | - Kenjiro Okada
- Department of Gastroenterological Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Naoki Tanimine
- Department of Gastroenterological Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Masahiro Ohira
- Department of Gastroenterological Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Kentaro Ide
- Department of Gastroenterological Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Hideki Ohdan
- Department of Gastroenterological Surgery, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| |
Collapse
|
25
|
Yano S, Kawaoka T, Johira Y, Miura R, Kosaka M, Shirane Y, Murakami S, Amioka K, Naruto K, Ando Y, Kosaka Y, Yamaoka K, Kodama K, Uchikawa S, Fujino H, Ohno A, Nakahara T, Murakami E, Okamoto W, Yamauchi M, Imamura M, Mori K, Arihiro K, Kuroda S, Kobayashi T, Ohdan H, Aikata H. Advanced hepatocellular carcinoma with response to lenvatinib after atezolizumab plus bevacizumab. Medicine (Baltimore) 2021; 100:e27576. [PMID: 34678902 PMCID: PMC8542139 DOI: 10.1097/md.0000000000027576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/24/2021] [Accepted: 10/07/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Various treatments are available for treating hepatocellular carcinoma (HCC). The immune checkpoint inhibitor combination of atezolizumab plus bevacizumab was recently approved for the treatment of unresectable HCC, but there are few reports on the failure of the combination treatment. Here, we present a case of unresectable HCC with adrenal metastasis that was eventually operated on after lenvatinib (LEN) treatment that followed failed treatment with atezolizumab plus bevacizumab. PATIENT CONCERNS A 68-year-old man was diagnosed with non-alcoholic steatohepatitis-based HCC with adrenal metastasis. DIAGNOSIS Cirrhosis was classified as Child-Pugh score of 5. HCC was diagnosed as Barcelona Clinic Liver Cancer stage C. INTERVENTIONS We initiated treatment with atezolizumab plus bevacizumab. Liver dysfunction appeared 2 days after the first administration but was improved by intravenous rehydration and did not appear after the second course. The HCC shrank, but the adrenal metastasis grew bigger after the fourth course, so we changed the therapy to LEN. After HCC and adrenal metastasis were necrotic by LEN, conversion surgery was performed. OUTCOMES After successful conversion therapy, the general condition of the patient was good, and has been carefully followed for 4 months to date without any evidence of further recurrences. LESSONS This case showed that even if atezolizumab plus bevacizumab is not effective, multidisciplinary treatment such as LEN and conversion surgery is possible. Given the efficacy of LEN after atezolizumab plus bevacizumab, it is important to consider that there is a possibility of cure even when first-line treatment is not effective for a patient with unresectable HCC.
Collapse
Affiliation(s)
- Shigeki Yano
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Tomokazu Kawaoka
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Yusuke Johira
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Ryoichi Miura
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Masanari Kosaka
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Yuki Shirane
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Serami Murakami
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Kei Amioka
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Kensuke Naruto
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Yuwa Ando
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Yumi Kosaka
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Kenji Yamaoka
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Kenichiro Kodama
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Shinsuke Uchikawa
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Hatsue Fujino
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Atsushi Ohno
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Takashi Nakahara
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Eisuke Murakami
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Wataru Okamoto
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Masami Yamauchi
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Michio Imamura
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| | - Keiichi Mori
- Anatomical Pathology, Hiroshima University, Japan
| | | | - Shintaro Kuroda
- Gastroenterological and Transplant Surgery, Hiroshima University, Japan
| | | | - Hideki Ohdan
- Gastroenterological and Transplant Surgery, Hiroshima University, Japan
| | - Hiroshi Aikata
- Department of Gastroenterology and Metabolism, Hiroshima University, Japan
| |
Collapse
|
26
|
Honmyo N, Kobayashi T, Kuroda S, Ide K, Ohira M, Tahara H, Morimoto H, Tanimine N, Hamaoka M, Yamaguchi M, Yamamoto M, Takei D, Aikata H, Chayama K, Ohdan H. Risk Factors for Hepatocellular Carcinoma After Splenectomy in Liver Cirrhotic Patients. Am Surg 2021:31348211041562. [PMID: 34455865 DOI: 10.1177/00031348211041562] [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] [Indexed: 12/24/2022]
Abstract
BACKGROUND Splenectomy is sometimes indicated for portal hypertension caused by cirrhosis, which is a risk for hepatic carcinogenesis. This study aimed to identify risk factors for hepatocellular carcinoma (HCC) development after splenectomy. METHODS This retrospective study included 65 patients who underwent splenectomy for portal hypertension between 2009 and 2017. Cox regression analyses were performed to identify factors related to HCC development after splenectomy. The predictive index for HCC development was constructed from the results of multivariate analysis, and 3 risk-dependent groups were defined. Discrimination among the groups was estimated using Kaplan-Meier curves and the log-rank test. RESULTS Post-splenectomy, 36.9% of patients developed HCC. In the univariate analysis, the etiology of cirrhosis (hepatitis C virus antibody, P = .005, and hepatitis B surface antigen, P = .008, referring to non-B and non-C patients, respectively), presence of HCC history (P < .001), and preoperative hemoglobin level (P = .007) were related to HCC development, and the presence of HCC history (P = .002) and preoperative hemoglobin level (P = .022) were independent risk factors. The predictive index classified three groups at risk; the hazards in each group were significantly different (low vs middle risk, P = .035, and middle vs high risk, P = .011). DISCUSSION The etiology of cirrhosis, presence of HCC history, and hemoglobin level were associated with HCC development after splenectomy. The predictive model may aid in HCC surveillance after splenectomy for patients with portal hypertension.
Collapse
Affiliation(s)
- Naruhiko Honmyo
- Department of Gastroenterological and Transplant Surgery, 12803Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, 12803Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, 12803Hiroshima University, Hiroshima, Japan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery, 12803Hiroshima University, Hiroshima, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, 12803Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, 12803Hiroshima University, Hiroshima, Japan
| | - Hiroshi Morimoto
- Department of Gastroenterological and Transplant Surgery, 12803Hiroshima University, Hiroshima, Japan
| | - Naoki Tanimine
- Department of Gastroenterological and Transplant Surgery, 12803Hiroshima University, Hiroshima, Japan
| | - Michinori Hamaoka
- Department of Gastroenterological and Transplant Surgery, 12803Hiroshima University, Hiroshima, Japan
| | - Megumi Yamaguchi
- Department of Gastroenterological and Transplant Surgery, 12803Hiroshima University, Hiroshima, Japan
| | - Masateru Yamamoto
- Department of Gastroenterological and Transplant Surgery, 12803Hiroshima University, Hiroshima, Japan
| | - Daisuke Takei
- Department of Gastroenterological and Transplant Surgery, 12803Hiroshima University, Hiroshima, Japan
| | - Hiroshi Aikata
- Department of Gastroenterology and Metabolism, 12803Hiroshima University, Hiroshima, Japan.,Research Center for Hepatology and Gastroenterology, 12803Hiroshima University, Hiroshima, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, 12803Hiroshima University, Hiroshima, Japan.,Research Center for Hepatology and Gastroenterology, 12803Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, 12803Hiroshima University, Hiroshima, Japan
| |
Collapse
|
27
|
Hayama T, Ijuin A, Ueno H, Hamada H, Miyakoshi A, Nishi M, Saito M, Hamanoue H, Komeya M, Takeshima T, Kuroda S, Sakakibara H, Yumura Y, Miyagi E, Murase M. P–572 Purifying selection for aneuploidy cells in mosaicism embryo at post-implantation stage. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.571] [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: 11/13/2022] Open
Abstract
Abstract
Study question
Why low ratio mosaicism embryos develop to normal karyotype babies?
Summary answer
Our in vitro implantation assay clarified purifying selection for aneuploid cells in post implantation embryos.
What is known already
There are some reports about healthy live birth after transfer of mosaic embryos, which was reported for the first time from Italy in 2015. It is also reported that the abnormal cell is screened with the mouse in the embryo development, and only a normal cell contributes to the development. But it has not been examined in human.
