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Toi M, Kinoshita T, Benson JR, Jatoi I, Kataoka M, Han W, Yamauchi C, Inamoto T, Takada M. Non-surgical ablation for breast cancer: an emerging therapeutic option. Lancet Oncol 2024; 25:e114-e125. [PMID: 38423057 DOI: 10.1016/s1470-2045(23)00615-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/18/2023] [Accepted: 11/21/2023] [Indexed: 03/02/2024]
Abstract
Non-surgical ablation is emerging as an alternative local therapy option for patients with early-stage breast cancer and encompasses two main types of percutaneous therapeutic procedures: radiofrequency ablation and cryoablation. Both techniques involve obliteration of a spherical lesion and feasibility studies have shown that complete tumour ablation is achievable with good or excellent cosmetic results. Although few clinical studies have directly compared non-surgical ablation with conventional surgical resection, observational studies indicate that clinical outcomes are favourable with acceptable rates of local control and no detriment to long-term survival. There remain outstanding issues with these percutaneous ablative techniques that require resolution before they could be incorporated into routine clinical practice. Hence, a consensus meeting was convened to discuss the challenges of non-surgical ablation and clarify indications for its use alongside clinical management pathways. In this Policy Review we will address some of the broader biological aspects of non-surgical ablation, including immune-modulatory effects and potential novel applications for the future.
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Affiliation(s)
- Masakazu Toi
- Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan; Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Takayuki Kinoshita
- Department of Breast Surgery, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan
| | - John R Benson
- Cambridge Breast Unit, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK; School of Medicine, Anglia Ruskin University, Chelmsford, UK
| | - Ismail Jatoi
- Division of Surgical Oncology and Endocrine Surgery, University of Texas Health Science Center, San Antonio, TX, USA
| | - Masako Kataoka
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Wonshik Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Chikako Yamauchi
- Department of Radiation Oncology, Shiga General Hospital, Moriyama, Japan
| | - Takashi Inamoto
- Breast Center, Ijinkai Takeda General Hospital, Kyoto, Japan
| | - Masahiro Takada
- Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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2
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Inamoto T, Ueda M, Ueno K, Shiroma C, Morita R, Naito Y, Ishii R. Motor-Related Mu/Beta Rhythm in Older Adults: A Comprehensive Review. Brain Sci 2023; 13:brainsci13050751. [PMID: 37239223 DOI: 10.3390/brainsci13050751] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 03/19/2023] [Revised: 04/23/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
Mu rhythm, also known as the mu wave, occurs on sensorimotor cortex activity at rest, and the frequency range is defined as 8-13Hz, the same frequency as the alpha band. Mu rhythm is a cortical oscillation that can be recorded from the scalp over the primary sensorimotor cortex by electroencephalogram (EEG) and magnetoencephalography (MEG). The subjects of previous mu/beta rhythm studies ranged widely from infants to young and older adults. Furthermore, these subjects were not only healthy people but also patients with various neurological and psychiatric diseases. However, very few studies have referred to the effect of mu/beta rhythm with aging, and there was no literature review about this theme. It is important to review the details of the characteristics of mu/beta rhythm activity in older adults compared with young adults, focusing on age-related mu rhythm changes. By comprehensive review, we found that, compared with young adults, older adults showed mu/beta activity change in four characteristics during voluntary movement, increased event-related desynchronization (ERD), earlier beginning and later end, symmetric pattern of ERD and increased recruitment of cortical areas, and substantially reduced beta event-related desynchronization (ERS). It was also found that mu/beta rhythm patterns of action observation were changing with aging. Future work is needed in order to investigate not only the localization but also the network of mu/beta rhythm in older adults.
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Affiliation(s)
- Takashi Inamoto
- Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Osaka 583-8555, Japan
- Faculty of Health Sciences, Kansai University of Health Sciences, Osaka 590-0482, Japan
| | - Masaya Ueda
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, Osaka 583-8555, Japan
| | - Keita Ueno
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, Osaka 583-8555, Japan
| | - China Shiroma
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, Osaka 583-8555, Japan
| | - Rin Morita
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, Osaka 583-8555, Japan
| | - Yasuo Naito
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, Osaka 583-8555, Japan
| | - Ryouhei Ishii
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, Osaka 583-8555, Japan
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita 565-0871, Japan
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3
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Yokoi K, Sakakibara Y, Inamoto T, Fujii Y, Sakai H. Dual-Task Training Combining Cognitive Tasks and Occupations among Japanese Community-Dwelling Older Adults: A Pilot Study. Occup Ther Health Care 2021; 36:422-439. [PMID: 34865607 DOI: 10.1080/07380577.2021.2010159] [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: 10/19/2022]
Abstract
This study investigated whether dual tasks comprising cognitive tasks and occupations related to daily living can improve the mental and cognitive function of Japanese community-dwelling older adults. Participants included 30 older adults, equally divided into intervention and control groups. The outcome measures were memory, attention, depression, and health-related quality of life. No adverse effects of the intervention were observed in any participant in the intervention group. Logical memory I, logical memory II, and Center for Epidemiologic Studies Depression Scale scores showed a significant interaction. Dual tasks combining cognitive tasks and occupations may help improve delayed recall and alleviate depression. A novel attempt to integrate cognitive stimulation and activities valued by individuals may help mediate age-related cognitive function decline and reduce depressive symptoms in community-dwelling older adults.
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Affiliation(s)
- K Yokoi
- Occupational Therapy, Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino, Japan
| | - Y Sakakibara
- Osaka College of Medical and Welfare, Osaka, Japan
| | - T Inamoto
- Home-Visit Nursing Station Kanaeru Heart, Kawachinagano, Japan
| | - Y Fujii
- Faculty of Health Sciences, Kansai University of Welfare Sciences, Kashiwara, Japan
| | - H Sakai
- Faculty of Health Sciences, Kansai University of Welfare Sciences, Kashiwara, Japan
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4
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Senda N, Kawaguchi-Sakita N, Kawashima M, Inagaki-Kawata Y, Yoshida K, Takada M, Kataoka M, Torii M, Nishimura T, Kawaguchi K, Suzuki E, Kataoka Y, Matsumoto Y, Yoshibayashi H, Yamagami K, Tsuyuki S, Takahara S, Yamauchi A, Shinkura N, Kato H, Moriguchi Y, Okamura R, Kan N, Suwa H, Sakata S, Mashima S, Yotsumoto F, Tachibana T, Tanaka M, Togashi K, Haga H, Yamada T, Kosugi S, Inamoto T, Sugimoto M, Ogawa S, Toi M. Optimization of prediction methods for risk assessment of pathogenic germline variants in the Japanese population. Cancer Sci 2021; 112:3338-3348. [PMID: 34036661 PMCID: PMC8353892 DOI: 10.1111/cas.14986] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 04/30/2021] [Accepted: 05/06/2021] [Indexed: 12/19/2022] Open
Abstract
Predicting pathogenic germline variants (PGVs) in breast cancer patients is important for selecting optimal therapeutics and implementing risk reduction strategies. However, PGV risk factors and the performance of prediction methods in the Japanese population remain unclear. We investigated clinicopathological risk factors using the Tyrer‐Cuzick (TC) breast cancer risk evaluation tool to predict BRCA PGVs in unselected Japanese breast cancer patients (n = 1,995). Eleven breast cancer susceptibility genes were analyzed using target‐capture sequencing in a previous study; the PGV prevalence in BRCA1, BRCA2, and PALB2 was 0.75%, 3.1%, and 0.45%, respectively. Significant associations were found between the presence of BRCA PGVs and early disease onset, number of familial cancer cases (up to third‐degree relatives), triple‐negative breast cancer patients under the age of 60, and ovarian cancer history (all P < .0001). In total, 816 patients (40.9%) satisfied the National Comprehensive Cancer Network (NCCN) guidelines for recommending multigene testing. The sensitivity and specificity of the NCCN criteria for discriminating PGV carriers from noncarriers were 71.3% and 60.7%, respectively. The TC model showed good discrimination for predicting BRCA PGVs (area under the curve, 0.75; 95% confidence interval, 0.69‐0.81). Furthermore, use of the TC model with an optimized cutoff of TC score ≥0.16% in addition to the NCCN guidelines improved the predictive efficiency for high‐risk groups (sensitivity, 77.2%; specificity, 54.8%; about 11 genes). Given the influence of ethnic differences on prediction, we consider that further studies are warranted to elucidate the role of environmental and genetic factors for realizing precise prediction.
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Affiliation(s)
- Noriko Senda
- Department of Breast Surgery, Kyoto University, Kyoto, Japan
| | | | | | | | - Kenichi Yoshida
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Masahiro Takada
- Department of Breast Surgery, Kyoto University, Kyoto, Japan
| | - Masako Kataoka
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Japan
| | - Masae Torii
- Department of Breast Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | | | | | - Eiji Suzuki
- Department of Breast Surgery, Kyoto University, Kyoto, Japan
| | - Yuki Kataoka
- Department of Healthcare Epidemiology, School of Public Health, in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Hiroshi Yoshibayashi
- Department of Breast Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Kazuhiko Yamagami
- Department of Breast Surgery and Oncology, Shinko Hospital, Kobe, Japan
| | - Shigeru Tsuyuki
- Department of Breast Surgery, Osaka Red Cross Hospital, Osaka, Japan
| | | | - Akira Yamauchi
- Department of Breast Surgery, Kitano Hospital, Osaka, Japan
| | - Nobuhiko Shinkura
- Department of Surgery, Ijinkai Takeda General Hospital, Kyoto, Japan
| | - Hironori Kato
- Department of Breast Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | | | - Ryuji Okamura
- Department of Breast Surgery, Yamatotakada Municipal Hospital, Yamatotakada, Japan
| | | | - Hirofumi Suwa
- Department of Breast Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Shingo Sakata
- Department of Breast Surgery, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Susumu Mashima
- Department of Surgery, Japan Community Health Care Organization, Yamato Koriyama Hospital, Yamato Koriyama, Japan
| | - Fumiaki Yotsumoto
- Department of Breast Surgery, Shiga General Hospital, Moriyama, Japan
| | | | - Mitsuru Tanaka
- Department of Surgery, Hirakata Kohsai Hospital, Hirakata, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University, Kyoto, Japan
| | - Hironori Haga
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Takahiro Yamada
- Department of Medical Ethics/Medical Genetics, Kyoto University, Kyoto, Japan
| | - Shinji Kosugi
- Department of Medical Ethics/Medical Genetics, Kyoto University, Kyoto, Japan
| | - Takashi Inamoto
- Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - Masahiro Sugimoto
- Health Promotion and Preemptive Medicine, Research and Development Center for Minimally Invasive Therapies, Tokyo Medical University, Tokyo, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Masakazu Toi
- Department of Breast Surgery, Kyoto University, Kyoto, Japan
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Soyama T, Masutani H, Lumi Hirata C, Iwai-Kanai E, Inamoto T. Thioredoxin as a novel sensitive marker of biological stress response in smoking. J Clin Biochem Nutr 2020; 67:228-231. [PMID: 33293762 PMCID: PMC7705090 DOI: 10.3164/jcbn.19-108] [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: 11/06/2019] [Accepted: 01/13/2020] [Indexed: 01/10/2023] Open
Abstract
Thioredoxin is a low molecular weight (approximately 12 kDa) redox protein, and protects against harmful stimuli such as oxidative stress. Smoking evokes oxidative stress, among other biological responses. The clinical relevance of thioredoxin in smoking has not been fully investigated. Here, we examined the effects of smoking on serum and urinary thioredoxin levels, in comparison with various stress markers. Serum thioredoxin levels in the smoking group (10 subjects) were significantly higher than those of the non-smoking group (5 subjects). After smoking, serum thioredoxin levels significantly decreased, while urinary levels significantly increased. On the other hand, the levels of serum and salivary cortisol, plasma norepinephrine, salivary amylase, salivary thioredoxin, and urinary 8-hydroxy-2'-deoxyguanosine levels before and after smoking were not significantly different. These results suggest that a decrease in thioredoxin in the serum and the concomitant increase in the urine is a novel sensitive marker of biological stress responses induced by smoking. The change seems to be evoked by mechanisms different from hormonal or 8-hydroxy-2'-deoxyguanosine-forming stress responses.
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Affiliation(s)
- Tomonori Soyama
- Department of Clinical Laboratory Science, Faculty of Health Care, Tenri Health Care University, 80-1, Bessho-cho, Tenri, Nara 632-0018, Japan
| | - Hiroshi Masutani
- Department of Clinical Laboratory Science, Faculty of Health Care, Tenri Health Care University, 80-1, Bessho-cho, Tenri, Nara 632-0018, Japan.,Health Care Education and Research Center, Faculty of Health Care, Tenri Health Care University, 80-1, Bessho-cho, Tenri, Nara 632-0018, Japan
| | - Cristiane Lumi Hirata
- Department of Clinical Laboratory Science, Faculty of Health Care, Tenri Health Care University, 80-1, Bessho-cho, Tenri, Nara 632-0018, Japan
| | - Eri Iwai-Kanai
- Department of Clinical Laboratory Science, Faculty of Health Care, Tenri Health Care University, 80-1, Bessho-cho, Tenri, Nara 632-0018, Japan.,Health Care Education and Research Center, Faculty of Health Care, Tenri Health Care University, 80-1, Bessho-cho, Tenri, Nara 632-0018, Japan
| | - Takashi Inamoto
- Health Care Education and Research Center, Faculty of Health Care, Tenri Health Care University, 80-1, Bessho-cho, Tenri, Nara 632-0018, Japan
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Inagaki-Kawata Y, Yoshida K, Kawaguchi-Sakita N, Kawashima M, Nishimura T, Senda N, Shiozawa Y, Takeuchi Y, Inoue Y, Sato-Otsubo A, Fujii Y, Nannya Y, Suzuki E, Takada M, Tanaka H, Shiraishi Y, Chiba K, Kataoka Y, Torii M, Yoshibayashi H, Yamagami K, Okamura R, Moriguchi Y, Kato H, Tsuyuki S, Yamauchi A, Suwa H, Inamoto T, Miyano S, Ogawa S, Toi M. Genetic and clinical landscape of breast cancers with germline BRCA1/2 variants. Commun Biol 2020; 3:578. [PMID: 33067557 PMCID: PMC7567851 DOI: 10.1038/s42003-020-01301-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 09/15/2020] [Indexed: 12/24/2022] Open
Abstract
The genetic and clinical characteristics of breast tumors with germline variants, including their association with biallelic inactivation through loss-of-heterozygosity (LOH) and second somatic mutations, remain elusive. We analyzed germline variants of 11 breast cancer susceptibility genes for 1,995 Japanese breast cancer patients, and identified 101 (5.1%) pathogenic variants, including 62 BRCA2 and 15 BRCA1 mutations. Genetic analysis of 64 BRCA1/2-mutated tumors including TCGA dataset tumors, revealed an association of biallelic inactivation with more extensive deletions, copy neutral LOH, gain with LOH and younger onset. Strikingly, TP53 and RB1 mutations were frequently observed in BRCA1- (94%) and BRCA2- (9.7%) mutated tumors with biallelic inactivation. Inactivation of TP53 and RB1 together with BRCA1 and BRCA2, respectively, involved LOH of chromosomes 17 and 13. Notably, BRCA1/2 tumors without biallelic inactivation were indistinguishable from those without germline variants. Our study highlights the heterogeneity and unique clonal selection pattern in breast cancers with germline variants. Yukiko Inagaki-Kawata et al. report an analysis of germline variants in breast cancer susceptibility genes in 1,995 Japanese breast cancer patients. They find that 5.1% of the patients carry germline variants in cancer-linked genes and investigate the characteristics of patients with germline mutations in BRCA1/2.
