1
|
Nakamura T, Hayashi T, Kimura Y, Kawakami H, Takahashi K, Ishiwatari H, Goto T, Motoya M, Yamakita K, Sakuhara Y, Ono M, Tanaka E, Omi M, Murakawa K, Iida T, Sakurai T, Haba S, Abiko T, Ito YM, Maguchi H, Hirano S. HOPS-R01 phase II trial evaluating neoadjuvant S-1 therapy for resectable pancreatic adenocarcinoma. Sci Rep 2022; 12:9966. [PMID: 35705607 PMCID: PMC9200853 DOI: 10.1038/s41598-022-14094-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 12/07/2021] [Accepted: 06/01/2022] [Indexed: 11/09/2022] Open
Abstract
Although neoadjuvant therapy (Nac) is recommended for high-risk resectable pancreatic cancer (R-PDAC), evidence regarding specific regimes is scarce. This report aimed to investigate the efficacy of S-1 Nac for R-PDAC. In a multicenter phase II trial, we investigated the efficacy of Nac S-1 (an oral fluoropyrimidine agent containing tegafur, gimeracil, and oteracil potassium) in R-PDAC patients. The protocol involved two cycles of preoperative S-1 chemotherapy, followed by surgery, and four cycles of postoperative S-1 chemotherapy. Two-year progression-free survival (PFS) rates were the primary endpoint. Overall survival (OS) rates and median survival time (MST) were secondary endpoints. Forty-nine patients were eligible, and 31 patients underwent resection following Nac, as per protocol (31/49; 63.3%). Per-protocol analysis included data from 31 patients, yielding the 2-year PFS rate of 58.1%, and 2-, 3-, and 5-year OS rates of 96.8%, 54.8%, and 44.0%, respectively. MST was 49.2 months. Intention-to-treat analysis involved 49 patients, yielding the 2-year PFS rate of 40.8%, and the 2-, 3-, and 5-year OS rates of 87.8%, 46.9%, and 33.9%, respectively. MST was 35.5 months. S-1 single regimen might be an option for Nac in R-PDAC; however, the high drop-out rate (36.7%) was a limitation of this study.
Collapse
Affiliation(s)
- Toru Nakamura
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, N-15 W-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
| | - Tsuyoshi Hayashi
- Center for Gastroenterology, Teine Keijinkai Hospital, 12-1-40 Maeda 1 Jo, Teine-ku, Sapporo, Hokkaido, 006-0811, Japan
- Department of Medical Oncology, School of Medicine, Sapporo Medical University, S1 W17, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan
| | - Yasutoshi Kimura
- Department of Surgery, Surgical Oncology and Science, School of Medicine, Sapporo Medical University, S1 W17, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan
| | - Hiroshi Kawakami
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Hokkaido University, N-15 W-7, Kita-Ku, Sapporo, 060-8638, Japan
| | - Kuniyuki Takahashi
- Center for Gastroenterology, Teine Keijinkai Hospital, 12-1-40 Maeda 1 Jo, Teine-ku, Sapporo, Hokkaido, 006-0811, Japan
| | - Hirotoshi Ishiwatari
- Department of Medical Oncology, School of Medicine, Sapporo Medical University, S1 W17, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan
| | - Takuma Goto
- Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 1-1-1 Midorigaoka Higashi 2 Jo, Asahikawa, Hokkaido, 078-8510, Japan
| | - Masayo Motoya
- Department of Gastroenterology and Hepatology, School of Medicine, Sapporo Medical University, S1 W17, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan
| | - Keisuke Yamakita
- Division of Metabolism and Biosystemic Science, Department of Medicine, Asahikawa Medical University, 1-1-1 Midorigaoka Higashi 2 Jo, Asahikawa, Hokkaido, 078-8510, Japan
| | - Yusuke Sakuhara
- Department of Diagnostic and Interventional Radiology, Hokkaido University, N-15 W-7, Kita-Ku, Sapporo, 060-8638, Japan
| | - Michihiro Ono
- Department of Medical Oncology, School of Medicine, Sapporo Medical University, S1 W17, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan
| | - Eiichi Tanaka
- Department of Surgery, Hokkaido Gastroenterology Hospital, 1-2-10 Honcho 1 Jo, Higashi-ku, Sapporo, Hokkaido, 065-0041, Japan
| | - Makoto Omi
- Department of Surgery, Kushiro Red Cross Hospital, 21-14 Shineicho, Kushiro, Hokkaido, 085-8512, Japan
| | - Katsuhiko Murakawa
- Department of Surgery, Obihiro Kosei General Hospital, 10-1 Nishi 14 Jominami, Obihiro, Hokkaido, 080-0024, Japan
| | - Tomoya Iida
- Department of Gastroenterology, Muroran City General Hospital, 3-8-1 Yamatecho, Muroran, Hokkaido, 051-8512, Japan
| | - Tamaki Sakurai
- Department of Gastroenterology, Steel Memorial Muroran Hospital, 1-45 Chiribetsucho, Muroran, Hokkaido, 050-0076, Japan
| | - Shin Haba
- Department of Gastroenterology, NTT East Sapporo Hospital, S1 W15 Chuo-ku, Sapporo, Hokkaido, 060-0061, Japan
| | - Takehiro Abiko
- Department of Surgery, Asahikawa Red Cross Hospital, 1-1-1 Akebono 1 Jo, Asahikawa, Hokkaido, 070-8530, Japan
| | - Yoichi M Ito
- Biostatistics Division, Hokkaido University Hospital Clinical Research and Medical Innovation Center, Kita 14, Nishi 5, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine Keijinkai Hospital, 12-1-40 Maeda 1 Jo, Teine-ku, Sapporo, Hokkaido, 006-0811, Japan
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, N-15 W-7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan
| |
Collapse
|
2
|
Sumimoto K, Uchida K, Ikeura T, Hirano K, Yamamoto M, Takahashi H, Nishino T, Mizushima I, Kawano M, Kamisawa T, Saeki T, Maguchi H, Ushijima T, Shiokawa M, Seno H, Goto H, Nakamura S, Okazaki K. Nationwide epidemiological survey of immunoglobulin G4-related disease with malignancy in Japan. J Gastroenterol Hepatol 2022; 37:1022-1033. [PMID: 35229347 DOI: 10.1111/jgh.15809] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 01/24/2022] [Accepted: 02/08/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIM To clarify the clinicoepidemiological characteristics of immunoglobulin G4 (IgG4)-related disease (IgG4-RD) with malignancy, a nationwide epidemiological survey was conducted. METHODS Immunoglobulin G4-related disease patients with malignancy who had visited selected hospitals in Japan were surveyed. The study consisted of two stages: the number of IgG4-RD patients with malignancy was estimated by the first questionnaire and their clinicoepidemiological characteristics were assessed by the second questionnaire. RESULTS The frequencies of autoimmune pancreatitis (AIP), IgG4-related sialadenitis, IgG4-related eye disease, IgG4-related kidney disease, and IgG4-related retroperitoneal fibrosis were 44.7%, 20.8%, 14.0%, 5.16%, and 5.12%, respectively. The overall prevalence of malignant disease in IgG4-RD cases was estimated to be 10 900 per 100 000 cases, which was significantly higher than that of malignant disease in the general population. The prevalence of malignant lymphoma in IgG4-RD cases was the highest and was estimated to be 1985 per 100 000 cases. IgG4-related kidney disease had the highest frequency of malignant disease (17.1%). In data from 200 patients, 61 (30.5%) cases of cancer were found 2 years or more before the IgG4-RD diagnosis, 92 cases (46%) during the 1 year preceding or following IgG4-RD diagnosis, and 62 cases of cancer (31%) 2 or more years following IgG4-RD diagnosis. CONCLUSIONS The nationwide survey for IgG4-RD with malignancy in Japan showed that IgG4-RD may be related with malignant diseases.