Study design, size, duration
To clarify the change of aneuploid cells and mitochondrial activity in human embryo, we biopsied several parts from one blastocyst and examined karyotype. After in vitro implantation assay for biopsied embryos, we compared the karyotype of biopsy sample with that of cultured cell mass.
Participants/materials, setting, methods
Under the ethical review of Yokohama City University and informed consent with patients, we collected human surplus blastocysts those are donated after successful clinical treatment or discarded because of poor development grade. We biopsied multiple parts from one blastocyst and cultured the biopsied embryos, and extracted whole DNA from the biopsy samples and cultured embryos. Karyotyping by next generation sequencing were performed.
Main results and the role of chance
We analyzed 34 samples from 11 embryos, including 25 biopsy sample from 11 embryos and 9 cell mass from 7 cultured embryos. In the karyotype tracking results, even though biopsy sample analysis before the culture were uniformed aneuploid or chromosome mosaic, the developing embryo cell mass had normal karyotype. In one embryo as an example, among the three biopsied extra trophectoderm samples from that, two of them were mosaic, and one of them had uniformed chromosome 21 trisomy and chromosome 16 mosaic monosomy. But the embryo formed multiple cell mass in implantation assay. We examined karyotype of three cell mass, and the result from all were normal karyotype. We suggested that the chromosome aberration cells were screened in the human embryo development, and when the function was not carried out the embryo stopped the development.
Limitations, reasons for caution
Because of small number of samples available, we need more samples for a more accurate evaluation. Furthermore, we cannot evaluate the absolute mechanism that cells with chromosome aberration decreases.
Wider implications of the findings: Conventional PGT-A techniques are based on uniformed embryos developing hypothesized past time. As showed in some clinical reports, PGT-A can reduce of spontaneous abortion and chance of embryo transfer. Thinking about aneuploid cell purifying system in embryo development, effectiveness of PGT-A should be more questionable for infertility treatment.
Trial registration number
A200326004
Collapse
Affiliation(s)
- T Hayama
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - A Ijuin
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Ueno
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Hamada
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - A Miyakoshi
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - M Nishi
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - M Saito
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Hamanoue
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - M Komeya
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - T Takeshima
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - S Kuroda
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Sakakibara
- Yokohama City University Medical Center, Department of Gynecology, Yokohama-shi- Kanagawa, Japan
| | - Y Yumura
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - E Miyagi
- Yokohama City University, Department of Gynecology, Yokohama-shi- Kanagawa, Japan
| | - M Murase
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| |
Collapse
|
28
|
Kawase A, Mukai H, Tateishi S, Kuroda S, Kazaoka A, Satoh R, Shimada H, Sugiura R, Iwaki M. Protein Kinase N Family Negatively Regulates Constitutive Androstane Receptor-Mediated Transcriptional Induction of Cytochrome P450 2b10 in the Livers of Mice. J Pharmacol Exp Ther 2021; 379:53-63. [PMID: 34312179 DOI: 10.1124/jpet.121.000790] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/22/2021] [Indexed: 01/04/2023] Open
Abstract
In receptor-type transcription factors-mediated cytochrome P450 (P450) induction, few studies have attempted to clarify the roles of protein kinase N (PKN) in the transcriptional regulation of P450s. This study aimed to examine the involvement of PKN in the transcriptional regulation of P450s by receptor-type transcription factors, including the aryl hydrocarbon receptor, constitutive androstane receptor (CAR), and pregnane X receptor. The mRNA and protein levels and metabolic activity of P450s in the livers of wild-type (WT) and double-mutant (D) mice harboring both PKN1 kinase-negative knock-in and PKN3 knockout mutations [PKN1 T778A/T778A; PKN3 -/-] were determined after treatment with activators for receptor-type transcription factors. mRNA and protein levels and metabolic activity of CYP2B10 were significantly higher in D mice treated with the CAR activator phenobarbital (PB) but not with 1,4-bis((3,5-dichloropyridin-2-yl)oxy)benzene compared with WT mice. We examined the CAR-dependent pathway regulated by PKN after PB treatment because the extent of CYP2B10 induction in WT and D mice was notably different in response to treatment with different CAR activators. The mRNA levels of Cyp2b10 in primary hepatocytes from WT and D mice treated with PB alone or in combination with Src kinase inhibitor 1 (SKI-1) or U0126 (a mitogen-activated protein kinase inhibitor) were evaluated. Treatment of hepatocytes from D mice with the combination of PB with U0126 but not SKI-1 significantly increased the mRNA levels of Cyp2b10 compared with those from the corresponding WT mice. These findings suggest that PKN may have inhibitory effects on the Src-receptor for activated C kinase 1 (RACK1) pathway in the CAR-mediated induction of Cyp2b10 in mice livers. SIGNIFICANCE STATEMENT: This is the first report of involvement of PKN in the transcriptional regulation of P450s. The elucidation of mechanisms responsible for induction of P450s could help optimize the pharmacotherapy and improve drug development. We examined whether the mRNA and protein levels and activities of P450s were altered in double-mutant mice harboring both PKN1 kinase-negative knock-in and PKN3 knockout mutations. PKN1/3 negatively regulates CAR-mediated induction of Cyp2b10 through phosphorylation of a signaling molecule in the Src-RACK1 pathway.
Collapse
Affiliation(s)
- Atsushi Kawase
- Department of Pharmacy, Faculty of Pharmacy, Kindai University, Osaka, Japan (A.Kaw., S.T., S.K., A.Kaz., H.S., M.I.); Biosignal Research Center, Kobe University, Hyogo, Japan (H.M.); Department of Clinical Laboratory, Kitano Hospital, Osaka, Japan (H.M.); Department of Pharmaceutical Sciences, Faculty of Pharmacy, Kindai University, Osaka, Japan (R.Sa., R.Su.); Pharmaceutical Research and Technology Institute, Kindai University, Osaka, Japan (R.Su., M.I.); and Antiaging Center, Kindai University, Osaka, Japan (R.Su., M.I.)
| | - Hideyuki Mukai
- Department of Pharmacy, Faculty of Pharmacy, Kindai University, Osaka, Japan (A.Kaw., S.T., S.K., A.Kaz., H.S., M.I.); Biosignal Research Center, Kobe University, Hyogo, Japan (H.M.); Department of Clinical Laboratory, Kitano Hospital, Osaka, Japan (H.M.); Department of Pharmaceutical Sciences, Faculty of Pharmacy, Kindai University, Osaka, Japan (R.Sa., R.Su.); Pharmaceutical Research and Technology Institute, Kindai University, Osaka, Japan (R.Su., M.I.); and Antiaging Center, Kindai University, Osaka, Japan (R.Su., M.I.)
| | - Shunsuke Tateishi
- Department of Pharmacy, Faculty of Pharmacy, Kindai University, Osaka, Japan (A.Kaw., S.T., S.K., A.Kaz., H.S., M.I.); Biosignal Research Center, Kobe University, Hyogo, Japan (H.M.); Department of Clinical Laboratory, Kitano Hospital, Osaka, Japan (H.M.); Department of Pharmaceutical Sciences, Faculty of Pharmacy, Kindai University, Osaka, Japan (R.Sa., R.Su.); Pharmaceutical Research and Technology Institute, Kindai University, Osaka, Japan (R.Su., M.I.); and Antiaging Center, Kindai University, Osaka, Japan (R.Su., M.I.)
| | - Shintaro Kuroda
- Department of Pharmacy, Faculty of Pharmacy, Kindai University, Osaka, Japan (A.Kaw., S.T., S.K., A.Kaz., H.S., M.I.); Biosignal Research Center, Kobe University, Hyogo, Japan (H.M.); Department of Clinical Laboratory, Kitano Hospital, Osaka, Japan (H.M.); Department of Pharmaceutical Sciences, Faculty of Pharmacy, Kindai University, Osaka, Japan (R.Sa., R.Su.); Pharmaceutical Research and Technology Institute, Kindai University, Osaka, Japan (R.Su., M.I.); and Antiaging Center, Kindai University, Osaka, Japan (R.Su., M.I.)