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Affiliation(s)
- Yukiko Inagaki-Kawata
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan.,Department of Breast Surgery, Kyoto University, Kyoto, Japan
| | - Kenichi Yoshida
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | | | | | - Tomomi Nishimura
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan.,Department of Breast Surgery, Kyoto University, Kyoto, Japan
| | - Noriko Senda
- Department of Breast Surgery, Kyoto University, Kyoto, Japan
| | - Yusuke Shiozawa
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Yasuhide Takeuchi
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan.,Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Kyoto, Japan.,Department of Diagnostic Pathology, Kyoto University, Kyoto, Japan
| | - Yoshikage Inoue
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Aiko Sato-Otsubo
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Yoichi Fujii
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Yasuhito Nannya
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Eiji Suzuki
- Department of Breast Surgery, Kyoto University, Kyoto, Japan
| | - Masahiro Takada
- Department of Breast Surgery, Kyoto University, Kyoto, Japan
| | - Hiroko Tanaka
- Laboratory of Sequence Analysis, Human Genome Centre, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yuichi Shiraishi
- Laboratory of DNA Information Analysis, Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Kenichi Chiba
- Laboratory of DNA Information Analysis, Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yuki Kataoka
- Hospital Care Research Unit/Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Masae Torii
- Department of Breast Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Hiroshi Yoshibayashi
- Department of Breast Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | | | - Ryuji Okamura
- Department of Breast Surgery, Yamatotakada Municipal Hospital, Yamatotakada, Japan
| | | | - Hironori Kato
- Department of Breast Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shigeru Tsuyuki
- Department of Breast Surgery, Osaka Red Cross Hospital, Osaka, Japan
| | - Akira Yamauchi
- Department of Breast Surgery, Kitano Hospital, Osaka, Japan
| | - Hirofumi Suwa
- Department of Breast Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | | | - Satoru Miyano
- Laboratory of Sequence Analysis, Human Genome Centre, Institute of Medical Science, The University of Tokyo, Tokyo, Japan.,Laboratory of DNA Information Analysis, Human Genome Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan. .,Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto University, Kyoto, Japan. .,Department of Medicine, Centre for Haematology and Regenerative Medicine, Karolinska Institute, Stockholm, Sweden.
| | - Masakazu Toi
- Department of Breast Surgery, Kyoto University, Kyoto, Japan.
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Inamoto T, Komura K, Uehara H, Ibuki N, Ichihashi A, Minami K, Taniguchi S, Hirano H, Nomi H, Azuma H. Bladder preserving tetra-modal therapy for octogenarian with localized muscle invasive bladder cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33623-5] [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: 10/23/2022] Open
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Miyake M, Marugami N, Fujiwara Y, Komura K, Inamoto T, Azuma H, Matsumoto H, Matsuyama H, Nishimura N, Hori S, Owari T, Itami Y, Nakai Y, Fujimoto K. Down-grading of ipsilateral hydronephrosis by neoadjuvant chemotherapy is associated with better oncological outcomes after radical nephroureterectomy in patients with ureteral cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34094-5] [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: 10/23/2022] Open
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9
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Senda N, Kawaguchi-Sakita N, Kawashima M, Inagaki-Kawata Y, Yoshida K, Nishimura T, Takada M, Suzuki E, Kataoka Y, Sato F, Matsumoto Y, Torii M, Yoshibayashi H, Yamagami K, Tsuyuki S, Yamauchi A, Shinkura N, Kato H, Moriguchi Y, Okamura R, Kan N, Suwa H, Sakata S, Mashima S, Yotsumoto F, Tachibana T, Tanaka M, Inamoto T, Sugimoto M, Ogawa S, Toi M. Abstract P2-10-12: Relationship between predicted risks of carrying breast cancer susceptibility genes and the presence of germline variants in Japanese patients with primary breast cancer. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p2-10-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Breast cancer risk models are used to predict the risk of carrying a variant, for one of the most common breast cancer susceptibility genes such as BRCA1 and BRCA2, and the lifetime risk of developing breast cancer. The prediction of harboring a germline variant of the BRCA gene and the development of breast or ovarian cancer over time affects the decision-making for undergoing genetic testing and screening using imaging techniques as the common practice. For instance, the American Cancer Society and the National Comprehensive Cancer Network (NCCN) recommends screening using MRI in women with 20% or greater lifetime risk of having breast cancer. We aimed to investigate the prediction of these risks in Japanese women, particularly on the relationship between the presence of pathogenic germline variants and breast cancer susceptibility genes, using a cohort of 1016 primary breast cancer patients.
Patients and Methods: We analyzed a cohort of Japanese patients with primary breast cancer who were treated at the Kyoto University Hospital and the related institutions or hospitals from the period of 2011 to 2016. The germline variants were examined for a set of 13 breast cancer susceptibility genes, using targeted-capture sequencing of pooled DNA, and it was found that 66 out of 1016 patients had pathogenic variants. These included 11 functionally well-established genes (BRCA1, BRCA2, TP53, PTEN, CDH1, STK11, NF1, PALB2, ATM, CHEK2, and NBN) and two additional genes (BARD1 and BRIP1), which are recommended for the screening of high-risk patients with hereditary breast cancer in the NCCN guidelines. Using this cohort, we studied the association of the calculated risk of carrying a germline variant of BRCA1/ BRCA2, using the Tyrer-Cuzick model Breast Cancer Risk Evaluation Tool, within the laboratory germline test results.
Results: Pathogenic germline variants of BRCA1/ BRCA2 were carried by 54 (5.3%) out of the 1016 patients (12 cases of BRCA1 and 42 cases of BRCA2). According to the NCCN guidelines, which focus on Genetic/ Familial High-Risk Assessment: Breast and Ovarian, it was found that 500 out of 1016 (49.2%)patients were categorized for considering germline testing. In fact, 38 (7.6%) of the 500 patients, harbored a pathogenic germline variant of BRCA1/ BRCA2. In the remaining 516 patients, 16 (3.1%) harbored the pathogenic germline variant of BRCA1/ BRCA2. The predictive risks of the Tyrer-Cuzick model Breast Cancer Risk Evaluation Tool were recorded as follows: Area under the ROC curve, BRCA1 (area 0.750, 95% CI- 0.581-0.919), BRCA2 (area 0.741, 95% CI- 0.661-0.820), BRCA1 or BRCA2 (Area 0.749, 95% CI: 0.675-0.822), suggesting that the Tyrer-Cuzick model may be useful for the Japanese population. In the mammography breast density analysis, 484 patients showed almost entirely fat or scattered fibroglandular breast tissue, and 362 cases had heterogeneous or extreme fibroglandular breast tissue. In this study, the correlations of breast tissue density with age and breast or ovarian cancer familial history have been reported in greater detail.
Discussion and Conclusions: In a retrospective cohort of 1016 Japanese patients with primary breast cancer, 5.3% had pathogenic germline variants of BRCA1/ BRCA2. In a group recommended by NCCN guidelines for considering genetic testing, the BRCA1/ BRCA2 variant rate was 7.6%. Predictive risks calculated by the Tyrer-Cuzick model similar with the known data. Further data are reported.
Citation Format: Noriko Senda, Nobuko Kawaguchi-Sakita, Masahiro Kawashima, Yukiko Inagaki-Kawata, Kenichi Yoshida, Tomomi Nishimura, Masahiro Takada, Eiji Suzuki, Yuki Kataoka, Fumiaki Sato, Yoshiaki Matsumoto, Masae Torii, Hiroshi Yoshibayashi, Kazuhiro Yamagami, Shigeru Tsuyuki, Akira Yamauchi, Nobuhiko Shinkura, Hironori Kato, Yoshio Moriguchi, Ryuji Okamura, Norimichi Kan, Hirofumi Suwa, Shingo Sakata, Susumu Mashima, Fumiaki Yotsumoto, Tsuyoshi Tachibana, Mitsuru Tanaka, Takashi Inamoto, Masahiro Sugimoto, Seishi Ogawa, Masakazu Toi. Relationship between predicted risks of carrying breast cancer susceptibility genes and the presence of germline variants in Japanese patients with primary breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-10-12.
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Affiliation(s)
- Noriko Senda
- 1Department of Breast Surgery, Kyoto University, Kyoto, Japan
| | | | | | | | - Kenichi Yoshida
- 3Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | | | - Masahiro Takada
- 1Department of Breast Surgery, Kyoto University, Kyoto, Japan
| | - Eiji Suzuki
- 1Department of Breast Surgery, Kyoto University, Kyoto, Japan
| | - Yuki Kataoka
- 4Hospital Care Research Unit/ Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Fumiaki Sato
- 5Department of Breast Surgery, Kansai Electric Power Hospital, Osaka, Japan
| | | | - Masae Torii
- 6Department of Breast Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Hiroshi Yoshibayashi
- 6Department of Breast Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | | | - Shigeru Tsuyuki
- 8Department of Breast Surgery, Osaka Red Cross Hospital, Osaka, Japan
| | - Akira Yamauchi
- 9Department of Breast Surgery, Kitano Hospital, Osaka, Japan
| | | | - Hironori Kato
- 11Department of Breast Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yoshio Moriguchi
- 12Department of Breast Surgery, Kyoto City Hospital, Kyoto, Japan
| | - Ryuji Okamura
- 13Department of Breast Surgery, Yamatotakada Municipal Hospital, Yamatotakada, Japan
| | | | - Hirofumi Suwa
- 15Department of Breast Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Shingo Sakata
- 16Department of Breast Surgery, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Susumu Mashima
- 17Department of Surgery, Japan Community Health Care Organization, Yamatokohriyama Hospital, Yamatokohriyama, Japan
| | - Fumiaki Yotsumoto
- 18Department of Breast Surgery, Shiga General Hospital, Moriyama, Japan
| | | | - Mitsuru Tanaka
- 20Department of Surgery, Hirakata Kohsai Hospital, Hirakata, Japan
| | - Takashi Inamoto
- 21Medical Department, Tenri Health Care University, Tenri, Japan
| | - Masahiro Sugimoto
- 22Research and Development Center for Minimally Invasive Therapies Health Promotion and Preemptive Medicine, Tokyo Medical University, Tokyo, Japan
| | - Seishi Ogawa
- 3Department of Pathology and Tumor Biology, Kyoto University, Kyoto, Japan
| | - Masakazu Toi
- 1Department of Breast Surgery, Kyoto University, Kyoto, Japan
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10
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Tsuyuki S, Yamagami K, Yoshibayashi H, Sugie T, Mizuno Y, Tanaka S, Kato H, Okuno T, Ogura N, Yamashiro H, Takuwa H, Kikawa Y, Hashimoto T, Kato T, Takahara S, Katayama T, Yamauchi A, Inamoto T. Effectiveness and safety of surgical glove compression therapy as a prophylactic method against nanoparticle albumin-bound-paclitaxel-induced peripheral neuropathy. Breast 2019; 47:22-27. [PMID: 31302389 DOI: 10.1016/j.breast.2019.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 05/02/2019] [Revised: 06/11/2019] [Accepted: 06/29/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND We have developed a surgical glove (SG)-compression therapy and reported that this method significantly reduced the overall occurrence of grade 2 or higher nanoparticle albumin-bound-paclitaxel (nab-PTX)-induced peripheral neuropathy (PN) from 76.1% to 21.4%. In this multicenter single-arm confirmatory study, we investigated the efficacy and safety of SG-compression therapy for the prevention of nab-PTX-induced PN, compared with the incidence of grade 2 or higher PN in published literature as controls. PATIENTS AND METHODS Primary breast cancer patients who received 260 mg/m2 of nab-PTX were eligible for this study. Patients wore two SGs (one size smaller than the tight-fitting size) in each hand for 90 min. PN was evaluated at each treatment cycle using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 and the Patient Neurotoxicity Questionnaire (PNQ). The temperature of each fingertip was measured using thermography. RESULTS Between October 2016 and June 2017, 58 patients were evaluated. The incidence of CTCAE grade 2 or higher PN was as low as 13.8% following SG-compression therapy. A goodness-of-fit test proved that the overall incidence of 13.8% grade 2 or higher PN in this study was comparable to the hypothesis-predicted value (13%). No adverse events, including compression intolerance or skin disorders caused by use of SG, were observed. SG-compression therapy significantly reduced the temperature of each fingertip by 1.3°C-2.3 °C compared to pre-chemotherapy level. CONCLUSIONS This study suggested the safety and efficacy of SG-compression therapy for the amelioration of CIPN. CLINICAL TRIAL NUMBER UMIN 000024836.