Collapse
Affiliation(s)
- Kimi Sumimoto
- The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan
| | - Kazushige Uchida
- Department of Gastroenterology and Hepatology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Tsukasa Ikeura
- The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan
| | - Kenji Hirano
- Department of Gastroenterology, Tokyo Takanawa Hospital, Tokyo, Japan
| | - Motohisa Yamamoto
- The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Hiroki Takahashi
- Department of Rheumatology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Takayoshi Nishino
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Center, Tokyo, Japan
| | - Ichiro Mizushima
- Division of Rheumatology, Department of Internal Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | - Mitsuhiro Kawano
- Division of Rheumatology, Department of Internal Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | | | - Takako Saeki
- Department of Internal Medicine, Nagaoka Red Cross Hospital, Niigata, Japan
| | - Hiroyuki Maguchi
- Education and Research Center, Teine-Keijinkai Hospital, Sapporo, Hokkaido, Japan
| | - Tomoyuki Ushijima
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Masahiro Shiokawa
- Division of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroshi Seno
- Division of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroshi Goto
- Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan
| | - Seiji Nakamura
- Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Kazuichi Okazaki
- The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan
| | | |
Collapse
|
3
|
Kuwatani M, Nakamura T, Hayashi T, Kimura Y, Ono M, Motoya M, Imai K, Yamakita K, Goto T, Takahashi K, Maguchi H, Hirano S. Clinical Outcomes of Biliary Drainage during a Neoadjuvant Therapy for Pancreatic Cancer: Metal versus Plastic Stents. Gut Liver 2021; 14:269-273. [PMID: 31060118 PMCID: PMC7096233 DOI: 10.5009/gnl18573] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 03/10/2019] [Accepted: 03/24/2019] [Indexed: 01/08/2023] Open
Abstract
Neoadjuvant chemotherapy/neoadjuvant chemoradiotherapy (NAC/NACRT) can be performed in patients with pancreatic cancer to improve survival. We aimed to clarify the clinical outcomes of biliary drainage with a metal stent (MS) or a plastic stent (PS) during NAC/NACRT. Between October 2013 and April 2016, 96 patients with pancreatic cancer were registered for NAC/NACRT. Of these, 29 patients who underwent biliary drainage with MS or PS before NAC/NACRT and a subsequent pancreatoduodenectomy were retrospectively analyzed with regard to patient characteristics, preoperative recurrent biliary obstruction rate, NAC/NACRT delay or discontinuation rate, and operative characteristics. The median age of the patients was 67 years. NAC and NACRT were performed in 14 and 15 patients, respectively, and MS and PS were used in 17 and 12 patients, respectively. Recurrent biliary obstruction occurred in 6% and 83% of the patients in the MS and PS groups, respectively (p<0.001). NAC/NACRT delay was observed in 35% and 50% of the patients in the MS and PS groups, respectively (p=0.680). NAC/NACRT discontinuation was observed in 12% and 17% of the patients in the MS and PS groups, respectively (p=1.000). The operative time in the MS group tended to be longer than that in the PS group (625 minutes vs 497 minutes, p=0.051), and the operative blood loss volumes and postoperative adverse event rates were not different between the two groups. MS was better than PS from the viewpoint of preventing recurrent biliary obstruction, although MS was similar to PS with regards to perioperative outcomes.
Collapse
Affiliation(s)
- Masaki Kuwatani
- Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Japan
| | - Toru Nakamura
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Tsuyoshi Hayashi
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yasutoshi Kimura
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Michihiro Ono
- Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masayo Motoya
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Koji Imai
- Department of Surgery, Asahikawa Medical University, Asahikawa, Japan
| | - Keisuke Yamakita
- Division of Metabolism and Biosystemic Science, Asahikawa Medical University, Asahikawa, Japan
| | - Takuma Goto
- Division of Gastroenterology and Hematology/Oncology, Asahikawa Medical University, Asahikawa, Japan
| | | | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | | |
Collapse
|
4
|
Nagino M, Hirano S, Yoshitomi H, Aoki T, Uesaka K, Unno M, Ebata T, Konishi M, Sano K, Shimada K, Shimizu H, Higuchi R, Wakai T, Isayama H, Okusaka T, Tsuyuguchi T, Hirooka Y, Furuse J, Maguchi H, Suzuki K, Yamazaki H, Kijima H, Yanagisawa A, Yoshida M, Yokoyama Y, Mizuno T, Endo I. Clinical practice guidelines for the management of biliary tract cancers 2019: The 3rd English edition. J Hepatobiliary Pancreat Sci 2020; 28:26-54. [PMID: 33259690 DOI: 10.1002/jhbp.870] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/18/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014. METHODS In this 3rd version, clinical questions (CQs) were proposed on six topics. The recommendation, grade for recommendation, and statement for each CQ were discussed and finalized by an evidence-based approach. Recommendations were graded as Grade 1 (strong) or Grade 2 (weak) according to the concepts of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. RESULTS The 31 CQs covered the six topics: (a) prophylactic treatment, (b) diagnosis, (c) biliary drainage, (d) surgical treatment, (e) chemotherapy, and (f) radiation therapy. In the 31 CQs, 14 recommendations were rated strong and 14 recommendations weak. The remaining three CQs had no recommendation. Each CQ includes a statement of how the recommendations were graded. CONCLUSIONS This latest guideline provides recommendations for important clinical aspects based on evidence. Future collaboration with the cancer registry will be key for assessing the guidelines and establishing new evidence.