| | - Akira Kazaoka
- Department of Pharmacy, Faculty of Pharmacy, Kindai University, Osaka, Japan (A.Kaw., S.T., S.K., A.Kaz., H.S., M.I.); Biosignal Research Center, Kobe University, Hyogo, Japan (H.M.); Department of Clinical Laboratory, Kitano Hospital, Osaka, Japan (H.M.); Department of Pharmaceutical Sciences, Faculty of Pharmacy, Kindai University, Osaka, Japan (R.Sa., R.Su.); Pharmaceutical Research and Technology Institute, Kindai University, Osaka, Japan (R.Su., M.I.); and Antiaging Center, Kindai University, Osaka, Japan (R.Su., M.I.)
| | - Ryosuke Satoh
- Department of Pharmacy, Faculty of Pharmacy, Kindai University, Osaka, Japan (A.Kaw., S.T., S.K., A.Kaz., H.S., M.I.); Biosignal Research Center, Kobe University, Hyogo, Japan (H.M.); Department of Clinical Laboratory, Kitano Hospital, Osaka, Japan (H.M.); Department of Pharmaceutical Sciences, Faculty of Pharmacy, Kindai University, Osaka, Japan (R.Sa., R.Su.); Pharmaceutical Research and Technology Institute, Kindai University, Osaka, Japan (R.Su., M.I.); and Antiaging Center, Kindai University, Osaka, Japan (R.Su., M.I.)
| | - Hiroaki Shimada
- Department of Pharmacy, Faculty of Pharmacy, Kindai University, Osaka, Japan (A.Kaw., S.T., S.K., A.Kaz., H.S., M.I.); Biosignal Research Center, Kobe University, Hyogo, Japan (H.M.); Department of Clinical Laboratory, Kitano Hospital, Osaka, Japan (H.M.); Department of Pharmaceutical Sciences, Faculty of Pharmacy, Kindai University, Osaka, Japan (R.Sa., R.Su.); Pharmaceutical Research and Technology Institute, Kindai University, Osaka, Japan (R.Su., M.I.); and Antiaging Center, Kindai University, Osaka, Japan (R.Su., M.I.)
| | - Reiko Sugiura
- Department of Pharmacy, Faculty of Pharmacy, Kindai University, Osaka, Japan (A.Kaw., S.T., S.K., A.Kaz., H.S., M.I.); Biosignal Research Center, Kobe University, Hyogo, Japan (H.M.); Department of Clinical Laboratory, Kitano Hospital, Osaka, Japan (H.M.); Department of Pharmaceutical Sciences, Faculty of Pharmacy, Kindai University, Osaka, Japan (R.Sa., R.Su.); Pharmaceutical Research and Technology Institute, Kindai University, Osaka, Japan (R.Su., M.I.); and Antiaging Center, Kindai University, Osaka, Japan (R.Su., M.I.)
| | - Masahiro Iwaki
- Department of Pharmacy, Faculty of Pharmacy, Kindai University, Osaka, Japan (A.Kaw., S.T., S.K., A.Kaz., H.S., M.I.); Biosignal Research Center, Kobe University, Hyogo, Japan (H.M.); Department of Clinical Laboratory, Kitano Hospital, Osaka, Japan (H.M.); Department of Pharmaceutical Sciences, Faculty of Pharmacy, Kindai University, Osaka, Japan (R.Sa., R.Su.); Pharmaceutical Research and Technology Institute, Kindai University, Osaka, Japan (R.Su., M.I.); and Antiaging Center, Kindai University, Osaka, Japan (R.Su., M.I.)
| |
Collapse
|
29
|
Takei D, Kuroda S, Matsubara K, Mashima H, Hashimoto M, Kobayashi T, Ohdan H. Usefulness and safety of midline incision for right-sided hepatectomy: Cohort study. Ann Med Surg (Lond) 2021; 67:102498. [PMID: 34234946 PMCID: PMC8246149 DOI: 10.1016/j.amsu.2021.102498] [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: 04/22/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background While the adoption rates of laparoscopic hepatectomy are increasing, most patients still undergo open hepatectomy. Open hepatectomies use inverted L-shaped or Mercedes incisions for right-sided liver tumor. To decrease procedural invasiveness, we performed midline incisions in such cases, excluding those of laparoscopic hepatectomy. This retrospective study examined the effects of this change in treatment policy on overall patient surgical outcomes. Materials and methods From 2012 to 2018, 374 patients who underwent hepatectomy for right-sided hepatocellular carcinoma were enrolled, and short-term patient outcomes were compared following stratification into the 1st (n = 157) or 2nd (n = 217) Era group based on whether procedures occurred before or after the policy change, respectively. Results Short-term outcomes were mostly comparable between the two groups, with significantly increased postoperative aspartate aminotransferase maximum values found in the 2nd Era group relative to the 1st Era group (median: 393 vs. 331, p < 0.05). Pain scores at rest during postoperative day 1 and while moving on postoperative days 1, 2, and 3 were significantly lower in the 2nd Era group than in the 1st Era group (p < 0.05, <0.01, <0.05, <0.01, respectively). Conclusions Utilization of midline incisions may provide some benefits in postoperative outcomes for right-sided open hepatectomy cases. Utilization of midline incisions may provide better postoperative outcomes in cases of right-sided open hepatectomy.
Collapse
Affiliation(s)
| | - Shintaro Kuroda
- Corresponding author. Department of Gastroenterological Surgery, Hiroshima University, 734-8551, 1-2-3, Kasumi, Hiroshima, Japan.
| | | | | | | | | | | |
Collapse
|
30
|
Kuroda S, Kobayashi T, Tashiro H, Onoe T, Oshita A, Abe T, Kohashi T, Oishi K, Ohmori I, Imaoka Y, Tanaka J, Ohdan H. A multicenter randomized controlled trial comparing administration of antithrombin III after liver resection (HiSCO-05 trial). Surgery 2021; 170:1140-1150. [PMID: 33926704 DOI: 10.1016/j.surg.2021.03.057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/28/2021] [Accepted: 03/29/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Posthepatectomy liver failure is a poor prognostic factor after hepatectomy. Various preventive treatments have been tried; however, there are no clinical trials that use posthepatectomy liver failure as the primary endpoint, and the clinical effects of posthepatectomy liver failure have not been fully verified. The aim of this study was to investigate whether administration of antithrombin III can prevent posthepatectomy liver failure in patients with coagulopathy after hepatectomy. This study also evaluated the safety of AT-III administration after hepatectomy. METHODS The current study enrolled 141 patients diagnosed with coagulopathy after hepatectomy between October 2015 and September 2018 at 7 hospitals in Hiroshima, Japan (HiSCO group). Patients were randomized to undergo either administration of antithrombin III (n = 64) or non-administration (n = 77). The primary endpoint was the incidence of posthepatectomy liver failure. This randomized controlled trial was registered with the University Medical Information Network Clinical Trial Registry (UMIN000018852). RESULTS Treatment for postoperative coagulopathy was performed safely without adverse events. The incidence of posthepatectomy liver failure was similar in both treatment groups (nonadministration of antithrombin III group, 28.5%, versus administration of antithrombin III group, 28.1%; P = .953) The rate of morbidity was higher in the administration group than the non-administrated group (17.2% vs 11.7%, P = .351). Following the multivariate analysis of the whole study group, body mass index ≥25, total bilirubin ≥1.5 mg/dL, and the disseminated intravascular coagulation score ≥5 postoperatively were the independent risk factors for posthepatectomy liver failure. CONCLUSION This study showed that the administration of antithrombin III resulted in no significant difference in preventing posthepatectomy liver failure, possibly through suppressing coagulopathy.
Collapse
Affiliation(s)
- Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan.