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Affiliation(s)
- Shigeru Tsuyuki
- Department of Breast Surgery, Osaka Red Cross Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka-city, Osaka, 543-8555, Japan.
| | - Kazuhiko Yamagami
- Department of Breast Surgery, Shinko Hospital, 1-4-47 Wakinohama-cho, Chuo-ku, Kobe-city, Hyogo, 651-0072, Japan. kazu.yama.-
| | - Hiroshi Yoshibayashi
- Department of Breast Surgery, Japanese Red Cross Society Wakayama Medical Center, 4-20, Komatsubara, Wakayama-city, Wakayama, 640-8558, Japan.
| | - Tomoharu Sugie
- Breast Surgery, Kansai Medical University Hospital, 2-3-1 Shin-machi, Hirakata-City, Osaka, 573-1191, Japan.
| | - Yutaka Mizuno
- Department of Breast Surgery, Yokkaichi Municipal Hospital, 2-Chome 2-37, Shibata, Yokkaichi-city, Mie, 510-8567, Japan.
| | - Satoru Tanaka
- Department of Breast Surgery, National Hospital Organization OsakaMinami Medical Center, 2-1 Kidohigashi-cho, Kawachinagano-City, Osaka, 586-8521, Japan.
| | - Hironori Kato
- Department of Breast Surgery, Kobe City Medical Center Central Hospital, 2-1-1, Minatojima Minamimachi, Chuo-ku, Kobe-city, Hyogo, 650-0047, Japan.
| | - Toshitaka Okuno
- Department of Breast Surgery, Kobe City Nishi-Kobe Medical Center, 5-7-1, Kojidai, Nishi-ku, Kobe, Hyogo, 651-2273, Japan.
| | - Nobuko Ogura
- Department of Breast Surgery, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka-city, Osaka, 553-0003, Japan.
| | - Hiroyasu Yamashiro
- Department of Breast Surgery, Tenri Hospital, 300 Mishima-cho, Tenri-city, Nara, 632-8552, Japan.
| | - Haruko Takuwa
- Department of Breast Surgery, Shiga General Hospital, 4-30 Moriyama 5-chome, Moriyama-city, Shiga, 524-8524, Japan.
| | - Yuichiro Kikawa
- Department of Breast Surgery, Kobe Minimally Invasive Cancer Center, 8-5-1, Minatojima Nakamachi, Chuo-ku, Kobe-city, Hyogo, 650-0046, Japan.
| | - Takashi Hashimoto
- Hashimoto Clinic, 1-7-2, Sumimoto Honnmati, Nada-ku, Kobe-city, Hyogo, 658-0051, Japan.
| | - Tatsushi Kato
- Department of Surgery, Yamato Takada Municipal Hospital, 1-1 Isonokita-cho, Yamatotakada-city, Nara, 635-8501, Japan.
| | - Sachiko Takahara
- Department of Breast Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20, Ohgimachi, Kita-ku, Osaka-city, Osaka, 530-8480, Japan.
| | - Toshiro Katayama
- Department of Medical Engineering, Faculty of Health Sciences, Morinomiya University of Medical Science, 1-26-16 Nankokita, Suminoe-ku, Osaka-city, Osaka, 559-8611, Japan.
| | - Akira Yamauchi
- Department of Breast Surgery, Nara Prefecture General Medical Center, 897-5 Shichijo-nishimachi 2-chome, Nara-city, Nara, 630-8581, Japan.
| | - Takashi Inamoto
- Department of Nursing Science, Tenri Health Care University, 80-1, Besho-cho, Tenri-city, Nara, 632-0018, Japan.
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11
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Hirano H, Matsunaga T, Maenosono R, Taniguchi S, Uehara H, Nomi H, Kano Y, Fujiwara Y, Ichihashi A, Kobayashi D, Tsutsumi T, Komura K, Ibuki N, Inamoto T, Matsumura H, Ashida A, Azuma H. Effect of Systematic Conversion to Generic Mycophenolate Mofetil (MMF) in Kidney Transplantation: A Single-Center Clinical Experience from Japan. Transplant Proc 2018; 50:3255-3257. [PMID: 30577194 DOI: 10.1016/j.transproceed.2018.04.064] [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: 03/02/2018] [Revised: 04/09/2018] [Accepted: 04/27/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Recently, more and more generic drugs have been used for immunosuppressive drugs in the field of organ transplantation. Some reports have indicated that blood concentration of most generic drugs is difficult to maintain stability, and it may cause the difference in graft survival of transplanted organs between original drugs and generic drugs. In this article, we report the cases could not maintain blood concentration of generic drugs of mycophenolate mofetil (MMF). RESULTS In 4 cases out of 5 cases that we had to change original MMF to generic MMF, there were cases that blood concentration level was not stabilized. There were possibility that the lowered blood concentration level of MMF caused a rejection, in two cases. Mean MMF trough level was decreased from 3.6 ± 1.9 μg/mL to 0.6 ± 0.4 μg/mL. Due to the early detection, it did not become severe or failure of graft function, however, we cannot deny the possibilities that side effects were increased and rejection rose. In these cases, we discontinued to use the generic drugs thereafter due to unstable plasma concentration of MMF. DISCUSSION Some reports have indicated that failure to maintain plasma concentration of MMF leads to rejection. Therefore, maintenance of effective plasma concentration and prevention of rejection are essential to long-term graft survival in kidney transplant. CONCLUSION Generic drug formulations may exhibit differences in effects and absorption compared to the brand-name drug. If the generic drug should be used, patients should be closely monitored.
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Affiliation(s)
- H Hirano
- Department of Urology, Osaka Medical College, Takatsuki, Japan.
| | - T Matsunaga
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - R Maenosono
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - S Taniguchi
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - H Uehara
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - H Nomi
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - Y Kano
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - Y Fujiwara
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - A Ichihashi
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - D Kobayashi
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - T Tsutsumi
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - K Komura
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - N Ibuki
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - T Inamoto
- Department of Urology, Osaka Medical College, Takatsuki, Japan
| | - H Matsumura
- Department of Pediatric, Osaka Medical College, Takatsuki, Japan
| | - A Ashida
- Department of Pediatric, Osaka Medical College, Takatsuki, Japan
| | - H Azuma
- Department of Urology, Osaka Medical College, Takatsuki, Japan
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12
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Hirano H, Maenosono R, Matsunaga T, Uehara H, Nomi H, Ichihashi A, Kobayashi D, Taniguchi S, Tsutsumi T, Tsujino T, Komura K, Ibuki N, Inamoto T, Azuma H. Safety of Elderly Living Kidney Donors: 2 Cases of Donors Older Than 80 Years: A Case Report. Transplant Proc 2018; 50:2569-2571. [PMID: 30316400 DOI: 10.1016/j.transproceed.2018.03.093] [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: 01/20/2018] [Accepted: 03/02/2018] [Indexed: 11/26/2022]
Abstract
Much controversy exists over the performance of elderly living donor kidney transplantation. We report the safety of 2 cases of elderly living kidney donations in our hospital. CASE 1: An 82-year-old man was a living kidney donor for his 56-year-old son. The donor suffered from hypertension, but has successfully managed his blood pressure with only one medication. His serum creatinine was 0.7 mg/dL and inulin clearance was 122.5 mL/min, which met the usual criteria for living kidney donors. This was his son's secondary kidney transplantation, and no other donors existed. CASE 2: An 80-year-old woman was a living kidney donor for her 45-year-old son. Her serum creatinine was 0.61 mg/dL and inulin clearance was 71.7 mL/min, which met the marginal kidney donor criteria. In both cases, we determined that the donor kidney function was acceptable. Though we explained the risks of the transplantation thoroughly, the patients' strong will to offer a kidney to their family member did not change. We decided to carry out the transplantation. At the time of publication, nearly 2 years have passed since the transplantation, but both donors and recipients are doing well. In the future, it seems more likely that the number of elderly living donor kidney transplantation will rise. On one hand, there is no absolute contraindication for elderly donors, while on the other hand, the criteria for a living kidney donor must be strictly examined. Furthermore, careful observation of both donors and recipients after transplantation is required.
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Affiliation(s)
- H Hirano
- Department of Urology, Osaka Medical College, Osaka, Japan.
| | - R Maenosono
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - T Matsunaga
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - H Uehara
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - H Nomi
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - A Ichihashi
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - D Kobayashi
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - S Taniguchi
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - T Tsutsumi
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - T Tsujino
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - K Komura
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - N Ibuki
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - T Inamoto
- Department of Urology, Osaka Medical College, Osaka, Japan
| | - H Azuma
- Department of Urology, Osaka Medical College, Osaka, Japan
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13
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Tsuyuki S, Yamagami K, Yoshibayashi H, Sugie T, Mizuno Y, Tanaka S, Kato H, Okuno T, Ogura N, Yamashiro H, Takuwa H, Kikawa Y, Hashimoto T, Kato T, Takahara S, Yamauchi A, Inamoto T. Effectiveness of surgical glove compression therapy as a prophylactic method against nab-paclitaxel induced peripheral neuropathy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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14
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Takada M, Sugimoto M, Masuda N, Iwata H, Kuroi K, Yamashiro H, Ohno S, Ishiguro H, Inamoto T, Toi M. Prediction of postoperative disease-free survival and brain metastasis for HER2-positive breast cancer patients treated with neoadjuvant chemotherapy plus trastuzumab using a machine learning algorithm. Breast Cancer Res Treat 2018; 172:611-618. [PMID: 30194511 DOI: 10.1007/s10549-018-4958-9] [Citation(s) in RCA: 12] [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: 05/08/2018] [Accepted: 09/03/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE This study aimed to develop mathematical tools to predict the likelihood of recurrence after neoadjuvant chemotherapy (NAC) plus trastuzumab in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. METHODS Data of 776 patients from a multicenter retrospective cohort study were collected. All patients had HER2-positive breast cancer and received NAC plus trastuzumab between 2001 and 2010. Two mathematical tools using a machine learning method were developed to predict the likelihood of disease-free survival (DFS) (DFS model) and brain metastasis (BM) (BM model) within 5 years after surgery. For validation, bootstrap analyses were conducted. The area under the receiver operating characteristics curve (AUC) was calculated to examine the discrimination. RESULTS The AUC values were 0.785 (95% CI 0.740-0.831, P < 0.001) for the DFS model and 0.871 (95% CI 0.830-0.912, P < 0.001) for the BM model. Patients with low-risk DFS or BM events, as predicted by the models, showed better 5-year DFS and BM rates than those with high-risk DFS or BM events (89% vs. 61% for the DFS model, P < 0.001; 99% vs. 87% for the BM model, P < 0.001). These models maintained discrimination abilities in both luminal and non-luminal subtypes, providing prognostic information independent of pathological response. Bootstrap validation confirmed the high generalization abilities of the models. CONCLUSIONS The DFS and BM models have a high accuracy to predict prognosis among HER2-positive patients treated with NAC plus trastuzumab. Our models can help optimize adjuvant therapy and postoperative surveillance.
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Affiliation(s)
- Masahiro Takada
- Department of Breast Surgery, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Masahiro Sugimoto
- Health Promotion and Preemptive Medicine, Research and Development Center for Minimally Invasive Therapies, Tokyo Medical University, Tokyo, Japan
| | - Norikazu Masuda
- Department of Surgery, Breast Oncology, Osaka National Hospital, Osaka, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Katsumasa Kuroi
- Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan
| | | | - Shinji Ohno
- Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroshi Ishiguro
- Department of Medical Oncology, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Takashi Inamoto
- Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - Masakazu Toi
- Department of Breast Surgery, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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15
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Nishida T, Hayashi T, Inamoto T, Kato R, Ibuki N, Takahara K, Takai T, Yoshikawa Y, Uchimoto T, Saito K, Tanda N, Kouno J, Minami K, Uehara H, Hirano H, Nomi H, Okada Y, Azuma H. Dual Gas Treatment With Hydrogen and Carbon Monoxide Attenuates Oxidative Stress and Protects From Renal Ischemia-Reperfusion Injury. Transplant Proc 2018; 50:250-258. [DOI: 10.1016/j.transproceed.2017.12.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 10/26/2017] [Accepted: 12/05/2017] [Indexed: 01/14/2023]
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16
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Yodoi J, Matsuo Y, Tian H, Masutani H, Inamoto T. Anti-Inflammatory Thioredoxin Family Proteins for Medicare, Healthcare and Aging Care. Nutrients 2017; 9:nu9101081. [PMID: 28961169 PMCID: PMC5691698 DOI: 10.3390/nu9101081] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 09/19/2017] [Accepted: 09/25/2017] [Indexed: 12/16/2022] Open
Abstract
Human thioredoxin (TRX) is a 12-kDa protein with redox-active dithiol in the active site -Cys-Gly-Pro-Cys-, which is induced by biological stress due to oxidative damage, metabolic dysfunction, chemicals, infection/inflammation, irradiation, or hypoxia/ischemia-reperfusion. Our research has demonstrated that exogenous TRX is effective in a wide variety of inflammatory diseases, including viral pneumonia, acute lung injury, gastric injury, and dermatitis, as well as in the prevention and amelioration of food allergies. Preclinical and clinical studies using recombinant TRX (rhTRX) are now underway. We have also identified substances that induce the expression of TRX in the body, in vegetables and other plant ingredients. Skincare products are being developed that take advantage of the anti-inflammatory and anti-allergic action of TRX. Furthermore, we are currently engaged in the highly efficient production of pure rhTRX in several plants, such as lettuce, grain and rice.
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Affiliation(s)
- Junji Yodoi
- Japan Biostress Research Promotion Alliance (JBPA), 1-6 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8397, Japan.
- Institute for Virus Research, Kyoto University, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Yoshiyuki Matsuo
- Department of Human Stress Response Science, Institute of Biomedical Science, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka 573-1010, Japan.
| | - Hai Tian
- Japan Biostress Research Promotion Alliance (JBPA), 1-6 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8397, Japan.
- Department of Anatomy, Basic Medicine Science, Medical College, Shaoxing University, No 900 Cengnan Avenue, Shaoxing 312000, China.
| | - Hiroshi Masutani
- Terni Health Care University, 80-1 Bessho-cho, Tenri, Nara 632-0018, Japan.
| | - Takashi Inamoto
- Japan Biostress Research Promotion Alliance (JBPA), 1-6 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8397, Japan.
- Terni Health Care University, 80-1 Bessho-cho, Tenri, Nara 632-0018, Japan.