Collapse
Affiliation(s)
| | - Satoshi Hirano
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Hideyuki Yoshitomi
- Department of Surgery, Saitama Medical Center, Dokkyo Medical University, Koshigaya, Japan
| | - Taku Aoki
- Second Department of Surgery, Dokkyo Medical University, Mibu, Japan
| | - Katsuhiko Uesaka
- Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Nagaizumi, Japan
| | - Michiaki Unno
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomoki Ebata
- Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masaru Konishi
- Department of Hepatobiliary Pancreatic Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Keiji Sano
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Kazuaki Shimada
- Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroaki Shimizu
- Department of Surgery, Teikyo University Chiba Medical Center, Ichihara, Japan
| | - Ryota Higuchi
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroyuki Isayama
- Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Toshio Tsuyuguchi
- Department of Gastroenterology, Chiba Prefectural Sawara Hospital, Sawara, Japan
| | - Yoshiki Hirooka
- Department of Gastroenterology and Gastroenterological Oncology, Fujita Health University, Toyoake, Japan
| | - Junji Furuse
- Department of Medical Oncology, Faculty of Medicine, Kyorin University, Mitaka, Japan
| | - Hiroyuki Maguchi
- Education and Research Center, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Kojiro Suzuki
- Department of Radiology, Aichi Medical University, Nagakute, Japan
| | - Hideya Yamazaki
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroshi Kijima
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Akio Yanagisawa
- Department of Pathology, Japanese Red Cross Kyoto Diichi Hospital, Kyoto, Japan
| | - Masahiro Yoshida
- Department of Hepato-Biliary-Pancreatic & Gastrointestinal Surgery, International University of Health and Welfare, Ichikawa, Japan
| | - Yukihiro Yokoyama
- Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Mizuno
- Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Itaru Endo
- Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| |
Collapse
|
5
|
Nakaji S, Okawa Y, Nakamura K, Itonaga M, Inase M, Sugiyama H, Suzuki R, Yamauchi K, Matsui H, Hirata N, Saito J, Ishii N, Tsuyuguchi T, Kato H, Kitano M, Kato N, Ohira H, Okada H, Torimura T, Maguchi H. Predictive model of bleeding following endoscopic sphincterotomy for the treatment of choledocholithiasis in hemodialysis patients: A retrospective multicenter study. JGH Open 2020; 4:915-922. [PMID: 33102764 PMCID: PMC7578281 DOI: 10.1002/jgh3.12363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 04/01/2020] [Accepted: 05/09/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM Although hemodialysis (HD) is a strong risk factor for postendoscopic sphincterotomy (ES) bleeding, additional risk factors in HD patients remain unclear. There is no model for predicting post-ES bleeding risk in HD patients. Therefore, we conducted a retrospective multicenter study to reveal these risk factors and develop a predictive model of post-ES bleeding in HD patients. METHODS We retrospectively reviewed the medical records of HD patients who underwent ES at eight hospitals between January 2006 and December 2016, with post-ES bleeding as the main outcome measure. Univariate analyses were performed to extract possible risk factors for post-ES bleeding. Factors that were clinically important and statistically significant in our univariate analyses were then included in our logistic regression analysis for the development of a multivariate predictive model of post-ES bleeding. This predictive model was visualized using a predictive nomogram. RESULTS Post-ES bleeding occurred in 20 (16.3%) of 123 HD patients. Based on clinically important factors and the results of our univariate analyses, platelet count, prothrombin time (international normalized ratio), and HD duration were included in our predictive model of post-ES bleeding. Receiver operating characteristic analysis found that this model had an area under the curve of 0.715 (95% confidence interval, 0.609-0.822). We developed a predictive nomogram based on these results. CONCLUSIONS We demonstrated that post-ES bleeding is more common in HD patients than in the general population and succeeded in constructing a predictive model that can effectively identify HD patients at risk of post-ES bleeding.