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Hirotaka Tashiro
- Department of Surgery, Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Takashi Onoe
- Department of Surgery, Kure Medical Center and Chugoku Cancer Center, Kure, Japan
| | - Akihiko Oshita
- Department of Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Tomoyuki Abe
- Department of Surgery, Onomichi General Hospital, Onomichi, Japan
| | - Toshihiko Kohashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Koichi Oishi
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | - Ichiro Ohmori
- Department of Surgery, Higashihiroshima Medical Center, Hiroshima, Japan
| | - Yasuhiro Imaoka
- Department of Surgery, Hiroshimanishi Medical Center, Hiroshima, Japan
| | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
31
|
Yamaoka K, Kawaoka T, Aikata H, Ando Y, Kosaka Y, Suehiro Y, Fujii Y, Uchikawa S, Morio K, Fujino H, Nakahara T, Murakami E, Yamauchi M, Tsuge M, Hiramatsu A, Imamura M, Takahashi S, Saeki Y, Kuroda S, Kobayashi T, Ohdan H, Miyata Y, Okada M, Chayama K. Complete Response for Advanced Hepatocellular Carcinoma by Conversion Surgery Therapy Following a Good Response of Regorafenib Despite Rapid Progressive Disease with Sorafenib. Intern Med 2021; 60:2047-2053. [PMID: 34193774 PMCID: PMC8313913 DOI: 10.2169/internalmedicine.5870-20] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
A 68-year-old man with hepatocellular carcinoma (HCC) visited his previous hospital due to abdominal pain and was diagnosed with ruptured HCC. Before visiting our hospital, he underwent HCC treatment at his previous hospital, but his tumors did not improve. Although he started treatment with sorafenib, the tumors rapidly grew. Subsequently, regorafenib was given, and the tumors shrank. After 22 months being treated with regorafenib, HCC reoccurred, with a new lung metastasis and a contrast-enhanced nodule on the peritoneal dissemination appearing. He underwent conversion surgery and survived for 4.5 years after his HCC was diagnosed.
Collapse
Affiliation(s)
- Kenji Yamaoka
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Tomokazu Kawaoka
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Hiroshi Aikata
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Yuwa Ando
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Yumi Kosaka
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Yosuke Suehiro
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Yasutomo Fujii
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Shinsuke Uchikawa
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Kei Morio
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Hatsue Fujino
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Takashi Nakahara
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Eisuke Murakami
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Masami Yamauchi
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Masataka Tsuge
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Akira Hiramatsu
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Michio Imamura
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Shoichi Takahashi
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Yoshihiro Saeki
- Department of Gastroenterological and Transplant Surgery, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Yoshihiro Miyata
- Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Morihito Okada
- Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Research Institute for Radiation Biology and Medicine, Graduate School of Biomedical and Health Science, Hiroshima University Hospital, Japan
| |
Collapse
|
32
|
Honmyo N, Kobayashi T, Kuroda S, Oshita A, Onoe T, Kohashi T, Fukuda S, Ohmori I, Abe T, Imaoka Y, Akita T, Tanaka J, Ohdan H. A novel model for predicting posthepatectomy liver failure based on liver function and degree of liver resection in patients with hepatocellular carcinoma. HPB (Oxford) 2021; 23:134-143. [PMID: 32563594 DOI: 10.1016/j.hpb.2020.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/23/2020] [Accepted: 05/13/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND The permissible liver resection rate for preventing posthepatectomy liver failure (PHLF) remains unclear. We aimed to develop a novel PHLF-predicting model and to strategize hepatectomy for hepatocellular carcinoma (HCC). METHODS This retrospective study included 335 HCC patients who underwent anatomical hepatectomy at eight institutions between 2013 and 2017. Risk factors, including volume-associated liver-estimating parameters, for PHLF grade B-C were analyzed in a training set (n = 122) via multivariate analysis, and a PHLF prediction model was developed. The utility of the model was evaluated in a validation set (n = 213). RESULTS Our model was based on the three independent risk factors for PHLF identified in the training set: volume-associated indocyanine green retention rate at 15 min, platelet count, and prothrombin time index (the VIPP score). The areas under the receiver operating characteristic curve of the VIPP scores for severe PHLF in the training and validation sets were 0.864 and 0.794, respectively. In both sets, the VIPP score stratified patients at risk for severe PHLF, with a score of 3 (specificity, 0.92) indicating higher risk. CONCLUSION Our model facilitates the selection of the appropriate hepatectomy procedure by providing permissible liver resection rates based on VIPP scores.
Collapse
Affiliation(s)
- Naruhiko Honmyo
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan.
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Akihiko Oshita
- Department of Gastroenterological, Breast, and Transplant Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujinakanda, Minami-ku, Hiroshima, Japan
| | - Takashi Onoe
- Department of Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyamacho, Kure, Japan
| | - Toshihiko Kohashi
- Department of Surgery, Hiroshima City Asa Citizens Hospital, 2-1-1 Kabeminami, Asakita-ku, Hiroshima, Japan
| | - Saburo Fukuda
- Department of Surgery, Chugoku Rosai Hospital, 1-5-1 Hirotagaya, Kure, Japan
| | - Ichiro Ohmori
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, 513 Saijochojike, Higashihiroshima, Japan
| | - Tomoyuki Abe
- Department of Surgery, Onomichi General Hospital, 1-10-23 Hirahara, Onomichi, Japan
| | - Yasuhiro Imaoka
- Department of Surgery, National Hospital Organization Hiroshima-nishi Medical Center, 4-4-1 Kuba, Otake, Japan
| | - Tomoyuki Akita
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| |
Collapse
|
33
|
Okimoto S, Tashiro H, Iwako H, Kuroda S, Kobayashi T, Hinoi T, Ohdan H. Antithrombin attenuates the progression of hepatocellular carcinoma by regulating neutrophil/interleukin-8 signaling. Hepatol Res 2020; 50:1284-1296. [PMID: 32893935 DOI: 10.1111/hepr.13558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/02/2020] [Revised: 07/22/2020] [Accepted: 07/28/2020] [Indexed: 12/12/2022]
Abstract
AIM Inflammation plays an important role in hepatocellular carcinoma (HCC) progression. Here, we examined whether antithrombin (AT) plays a role in attenuating HCC progression, via its anti-inflammatory effects. METHODS HCCs were developed in AT-insufficient (AT+/- ) mice and wild-type (AT+/+ ) mice treated with diethyl nitrosamine and carbon tetrachloride. AT was administered to AT+/- mice. The development of HCC was compared between the three groups. In vitro study, migration assay was performed. The association of the prognosis of patients with HCC and plasma AT values was clinically examined. RESULTS AT suppressed the release of interleukin (IL)-8 from lipopolysaccharide (LPS)-stimulated human neutrophils in vitro. Huh-7 cells that were co-cultured with neutrophils and stimulated with LPS showed significantly enhanced migration; however, Huh-7 cells co-cultured with LPS/AT-stimulated neutrophils showed significantly decreased migration. Moreover, the addition of anti-IL-8 antibodies to LPS-stimulated Huh-7 cells co-cultured with neutrophils also suppressed migration. AT+/- mice (AT plasma activity: 64%) promoted liver cancer, as compared with wild-type mice (AT plasma activity: 135%); AT administration attenuated liver cancer in AT+/- mice. Patients with HCC with a preoperative AT level of ≥70% showed better outcomes after liver resection, as compared with those with an AT level of <70%. IL-8 expression and neutrophil infiltration in HCC tissues were negatively correlated with the AT level. CONCLUSIONS AT attenuates HCC progression by regulating neutrophil/IL-8 signaling.