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17
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Tsuyuki S, Senda N, Kanng Y, Yamaguchi A, Yoshibayashi H, Kikawa Y, Katakami N, Kato H, Hashimoto T, Okuno T, Yamauchi A, Inamoto T. Abstract PD4-08: Efficacy of compression therapy using surgical gloves for nanoparticle albumin-bound-paclitaxel-induced peripheral neuropathy: A phase II multicenter study by the Kamigata breast cancer study group. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-pd4-08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
PURPOSE: Chemotherapy-induced peripheral neuropathy (CIPN) is an adverse effect of many commonly used chemotherapeutic agents, including taxanes. However, there is currently no established effective prophylactic management for CIPN. Thus, we investigated the efficacy of using surgical glove (SG) compression therapy to prevent nanoparticle albumin-bound-paclitaxel (nab-PTX)-induced peripheral neuropathy.
PATIENTS AND METHODS: Patients with primary and recurrent breast cancer who received 260 mg/m2 of nab-PTX were eligible for this case-control study. The patients wore two SGs of the same size, that is, one size smaller than the size that fit, on their dominant hand for 90 minutes. They did not wear SGs on the non-dominant hand, which served as the control hand. Peripheral neuropathy was evaluated at each treatment cycle using Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 and the Patient Neurotoxicity Questionnaire (PNQ). The temperatures of each fingertip of the compression SG-protected and control hands were measured by using thermography.
RESULTS: Between August 2013 and January 2016, 43 patients were enrolled, and 42 were evaluated. As shown in Table 1, the overall occurrence of ≥grade 2 sensory and motor peripheral neuropathy according to the CTCAE was significantly lower in the SG-protected hands than in the control hands (76.1% vs. 21.4% and 57.1% vs. 26.2%, respectively, p < 0.0001). The PNQ results showed that the incidence of ≥grade 4 neuropathy was significantly higher in the control hands than in the SG-protected hands in terms of both sensory and motor neurotoxicity (p < 0.0001, Table 2). As the treatment cycles of nab-PTX increased, the mean CTCAE and PNQ grades of the control hands gradually increased. However, the SG-protected hands maintained significantly lower mean grades than the control hands over time (p < 0.0001).
No patients withdrew from this study because they could not tolerate the compression from the SGs. The mean temperature of each fingertip significantly decreased (1.42–2.60 °C) in the SG-protected hands compared to in the control hands.
CONCLUSIONS: SG compression therapy appears effective for reducing nab-PTX-induced peripheral neuropathy. The nab-PTX exposure to the peripheral nerve may be decreased because the SG decreases microvascular flow to the fingertip.
Table 1: Comparison of the overall occurrences of the different grades of peripheral neuropathy according to CTCAE version 4.0 between the compression surgical glove-protected hands and control handsCTCAE v.4.0SensoryMotorGradeSurgical GloveControlSurgical GloveControl012418712161311292411163080840000
Table 2: Changes in the overall occurrence of the Patient Neurotoxicity Questionnaire (PNQ) grade with surgical glove compression therapyPNQSensoryMotorGradeSurgical gloveControlSurgical gloveControl194209223512113717912431611050000
Citation Format: Tsuyuki S, Senda N, Kanng Y, Yamaguchi A, Yoshibayashi H, Kikawa Y, Katakami N, Kato H, Hashimoto T, Okuno T, Yamauchi A, Inamoto T. Efficacy of compression therapy using surgical gloves for nanoparticle albumin-bound-paclitaxel-induced peripheral neuropathy: A phase II multicenter study by the Kamigata breast cancer study group [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr PD4-08.
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Affiliation(s)
- S Tsuyuki
- OsakaRed Cross Hospital, Osaka, Japan; Kyoto University, Graduate School of Medicine, Kyoto, Japan; Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan; Kobe City Medical Center West Hospital, Kyobe, Hyogo, Japan; Institute of Biomedical Research and Innovation Hospital, Kobe, Hyogo, Japan; Kobe City Medical Center Central Hospital, Kobe, Hyogo, Japan; Hashimoto Clinic, Kobe, Hyogo, Japan; Nishi-Kobe Medical Center, Kobe, Hyogo, Japan; Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan; Tenri Health Care University, Tenri, Nara, Japan
| | - N Senda
- OsakaRed Cross Hospital, Osaka, Japan; Kyoto University, Graduate School of Medicine, Kyoto, Japan; Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan; Kobe City Medical Center West Hospital, Kyobe, Hyogo, Japan; Institute of Biomedical Research and Innovation Hospital, Kobe, Hyogo, Japan; Kobe City Medical Center Central Hospital, Kobe, Hyogo, Japan; Hashimoto Clinic, Kobe, Hyogo, Japan; Nishi-Kobe Medical Center, Kobe, Hyogo, Japan; Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan; Tenri Health Care University, Tenri, Nara, Japan
| | - Y Kanng
- OsakaRed Cross Hospital, Osaka, Japan; Kyoto University, Graduate School of Medicine, Kyoto, Japan; Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan; Kobe City Medical Center West Hospital, Kyobe, Hyogo, Japan; Institute of Biomedical Research and Innovation Hospital, Kobe, Hyogo, Japan; Kobe City Medical Center Central Hospital, Kobe, Hyogo, Japan; Hashimoto Clinic, Kobe, Hyogo, Japan; Nishi-Kobe Medical Center, Kobe, Hyogo, Japan; Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan; Tenri Health Care University, Tenri, Nara, Japan
| | - A Yamaguchi
- OsakaRed Cross Hospital, Osaka, Japan; Kyoto University, Graduate School of Medicine, Kyoto, Japan; Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan; Kobe City Medical Center West Hospital, Kyobe, Hyogo, Japan; Institute of Biomedical Research and Innovation Hospital, Kobe, Hyogo, Japan; Kobe City Medical Center Central Hospital, Kobe, Hyogo, Japan; Hashimoto Clinic, Kobe, Hyogo, Japan; Nishi-Kobe Medical Center, Kobe, Hyogo, Japan; Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan; Tenri Health Care University, Tenri, Nara, Japan
| | - H Yoshibayashi
- OsakaRed Cross Hospital, Osaka, Japan; Kyoto University, Graduate School of Medicine, Kyoto, Japan; Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan; Kobe City Medical Center West Hospital, Kyobe, Hyogo, Japan; Institute of Biomedical Research and Innovation Hospital, Kobe, Hyogo, Japan; Kobe City Medical Center Central Hospital, Kobe, Hyogo, Japan; Hashimoto Clinic, Kobe, Hyogo, Japan; Nishi-Kobe Medical Center, Kobe, Hyogo, Japan; Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan; Tenri Health Care University, Tenri, Nara, Japan
| | - Y Kikawa
- OsakaRed Cross Hospital, Osaka, Japan; Kyoto University, Graduate School of Medicine, Kyoto, Japan; Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan; Kobe City Medical Center West Hospital, Kyobe, Hyogo, Japan; Institute of Biomedical Research and Innovation Hospital, Kobe, Hyogo, Japan; Kobe City Medical Center Central Hospital, Kobe, Hyogo, Japan; Hashimoto Clinic, Kobe, Hyogo, Japan; Nishi-Kobe Medical Center, Kobe, Hyogo, Japan; Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan; Tenri Health Care University, Tenri, Nara, Japan
| | - N Katakami
- OsakaRed Cross Hospital, Osaka, Japan; Kyoto University, Graduate School of Medicine, Kyoto, Japan; Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan; Kobe City Medical Center West Hospital, Kyobe, Hyogo, Japan; Institute of Biomedical Research and Innovation Hospital, Kobe, Hyogo, Japan; Kobe City Medical Center Central Hospital, Kobe, Hyogo, Japan; Hashimoto Clinic, Kobe, Hyogo, Japan; Nishi-Kobe Medical Center, Kobe, Hyogo, Japan; Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan; Tenri Health Care University, Tenri, Nara, Japan
| | - H Kato
- OsakaRed Cross Hospital, Osaka, Japan; Kyoto University, Graduate School of Medicine, Kyoto, Japan; Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan; Kobe City Medical Center West Hospital, Kyobe, Hyogo, Japan; Institute of Biomedical Research and Innovation Hospital, Kobe, Hyogo, Japan; Kobe City Medical Center Central Hospital, Kobe, Hyogo, Japan; Hashimoto Clinic, Kobe, Hyogo, Japan; Nishi-Kobe Medical Center, Kobe, Hyogo, Japan; Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan; Tenri Health Care University, Tenri, Nara, Japan
| | - T Hashimoto
- OsakaRed Cross Hospital, Osaka, Japan; Kyoto University, Graduate School of Medicine, Kyoto, Japan; Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan; Kobe City Medical Center West Hospital, Kyobe, Hyogo, Japan; Institute of Biomedical Research and Innovation Hospital, Kobe, Hyogo, Japan; Kobe City Medical Center Central Hospital, Kobe, Hyogo, Japan; Hashimoto Clinic, Kobe, Hyogo, Japan; Nishi-Kobe Medical Center, Kobe, Hyogo, Japan; Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan; Tenri Health Care University, Tenri, Nara, Japan
| | - T Okuno
- OsakaRed Cross Hospital, Osaka, Japan; Kyoto University, Graduate School of Medicine, Kyoto, Japan; Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan; Kobe City Medical Center West Hospital, Kyobe, Hyogo, Japan; Institute of Biomedical Research and Innovation Hospital, Kobe, Hyogo, Japan; Kobe City Medical Center Central Hospital, Kobe, Hyogo, Japan; Hashimoto Clinic, Kobe, Hyogo, Japan; Nishi-Kobe Medical Center, Kobe, Hyogo, Japan; Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan; Tenri Health Care University, Tenri, Nara, Japan
| | - A Yamauchi
- OsakaRed Cross Hospital, Osaka, Japan; Kyoto University, Graduate School of Medicine, Kyoto, Japan; Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan; Kobe City Medical Center West Hospital, Kyobe, Hyogo, Japan; Institute of Biomedical Research and Innovation Hospital, Kobe, Hyogo, Japan; Kobe City Medical Center Central Hospital, Kobe, Hyogo, Japan; Hashimoto Clinic, Kobe, Hyogo, Japan; Nishi-Kobe Medical Center, Kobe, Hyogo, Japan; Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan; Tenri Health Care University, Tenri, Nara, Japan
| | - T Inamoto
- OsakaRed Cross Hospital, Osaka, Japan; Kyoto University, Graduate School of Medicine, Kyoto, Japan; Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan; Kobe City Medical Center West Hospital, Kyobe, Hyogo, Japan; Institute of Biomedical Research and Innovation Hospital, Kobe, Hyogo, Japan; Kobe City Medical Center Central Hospital, Kobe, Hyogo, Japan; Hashimoto Clinic, Kobe, Hyogo, Japan; Nishi-Kobe Medical Center, Kobe, Hyogo, Japan; Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan; Tenri Health Care University, Tenri, Nara, Japan
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Takada M, Sugimoto M, Masuda N, Iwata H, Kuroi K, Yamashiro H, Ohno S, Ishiguro H, Inamoto T, Toi M. Abstract P4-21-24: Development of mathematical prediction models to identify disease-free survival events for HER2-positive primary breast cancer patients treated by neoadjuvant chemotherapy and trastuzumab. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-21-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background)
The addition of trastuzumab to standard neoadjuvant chemotherapy (NAC) doubles the pathological complete response (pCR) rate in patients with HER2-positive primary breast cancer. Patients who achieved pCR after NAC with trastuzumab showed a better prognosis compared to those without pCR. However, it is still difficult to predict the likelihood of recurrence after surgery at an individual patient-level. The aim of this study was to develop a mathematical model to predict disease-free survival (DFS) events such as recurrence for patients treated with NAC and trastuzumab. Because brain metastasis (BM) often occurs in HER2-positive cancer patients and it is a particular event for those, we planned to develop a specific model for BM as well.
Patients and Methods)
Data of 776 HER2-positive primary breast cancer patients from the multicenter cohort study (JBCRG-C03) were used in the analysis. All patients had received NAC plus trastuzumab between 2001 and 2010. Two prediction models using a machine learning method (alternating decision tree algorithm) were developed using age, body-mass index, menopausal status, clinical stage, histological type, ER/PgR status, histological/nuclear grade, type of surgery, pathological response, adjuvant radiation therapy, and adjuvant hormonal therapy. The model A (DFS) predicted the probability of any disease recurrence, death by any cause, or secondary malignancy within 5 years after starting treatment. The model B (BM) predicted the probability of occurrence of BM within the 5 years. First, bias-controlled virtual datasets were generated for the training of the models using a resampling method. Second, the models were optimized by cross-validation (CV). Finally, the developed models were validated using the original dataset. The area under the receiver operating characteristics curve (AUC) was calculated to assess the discrimination ability of the models.
Results)
The DFS and BM event was observed in 118 and 30 patients, respectively. The AUC values for the model A and model B were 0.833 (95% CI, 0.798–0.868, P < 0.001) and 0.927 (95% CI, 0.905–0.949, P < 0.001), respectively. The sensitivity and specificity at the cut-off value of 50% were 72.0% and 78.4% for the model A, and 100% and 83.7% for the model B, respectively. Patients predicted as “low-risk” by the model A showed a significantly better 5-year DFS rate than “high-risk” patients (91.2% vs 53.8%, P < 0.001). Patients predicted as “low-risk” by the model B showed a significantly better 5-year BM-free survival rate than “high-risk” patients (100% vs 76.1%, P < 0.001). The discrimination ability of these models were maintained for both ER/PgR-positive and ER/PgR-negative subgroups, and also for both pCR and non-pCR subgroups.
Conclusions)
Our models showed high accuracy for predicting DFS events and BM in HER2-positive primary breast cancer patients treated with NAC and trastuzumab. These two models would help to realize accurate prediction of DFS events and to optimize the postoperative surveillance plan. The identification of high-risk patients for recurrence including BM may be useful for selecting a patient-subpopulation who requires new therapeutic approach.
Citation Format: Takada M, Sugimoto M, Masuda N, Iwata H, Kuroi K, Yamashiro H, Ohno S, Ishiguro H, Inamoto T, Toi M. Development of mathematical prediction models to identify disease-free survival events for HER2-positive primary breast cancer patients treated by neoadjuvant chemotherapy and trastuzumab [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-21-24.