Collapse
Affiliation(s)
- So Nakaji
- Department of GastroenterologyKameda Medical CenterChibaJapan
| | | | - Kenji Nakamura
- Department of GastroenterologySt. Luke's International HospitalTokyoJapan
| | - Masahiro Itonaga
- Second Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Masami Inase
- Department of GastroenterologyEbina General HospitalEbinaJapan
| | - Harutoshi Sugiyama
- Department of Gastroenterology, Graduate School of MedicineChiba UniversityChibaJapan
| | - Rei Suzuki
- Department of GastroenterologyFukushima Medical UniversityFukushimaJapan
| | - Kenji Yamauchi
- Department of Gastroenterology and HepatologyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
| | - Hiroki Matsui
- Clinical Research Support DivisionKameda Institute for Health Science, Kameda College of Health SciencesChibaJapan
| | - Nobuto Hirata
- Department of GastroenterologyKameda Medical CenterChibaJapan
| | - Junko Saito
- Department of GastroenterologyChikamori HospitalKochiJapan
| | - Naoki Ishii
- Division of GastroenterologyTokyo Shinagawa HospitalShinagawa CityJapan
| | - Toshio Tsuyuguchi
- Department of Gastroenterology, Graduate School of MedicineChiba UniversityChibaJapan
| | - Hironari Kato
- Department of Gastroenterology and HepatologyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
| | - Masayuki Kitano
- Second Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Naoya Kato
- Department of Gastroenterology, Graduate School of MedicineChiba UniversityChibaJapan
| | - Hiromasa Ohira
- Department of GastroenterologyFukushima Medical UniversityFukushimaJapan
| | - Hiroyuki Okada
- Department of Gastroenterology and HepatologyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
| | - Takuji Torimura
- Department of MedicineKurume University School of MedicineKurumeJapan
| | | |
Collapse
|
6
|
Hirota M, Shimosegawa T, Kitamura K, Takeda K, Takeyama Y, Mayumi T, Ito T, Takenaka M, Iwasaki E, Sawano H, Ishida E, Miura S, Masamune A, Nakai Y, Mitoro A, Maguchi H, Kimura K, Sanuki T, Ito T, Haradome H, Kozaka K, Gabata T, Kataoka K, Hirota M, Isaji S, Nakamura R, Yamagiwa K, Kayaba C, Ikeda K. Continuous regional arterial infusion versus intravenous administration of the protease inhibitor nafamostat mesilate for predicted severe acute pancreatitis: a multicenter, randomized, open-label, phase 2 trial. J Gastroenterol 2020; 55:342-352. [PMID: 31758329 PMCID: PMC7026212 DOI: 10.1007/s00535-019-01644-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/11/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Continuous regional arterial infusion (CRAI) of protease inhibitor nafamostat mesilate (NM) is used in the context of predicted severe acute pancreatitis (SAP) to prevent the development of pancreatic necrosis. Although this therapy is well known in Japan, its efficacy and safety remain unclear. METHODS This investigator-initiated and -driven, multicenter, open-label, randomized, controlled trial (UMIN000020868) enrolled 39 patients with predicted SAP and low enhancement of the pancreatic parenchyma on computed tomography (CT). Twenty patients were assigned to the CRAI group, while 19 served as controls and were administered NM at the same dose intravenously (IV group). The primary endpoint was the development of pancreatic necrosis as determined by CT on Day 14, judged by blinded central review. RESULTS There was no difference between the CRAI and IV groups regarding the percentages of participants who developed pancreatic necrosis (more than 1/3 of the pancreas: 25.0%, range 8.7-49.1% vs. 15.8%, range 3.4-39.6%, respectively, P = 0.694; more than 2/3 of the pancreas: 20%, range 5.7-43.7% vs. 5.3%, range 0.1-26.0%, respectively, P = 0.341). The early analgesic effect was evaluated based on 24-h cumulative fentanyl consumption and additional administration by intravenous patient-controlled analgesia. The results showed that the CRAI group used significantly less analgesic. There were two adverse events related to CRAI, namely bleeding and splenic infarction. CONCLUSIONS CRAI with NM did not inhibit the development of pancreatic necrosis although early analgesic effect of CRAI was superior to that of IV. Less-invasive IV therapy can be considered a viable alternative to CRAI therapy.
Collapse
Affiliation(s)
- Morihisa Hirota
- Division of Gastroenterology and Hepatology, Tohoku Medical and Pharmaceutical University, 1-15-1, Fukumuro, Miyagino-ku, Sendai, Miyagi, 9838536, Japan.
| | - Tooru Shimosegawa
- Department of Gastroenterology, South Miyagi Medical Center, 28-1 Nishi, Ohgawara, Miyagi, 9891253, Japan
| | - Katsuya Kitamura
- Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, 1-5-8, Hatanodai, Shinagawa-ku, Tokyo, 1428666, Japan
- Department of Gastroenterology and Hepatology, Tokyo Medical University Hachioji Medical Center, 1163, Tatemachi, Hachioji-Shi, Tokyo, 1930998, Japan
| | - Kazunori Takeda
- Miyagi Branch, Health Insurance Claims Review & Reimbursement Services, 5-1-27, Tsutsujigaoka, Miyagino-ku, Sendai, Miyagi, 9838504, Japan
| | - Yoshifumi Takeyama
- Department of Surgery, Kindai University, Faculty of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka, 5898511, Japan
| | - Toshihiko Mayumi
- Department of Emergency Medicine, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 8078555, Japan
| | - Tetsuhide Ito
- Department of Gastroenterology and Hepatology, International University of Health and Welfare Graduate School of Medicine, Neuroendocrine Tumor Center, Fukuoka Sanno Hospital, 3-6-45, Momochihama, Sawara-ku, Fukuoka, 8140001, Japan
| | - Mamoru Takenaka
- Department of Gastroenterology and Hepatology, Kindai University, Faculty of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, Osaka, 5898511, Japan
| | - Eisuke Iwasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, 35, Shinanomachi, Shinjuku-ku, Tokyo, 1608582, Japan
| | - Hirotaka Sawano
- Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital, 1-1-6, Tsukumodai, Suita, Osaka, 5650862, Japan
| | - Etsuji Ishida
- Department of Gastroenterology, Kurashiki Central Hospital, 1-1-1, Miwa, Kurashiki, Okayama, 7108602, Japan
| | - Shin Miura
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba-ku, Sendai, Miyagi, 9808574, Japan
| | - Atsushi Masamune
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba-ku, Sendai, Miyagi, 9808574, Japan
| | - Yousuke Nakai
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 1138655, Japan
| | - Akira Mitoro
- Third Department of Internal Medicine, Nara Medical University, 840, Shijo-cho, Kashihara, Nara, 6348522, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-keijinkai Hospital, 1-12-1-40, Maeda, Teine-ku, Sapporo, 0068555, Japan
| | - Kenji Kimura