Collapse
Affiliation(s)
- Sho Okimoto
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Kasumi, Hiroshima, Japan
| | - Hirotaka Tashiro
- Department of Surgery, National Hospital Organization Kure Medical Center, Kure City, Hiroshima, Japan
| | - Hiroshi Iwako
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Kasumi, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Kasumi, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Kasumi, Hiroshima, Japan
| | - Takao Hinoi
- Department of clinical and molecular Genetics, Hiroshima University Hospital, Kasumi, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Kasumi, Hiroshima, Japan
| |
Collapse
|
34
|
Fukuhara S, Ohira M, Chosa K, BaBa Y, Hamaoka M, Tanimine N, Morimoto H, Kuroda S, Tahara H, Ide K, Kobayashi T, Awai K, Ohdan H. Obliteration of a Portosystemic Shunt by Hybrid Interventional Radiology Using a Transmesenteric Approach Under Minilaparotomy After Liver Transplantation: A Case Report. Transplant Proc 2020; 52:2762-2766. [DOI: 10.1016/j.transproceed.2020.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/04/2020] [Indexed: 01/10/2023]
|
35
|
Imaoka Y, Ohira M, Sato K, Kuroda S, Tahara H, Ide K, Kobayashi T, Tanaka Y, Kawano R, Ohdan H. Impact on biliary complications of donor abdominal aortic calcification among living donor liver transplantation: a retrospective study. Transpl Int 2020; 33:1745-1753. [PMID: 32970890 DOI: 10.1111/tri.13748] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/11/2020] [Accepted: 09/13/2020] [Indexed: 12/15/2022]
Abstract
Abdominal aortic calcification (AAC) was reported as a poor prognostic factor among liver transplantation. However, donor AAC is not enough discussed. We analyzed the impact of the donor AAC level on graft function on outcomes following living donor liver transplantation (LDLT). A total of 133 consecutive patients who had undergone LDLT were divided into two groups (non-AAC group and AAC group) according to their donor AAC level by plain computed tomography. The rate of postoperative biliary complications (BC) was significantly higher in AAC group (N = 17) than in non-AAC group (N = 116; HR, 2.77; 95% CI, 1.32-5.83; P = 0.0008). The Cox proportional hazards regression model revealed that donor AAC (HR, 4.15; 95% CI, 1.93-8.97; P = 0.0003) and right lobe graft (HR, 2.81; 95% CI, 1.41-5.61; P = 0.003) increased the risk of BC. Conversely, splenectomy (HR, 0.39; 95% CI, 0.16-0.92; P = 0.03) decreased the risk of BC after LDLT independently. The long-term survival was also significantly worse in AAC group than in non-AAC group (HR, 2.25; 95% CI, 1.04-4.89; P = 0.04). Donor AAC was an independent prognostic factor for BC among patients undergoing LDLT. Although further investigations are needed to verify our results, the levels of donor AAC could be a useful tool to identify the risks of BC and predict better outcomes following LDLT.
Collapse
Affiliation(s)
- Yuki Imaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Koki Sato
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuka Tanaka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Reo Kawano
- Clinical Research Center in Hiroshima, Hiroshima University Hospital, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
36
|
Yamamoto M, Kobayashi T, Mashima H, Miki D, Kuroda S, Hamaoka M, Aikata H, Chayama K, Ohdan H. PD1 gene polymorphism is associated with a poor prognosis in hepatocellular carcinoma following liver resection, cohort study. Int J Surg 2020; 80:84-90. [PMID: 32615319 DOI: 10.1016/j.ijsu.2020.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/26/2020] [Accepted: 05/07/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study examined whether single nucleotide polymorphism (SNP) in programmed cell death protein (PD)-1 is related to the postoperative prognosis of patients with hepatocellular carcinoma (HCC). The immune checkpoint protein PD-1 is an important inhibitor of T cell responses. SNP in the promoter region of PD-1 -606 G/A has been reported to result in high activation and expression of PD-1 associated with cancer risk. MATERIALS AND METHODS We analyzed 321 patients with HCC who underwent hepatectomy between 2010 and 2015. PD-1 SNP was analyzed by polymerase chain reaction, and the prognosis after surgical treatment of patients with HCC was analyzed. RESULTS The PD-1 SNP statuses were as follows: 90 AA (28.1%), 163 GA (50.8%), 68 GG (21.2%). The baseline parameters did not statistically differ between the three groups. The overall survival (OS) of patients with the GG genotype was significantly lower than that of those with the other genotypes (P = 0.031). The GG genotype was an independent risk factor for OS (P = 0.009; HR 2.201). There was no significant difference between the GG genotype and other genotypes in recurrent-free survival. The extrahepatic recurrence (EHR) rate of those with the GG genotype was significantly higher than that of those with the other genotypes (P = 0.036). The GG genotype was an independent risk factor for EHR (P = 0.008; HR 2.037). CONCLUSIONS The PD-1 SNP GG genotype is associated with poor survival and increased EHR in HCC. Furthermore, the GG genotype is an independent predictive factor for OS and EHR.
Collapse
Affiliation(s)
- Masateru Yamamoto
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan.
| | - Hiroaki Mashima
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Daiki Miki
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Michinori Hamaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Aikata
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
37
|
Yamamoto M, Kobayashi T, Kuroda S, Hamaoka M, Honmyo N, Yamaguchi M, Takei D, Ohdan H. Impact of postoperative bile leakage on long‐term outcome in patients following liver resection for hepatocellular carcinoma. J Hepatobiliary Pancreat Sci 2020; 27:931-941. [DOI: 10.1002/jhbp.750] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 04/03/2020] [Accepted: 04/20/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Masateru Yamamoto
- Department of Gastroenterological and Transplant Surgery Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Michinori Hamaoka
- Department of Gastroenterological and Transplant Surgery Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Naruhiko Honmyo
- Department of Gastroenterological and Transplant Surgery Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Megumi Yamaguchi
- Department of Gastroenterological and Transplant Surgery Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Daisuke Takei
- Department of Gastroenterological and Transplant Surgery Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan
| |
Collapse
|
38
|
Fukuhara S, Tahara H, Hirata Y, Ono K, Hamaoka M, Shimizu S, Hashimoto S, Kuroda S, Ohira M, Ide K, Kobayashi T, Ohdan H. Hepatic epithelioid hemangioendothelioma successfully treated with living donor liver transplantation: A case report and literature review. Clin Case Rep 2020; 8:108-115. [PMID: 31998498 PMCID: PMC6982499 DOI: 10.1002/ccr3.2558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/05/2019] [Revised: 09/24/2019] [Accepted: 10/20/2019] [Indexed: 12/13/2022] Open
Abstract
Hepatic epithelioid hemangioendothelioma is a rare neoplasm with a variable malignant potential and a high risk of recurrence. No general treatment guidelines have been established. Fortunately, we were able to minimize immunosuppressant after liver transplantation because of a full HLA-matched case. There was no recurrence 1 year after treatment.