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Affiliation(s)
- M Takada
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - M Sugimoto
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - N Masuda
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - H Iwata
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - K Kuroi
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - H Yamashiro
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - S Ohno
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - H Ishiguro
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - T Inamoto
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
| | - M Toi
- Kyoto University Hospital, Kyoto, Japan; Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan; Osaka National Hospital, Osaka, Japan; Aichi Cancer Center, Nagoya, Japan; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital, Tokyo, Japan; Tenri Hospital, Tenri, Japan; Breast Oncology Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan; Graduate School of Medicine, Kyoto University, Kyoto, Japan; Faculty of Health Care, Tenri Health Care University, Tenri, Japan
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Takada M, Sugimoto M, Masuda N, Iwata H, Kuroi K, Yamashiro H, Ohno S, Ishiguro H, Inamoto T, Toi M. Predictions of pathological response after preoperative chemotherapy plus trastuzumab in HER2-positive breast cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv470.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Toi M, Winer EP, Benson JR, Inamoto T, Forbes JF, von Minckwitz G, Robertson JFR, Grobmyer SR, Jatoi I, Sasano H, Kunkler I, Ho AY, Yamauchi C, Chow LWC, Huang CS, Han W, Noguchi S, Pegram MD, Yamauchi H, Lee ES, Larionov AA, Bevilacqua JLB, Yoshimura M, Sugie T, Yamauchi A, Krop IE, Noh DY, Klimberg VS. Personalization of loco-regional care for primary breast cancer patients (part 1). Future Oncol 2015; 11:1297-300. [DOI: 10.2217/fon.15.65] [Citation(s) in RCA: 5] [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] [Indexed: 01/06/2023] Open
Abstract
ABSTRACT Kyoto Breast Cancer Consensus Conference, Kyoto, Japan, 18–20 February 2014 The loco-regional management of breast cancer is increasingly complex with application of primary systemic therapies, oncoplastic techniques and genetic testing for breast cancer susceptibility. Personalization of loco-regional treatment is integral to optimization of breast cancer care. Clinical and pathological tumor stage, biological features and host factors influence loco-regional treatment strategies and extent of surgical procedures. Key issues including axillary staging, axillary treatment, radiation therapy, primary systemic therapy (PST), preoperative hormonal therapy and genetic predisposition were identified and discussed at the Kyoto Breast Cancer Consensus Conference (KBCCC2014). In the first of a two part conference scene, consensus recommendations for axillary management are presented and focus on the following topics: indications for completion axillary lymph node dissection in primary surgical patients with ≤2 macrometastases or any sentinel nodal deposits after PST; the timing of sentinel lymph node biopsy in the context of PST; use of axillary irradiation as a component of primary treatment plans and the role of intraoperative node assessment in the post-Z0011 era.
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Affiliation(s)
- Masakazu Toi
- Breast Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawara-cho, Sakyo-ku, Kyoto 606–8507, Japan
| | - Eric P Winer
- Breast Oncology Center, Dana-Farber Cancer Institute, Brigham & Women's Cancer Center, Harvard Medical School, Boston, MA 02215, USA
| | - John R Benson
- Cambridge Breast Unit, Addenbrooke's Hospital & University of Cambridge, Cambridge, UK
| | - Takashi Inamoto
- Faculty of Health Care, Tenri Health Care University, Nara, Japan
| | - John F Forbes
- Surgical Oncology, University of Newcastle, Newcastle, Australia
| | | | - John FR Robertson
- Breast Surgery, University of Nottingham, Royal Derby Hospital, Nottingham, UK
| | - Stephen R Grobmyer
- Cleveland Clinic & Lerner College of Medicine of Case Western Reserve University, Cleveland, OH 44195, USA
| | - Ismail Jatoi
- The University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - Hironobu Sasano
- Pathology, Tohoku University School of Medicine, Sendai, Japan
| | - Ian Kunkler
- Edinburgh Cancer Research UK Centre, The University of Edinburgh, UK
| | - Alice Y Ho
- Radiation Oncology, Memorial Sloan–Kettering Cancer Center, NY 10065, USA
| | - Chikako Yamauchi
- Radiation Oncology, Shiga Medical Center for Adults, Moriyama, Japan
| | - Louis WC Chow
- UNIMED Medical Institute/University of Hong Kong, Hong Kong
| | - Chiun-Sheng Huang
- Surgery, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wonshik Han
- Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Shinzaburo Noguchi
- Breast & Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mark D Pegram
- Stanford Cancer Institute, School of Medicine, Stanford University, CA 94305, USA
| | | | - Eun-Sook Lee
- Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Alexey A Larionov
- Statistics & Computational Biology Laboratory, University of Cambridge, Cancer Research UK Cambridge Institute, UK
| | - Jose LB Bevilacqua
- Department of Breast Surgery, AC Camargo Cancer Center, Sao Paulo, Brazil
| | - Michio Yoshimura
- Radiation Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Akira Yamauchi
- Breast Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - Ian E Krop
- Breast Oncology Center, Dana-Farber Cancer Institute, Brigham & Women's Cancer Center, Harvard Medical School, Boston, MA 02215, USA
| | - Dong Young Noh
- Surgery, Seoul National University Hospital, Seoul, South Korea
| | - V Suzanne Klimberg
- Surgery, Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, AR 72205, USA
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21
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Toi M, Winer EP, Benson JR, Inamoto T, Forbes JF, von Minckwitz G, Robertson JFR, Grobmyer SR, Jatoi I, Sasano H, Kunkler I, Ho AY, Yamauchi C, Chow LWC, Huang CS, Han W, Noguchi S, Pegram MD, Yamauchi H, Lee ES, Larionov AA, Bevilacqua JLB, Yoshimura M, Sugie T, Yamauchi A, Krop IE, Noh DY, Klimberg VS. Personalization of loco-regional care for primary breast cancer patients (part 2). Future Oncol 2015; 11:1301-5. [DOI: 10.2217/fon.15.66] [Citation(s) in RCA: 3] [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] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Kyoto Breast Cancer Consensus Conference, Kyoto, Japan, 18–20 February 2014 The loco-regional management of breast cancer is increasingly complex with application of primary systemic therapies, oncoplastic techniques and genetic testing for breast cancer susceptibility. Personalization of loco-regional treatment is integral to optimization of breast cancer care. Clinical and pathological tumor stage, biological features and host factors influence loco-regional treatment strategies and extent of surgical procedures. Key issues including axillary staging, axillary treatment, radiation therapy, primary systemic therapy (PST), preoperative hormonal therapy and genetic predisposition were identified and discussed at the Kyoto Breast Cancer Consensus Conference (KBCCC2014). In the second of a two part conference scene, consensus recommendations for radiation treatment, primary systemic therapies and management of genetic predisposition are reported and focus on the following topics: influence of both clinical response to PST and stage at presentation on recommendations for postmastectomy radiotherapy; use of regional nodal irradiation in selected node-positive patients and those with adverse pathological factors; extent of surgical resection following downstaging of tumors with PST; use of preoperative hormonal therapy in premenopausal women with larger, node-negative luminal A-like tumors and managing increasing demands for contralateral prophylactic mastectomy in patients with a unilateral sporadic breast cancer.
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Affiliation(s)
- Masakazu Toi
- Breast Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawara-cho, Sakyo-ku, Kyoto 606–8507, Japan
| | - Eric P Winer
- Breast Oncology Center, Dana-Farber Cancer Institute, Brigham & Women's Cancer Center, Harvard Medical School, Boston, MA 02215, USA
| | - John R Benson
- Cambridge Breast Unit, Addenbrooke's Hospital & University of Cambridge, Cambridge, UK
| | - Takashi Inamoto
- Faculty of Health Care, Tenri Health Care University, Nara, Japan
| | - John F Forbes
- Surgical Oncology, University of Newcastle, Newcastle, Australia
| | | | - John FR Robertson
- Breast Surgery, University of Nottingham, Royal Derby Hospital, Nottingham, UK
| | - Stephen R Grobmyer
- Cleveland Clinic & Lerner College of Medicine of Case Western Reserve University, Cleveland, OH 44195, USA
| | - Ismail Jatoi
- The University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - Hironobu Sasano
- Pathology, Tohoku University School of Medicine, Sendai, Japan
| | - Ian Kunkler
- Edinburgh Cancer Research UK Centre, The University of Edinburgh, UK
| | - Alice Y Ho
- Radiation Oncology, Memorial Sloan-Kettering Cancer Center, NY 10065, USA
| | - Chikako Yamauchi
- Radiation Oncology, Shiga Medical Center for Adults, Moriyama, Japan
| | - Louis WC Chow
- UNIMED Medical Institute/University of Hong Kong, Hong Kong
| | - Chiun-Sheng Huang
- Surgery, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wonshik Han
- Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Shinzaburo Noguchi
- Breast & Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mark D Pegram
- Stanford Cancer Institute, School of Medicine, Stanford University, USA
| | | | - Eun-Sook Lee
- Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Alexey A Larionov
- Statistics & Computational Biology Laboratory, University of Cambridge, Cancer Research UK Cambridge Institute, UK
| | - Jose LB Bevilacqua
- Department of Breast Surgery, AC Camargo Cancer Center, Sao Paulo, Brazil
| | - Michio Yoshimura
- Radiation Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Akira Yamauchi
- Breast Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - Ian E Krop
- Breast Oncology Center, Dana-Farber Cancer Institute, Brigham & Women's Cancer Center, Harvard Medical School, Boston, MA 02215, USA
| | - Dong Young Noh
- Surgery, Seoul National University Hospital, Seoul, South Korea
| | - V Suzanne Klimberg
- Surgery, Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, AR 72205, USA
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Takada M, Ishiguro H, Nagai S, Ohtani S, Kawabata H, Yanagita Y, Hozumi Y, Shimizu C, Takao S, Sato N, Kosaka Y, Sagara Y, Iwata H, Ohno S, Kuroi K, Masuda N, Yamashiro H, Sugimoto M, Kondo M, Naito Y, Sasano H, Inamoto T, Morita S, Toi M. Survival of HER2-positive primary breast cancer patients treated by neoadjuvant chemotherapy plus trastuzumab: a multicenter retrospective observational study (JBCRG-C03 study). Breast Cancer Res Treat 2014; 145:143-53. [PMID: 24682674 DOI: 10.1007/s10549-014-2907-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 03/04/2014] [Indexed: 10/25/2022]
Abstract
We investigated the disease-free survival (DFS) of HER2-positive primary breast cancer patients treated with neoadjuvant chemotherapy plus trastuzumab, as well as predictive factors for DFS and pathologic response. Data from 829 female patients treated between 2001 and 2010 were collected from 38 institutions in Japan. Predictive factors were evaluated using multivariate analyses. The 3-year DFS rate was 87 % [95 % confidence interval (CI) 85-90]. The pathologic complete response (pCR: ypT0/is + ypN0) rate was 51 %. The pCR rate was higher in the ER/PgR-negative patients than in the ER/PgR-positive patients (64 vs. 36 %, P < 0.001). Patients with pCR showed a higher DFS rate than patients without pCR (93 vs. 82 %, P < 0.001). Multivariate analysis revealed three independent predictors for poorer DFS: advanced nodal stage [hazard ratio (HR) 2.63, 95 % CI 1.36-5.21, P = 0.004 for cN2-3 vs. cN0], histological/nuclear grade 3 (HR 1.81, 95 % CI 1.15-2.91, P = 0.011), and non-pCR (HR 1.98, 95 % CI 1.22-3.24, P = 0.005). In the ER/PgR-negative dataset, non-pCR (HR 2.63, 95 % CI 1.43-4.90, P = 0.002) and clinical tumor stage (HR 2.20, 95 % CI 1.16-4.20, P = 0.017 for cT3-4 vs. cT1-2) were independent predictors for DFS, and in the ER/PgR-positive dataset, histological grade of 3 (HR 3.09, 95 % CI 1.48-6.62, P = 0.003), clinical nodal stage (HR 4.26, 95 % CI 1.53-13.14, P = 0.005 for cN2-3 vs. cN0), and young age (HR 2.40, 95 % CI 1.12-4.94, P = 0.026 for ≤40 vs. >40) were negative predictors for DFS. Strict pCR (ypT0 + ypN0) was an independent predictor for DFS in both the ER/PgR-negative and -positive datasets (HR 2.66, 95 % CI 1.31-5.97, P = 0.006 and HR 3.86, 95 % CI 1.13-24.21, P = 0.029, respectively). These results may help assure a more accurate prognosis and personalized treatment for HER2-positive breast cancer patients.
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Affiliation(s)
- M Takada
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, 54 Kawaracho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Takada M, Ishiguro H, Nagai S, Ohtani S, Kawabata H, Yanagita Y, Hozumi Y, Shimizu C, Takao S, Sato N, Kosaka Y, Sagara Y, Iwata H, Ohno S, Kuroi K, Masuda N, Yamashiro H, Sugimoto M, Kondo M, Naito Y, Sasano H, Inamoto T, Morita S, Toi M. Abstract P6-06-20: Predictive factors for pathologic complete response and disease-free survival after neoadjuvant chemotherapy with trastuzumab: A multicenter retrospective observational study in patients with HER2-positive primary breast cancer (JBCRG-C03 study). Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p6-06-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND:
Addition of trastuzumab to neoadjuvant chemotherapy (NAC) improved pathologic complete response (pCR) rate in HER2-positive breast cancer. Although recent trials have shown favorable prognosis with NAC plus trastuzumab, clinicopathological factors to predict the outcome have not been fully understood. The aim of this study was to investigate the survival after NAC with trastuzumab and to explore the predictive factors.
PATIENTS AND METHODS:
This is a multicenter retrospective observational study. Patients with HER2-positive primary breast cancer treated with NAC plus trastuzumab from 2001 to 2010 were identified from the institutional database. Primary end point was disease-free survival (DFS). pCR was defined as ypT0/is+ypN0. Kaplan-Meier method was used to estimate DFS. Logistic regression and proportional hazard analysis were used to identify clinicopathological factors to predict pCR and DFS, respectively.
RESULTS:
733 patients were included in the analysis (whole dataset). 425 were ER/PgR-negative (HR- dataset) and 306 were ER/PgR-positive (HR+ dataset). Radiation therapy was performed in 90% of lumpectomy and 31% of mastectomy. Hormonal therapy was performed in 84% of HR+ dataset. pCR rate was 45% in whole dataset, 60% in HR- dataset, and 34% in HR+ dataset. Table 1 showed the result of multivariate analysis for pCR in whole dataset. When HR+ and HR- dataset were analyzed separately, no definitive predictors for pCR were identified in multivariate analysis. Although the patients with pCR showed a significantly favorable prognosis than those without pCR at 3 years DFS, in whole dataset (93% vs 83%, p<0.0001) and HR- dataset (94% vs 80%, p<0.0001), there was no significant difference in HR+ dataset (89% vs 86%, p = 0.10). Different predictors were selected for DFS when multivariate analysis was conducted separately between HR- and HR+ dataset (Table 2).