- Department of Gastroenterology, National Hospital Organization Sendai Medical Center, 2-11-12, Miyagino, Miyagino-ku, Sendai, Miyagi, 9838520, Japan
| | - Tsuyoshi Sanuki
- Department of Gastroenterology, Kita-Harima Medical Center, 926-250, Ichiba-cho, Ono, Hyogo, 6751392, Japan
| | - Tetsuya Ito
- Department of Internal Medicine, Gastroenterology, Shinshu University Hospital, 3-1-1, Akashi, Matsumoto, Nagano, 3908621, Japan
- Division of Gastroenterology, Nagano Red Cross Hospital, 5-22-1, Wakasato, Nagano, 3808582, Japan
| | - Hiroki Haradome
- Department of Radiological Advanced Medicine, Kitasato University School of Medicine, 1-15-1, Kitasato, Minami-ku, Sagamihara, Kanagawa, 2520375, Japan
| | - Kazuto Kozaka
- Department of Radiology, Kanazawa University, Graduate School of Medical Sciences, 13-1, Takaramachi, Kanazawa, Ishikawa, 9208641, Japan
| | - Toshifumi Gabata
- Department of Radiology, Kanazawa University, Graduate School of Medical Sciences, 13-1, Takaramachi, Kanazawa, Ishikawa, 9208641, Japan
| | - Keisho Kataoka
- Department of Gastroenterology, Otsu Municipal Hospital, 2-9-9, Motomiya, Otsu, Shiga, 5200804, Japan
| | - Masahiko Hirota
- Department of Surgery, Kumamoto Regional Medical Center, 5-16-10, Honjou, Chuou-ku, Kumamoto, 8600811, Japan
| | - Shuji Isaji
- Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu, Mie, 5148507, Japan
| | - Ryoji Nakamura
- Inter Scientific Research Co., Ltd, 3-14-1, Higashinakano, Nakano-ku, Tokyo, 1640003, Japan
| | - Koki Yamagiwa
- Department of Development Promotion, Clinical Research, Innovation, Education Center, Tohoku University Hospital, 1-1, Seiryo, Aoba-ku, Sendai, Miyagi, 9808574, Japan
| | - Chie Kayaba
- Department of Development Promotion, Clinical Research, Innovation, Education Center, Tohoku University Hospital, 1-1, Seiryo, Aoba-ku, Sendai, Miyagi, 9808574, Japan
| | - Koji Ikeda
- Department of Development Promotion, Clinical Research, Innovation, Education Center, Tohoku University Hospital, 1-1, Seiryo, Aoba-ku, Sendai, Miyagi, 9808574, Japan
| |
Collapse
|
7
|
Kimura Y, Nakamura T, Hayashi T, Kuwatani M, Motoya M, Yoshida M, Imamura M, Nagayama M, Yamaguchi H, Yamakita K, Goto T, Sakuhara Y, Takahashi K, Maguchi H, Hirano S, Takemasa I. Clinical usefulness of conversion surgery for unresectable pancreatic cancer diagnosed on multidetector computed tomography imaging: Results from a multicenter observational cohort study by the Hokkaido Pancreatic Cancer Study Group (HOPS UR-01). Ann Gastroenterol Surg 2019; 3:523-533. [PMID: 31549012 PMCID: PMC6749954 DOI: 10.1002/ags3.12272] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 04/26/2019] [Accepted: 06/04/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND AND AIM Effective multidisciplinary approaches for unresectable pancreatic cancer (UR-PC) that include modern chemotherapeutic regimens and subsequent conversion surgery (CS) are being developed. The aim of this study was to evaluate outcomes of patients clinically diagnosed with UR-PC, focusing on the efficacy of CS. METHODS Patients ineligible for two multicenter phase II studies conducted by the Hokkaido Pancreatic Cancer Study Group (HOPS) were recruited. Sequential treatment regimens, conversion to radical surgery, and overall survival (OS) were analyzed by multidetector computed tomography (MDCT)-based UR factors. Univariate and multivariate analyses were performed to identify predictors of OS. RESULTS Sixty-six of 247 intended recruits for HOPS studies from October 2013 to April 2016 were included. Unresectability was due to locally advanced (LA) disease and metastasis (M) in 42 and 24 patients, respectively. Induction therapy began with chemotherapy (CT) and chemoradiotherapy (CRT) in 44 and 17 patients, respectively, of whom 23 received modern CT regimens. Radical surgery was completed in 12 (LA, 10; M, two) with a median treatment interval of 10.3 months (range, 2-32). Eleven patients (91.6%) achieved pathological R0 resection. Median OS was significantly longer in patients who underwent CS than those who did not (44.1 vs 14.5 months, P < 0.0001). CS was an independent predictor of OS (hazard ratio, 0.078; 95% confident interval, 0.017-0.348; P = 0.001). CONCLUSION Conversion surgery after a favorable response to sequential treatment might prolong survival in patients with UR-PC. Precise diagnosis on MDCT followed by sequential multimodal anticancer treatment is essential.
Collapse
Affiliation(s)
- Yasutoshi Kimura
- Department of SurgerySurgical Oncology and ScienceSapporo Medical University School of MedicineSapporoJapan
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
| | - Toru Nakamura
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
- Department of Gastroenterological Surgery IIHokkaido UniversityFaculty of MedicineSapporoJapan
| | - Tsuyoshi Hayashi
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
- Center for GastroenterologyTeine‐Keijinkai HospitalSapporoJapan
| | - Masaki Kuwatani
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
- Department of Gastroenterology and HepatologyHokkaido University Graduate School of MedicineSapporoJapan
| | - Masayo Motoya
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
- Department of Gastroenterology and HepatologySapporo Medical University School of MedicineSapporoJapan
| | - Makoto Yoshida
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
- Department of Medical OncologySapporo Medical University School of MedicineSapporoJapan
| | - Masafumi Imamura
- Department of SurgerySurgical Oncology and ScienceSapporo Medical University School of MedicineSapporoJapan
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
| | - Minoru Nagayama
- Department of SurgerySurgical Oncology and ScienceSapporo Medical University School of MedicineSapporoJapan
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
| | - Hiroshi Yamaguchi
- Department of SurgerySurgical Oncology and ScienceSapporo Medical University School of MedicineSapporoJapan
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
| | - Keisuke Yamakita
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
- Division of Metabolism and Biosystemic ScienceDepartment of MedicineAsahikawa Medical UniversitySapporoJapan
| | - Takuma Goto
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
- Division of Gastroenterology and Hematology/OncologyDepartment of MedicineAsahikawa Medical UniversitySapporoJapan
| | - Yusuke Sakuhara
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
- Department of RadiologyTonan HospitalSapporoJapan
| | - Kuniyuki Takahashi
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
- Center for GastroenterologyTeine‐Keijinkai HospitalSapporoJapan
| | - Hiroyuki Maguchi
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
- Center for GastroenterologyTeine‐Keijinkai HospitalSapporoJapan