Collapse
Affiliation(s)
- Sotaro Fukuhara
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Yoshito Hirata
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Kosuke Ono
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Michinori Hamaoka
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Seiichi Shimizu
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Shinji Hashimoto
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| |
Collapse
|
39
|
Tanaka H, Toyoshima Y, Kawakatsu S, Kobayashi R, Yokota O, Terada S, Kuroda S, Miura T, Higuchi Y, Otsu H, Sanpei K, Otani K, Ikeuchi T, Onodera O, Kakita A, Takahashi H. Morphological characterisation of glial and neuronal tau pathology in globular glial tauopathy (Types II and III). Neuropathol Appl Neurobiol 2019; 46:344-358. [DOI: 10.1111/nan.12581] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/03/2019] [Indexed: 12/11/2022]
Affiliation(s)
- H. Tanaka
- Department of Pathology Brain Research Institute Niigata University Niigata Japan
| | - Y. Toyoshima
- Department of Pathology Brain Research Institute Niigata University Niigata Japan
| | - S. Kawakatsu
- Department of Neuropsychiatry Aizu Medical Center Fukushima Medical University Aizu Fukushima Japan
| | - R. Kobayashi
- Department of Psychiatry Yamagata University School of Medicine Yamagata Japan
| | - O. Yokota
- Department of Psychiatry Kinoko Espoir Hospital Okayama Japan
| | - S. Terada
- Department of Neuropsychiatry Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - S. Kuroda
- Department of Psychiatry Zikei Institute of Psychiatry Okayama Japan
| | - T. Miura
- Department of Neurology Brain Research Institute Niigata University Niigata Japan
| | - Y. Higuchi
- Department of Neurology Brain Research Institute Niigata University Niigata Japan
| | - H. Otsu
- Department of Neurology Brain Research Institute Niigata University Niigata Japan
| | - K. Sanpei
- Department of Neurology Sado General Hospital Niigata Japan
| | - K. Otani
- Department of Psychiatry Yamagata University School of Medicine Yamagata Japan
| | - T. Ikeuchi
- Department of Molecular Genetics Brain Research Institute Niigata University Niigata Japan
| | - O. Onodera
- Department of Neurology Brain Research Institute Niigata University Niigata Japan
| | - A. Kakita
- Department of Pathology Brain Research Institute Niigata University Niigata Japan
| | - H. Takahashi
- Department of Pathology Brain Research Institute Niigata University Niigata Japan
| |
Collapse
|
40
|
Yamamoto M, Kobayashi T, Kuroda S, Hamaoka M, Okimoto S, Honmyo N, Yamaguchi M, Ohdan H. Verification of inflammation-based prognostic marker as a prognostic indicator in hepatocellular carcinoma. Ann Gastroenterol Surg 2019; 3:667-675. [PMID: 31788655 PMCID: PMC6875930 DOI: 10.1002/ags3.12286] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/29/2019] [Accepted: 08/14/2019] [Indexed: 12/14/2022] Open
Abstract
AIM Although inflammation-based markers in cancer have been used for prognostic prediction, the most useful marker for hepatocellular carcinoma (HCC) has not been established. We investigated the usefulness of various inflammation-based markers in HCC patients after hepatectomy. METHODS A total of 478 patients who underwent initial hepatectomy for HCC from 2009 to 2015 and were diagnosed with pathological HCC were included in this retrospective study. Inflammation-based markers consisted of the C-reactive protein to albumin ratio (CAR), Glasgow prognostic score (GPS), neutrophil to lymphocyte ratio, lymphocyte to monocyte ratio, platelet to lymphocyte ratio and prognostic index. Univariate and multivariate analyses for overall survival (OS) and disease-free survival (DFS) using the Cox proportional hazard model were carried out. Kaplan-Meier analysis and log-rank test were used for comparison of OS and DFS. To reduce influences of selection bias and confounders for stratifying CAR, clinicopathological characteristics of patients were balanced by propensity score matching. RESULTS Multivariate analysis identified only high CAR (>0.027) as an indicator of poor OS, and high CAR and high GPS (1-2) as indicators of poor DFS among inflammation-based markers. After propensity score matching, 124 patients each with low CAR and high CAR were matched. High CAR was correlated with both poor OS and DFS. CONCLUSION C-reactive protein to albumin ratio was the most valuable prognostic indicator after hepatectomy for HCC among inflammation-based markers.
Collapse
Affiliation(s)
- Masateru Yamamoto
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health ScienceHiroshima UniversityHiroshimaJapan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health ScienceHiroshima UniversityHiroshimaJapan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health ScienceHiroshima UniversityHiroshimaJapan
| | - Michinori Hamaoka
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health ScienceHiroshima UniversityHiroshimaJapan
| | - Sho Okimoto
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health ScienceHiroshima UniversityHiroshimaJapan
| | - Naruhiko Honmyo
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health ScienceHiroshima UniversityHiroshimaJapan
| | - Megumi Yamaguchi
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health ScienceHiroshima UniversityHiroshimaJapan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant SurgeryGraduate School of Biomedical and Health ScienceHiroshima UniversityHiroshimaJapan
| |
Collapse
|
41
|
Zenke Y, Yoh K, Sakakibara-Konishi J, Daga H, Hosomi Y, Nogami N, Okamoto I, Matsumoto S, Kuroda S, Wakabayashi M, Nomura S, Ishii G, Sato A, Tsuboi M, Goto K. P1.18-04 Neoadjuvant Ceritinib for Locally Advanced Non-Small Cell Lung Cancer with ALK Rearrangement: SAKULA Trial. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1320] [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: 10/25/2022]
|
42
|
Kanehama N, Kimura S, Kawakami T, Tateishi R, Tachibana S, Hayasaka K, Arai H, Hiroki J, Yoshioka K, Kuroda S, Ueshima D, Iwatsuka R, Hayashi T, Mizukami A, Matsumura A. P6154Association between n-3 and n-6 polyunsaturated fatty acids and plaque vulnerability by optical coherence tomography in acute myocardial infarction patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0760] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The values of n-3 and n-6 polyunsaturated fatty acids (PUFAs) like low eicosapentaenoic acid (EPA) /arachidonic acid (AA) ratio are known to be associated with cardiovascular events, however their relationship with coronary plaque vulnerability in acute myocardial infarction (AMI) is not revealed.
Purpose
We evaluated the relationship between n-3 and n-6 PUFAs and coronary plaque vulnerability assessed by optical coherence tomography (OCT) in AMI patients.
Methods
We investigated 79 AMI lesions (51 ST elevated myocardial infarction (STEMI) lesions and 28 non-STEMI lesions) that had undergone emergency percutaneous coronary intervention using OCT. Coronary plaque characteristics by OCT were compared with n-3 and n-6 PUFAs values which were measured on admission.
Results
Of all AMI lesions (n=79), 43 thin-cap fibroatheroma (TCFA) and 35 plaque rapture (PR) were detected by OCT. Lesions with TCFA had no significant relationship with n-3 and n-6 PUFAs values, whereas lesion with PR had significantly lower EPA values than those without (55.8±29.5 vs 74.3±37.1 μg/ml, p=0.018). Median low-density lipoprotein (LDL) cholesterol value was 117 (98–137) mg/dl and sub-analysis in patients who had lower LDL cholesterol values than median (n=39) revealed that EPA values were significantly lower in lesions with TCFA (56.3±30.9 vs 85.3±47.7 μg/ml, p=0.03). In STEMI patients, the values of EPA and EPA/AA ratio were significantly lower in lesions with TCFA (EPA: 55.5±22.8 vs 80.8±46.1 μg/ml, p=0.01; EPA/AA ratio: 0.34±0.16 vs 0.50±0.36, p=0.03). STEMI patients who had lower LDL cholesterol values <114 mg/dl of median (n=26), the values of EPA, EPA/AA ratio, and EPA+ docosahexaenoic acid (DHA) /AA ratio were significantly lower in lesions with TCFA (EPA: 51.4±20.7 vs 93.1±53.0 μg/ml, p=0.01; EPA/AA ratio: 0.37±0.16 vs 0.67±0.41, p=0.01; EPA+DHA/AA ratio: 1.13±0.41 vs 1.63±0.76, p=0.04). In STEMI patients with lower LDL cholesterol values, EPA/AA ratio positively correlated with fibrous cap thickness (Spearman, ρ=0.35, p=0.08). The cutoff value of EPA/AA ratio predicting the existence of TCFA was 0.52 (area under the curve 0.78, sensitivity 93.8%, specificity 70.0%, p=0.02).
Conclusion
This study demonstrated that n-3 and n-6 PUFAs values were associated with coronary plaque vulnerability by OCT in AMI patients, especially in STEMI. These results suggest that n-3 and n-6 PUFAs may be residual risk markers of severe acute cardiovascular events in patients with low LDL cholesterol values.