CONCLUSIONS:
In this observational study, we clarified predictors for pCR and DFS in HER2-positive patients treated with neoadjuvant trastuzumab containing therapy based on tumor subtype. Our results may help us to predict the prognosis more precisely and to simulate the disease course.
Table 1) Multivariate logistic regression analysis for pCR in whole datasetFactorsOR95%CIp-valuePost- vs Pre-menopause1.50(1.05-2.15)0.026*cT1-2 vs cT3-41.72(1.16-2.59)0.008*ER/PgR-negative vs ER/PgR-positive3.32(2.30-4.82)<0.0001*Grade 3 vs 1-21.28(0.89-1.84)0.183
Table 2) Multivariate proportional hazard analysis for DFSFactors†HR95%CIp-valueWhole dataset Pre- vs Post-menopause1.61(1.04-2.52)0.033*cN2-3 vs cN03.06(1.58-6.24)0.001*cN1 vs cN02.26(1.23-4.41)0.007*Grade 3 vs 1-21.87(1.20-2.97)0.006*non-pCR vs pCR1.90(1.18-3.13)0.008*HR- dataset Pre- vs Post-menopause1.70(1.01-2.85)0.046*cT3-4 vs cT1-21.86(1.09-3.17)0.024*non-pCR vs pCR3.28(1.90-5.87)<0.0001*HR+ dataset cN2-3 vs cN05.01(1.79-16.19)0.002*cN1 vs cN03.50(1.40-10.61)0.006*Grade 3 vs 1-22.95(1.52-5.87)0.001*†Only factors with statistical significance
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-06-20.
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Affiliation(s)
- M Takada
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - H Ishiguro
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - S Nagai
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - S Ohtani
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - H Kawabata
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - Y Yanagita
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - Y Hozumi
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - C Shimizu
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - S Takao
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - N Sato
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - Y Kosaka
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - Y Sagara
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - H Iwata
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - S Ohno
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - K Kuroi
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - N Masuda
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - H Yamashiro
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - M Sugimoto
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - M Kondo
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - Y Naito
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - H Sasano
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - T Inamoto
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - S Morita
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
| | - M Toi
- Kyoto University Hospital, Kyoto, Japan; Kyoto University Hospital; Saitama Cancer Center; Hiroshima City Hospital; Toranomon Hospital; Gunma Prefectural Cancer Center; Jichi Medical University Hospital; National Cancer Center Hospital; Hyogo Cancer Center; Niigata Cancer Center Hospital; Kitasato University School of Medicine; Social Medical Corporation Hakuaikai, Sagara Hospital; Aichi Cancer Center; Clinical Cancer Center, National Kyushu Cancer Center; Tokyo Metropolitan Cancer and Infectious Diseases Centre, Komagome Hospital; Osaka National Hospital; National Hospital Organization Kure Medical Center; Institute for Advanced Biosciences, Keio University; Faculty of Medicine, University of Tsukuba; Keio University; Tohoku University Hospital and School of Medicine; Faculty of Health Care, Tenri Health Care University; Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital; Graduate School of Medicine, Kyoto University
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Toi M, Benson JR, Winer EP, Forbes JF, von Minckwitz G, Golshan M, Robertson JFR, Sasano H, Cole BF, Chow LWC, Pegram MD, Han W, Huang CS, Ikeda T, Kanao S, Lee ES, Noguchi S, Ohno S, Partridge AH, Rouzier R, Tozaki M, Sugie T, Yamauchi A, Inamoto T. Preoperative systemic therapy in locoregional management of early breast cancer: highlights from the Kyoto Breast Cancer Consensus Conference. Breast Cancer Res Treat 2012; 136:919-26. [PMID: 23143284 DOI: 10.1007/s10549-012-2333-9] [Citation(s) in RCA: 3] [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: 10/22/2012] [Accepted: 11/01/2012] [Indexed: 10/27/2022]
Abstract
Data reviewed at the Kyoto Breast Cancer Consensus Conference (KBCCC) showed that preoperative systemic therapy (PST) could optimize surgery through the utilization of information relating to pre- and post-PST tumor stage, therapeutic sensitivity, and treatment-induced changes in the biological characteristics of the tumor. As such, it was noted that the biological characteristics of the tumor, such as hormone receptors, human epidermal growth factor receptor-2, histological grade, cell proliferative activity, mainly defined by the Ki67 labeling index, and the tumor's multi-gene signature, should be considered in the planning of both systemic and local therapy. Furthermore, the timing of axillary sentinel lymph node diagnosis (i.e., before or after the PST) was also noted to be critical in that it may influence the likelihood of axillary preservation, even in node positive cases. In addition, axillary diagnosis with ultrasound and concomitant fine needle aspiration cytology or core needle biopsy (CNB) was reported to contribute to the construction of a treatment algorithm for patient-specific or individualized axillary surgery. Following PST, planning for breast surgery should therefore be based on tumor subtype, tumor volume and extent, therapeutic response to PST, and patient preference. Nomograms for predicting nodal status and drug sensitivity were also recognized as a tool to support decision-making in the selection of surgical treatment. Overall, review of data at the KBCCC showed that PST increases the likelihood of patients receiving localized surgery and individualized treatment regimens.
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Affiliation(s)
- Masakazu Toi
- Breast Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
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Tsuji W, Inamoto T, Ito R, Morimoto N, Tabata Y, Toi M. Simple and longstanding adipose tissue engineering in rabbits. J Artif Organs 2012; 16:110-4. [PMID: 23114565 DOI: 10.1007/s10047-012-0670-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 10/10/2012] [Indexed: 12/30/2022]
Abstract
Adipose tissue engineering for breast reconstruction can be performed for patients who have undergone breast surgery. We have previously confirmed adipogenesis in mice implanted with type I collagen sponge with controlled release of fibroblast growth factor 2 (FGF2) and human adipose tissue-derived stem cells. However, in order to use this approach to treat breast cancer patients, a large amount of adipose tissue is needed, and FGF2 is not readily available. Thus, we aimed to regenerate large amounts of adipose tissue without FGF2 for a long period. Under general anesthesia, cages made of polypropylene mesh were implanted into the rabbits' bilateral fat pads. Each cage was 10 mm in radius and 10 mm in height. Minced type I collagen sponge was injected as a scaffold into the cage. Regenerated tissue in the cage was examined with ultrasonography, and the cages were harvested 3, 6, and 12 months after the implantation. Ultrasonography revealed a gradually increasing homogeneous high-echo area in the cage. Histology of the specimen was assessed with hematoxylin and eosin staining. The percentages of regenerated adipose tissue area were 76.2 ± 13.0 and 92.8 ± 6.6 % at 6 and 12 months after the implantation, respectively. Our results showed de novo adipogenesis 12 months after the implantation of only type I collagen sponge inside the space. Ultrasonography is a noninvasive and useful method of assessing the growth of the tissue inside the cage. This simple method could be a promising clinical modality in breast reconstruction.
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Affiliation(s)
- Wakako Tsuji
- Division of Breast Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, Japan.
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Takada M, Sugimoto M, Naito Y, Moon HG, Han W, Noh DY, Kondo M, Kuroi K, Sasano H, Inamoto T, Tomita M, Toi M. Prediction of axillary lymph node metastasis in primary breast cancer patients using a decision tree-based model. BMC Med Inform Decis Mak 2012; 12:54. [PMID: 22695278 PMCID: PMC3407483 DOI: 10.1186/1472-6947-12-54] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Accepted: 06/13/2012] [Indexed: 01/17/2023] Open
Abstract
Background The aim of this study was to develop a new data-mining model to predict axillary lymph node (AxLN) metastasis in primary breast cancer. To achieve this, we used a decision tree-based prediction method—the alternating decision tree (ADTree). Methods Clinical datasets for primary breast cancer patients who underwent sentinel lymph node biopsy or AxLN dissection without prior treatment were collected from three institutes (institute A, n = 148; institute B, n = 143; institute C, n = 174) and were used for variable selection, model training and external validation, respectively. The models were evaluated using area under the receiver operating characteristics (ROC) curve analysis to discriminate node-positive patients from node-negative patients. Results The ADTree model selected 15 of 24 clinicopathological variables in the variable selection dataset. The resulting area under the ROC curve values were 0.770 [95% confidence interval (CI), 0.689–0.850] for the model training dataset and 0.772 (95% CI: 0.689–0.856) for the validation dataset, demonstrating high accuracy and generalization ability of the model. The bootstrap value of the validation dataset was 0.768 (95% CI: 0.763–0.774). Conclusions Our prediction model showed high accuracy for predicting nodal metastasis in patients with breast cancer using commonly recorded clinical variables. Therefore, our model might help oncologists in the decision-making process for primary breast cancer patients before starting treatment.
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Affiliation(s)
- Masahiro Takada
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Takada M, Sugimoto M, Ohno S, Kuroi K, Sato N, Bando H, Masuda N, Iwata H, Kondo M, Sasano H, Chow LWC, Inamoto T, Naito Y, Tomita M, Toi M. Predictions of the pathological response to neoadjuvant chemotherapy in patients with primary breast cancer using a data mining technique. Breast Cancer Res Treat 2012; 134:661-70. [PMID: 22689089 DOI: 10.1007/s10549-012-2109-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 05/22/2012] [Indexed: 11/30/2022]
Abstract
Nomogram, a standard technique that utilizes multiple characteristics to predict efficacy of treatment and likelihood of a specific status of an individual patient, has been used for prediction of response to neoadjuvant chemotherapy (NAC) in breast cancer patients. The aim of this study was to develop a novel computational technique to predict the pathological complete response (pCR) to NAC in primary breast cancer patients. A mathematical model using alternating decision trees, an epigone of decision tree, was developed using 28 clinicopathological variables that were retrospectively collected from patients treated with NAC (n = 150), and validated using an independent dataset from a randomized controlled trial (n = 173). The model selected 15 variables to predict the pCR with yielding area under the receiver operating characteristics curve (AUC) values of 0.766 [95 % confidence interval (CI)], 0.671-0.861, P value < 0.0001) in cross-validation using training dataset and 0.787 (95 % CI 0.716-0.858, P value < 0.0001) in the validation dataset. Among three subtypes of breast cancer, the luminal subgroup showed the best discrimination (AUC = 0.779, 95 % CI 0.641-0.917, P value = 0.0059). The developed model (AUC = 0.805, 95 % CI 0.716-0.894, P value < 0.0001) outperformed multivariate logistic regression (AUC = 0.754, 95 % CI 0.651-0.858, P value = 0.00019) of validation datasets without missing values (n = 127). Several analyses, e.g. bootstrap analysis, revealed that the developed model was insensitive to missing values and also tolerant to distribution bias among the datasets. Our model based on clinicopathological variables showed high predictive ability for pCR. This model might improve the prediction of the response to NAC in primary breast cancer patients.
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Affiliation(s)
- M Takada
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, 54 Kawaracho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
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Tsuji W, Teramukai S, Ueno M, Toi M, Inamoto T. Prognostic factors for survival after first recurrence in breast cancer: a retrospective analysis of 252 recurrent cases at a single institution. Breast Cancer 2012; 21:86-95. [DOI: 10.1007/s12282-012-0358-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 03/07/2012] [Indexed: 10/28/2022]
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Kimura Y, Inamoto T, Tabata Y. Adipose Tissue Formation in Collagen Scaffolds with Different Biodegradabilities. Journal of Biomaterials Science, Polymer Edition 2012; 21:463-76. [DOI: 10.1163/156856209x424396] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Yu Kimura
- a Department of Biomaterials, Field of Tissue Engineering, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Takashi Inamoto
- b Department of Breast Surgery, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - Yasuhiko Tabata
- c Department of Biomaterials, Field of Tissue Engineering, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
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Inamoto T, Azuma H, Komura K, Fujisue Y, Black P, Watsuji T, Katsuoka Y, Katsuoka Y. Clinically Significant Urethral Stricture and/or Subclinical Urethral Stricture after High-intensity Focused Ultrasound (HIFU) Paradoxically Correlates with Disease-free Survival in Patients with Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1243] [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: 10/16/2022]
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31
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Qian N, Ueno T, Kawaguchi-Sakita N, Kawashima M, Yoshida N, Mikami Y, Wakasa T, Shintaku M, Tsuyuki S, Inamoto T, Toi M. Prognostic significance of tumor/stromal caveolin-1 expression in breast cancer patients. Cancer Sci 2011; 102:1590-6. [PMID: 21585620 DOI: 10.1111/j.1349-7006.2011.01985.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Caveolin-1 (Cav-1) has been extensively characterized in cancer biological research. However, the role of Cav-1 in the interaction between tumor and stromal cells remains unclear. In the present study, we examined Cav-1 expression in tumor cells and stromal cells in breast cancer tissue by immunohistochemical analysis and evaluated its prognostic value in a training cohort. Immunohistochemical analysis of Cav-1 expression was scored as (++), (+) or (-) according to the proportion of positively stained tumor cells (T) and stromal cells (S). Correlation analysis between tumor/stromal Cav-1 expression and clinicopathological parameters revealed that only T(++) Cav-1 status was positively associated with tumor size and histological nodal status (P = 0.019 and 0.021, respectively). Univariate analysis revealed that combined T(++)/S(-) status was significantly correlated with unfavorable prognostic outcomes (P < 0.001). Multivariate analysis demonstrated that this combined status is an independent prognostic factor for primary breast cancer (P = 0.002). Clinical outcomes in different subgroups of breast cancer patients were also strictly dependent on this combined status (P < 0.05). The prognostic value of T(++)/S(-) Cav-1 status was also validated in the testing cohort. Collectively, our data indicate that high Cav-1 expression in tumor cells and lack of this expression in stromal cells could help identify a particular subgroup of breast cancer patients with potentially poor survival. Further studies are required to understand the regulatory mechanism of Cav-1 in the tumor microenvironment.