| | - Satoshi Hirano
- Hokkaido Pancreatic Cancer Study Group; HOPSSapporoJapan
- Department of Gastroenterological Surgery IIHokkaido UniversityFaculty of MedicineSapporoJapan
| | - Ichiro Takemasa
- Department of SurgerySurgical Oncology and ScienceSapporo Medical University School of MedicineSapporoJapan
| |
Collapse
|
8
|
Terao C, Ota M, Iwasaki T, Shiokawa M, Kawaguchi S, Kuriyama K, Kawaguchi T, Kodama Y, Yamaguchi I, Uchida K, Higasa K, Yamamoto M, Kubota K, Yazumi S, Hirano K, Masaki Y, Maguchi H, Origuchi T, Matsui S, Nakazawa T, Shiomi H, Kamisawa T, Hasebe O, Iwasaki E, Inui K, Tanaka Y, Ohshima KI, Akamizu T, Nakamura S, Nakamura S, Saeki T, Umehara H, Shimosegawa T, Mizuno N, Kawano M, Azumi A, Takahashi H, Mimori T, Kamatani Y, Okazaki K, Chiba T, Kawa S, Matsuda F. IgG4-related disease in the Japanese population: a genome-wide association study. Lancet Rheumatol 2019; 1:e14-e22. [PMID: 38229354 DOI: 10.1016/s2665-9913(19)30006-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/29/2019] [Accepted: 05/30/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND IgG4-related disease is a newly recognised immunopathological entity that includes autoimmune pancreatitis, IgG4-related sialadenitis, and IgG4-related kidney disease. To understand the genetic landscape of IgG4-related disease, we did a genome-wide association study. METHODS We did a genome-wide association study of Japanese individuals, initially screening 857 patients with IgG4-related disease at 50 Japanese research institutions and DNA samples from 2082 healthy control participants from the Nagahama Prospective Genome Cohort for the Comprehensive Human Bioscience. From Oct 27, 2008, to July 22, 2014, we enrolled 835 patients and used data from 1789 healthy participants. Only patients with confirmed diagnosis of IgG4-related disease according to the international diagnostic criteria were included. Genotyping was done with the Infinium HumanOmni5Exome, HumanOmni2.5Exome, or HumanOmni2.5 Illumina arrays, and genomic distributions were compared between case and control samples for 958 440 single nucleotide polymorphisms. The HLA region was extensively analysed using imputation of HLA alleles and aminoacid residues. Fine mapping of the FCGR2B region was also done. Associations between clinical manifestations of disease and the genetic variations identified in these two genes were examined. FINDINGS We identified the HLA-DRB1 (p=1·1×10-11) and FCGR2B (p=2·0×10-8) regions as susceptibility loci for IgG4-related disease. We also identified crucial aminoacid residues in the β domain of the peptide-binding groove of HLA-DRB1, in which the seventh aminoacid residue showed the strongest association signal with IgG4-related disease (p=1·7×10-14), as has been reported with other autoimmune diseases. rs1340976 in FCGR2B showed an association with increased FCGR2B expression (p=2·7×10-10) and was in weak linkage disequilibrium with rs1050501, a missense variant of FCGR2B previously associated with systemic lupus erythematosus. Furthermore, rs1340976 was associated with the number of swollen organs at diagnosis (p=0·011) and IgG4 concentration at diagnosis (p=0·035). INTERPRETATION Two susceptibility loci for IgG4-related disease were identified. Both FCGR2B and HLA loci might have important roles in IgG4-related disease development. Common molecular mechanisms might underlie IgG4-related disease and other immune-related disorders FUNDING: The Japanese Ministry of Health, Labour, and Welfare, the Japanese Agency of Medical Research and Development, and Kyoto University Grant for Top Global University Japan Project.
Collapse
Affiliation(s)
- Chikashi Terao
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masao Ota
- Department of Internal Medicine 2, School of Medicine, Shinshu University, Matsumoto, Japan
| | - Takeshi Iwasaki
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Rheumatology and Clinical Immunology, Kyoto University, Kyoto, Japan
| | - Masahiro Shiokawa
- Department of Gastroenterology and Hepatology, Kyoto University, Kyoto, Japan
| | - Shuji Kawaguchi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Katsutoshi Kuriyama
- Department of Gastroenterology and Hepatology, Kyoto University, Kyoto, Japan
| | - Takahisa Kawaguchi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuzo Kodama
- Department of Gastroenterology and Hepatology, Kyoto University, Kyoto, Japan
| | - Izumi Yamaguchi
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazushige Uchida
- Department of Gastroenterology and Hepatology Kansai Medical University, Hirakata, Japan
| | - Koichiro Higasa
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Motohisa Yamamoto
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kensuke Kubota
- Department of Endoscopy, Yokohama City University Hospital, Yokohama, Japan
| | - Shujiro Yazumi
- Department of Gastroenterology and Hepatology, Kitano Hospital, Osaka, Japan
| | - Kenji Hirano
- Department of Gastroenterology, Tokyo Takanawa Hospital, Tokyo, Japan
| | - Yasufumi Masaki
- Department of Hematology and Immunology, Kanazawa Medical University, Uchinada, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Tomoki Origuchi
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shoko Matsui
- Center for Health Care and Human Sciences, University of Toyama, Toyama, Japan
| | - Takahiro Nakazawa
- Department of Gastroenterology and Metabolism, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
| | - Hideyuki Shiomi
- Department of Gastroenterology, Kobe University Hospital, Kobe, Japan
| | - Terumi Kamisawa
- Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Osamu Hasebe
- Department of Gastroenterology, Nagano Municipal Hospital, Tomitake, Japan
| | - Eisuke Iwasaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Inui
- Department of Gastroenterology, Second Teaching Hospital, Fujita Health University, Toyoake, Japan
| | - Yoshiya Tanaka
- First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Koh-Ichi Ohshima
- Department of Ophthalmology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Takashi Akamizu
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Seiji Nakamura
- Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Takako Saeki
- Department of Internal Medicine, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Hisanori Umehara
- Division of Rheumatology and Immunology, Nagahama City Hospital, Nagahama, Japan
| | - Tooru Shimosegawa
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nobumasa Mizuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Mitsuhiro Kawano
- Department of Rheumatology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Atsushi Azumi
- Department of Ophthalmology, Kobe Kaisei Hospital, Kobe, Japan