Collapse
Affiliation(s)
- N Kanehama
- Kameda Medical Center, Cardiology, Kamogawa, Japan
| | - S Kimura
- Yokohama Minami Kyosai Hospital, Cardiology, Yokohama, Japan
| | - T Kawakami
- Kameda Medical Center, Cardiology, Kamogawa, Japan
| | - R Tateishi
- Kameda Medical Center, Cardiology, Kamogawa, Japan
| | - S Tachibana
- Kameda Medical Center, Cardiology, Kamogawa, Japan
| | - K Hayasaka
- Kameda Medical Center, Cardiology, Kamogawa, Japan
| | - H Arai
- Kameda Medical Center, Cardiology, Kamogawa, Japan
| | - J Hiroki
- Kameda Medical Center, Cardiology, Kamogawa, Japan
| | - K Yoshioka
- Kameda Medical Center, Cardiology, Kamogawa, Japan
| | - S Kuroda
- Kameda Medical Center, Cardiology, Kamogawa, Japan
| | - D Ueshima
- Kameda Medical Center, Cardiology, Kamogawa, Japan
| | - R Iwatsuka
- Kameda Medical Center, Cardiology, Kamogawa, Japan
| | - T Hayashi
- Kameda Medical Center, Cardiology, Kamogawa, Japan
| | - A Mizukami
- Kameda Medical Center, Cardiology, Kamogawa, Japan
| | - A Matsumura
- Kameda Medical Center, Cardiology, Kamogawa, Japan
| |
Collapse
|
43
|
Shimizu S, Ohira M, Nakano R, Imaoka Y, Sato K, Tahara H, Ide K, Kobayashi T, Kuroda S, Ono H, Tanaka Y, Ohdan H. Management of Refractory Ascites for Liver Transplant Candidates: A Novel Cell-free and Concentrated Ascites Reinfusion Therapy. Transplant Proc 2019; 51:2740-2744. [PMID: 31563243 DOI: 10.1016/j.transproceed.2019.02.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 02/06/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Refractory ascites is one of the major complications of liver transplant (LT) and is associated with increased morbidity and mortality. The aim of this study was to analyze the efficacy and safety of novel cell-free and concentrated ascites reinfusion therapy (KM-CART) for the treatment of refractory ascites during preoperative living donor liver transplant. METHODS Forty KM-CART procedures were performed on 8 liver transplant candidates. We investigated the safety and efficacy of KM-CART in terms of the processed ascites, adverse events, laboratory data, and patient condition. RESULTS By using KM-CART, an average of 12.5 L (range, 2.6-26.1 L) of ascites was filtered and concentrated to 0.5 L (range, 0.1-1.6 L) in 62 minutes (range, 8-187 minutes). Final products contained 21.5 g (range, 2.5-65.6 g) of albumin and 13.5 g (range, 1.5-61.8 g) of globulin. No endotoxin contamination was detected in the ascites. Although the incidence of adverse events was 35.0% (including fever, hypotension, bleeding, leg cramps, and nausea), all of these could be treated conservatively. Body weight and oral intake were significantly improved after KM-CART. Furthermore, the use of fresh frozen plasma for the LT recipients with KM-CART was significantly lower than that for patients without KM-CART. In addition, no patients lost their opportunity for LT because of adverse events due to KM-CART. CONCLUSIONS Our findings show that KM-CART could be a promising option for the treatment of refractory ascites during the preoperative period of LT. This study provides the foundation for further large-scale prospective studies.
Collapse
Affiliation(s)
- Seiichi Shimizu
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.
| | - Ryosuke Nakano
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuki Imaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Koki Sato
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroaki Ono
- Department of Clinical Engineer, Hiroshima University Hospital, Hiroshima, Japan
| | - Yuka Tanaka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
44
|
Kuroda S, Kihara T, Akita Y, Kobayashi T, Nikawa H, Ohdan H. Simulation and navigation of living donor hepatectomy using a unique three-dimensional printed liver model with soft and transparent parenchyma. Surg Today 2019; 50:307-313. [PMID: 31471747 DOI: 10.1007/s00595-019-01868-9] [Citation(s) in RCA: 10] [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] [Received: 03/22/2019] [Accepted: 08/08/2019] [Indexed: 01/17/2023]
Abstract
Three-dimensional printed liver models have been used for preoperative simulation. Unlike the standard three-dimensional system on a monitor, the three-dimensional printed model can be observed from any angle manually; therefore, surgeons can obtain a clear image directly from the model. We herein report the use of a unique three-dimensional liver model with a soft and transparent liver parenchyma. Through the parenchyma, the surgeons can observe the intrahepatic vessels and perform incisions in the model as a preoperative simulation. In this study, we applied this model to donor hepatectomy, which under most circumstances requires meticulous attention to detail. The actual processes and uses of a three-dimensional liver model in clinical surgery for liver transplantation are presented.
Collapse
Affiliation(s)
- Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Hiroshima, 734-8551, Japan.
| | - Takuya Kihara
- Department of Fixed Prosthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Yurina Akita
- Department of Oral Biology and Engineering, Division of Oral Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University Graduate School, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Hiroshima, 734-8551, Japan
| | - Hiroki Nikawa
- Department of Oral Biology and Engineering, Division of Oral Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University Graduate School, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Hiroshima, 734-8551, Japan
| |
Collapse
|
45
|
Hamaoka M, Kobayashi T, Kuroda S, Okimoto S, Honmyo N, Yamaguchi M, Yamamoto M, Ohdan H. Experience and outcomes in living donor liver procurement using the water jet scalpel. J Hepatobiliary Pancreat Sci 2019; 26:370-376. [PMID: 31211914 DOI: 10.1002/jhbp.643] [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] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The aim of the present study was to clarify treatment outcomes of living donor liver procurement using the water jet scalpel (WJS). METHODS This single-center, retrospective cohort study included 40 living donors who underwent liver procurement from January 2014 to December 2018. One living donor who underwent posterior segmentectomy was excluded. Clinical data and outcomes after surgery for 20 WJS donors and 19 Cavitron Ultrasonic Surgical Aspirator (CUSA) donors were compared. RESULTS Preoperative and excised graft data did not differ significantly between the WJS and CUSA groups. Operation time (P = 0.025) and parenchymal transection time (P = 0.007) were significantly shorter in the WJS group. There was no difference between the groups in terms of short-term outcomes after surgery. Multivariate analysis revealed that WJS offered significant advantages over CUSA in terms of shortening parenchymal transection time (P = 0.017). CONCLUSION Living donor liver procurement using WJS contributes to shortening of parenchymal transection time while maintaining the same level of safety as when using CUSA.
Collapse
Affiliation(s)
- Michinori Hamaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Sho Okimoto
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naruhiko Honmyo
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Megumi Yamaguchi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masateru Yamamoto
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
46
|
Ono K, Hamaoka M, Egi H, Kobayashi T, Tahara H, Kuroda S, Shimizu S, Mukai S, Kochi M, Shiroma N, Arihiro K, Ohdan H. Successful Resection of Solitary Abdominal Wall Metastasis of Sarcomatous Intrahepatic Cholangiocarcinoma. Case Rep Gastroenterol 2019; 13:66-72. [PMID: 31182943 PMCID: PMC6547282 DOI: 10.1159/000496917] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 01/11/2019] [Indexed: 11/19/2022] Open
Abstract
Sarcomatous intrahepatic cholangiocarcinoma (ICC) is a rare histological variant of ICC that is composed of both adenocarcinoma (ICC component) and sarcomatous components. Surgery is believed to be the primary treatment, and some reports describe primary resection. However, due to the aggressive malignancy of sarcomatous ICC, there is no report regarding resection of a metastatic lesion. In this report, we present the case of a 75-year-old woman admitted to our hospital with the chief complaint of weight loss. Various imaging techniques demonstrated a single mass in the liver and cecum. A cecal gastrointestinal stromal tumor accompanied by liver metastasis was suspected, and ileocecal resection was performed for diagnostic purposes. However, the tumor was present in the abdominal wall rather than in the cecum. The tumor was resected and diagnosed as undifferentiated sarcoma. We suspected the liver tumor was a series of lesions, so we performed hepatectomy. As the tumor was composed of both adenocarcinoma and sarcomatous components, it was diagnosed as sarcomatous ICC. The histological findings of the abdominal wall tumor were similar to those of sarcomatous ICC, so we diagnosed the abdominal wall tumor as a solitary metastasis of sarcomatous ICC. In this case, solitary metastasis was observed, and we were able to resect both the primary and metastatic lesions. This case illustrates that when solitary metastasis can be seen in sarcomatous ICC, radical resection is possible.