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Affiliation(s)
- Niansong Qian
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Tanikawa T, Shoji N, Sonohara N, Saito S, Shimura Y, Fukushima J, Inamoto T. Aging transition of the bacterial community structure in the chick ceca. Poult Sci 2011; 90:1004-8. [DOI: 10.3382/ps.2010-01153] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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33
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Toi M, Winer EP, Inamoto T, Benson JR, Forbes JF, Mitsumori M, Robertson JFR, Sasano H, von Minckwitz G, Yamauchi A, Klimberg VS. Identifying gaps in the locoregional management of early breast cancer: highlights from the Kyoto Consensus Conference. Ann Surg Oncol 2011; 18:2885-92. [PMID: 21431404 DOI: 10.1245/s10434-011-1666-7] [Citation(s) in RCA: 8] [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: 12/08/2010] [Indexed: 02/05/2023]
Abstract
A consensus conference was held to investigate issues related to the local management of early breast cancer. Here, we highlight the major topics discussed at the conference and propose ideas for future studies. Regarding axillary management, we examined three major issues. First, we discussed whether the use of axillary reverse mapping could clarify the lymphatic system of breast and whether the ipsilateral arm might help avoid lymphedema. Second, the use of an indocyanine green fluorescent navigation system was discussed for intraoperative lymphatic mapping. These new issues should be examined further in practice. Finally, some agreement was reached on the importance of "four-node diagnosis" to aid in the diagnostic accuracy of sentinel nodes. Regarding breast treatment, there was general agreement that the clinical value of surgical margins in predicting local failure was dependent on the tumor's intrinsic biology and subtypes. For patients treated with preoperative chemotherapy, less extensive excision may be feasible in those who respond to systemic therapy in an acceptable manner. Most trials of preoperative chemotherapy lack outcome data on local recurrence. Therefore, there is a need for such data for overview analysis. We also agreed that radiation after mastectomy may be beneficial in node-positive cases where more than four nodes are involved. Throughout the discussions for both invasive and noninvasive disease, the investigation of nomograms was justified for major issues in the decision-making process, such as the presence or absence of microinvasion and the involvement of nonsentinel nodes in sentinel node-positive patients.
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Affiliation(s)
- Masakazu Toi
- Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawara-cho, Sakyo-ku, Kyoto, Japan.
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Kimura Y, Tsuji W, Yamashiro H, Toi M, Inamoto T, Tabata Y. In situ adipogenesis in fat tissue augmented by collagen scaffold with gelatin microspheres containing basic fibroblast growth factor. J Tissue Eng Regen Med 2010; 4:55-61. [PMID: 19830791 DOI: 10.1002/term.218] [Citation(s) in RCA: 8] [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] [Indexed: 11/06/2022]
Abstract
In situ adipose tissue regeneration in fat tissue by collagen sponges and gelatin microspheres containing basic fibroblast growth factor (bFGF) was investigated. A minced collagen sponge scaffold (1 ml) was incorporated with microspheres containing 10 microg bFGF and administered into a defect of rabbit fat tissues. Adipogenesis at the administered site was evaluated histologically. The adipose tissue regeneration induced by the administration of mixed collagen scaffold and microspheres containing bFGF was significantly stronger than that of either collagen scaffold alone or microspheres containing bFGF alone. The histological area of in situ adipogenesis by the mixed collagen scaffold and microspheres containing bFGF was enhanced over time by repeated administration. It is concluded that the repeated administration of collagen scaffold and microspheres containing bFGF is a promising way to achieve adipose tissue regeneration inside inherent fat tissue. This technique might be applicable for the reconstruction of volume contour deformities by trauma or surgical interventions of adipose tissue in a minimally invasive manner.
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Affiliation(s)
- Yu Kimura
- Department of Biomaterials, Institute for Frontier Medical Sciences, Kyoto University, Japan
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35
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Inamoto T, Dinney C, Czerniak B, Kamat A. UP-3.017: Cytoplasmic MislocalizatIon of the Orphan Nuclear Receptor is a Prognostic Factor in Bladder Cancer. Urology 2009. [DOI: 10.1016/j.urology.2009.07.020] [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: 10/20/2022]
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Tsuji W, Inamoto T, Yamashiro H, Ueno T, Kato H, Kimura Y, Tabata Y, Toi M. Adipogenesis Induced by Human Adipose Tissue–Derived Stem Cells. Tissue Eng Part A 2009; 15:83-93. [PMID: 18759663 DOI: 10.1089/ten.tea.2007.0297] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Wakako Tsuji
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takashi Inamoto
- Department of Breast Surgery, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, Osaka, Japan
| | - Hiroyasu Yamashiro
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takayuki Ueno
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hironori Kato
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yu Kimura
- Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Yasuhiko Tabata
- Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Masakazu Toi
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Kiba T, Inamoto T, Nishimura T, Ueno M, Yanagihara K, Teramukai S, Kato H, Toi M, Fukushima M. The reversal of recurrence hazard rate between ER positive and negative breast cancer patients with axillary lymph node dissection (pathological stage I-III) 3 years after surgery. BMC Cancer 2008; 8:323. [PMID: 18990247 PMCID: PMC2585098 DOI: 10.1186/1471-2407-8-323] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2008] [Accepted: 11/07/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prognostic factors are defined as biological or clinical measurement associated with overall survival and/or disease-free survival. Previous studies have shown that patients with estrogen receptor (ER) positive cancers have a better prognosis than patients whose cancers do not have these receptors. METHODS This study investigated the assessment of variables in defining prognosis of 742 breast cancer women with pathological stage (pTNM) I-III diagnosed between 1980 and 2005 at the Kyoto University Hospital in Japan, by age, clinical stage (cTNM), pTNM, the numbers of positive lymph nodes (pN), and ER status. RESULTS Multivariate analysis demonstrated that pTNM and ER status were the independent prognostic factors for overall survival, and that pTNM and pN were the independent prognostic factors for disease-free survival. For the 0- to 2-year interval, the hazard of recurrence was higher for the ER-negative patients than the ER-positive patients, and beyond 3 years the hazard was higher for ER-positive patients. CONCLUSION The present study confirmed the previous reports which showed favorable prognosis of the patients with lesser pTNM or positive ER status. A reversal of recurrence hazard rate between ER positive and negative breast cancer patients beyond 3 years after operation was detected. The fact may indicate the importance of long term adjuvant hormone therapy for ER positive cancer patients.
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Affiliation(s)
- Takayoshi Kiba
- Outpatient Oncology Unit, Kyoto University Hospital, Kyoto, Japan.
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38
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Azuma H, Isaka Y, Li X, Hünig T, Sakamoto T, Nohmi H, Takabatake Y, Mizui M, Kitazawa Y, Ichimaru N, Ibuki N, Ubai T, Inamoto T, Katsuoka Y, Takahara S. Superagonistic CD28 antibody induces donor-specific tolerance in rat renal allografts. Am J Transplant 2008; 8:2004-14. [PMID: 18727698 DOI: 10.1111/j.1600-6143.2008.02358.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The ultimate goal of organ transplantation is to establish graft tolerance where CD4+CD25+FOXP3+ regulatory T (Treg) cells play an important role. We examined whether a superagonistic monoclonal antibody specific for CD28 (CD28 SA), which expands Treg cells in vivo, would prevent acute rejection and induce tolerance using our established rat acute renal allograft model (Wistar to Lewis). In the untreated or mouse IgG-treated recipients, graft function significantly deteriorated with marked destruction of renal tissue, and all rats died by 13 days with severe azotemia. In contrast, 90% of recipients treated with CD28 SA survived over 100 days, and 70% survived with well-preserved graft function until graft recovery at 180 days. Analysis by flow cytometry and immunohistochemistry demonstrated that CD28 SA induced marked infiltration of FOXP3+ Treg cells into the allografts. Furthermore, these long-surviving recipients showed donor-specific tolerance, accepting secondary (donor-matched) Wistar cardiac allografts, but acutely rejecting third-party BN allografts. We further demonstrated that adoptive transfer of CD4+CD25+ Treg cells, purified from CD28 SA-treated Lewis rats, significantly prolonged allograft survival and succeeded in inducing donor-specific tolerance. In conclusion, CD28 SA treatment successfully induces donor-specific tolerance with the involvement of Treg cells, and thus the therapeutic value of this approach warrants further investigation and preclinical studies.
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Affiliation(s)
- H Azuma
- Department of Urology, Osaka Medical College, Takatsuki, Osaka, Japan
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Ueno M, Kiba T, Nishimura T, Kitano T, Yanagihara K, Yoshikawa K, Ishiguro H, Teramukai S, Fukushima M, Kato H, Inamoto T. Changes in survival during the past two decades for breast cancer at the Kyoto University Hospital. Eur J Surg Oncol 2007; 33:696-9. [PMID: 17376645 DOI: 10.1016/j.ejso.2007.01.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 04/20/2006] [Accepted: 01/26/2007] [Indexed: 11/22/2022] Open
Abstract
AIMS To report the changes in survival over 20 years of 775 breast cancer women operated between 1982 and 2003 at the Kyoto University Hospital in Japan, reflecting changes in clinical practice over that period. RESULTS Survival curves have significantly improved between the periods 1982-1989 and 1990-2003. The 5- and 10-year survival rates between these periods were 80.3% and 85.1%, and 67.5% and 75.0%, respectively. Moreover, there was a difference in overall survival curves of patients of stages II and III, of 35-54 ages, or of positive estrogen receptor (ER) status between these periods. CONCLUSION The present study presented the recent advance of the survival rates might be due to the rational development of breast cancer treatment, and suggested the possibility that the patients of stages II and III, of 35-54 ages, or of positive ER status were received benefits by these treatments.
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Affiliation(s)
- M Ueno
- Outpatient Oncology Unit, Kyoto University Hospital, Kyoto 606-8507, Japan
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Hiraoka Y, Yamashiro H, Yasuda K, Kimura Y, Inamoto T, Tabata Y. In situ regeneration of adipose tissue in rat fat pad by combining a collagen scaffold with gelatin microspheres containing basic fibroblast growth factor. ACTA ACUST UNITED AC 2006; 12:1475-87. [PMID: 16846345 DOI: 10.1089/ten.2006.12.1475] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
This study is an investigation to evaluate in situ adipose tissue regeneration in fat pads. Gelatin microspheres with different water contents were prepared for the controlled release of basic fibroblast growth factor (bFGF). After a collagen sponge scaffold was incorporated by the microspheres containing 0, 0.01, 0.1, 1, and 10 microg of bFGF with or without syngeneic rat preadipocytes (1 x 10(5) cells/site) into a defect of rat fat pad, adipogenesis at the implanted site of scaffold was evaluated histologically. in situ formation of adipose tissue accompanied with angiogenesis was observed in the scaffold implanted with the microspheres containing 1.0 microg of bFGF, although the extent was less at the lower and higher bFGF doses. The in situ formation induced by the microspheres containing bFGF was significantly higher than that induced by free bFGF of the same dose. Adipogenesis was enhanced with time after implantation up to 4 weeks and thereafter leveled off. Such in situ adipogenesis was reproducibly induced by implantation of collagen scaffold incorporating gelatin microspheres containing 1 microg of bFGF, whereas addition of rat syngeneic preadipocytes did not promote the adipogenesis. The degradation of microspheres and the consequent FGF release became faster with an increase in the water content of gelatin microspheres. Less in situ formation of adipose tissue was observed at the lower water content of microspheres, which showed longer-term bFGF release. We conclude that combination of scaffold collagen with an appropriate controlled release of bFGF was essential to achieve the in situ formation of adipose tissue even without preadipocytes.
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Affiliation(s)
- Yosuke Hiraoka
- Department of Biomaterials, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
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Inamoto S, Iwata S, Inamoto T, Nomura S, Sasaki T, Urasaki Y, Hosono O, Kawasaki H, Tanaka H, Dang NH, Morimoto C. Crk-associated substrate lymphocyte type regulates transforming growth factor-beta signaling by inhibiting Smad6 and Smad7. Oncogene 2006; 26:893-904. [PMID: 16909115 DOI: 10.1038/sj.onc.1209848] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Crk-associated substrate lymphocyte type (Cas-L) is a 105 kDa docking protein with diverse functional properties, including regulation of cell division, proliferation, migration and adhesion. Cas-L is also involved in beta1 integrin- or antigen receptor-mediated signaling in B and T cells. In the present study, we demonstrate that Cas-L potentiates transforming growth factor-beta (TGF-beta) signaling pathway by interacting with Smad6 and Smad7. Immunoprecipitation experiments reveal that single domain deletion of full-length Cas-L completely abolishes its docking function with Smad6 and Smad7, suggesting that the natural structure of Cas-L is necessary for its association with Smad6 and Smad7. On the other hand, both N-terminal and C-terminal deletion mutants of Smad6 and Smad7 still retain their docking ability to Cas-L, suggesting that Smad6 and Smad7 possess several binding motifs to Cas-L. Moreover, Cas-L interaction with Mad-homology (MH)2 domain, but not with MH1 domain of Smad6 or Smad7, ameliorates TGF-beta-induced signaling pathway. Finally, depletion of Cas-L by small-interfering RNA oligo attenuates TGF-beta-induced growth inhibition of Huh-7 cells, with a concomitant reduction in phosphorylation of Smad2 and Smad3. These results strongly suggest that Cas-L is a potential regulator of TGF-beta signaling pathway.
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Affiliation(s)
- S Inamoto
- Division of Clinical Immunology, Advanced Clinical Research Center, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
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Inoue S, Hori Y, Hirano Y, Inamoto T, Tabata Y. Effect of culture substrate and fibroblast growth factor addition on the proliferation and differentiation of human adipo-stromal cells. J Biomater Sci Polym Ed 2005; 16:57-77. [PMID: 15796305 DOI: 10.1163/1568562052843366] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The objective of this study is to investigate the proliferation and differentiation of stromal cells derived from human adipose tissues cultured on substrates with different surface properties. In addition, a similar investigation was performed on cells proliferated in different concentrations of basic fibroblast growth factor (FGF-2). The culture substrates include several polymer films with different water wettabilities, glass or a cell-culture plate, and that coated with collagen type I or IV, gelatin and FGF-2. The proliferation profiles of cells were influenced by the type of culture substrate and the growth factor concentration. A larger number of proliferated cells was observed for substrates with a water contact angle around 80 degrees, while the cell number was significantly larger for every protein-coated substrate. The rate of cell proliferation became maximal at a FGF-2 concentration of 1000 ng/ml. The FGF-2 concentration used for cell proliferation affected the differentiation profile of cells proliferated. Stromal cells, proliferated in 1 ng/ml FGF-2, were osteogenically differentiated to the strongest and fastest extent among those in other growth factor doses. The alkaline phosphatase (ALP) activity of cells increased with the increased cell number, although the activity per cell was identical, irrespective of the substrate type. The strongest adipogenic differentiation was observed for cells proliferated in 1000 ng/ml FGF-2 and the differentiation induction was maintained for a long time period. No clear dependence of the cell number on adipogenesis was observed. These findings indicate that the proliferation and differentiation of human adipose tissue-derived stromal cells are influenced by the culture substrate and the concentration of FGF-2 used for proliferation.