| | - Hiroki Takahashi
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tsuneyo Mimori
- Department of Rheumatology and Clinical Immunology, Kyoto University, Kyoto, Japan
| | - Yoichiro Kamatani
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuichi Okazaki
- Department of Gastroenterology and Hepatology Kansai Medical University, Hirakata, Japan
| | - Tsutomu Chiba
- Department of Gastroenterology and Hepatology, Kyoto University, Kyoto, Japan
| | - Shigeyuki Kawa
- Center for Health Safety and Environmental Management, Shinshu University, Matsumoto, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| |
Collapse
|
9
|
Omori Y, Ono Y, Tanino M, Karasaki H, Yamaguchi H, Furukawa T, Enomoto K, Ueda J, Sumi A, Katayama J, Muraki M, Taniue K, Takahashi K, Ambo Y, Shinohara T, Nishihara H, Sasajima J, Maguchi H, Mizukami Y, Okumura T, Tanaka S. Pathways of Progression From Intraductal Papillary Mucinous Neoplasm to Pancreatic Ductal Adenocarcinoma Based on Molecular Features. Gastroenterology 2019; 156:647-661.e2. [PMID: 30342036 DOI: 10.1053/j.gastro.2018.10.029] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 09/14/2018] [Accepted: 10/05/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS Intraductal papillary mucinous neoplasms (IPMNs) are regarded as precursors of pancreatic ductal adenocarcinomas (PDAs), but little is known about the mechanism of progression. This makes it challenging to assess cancer risk in patients with IPMNs. We investigated associations of IPMNs with concurrent PDAs by genetic and histologic analyses. METHODS We obtained 30 pancreatic tissues with concurrent PDAs and IPMNs, and 168 lesions, including incipient foci, were mapped, microdissected, and analyzed for mutations in 18 pancreatic cancer-associated genes and expression of tumor suppressors. RESULTS We determined the clonal relatedness of lesions, based on driver mutations shared by PDAs and concurrent IPMNs, and classified the lesions into 3 subtypes. Twelve PDAs contained driver mutations shared by all concurrent IPMNs, which we called the sequential subtype. This subset was characterized by less diversity in incipient foci with frequent GNAS mutations. Eleven PDAs contained some driver mutations that were shared with concurrent IPMNs, which we called the branch-off subtype. In this subtype, PDAs and IPMNs had identical KRAS mutations but different GNAS mutations, although the lesions were adjacent. Whole-exome sequencing and methylation analysis of these lesions indicated clonal origin with later divergence. Ten PDAs had driver mutations not found in concurrent IPMNs, called the de novo subtype. Expression profiles of TP53 and SMAD4 increased our ability to differentiate these subtypes compared with sequencing data alone. The branch-off and de novo subtypes had substantial heterogeneity among early clones, such as differences in KRAS mutations. Patients with PDAs of the branch-off subtype had a longer times of disease-free survival than patients with PDAs of the de novo or the sequential subtypes. CONCLUSIONS Detailed histologic and genetic analysis of PDAs and concurrent IPMNs identified 3 different pathways by which IPMNs progress to PDAs-we call these the sequential, branch-off, and de novo subtypes. Subtypes might be associated with clinical and pathologic features and be used to select surveillance programs for patients with IPMNs.
Collapse
Affiliation(s)
- Yuko Omori
- Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan; Department of Pathology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Yusuke Ono
- Institute of Biomedical Research, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan; Department of Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Mishie Tanino
- Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hidenori Karasaki
- Institute of Biomedical Research, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Hiroshi Yamaguchi
- Division of Diagnostic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Toru Furukawa
- Department of Histopathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Katsuro Enomoto
- Department of Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Jun Ueda
- Center for Advanced Research and Education, Asahikawa Medical University, Asahikawa, Japan
| | - Atsuko Sumi
- Institute of Biomedical Research, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Jin Katayama
- Diagnostic Partnering, Clinical Sequencing Division, Thermo Fisher Scientific, Tokyo, Japan
| | | | - Kenzui Taniue
- Institute of Biomedical Research, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan; Genomedia Inc., Tokyo, Japan
| | | | - Yoshiyasu Ambo
- Department of Surgery, Teine-Keijinkai Hospital, Sapporo, Japan
| | | | | | - Junpei Sasajima
- Institute of Biomedical Research, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan; Department of Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Yusuke Mizukami
- Institute of Biomedical Research, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan; Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
| | | | - Shinya Tanaka
- Department of Cancer Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| |
Collapse
|
10
|
Nagai K, Katanuma A, Takahashi K, Yane K, Kin T, Maguchi H. A simple and novel marking method for correctly identifying the precutting direction to achieve safe and efficacious precut sphincterotomy (with video). Endosc Int Open 2019; 7:E3-E8. [PMID: 30648133 PMCID: PMC6327752 DOI: 10.1055/a-0752-9755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 05/09/2018] [Indexed: 01/17/2023] Open
Abstract
Background and study aims Failure to recognize the right direction and precise incision length during precutting has been reported. To address these concerns, we developed a marking method that places a marking on the cutting endpoint before starting precutting. This preliminary study aimed to assess the effectiveness and safety of precut sphincterotomy using our new marking method. Patients and methods Between April 2015 and May 2017, 21 patients from our tertiary referral center were included in this study. Precut sphincterotomy using our marking method was employed for difficult common bile duct cannulation cases. Before starting precutting, a marking was placed slightly before the upper margin of the bulge of the papilla in the 11- to 12-o'clock direction as a cutting endpoint by cauterization with a needle knife. Results Technical success was obtained in all 21 procedures. There were no post-endoscopic retrograde cholangiopancreatography (ERCP) complications except for one mild case of post-ERCP pancreatitis. Conclusion Our new marking method before precutting enabled precise incision and quick bile duct cannulation without causing severe complications.