Collapse
Affiliation(s)
- Kosuke Ono
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Michinori Hamaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Egi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Seiichi Shimizu
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shoichiro Mukai
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masatoshi Kochi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Noriyuki Shiroma
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Koji Arihiro
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biochemical & Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
47
|
Radford J, Connors J, Younes A, Gallamini A, Ansell S, Kim W, Cheong J, Flinn I, Kalakonda N, Kaminski M, Pettengell R, Onsum M, Josephson N, Kuroda S, Liu R, Miao H, Gautam A, Trepicchio W, Sureda A. EXPLORATORY BIOMARKER ANALYSIS IN THE PH 3 ECHELON-1 STUDY: WORSE OUTCOME WITH ABVD IN PATIENTS WITH ELEVATED BASELINE LEVELS OF SCD30 AND TARC. Hematol Oncol 2019. [DOI: 10.1002/hon.99_2630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- J. Radford
- Department of Medical Oncology; University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre; Manchester United Kingdom
| | - J.M. Connors
- Centre for Lymphoid Cancer; British Columbia Cancer Centre for Lymphoid Cancer; Vancouver Canada
| | - A. Younes
- Division of Hematologic Oncology; Memorial Sloan Kettering Cancer Center; New York United States
| | - A. Gallamini
- Research; Innovation and Statistics Department, A Lacassagne Cancer Centre; Nice France
| | - S.M. Ansell
- Department of Medicine; Mayo Clinic; Rochester United States
| | - W.S. Kim
- Hematology-Oncology; Samsung Medical Center; Seoul Republic of Korea
| | - J. Cheong
- Division of Hematology; Department of Internal Medicine, Yonsei University College of Medicine; Seoul Republic of Korea
| | - I. Flinn
- Department of Oncology; Sarah Cannon Research Institute; Nashville United States
| | - N. Kalakonda
- Molecular and Clinical Cancer Medicine; University of Liverpool; Liverpool United Kingdom
| | - M. Kaminski
- Internal Medicine; University of Michigan; Ann Arbor United States
| | - R. Pettengell
- Haematology; St George's Hospital; London United Kingdom
| | - M. Onsum
- Biomarkers; Seattle Genetics, Inc.; Bothell United States
| | - N. Josephson
- Clinical Development; Seattle Genetics, Inc.; Bothell United States
| | - S. Kuroda
- Biostatistics; Takeda Development Center Japan, Takeda Pharmaceutical Company Limited; Osaka Japan
| | - R. Liu
- Biostatistics; Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge United States
| | - H. Miao
- OTAU Clinical Research; Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge United States
| | - A. Gautam
- Global Medical Affairs; Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge United States
| | - W.L. Trepicchio
- Translational and Biomarker Research; Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge United States
| | - A. Sureda
- Clinical Hematology; Institut Català d'Oncologia - Hospital Duran i Reynals; Barcelona Spain
| |
Collapse
|
48
|
Sato K, Ohira M, Shimizu S, Imaoka Y, Hashimoto S, Tahara H, Kobayashi T, Kuroda S, Ide K, Tanaka Y, Ohdan H. Risk Factors for Refractory Ascites After Living Donor Liver Transplant. Transplant Proc 2019; 51:1516-1519. [PMID: 31155185 DOI: 10.1016/j.transproceed.2019.01.120] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 01/28/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Refractory ascites after liver transplant commonly occurs in living donor liver transplant (LDLT). Refractory ascites is associated with postoperative complications and poor prognosis. This study sought to determine the risk factors of refractory ascites and discuss their perioperative management. METHODS A retrospective study of 122 living donor liver transplant recipients between 2008 and 2017 was performed to analyze the risk factors, incidence, and characteristics of refractory ascites. Refractory ascites post LDLT was defined as the production of ascites fluid >1000 mL/d on postoperative day 14 or required repeated drainage. RESULTS A total of 24 patients (19.6%) developed refractory ascites. The 1-year survival rate was significantly worse in the refractory ascites group compared with the nonrefractory ascites group (P < .001). In a univariate analysis, patients with refractory ascites had a higher Model for End-Stage Liver Disease (MELD) score, donor age, presence of left lobe graft, ascites at laparotomy, portal venous pressure just after surgery, cold ischemia time, and absence of hepatocellular carcinoma compared with patients without refractory ascites. Multivariate proportional regression analyses revealed that MELD score ≥20, left lobe graft, donor age 50 years or older, and ascites at laparotomy ≥350 mL were independently associated with refractory ascites. Postoperative complications, such as bleeding (P < .001), sepsis (P < .001), and bloodstream infection within 30 days after LDLT (P < .00), were significantly higher in the refractory ascites group. CONCLUSION Refractory ascites is associated with reduced 1-year survival and increased postoperative complications. Four factors including MELD score ≥20, donor age 50 years or older, presence of left graft, and ascites at laparotomy ≥350 mL were independent predictors for refractory ascites.
Collapse
Affiliation(s)
- Koki Sato
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Seiichi Shimizu
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuki Imaoka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shinji Hashimoto
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuka Tanaka
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
49
|
Okimoto S, Kuroda S, Tashiro H, Kobayashi T, Taogoshi T, Matsuo H, Ohdan H. Vitamin A-coupled liposomal Rho-kinase inhibitor ameliorates liver fibrosis without systemic adverse effects. Hepatol Res 2019; 49:663-675. [PMID: 30675748 DOI: 10.1111/hepr.13317] [Citation(s) in RCA: 10] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 01/13/2019] [Accepted: 01/14/2019] [Indexed: 02/08/2023]
Abstract
AIM Rho-kinase (ROCK) inhibitor could ameliorate liver fibrosis by suppressing hepatic stellate cell (HSC) activation. However, because systemic administration of ROCK inhibitor causes serious adverse effects, we developed a drug delivery system selectively delivering ROCK inhibitor to HSCs. Here, we examined whether our developed vitamin A (VA)-coupled liposomal ROCK inhibitor reduced liver fibrosis in rats without causing systemic adverse effects. METHODS LX-2 HSCs were analyzed for morphological changes and the expression of profibrotic proteins. The inhibitory effects of VA-coupled liposomal ROCK inhibitor on liver fibrosis were confirmed in a rat model of liver fibrosis induced by i.p. injection of carbon tetrachloride. The degree of liver fibrosis, biochemical changes, and survival rates were also investigated. RESULTS Vitamin A-coupled liposomal ROCK inhibitor had an effect at approximately 1/100 the amount of the free ROCK inhibitor for inhibiting the activation of LX-2 cells and caused significant decreases in the expression levels of α-smooth muscle actin (SMA) and transforming growth factor (TGF)-β1. The degree of liver fibrosis was suppressed by treatment with VA-coupled liposomal ROCK inhibitor, and the expression of α-SMA and TGF-β1 in liver tissues was also significantly suppressed. In addition, serum levels of alanine aminotransferase and hyaluronic acid were significantly reduced, and there was no decline in kidney function, which has been noted as a systemic adverse effect of ROCK inhibitor. Furthermore, VA-coupled liposomal ROCK inhibitor improved survival rates in rats with liver fibrosis. CONCLUSION Vitamin A-coupled liposomal ROCK inhibitor efficiently suppressed liver fibrosis without causing systemic adverse effects.
Collapse
Affiliation(s)
- Sho Okimoto
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hirotaka Tashiro
- Department of Surgery, National Hospital Organization Kure Medical Center, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takanori Taogoshi
- Department of Pharmaceutical Services, Hiroshima University, Hiroshima, Japan
| | - Hiroaki Matsuo
- Department of Pharmaceutical Services, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
50
|
Makita E, Kuroda S, Itabashi K, Taniguchi S, Maruyama A, Sato H, Ichihashi K. Two Neonatal Cases of Food Protein-Induced Enterocolitis Syndrome With Pale Stool and Transient Biliary Dilatation. J Investig Allergol Clin Immunol 2019; 29:158-159. [PMID: 31017121 DOI: 10.18176/jiaci.0360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- E Makita
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan
| | - S Kuroda
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan.,Department of Pediatrics, Saitama Red Cross Hospital, Saitama, Japan
| | - K Itabashi
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan
| | - S Taniguchi
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan
| | - A Maruyama
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan
| | - H Sato
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan
| | - K Ichihashi
- Department of Pediatrics, Saitama Medical Center Jichi Medical University, Saitama, Japan
| |
Collapse
|