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Affiliation(s)
- Sachiko Inoue
- Institute for Frontier Medical Sciences, Kyoto University, 53 Kawara-cho Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
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Yamauchi C, Mitsumori M, Nagata Y, Kokubo M, Inamoto T, Mise K, Kodama H, Hiraoka M. Bilateral breast-conserving therapy for bilateral breast cancer: results and consideration of radiation technique. Breast Cancer 2005; 12:135-9. [PMID: 15858445 DOI: 10.2325/jbcs.12.135] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although breast-conserving surgery followed by definitive irradiation is an established treatment for patients with early breast cancer, the role of breast-conserving therapy (BCT) for patients with bilateral breast cancer has not been well studied and the radiation therapy technique is still under investigation. We examined the feasibility of breast-conserving therapy for bilateral breast cancer and present here our radiation therapy technique with CT simulator. METHODS Between July 1990 and December 1998, we treated 17 patients with bilateral breast cancer who underwent bilateral breast-conserving surgery followed by definitive irradiation. Seven patients had synchronous bilateral breast cancer and ten had metachronous bilateral breast cancer. Radiation therapy consisted of 50 Gy to the bilateral whole breast in all patients but one. A CT simulator was used to plan a tangential radiation field to the breast in all patients. Boost irradiation of 10 Gy was administered to 8 tumors with close or positive margins. RESULTS With a median follow-up periods of 95 months from each operation, no patients showed loco-regional recurrence on either side, and none suffered distant metastasis. Furthermore no serious late adverse effects were observed. CONCLUSION This study demonstrated that BCT is feasible for bilateral breast cancer and the CT simulator is useful for determining the radiation field, especially when lesions are metachronous.
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Affiliation(s)
- Chikako Yamauchi
- Department of Therapeutic Radiology and Oncology Graduate School of Medicine, Kyoto University 54 Kawahara-cho, Shogoin, Sakyo, Kyoto, 606-8507, Japan.
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Fujino S, Kan N, Lee CJ, Inamoto T, Mise K, Sawai S, Okamoto M, Nishimura S, Hori T, Maruhashi K, Yamauchi A, Fujii K, Mitsumori M, Higashide S, Takemoto Y, Okamura T. [Bi-weekly chemotherapy with medium-dose docetaxel for advanced and recurrent breast cancers (The 15th study of Keiji Breast Cancer Study Group)]. Gan To Kagaku Ryoho 2005; 32:631-5. [PMID: 15918562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The efficacy and safety of bi-weekly administration of medium-dose docetaxel (TXT) were evaluated in patients with advanced and recurrent breast cancers. The additional effect of 5'-DFUR for non-responders was also evaluated. Forty patients with advanced and recurrent breast cancers were treated and 38 cases of 40 were evaluated (34 with recurrent cases and 4 with advanced cases). All cases were female, and their mean age was 56.0 (38-74). TXT of 60 mg/body, which was equivalent to 30-50 mg/m2 for standard-sized Japanese women, was administered every two weeks. 5'-DFUR of 800 mg/body was added for non-responders after 5 weeks. The response rate was calculated from the data of 32 cases with measurable lesions, and side effects were evaluated in about 34 cases with exact records. Two hundred seventy-one courses were performed for 38 patients (4-24 courses per person, average 7.13 courses). The mean dosage per course of TXT was 58.4 mg/body (38.3 mg/ m2). Three complete and 7 partial responses were observed (overall response rate: 31.3%). Ten non-responders were evaluated for the additional effect of 5' DFUR, and one case reached PR. Grade 3/4 bone marrow suppression occurred in 9 patients, and Grade 3/4 general malaise was observed in two patient. According to the results, bi-weekly administration of medium dose TXT is an active and safe regimen in patients with advanced and recurrent breast cancers. The additional effect of 5'-DFUR was observed in one of 10 non-responders of bi-weekly chemotherapy with medium-dose TXT.
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Yamashiro H, Inamoto T, Yagi M, Ueno M, Kato H, Takeuchi M, Miyatake SI, Tabata Y, Yamaoka Y. Efficient proliferation and adipose differentiation of human adipose tissue-derived vascular stromal cells transfected with basic fibroblast growth factor gene. ACTA ACUST UNITED AC 2004; 9:881-92. [PMID: 14633373 DOI: 10.1089/107632703322495538] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Human vascular stromal (VS) cells obtained from mature adipose tissue were transfected with an adenovirus vector carrying the basic fibroblast growth factor (bFGF) gene. bFGF protein was observed in VS cell nuclei 24 h after transfection and in the cytoplasm and extracellular space 72 h after transfection. Naive VS cells were almost static in vitro and proliferated in a dose-dependent manner on stimulation with recombinant bFGF (rbFGF). However, bFGF-transfected VS cells proliferated spontaneously to the same extent as naive VS cells when stimulated with rbFGF at 100 ng/ml. The former cells started to proliferate on day 3 after transfection and the proliferation pattern was similar to that of the latter cells, although only a slight amount of bFGF protein was detected in the culture medium when the bFGF-transfected cells started to proliferate. The proliferation of bFGF-transfected VS cells was completely inhibited by bFGF neutralizing antibody, which also completely inhibited the proliferation of naive VS cells stimulated with rbFGF. Under conditions favoring differentiation to adipocytes, bFGF-transfected VS cells stopped proliferating and started to accumulate lipid in the cytoplasm. bFGF-transfected VS cells, which spontaneously and efficiently proliferate while preserving their ability to differentiate into adipocytes, may be an adequate cell source for human adipose tissue regeneration.
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Affiliation(s)
- Hiroyasu Yamashiro
- Department of Gastroenterological Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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46
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Kimura Y, Ozeki M, Inamoto T, Tabata Y. Adipose tissue engineering based on human preadipocytes combined with gelatin microspheres containing basic fibroblast growth factor. Biomaterials 2003; 24:2513-21. [PMID: 12695078 DOI: 10.1016/s0142-9612(03)00049-8] [Citation(s) in RCA: 173] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Gelatin microspheres containing basic fibroblast growth factor (bFGF) were prepared for the controlled release of bFGF. Co-implantation with the gelatin microspheres enabled preadipocytes to induce adipose tissue formation at the implanted site. Preadipocytes isolated from human fat tissue were suspended with the gelatin microspheres containing bFGF and incorporated into a collagen sponge of cell scaffold. Following subcutaneous implantation of the collagen sponge incorporating human preadipocytes, and gelatin microspheres containing 1 microg of bFGF into the back of nude mice, adipose tissue was formed at the implanted site of collagen sponge within 6 weeks postoperatively although the extent depended on the number of preadipocytes transplanted and the bFGF dose. The formation of adipose tissue was significant compared with the implantation of collagen sponge incorporating human preadipocytes and 1 microg of free bFGF. The area of adipose tissue newly formed was increased with the number of preadipocytes transplanted until to 1.0 x 10(5) cells/site and thereafter leveled off. The maximum area was observed at the bFGF dose of 1 microg/site. The area was significantly smaller at the bFGF dose of 0.5 microg/site or larger than 1 microg/site. Immunohistochemical examination indicated that the adipose tissue newly formed was composed of human matured adipocytes. No adipogenesis was observed at the implanted site of collagen sponge incorporating either gelatin microspheres containing bFGF or human preadipocytes and the mixed gelatin microspheres containing bFGF and human preadipocytes. We conclude that combination of gelatin microspheres containing bFGF and preadipocytes with the collagen sponge is essential to achieve tissue engineering of fat tissue.
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Affiliation(s)
- Yu Kimura
- Institute for Frontier Medical Sciences, Kyoto University, 53 Kawara-cho Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
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Kimura Y, Ozeki M, Inamoto T, Tabata Y. Time course of de novo adipogenesis in matrigel by gelatin microspheres incorporating basic fibroblast growth factor. Tissue Eng 2002; 8:603-13. [PMID: 12202000 DOI: 10.1089/107632702760240526] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Controlled release of basic fibroblast growth factor (bFGF) from gelatin microspheres achieved de novo adipogenesis at the implanted site of a basement membrane extract (Matrigel). Following subcutaneous co-implantation of Matrigel and gelatin microspheres incorporating 0.1 microg of bFGF into the back of mice, adipose tissue was formed at the implanted site after 4 weeks postoperatively although the extent increased with implantation time. Formation of adipose tissue was significantly faster than the co-implantation of Matrigel, and 0.1 microg of free bFGF while a larger volume of the adipose tissue formed was retained 15 weeks later. When measured in Matrigel co-implanted with the gelatin microspheres incorporating bFGF, the number of cells infiltrated into Matrigel increased to a significantly high extent compared with the bFGF co-implantation. Matrigel alone was much less effective in inducing formation of adipose tissue. We conclude that gelatin microspheres incorporating bFGF enable Matrigel to efficiently induce de novo adipogenesis at the implanted site in respect to the formation rate and volume of adipose tissue.
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Affiliation(s)
- Yu Kimura
- The Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
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Matsutani Y, Yamauchi A, Takahashi R, Ueno M, Yoshikawa K, Honda K, Nakamura H, Kato H, Kodama H, Inamoto T, Yodoi J, Yamaoka Y. Inverse correlation of thioredoxin expression with estrogen receptor- and p53-dependent tumor growth in breast cancer tissues. Clin Cancer Res 2001; 7:3430-6. [PMID: 11705859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Estrogen receptor (ER) and p53 are important transcription factors in the growth regulation of tumor cells in breast cancer. We reported previously that thioredoxin (TRX) regulates the DNA binding activities of ER and p53 in vitro. The expression of pS-2, a trefoil factor, is also correlated with that of ER. To clarify the regulation mechanism of tumor growth in breast cancer, here we investigated the expression of TRX, ER, pS-2, and p53 and the mitotic index (MI) in 147 breast cancer tissues using immunohistochemical analysis. Of 123 TRX+ cases, ER+ cases (n = 62) showed a higher pS-2 score and lower MI than did ER- cases (n = 61). Furthermore, p53- cases (no mutation in p53; n = 76) also showed a lower MI than did p53+ cases (n = 47). There was no significant correlation between pS-2 and ER, MI and ER, or p53 and MI in the TRX- group. Among the ER+ and p53- cases (ER+/p53- group; n = 61), MI was lower in the TRX+ group (n = 46) than in the TRX- group (n = 15). However, in all other groups (n = 86) with abnormalities in the immunohistochemical expression of either p53 or ER, there was no significant correlation between MI and TRX expression. In the TRX+ and ER +/p53- group (n = 46), histological grading was lower than that in all other groups (n = 101). These findings suggest that TRX expression is linked to the ER- and p53-dependent regulation of tumor growth in breast cancer. In addition, TRX expression in ER+ and p53 intact (wild-type p53+) groups may mean better prognosis than in other conditions.
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Affiliation(s)
- Y Matsutani
- Department of Gastroenterological Surgery, Institute for Virus Research, Graduate School of Medicine, Kyoto University, Shogoin, Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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Tamai K, Mitsumori M, Fujishiro S, Kokubo M, Ooya N, Nagata Y, Sasai K, Hiraoka M, Inamoto T. A case of allergic reaction to surgical metal clips inserted for postoperative boost irradiation in a patient undergoing breast-conserving therapy. Breast Cancer 2001; 8:90-2. [PMID: 11180773 DOI: 10.1007/bf02967485] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We report a case of a 28-year-old woman with right-sided breast cancer. The patient had been treated for atopic dermatitis since her infancy. She underwent breast-conserving surgery (BCS) in July 1998, and three titanium clips were placed at the margin of the excision cavity at the time of surgery. Two months after surgery, the patient exhibited a rapid exacerbation of atopic dermatitis. Various drugs were suspected to be the cause of the allergic reaction, but the results of a bi-digital O-ring test (BDORT) suggested an allergic reaction to titanium clips. In August 1999, the patient underwent a second operation to remove the titanium clips under local anesthesia. Allergy to surgical titanium clips is a rare complication, but in patients with a history of severe allergic diseases, a preoperative immunologic examination should be performed and the patient's history of metal allergy should be investigated.
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Affiliation(s)
- K Tamai
- Department of Therapeutic Radiology and Oncology, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan
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50
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Kokubo M, Mitsumori M, Kanehira K, Inamoto T, Mise K, Kodama H, Yamabe H, Hiraoka M. Results of breast-conserving therapy for ductal carcinoma in situ: the Kyoto University experiences. Breast Cancer 2001; 8:153-7. [PMID: 11342989 DOI: 10.1007/bf02967495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the results of breast-conserving therapy (BCT), defined as the combination of breast-conserving surgery with axillary dissection and definitive radiation therapy for ductal carcinoma in situ (DCIS). METHODS Between November 1987 and March 1998, 33 patients with DCIS undergoing BCT at our hospital were examined. The mean age was 48. All patients underwent quadrantectomy or wide excision as well as axillary dissection. Radiation therapy consisted of 50 Gy to the ipsilateral whole breast. Boost irradiation of 10 Gy was given to 15 patients with close or positive margins. Nearly all patients received adjuvant chemotherapy with 5-fluorouracil or its derivatives and adjuvant endocrine therapy with tamoxifen for 2 years. RESULTS The minimum and median follow-up periods were 32 and 80 months, respectively. All patients but one were followed. Only one patient had a non-invasive local recurrence, 23 months after her operation. This patient was salvaged with simple mastectomy. Her prognostic index score was 8. The five-year local control rate was 97%. No serious acute or late complications were noted. CONCLUSION The results of this retrospective study substantiate favorable data and appear to confirm the efficacy and reasonable local recurrence rate of BCT for the treatment of DCIS.
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Affiliation(s)
- M Kokubo
- Department of Therapeutic Radiology and Oncology, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
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