Collapse
Affiliation(s)
- Kazumasa Nagai
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan,Corresponding author Kazumasa Nagai, MD Center for GastroenterologyTeine Keijinkai Hospital1-40, 1-jo 12-chome, MaedaTeine-ku, Sapporo 006-8555Japan+81-11-681-8111+81-11-685-2967
| | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | | | - Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Toshifumi Kin
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| |
Collapse
|
11
|
Ioka T, Ueno M, Ueno H, Park JO, Chang HM, Sasahira N, Kanai M, Chung IJ, Ikeda M, Nakamori S, Mizuno N, Omuro Y, Yamaguchi T, Hara H, Sugimori K, Furuse J, Maguchi H, Furukawa M, Fukuzawa K, Kim JS, Yukisawa S, Takeuchi M, Okusaka T, Boku N, Hyodo I. TAS-118 (S-1 plus leucovorin) versus S-1 in patients with gemcitabine-refractory advanced pancreatic cancer: a randomised, open-label, phase 3 study (GRAPE trial). Eur J Cancer 2018; 106:78-88. [PMID: 30471651 DOI: 10.1016/j.ejca.2018.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 07/12/2018] [Revised: 10/09/2018] [Accepted: 10/11/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND In our previous randomised phase 2 study for patients with gemcitabine-refractory advanced pancreatic cancer, S-1 plus leucovorin improved progression-free survival compared with S-1 alone. Here, we evaluated the efficacy of TAS-118 (S-1 plus leucovorin) versus S-1 in overall survival (OS). PATIENTS AND METHODS This randomised, open-label, phase 3 study was conducted at 58 centres in Japan and Korea. Patients with metastatic pancreatic cancer that progressed during first-line gemcitabine-based chemotherapy or recurred during or after post-operative gemcitabine-based adjuvant treatment were randomly assigned (1:1) to receive either S-1 (40-60 mg, twice daily for 4 weeks in a 6-week cycle) or TAS-118 (S-1 40-60 mg plus leucovorin 25 mg, twice daily for 1 week in a 2-week cycle). The primary end-point was OS. RESULTS A total of 603 patients were randomised, and 300 and 301 patients received TAS-118 and S-1, respectively. There was no difference in OS between groups (median OS for TAS-118 versus S-1, 7.6 months versus 7.9 months; hazard ratio [HR], 0.98 [95% confidence interval (CI), 0.82-1.16]; P = 0.756). Progression-free survival was significantly longer with TAS-118 than S-1 (median, 3.9 months versus 2.8 months; HR, 0.80 [95% CI, 0.67-0.95]; P = 0.009). There were interactions between Japan and Korea (P = 0.004) and between unresectable and recurrent disease (P = 0.025) in OS. Incidence, profile and severity of adverse events were similar between groups. CONCLUSION TAS-118 did not improve OS in patients with gemcitabine-refractory advanced pancreatic cancer compared to S-1. Further studies are needed to find patients who have benefit from adding leucovorin to S-1.
Collapse
Affiliation(s)
- Tatsuya Ioka
- Department of Cancer Survey and Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Makoto Ueno
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama, Japan
| | - Hideki Ueno
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Joon Oh Park
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Heung-Moon Chang
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Naoki Sasahira
- Department of Gastroenterology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Masashi Kanai
- Department of Clinical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - Ik Joo Chung
- Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Masafumi Ikeda
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Shoji Nakamori
- Department of Hepatobiliary and Pancreatic Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Nobumasa Mizuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yasushi Omuro
- Department of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Taketo Yamaguchi
- Department of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - Hiroki Hara
- Department of Gastroenterology, Saitama Cancer Center Hospital, Saitama, Japan
| | - Kazuya Sugimori
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Junji Furuse
- Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Hiroyuki Maguchi
- Center of Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Masayuki Furukawa
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Kengo Fukuzawa
- Department of Surgery, Oita Red Cross Hospital, Oita, Japan
| | - Jun-Suk Kim
- Department of Oncology and Hematology, Korea University Guro Hospital, Seoul, South Korea
| | - Seigo Yukisawa
- Department of Medical Oncology, Tochigi Cancer Center, Utsunomiya, Japan
| | - Masahiro Takeuchi
- Department of Clinical Medicine, School of Pharmacy (Biostatistics), Kitasato University, Tokyo, Japan
| | - Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Narikazu Boku
- Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ichinosuke Hyodo
- Department of Gastroenterology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
| |
Collapse
|
12
|
Abstract
We herein report a 69-year-old man who underwent right nephrectomy 1 year previously to remove renal cell carcinoma (RCC). On our examinations, contrast-enhanced computed tomography revealed a tumor with intensive early enhancement near the cystic duct of the gallbladder. Endoscopic ultrasonography showed a low echoic mass in the cystic duct. We diagnosed the patient's condition as cystic duct metastasis from RCC and performed open cholecystectomy. Histopathology indicated a metastatic tumor of clear cell RCC in the cystic duct wall. In patients with a medical history of RCC, hypervascular lesions suggest the possibility of metastasis. Therefore, detailed imaging examinations should be performed.
Collapse
Affiliation(s)
- Hideaki Koga
- Center for Gastroenterology, Teine-Keijinkai Hospital, Japan
| | - Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Japan
| | | | | | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Japan
| | - Toshifumi Kin
- Center for Gastroenterology, Teine-Keijinkai Hospital, Japan
| | | | - Yuko Omori
- Department of Pathology, Teine-Keijinkai Hospital, Japan
| | | |
Collapse
|
13
|
Maguchi H. [Detection of early pancreatic cancer:past, present and future initiatives]. Nihon Shokakibyo Gakkai Zasshi 2018; 115:317-326. [PMID: 29643284 DOI: 10.11405/nisshoshi.115.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
|
14
|
Kanno A, Masamune A, Hanada K, Maguchi H, Shimizu Y, Ueki T, Hasebe O, Ohtsuka T, Nakamura M, Takenaka M, Kitano M, Kikuyama M, Gabata T, Yoshida K, Sasaki T, Serikawa M, Furukawa T, Yanagisawa A, Shimosegawa T. Multicenter study of early pancreatic cancer in Japan. Pancreatology 2018; 18:61-67. [PMID: 29170051 DOI: 10.1016/j.pan.2017.11.007] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 10/21/2017] [Accepted: 11/16/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES The diagnosis of early-stage pancreatic ductal adenocarcinoma (PDAC) is still challenging. We conducted a multicenter study to clarify the clinical features of early-stage PDAC in Japan. METHODS We collected patients with stage 0 and stage I PDAC according to the sixth edition of the Japanese Classification of Pancreatic Carcinoma. We retrospectively analyzed the clinical profiles including opportunities for medical examination, imaging modalities and findings, methods of cytological diagnosis, and prognosis according to the stages at diagnosis. RESULTS Two hundred cases with Stage 0 and stage I PDAC were reported from 14 institutions, which accounted for approximately 0.7% and 3% of all PDAC cases, respectively. Overall, 20% of the early-stage PDAC cases were symptomatic. Indirect imaging findings such as dilatation of the main pancreatic duct were useful to detect early-stage PDAC. In particular, local fatty changes may be specific to early-stage PDAC. For preoperative pathologic diagnosis, cytology during endoscopic retrograde cholangiopancreatography was more commonly applied than endoscopic ultrasound fine-needle aspiration. Although the overall prognosis was favorable, new PDAC lesions developed in the remnant pancreas in 11.5% cases. CONCLUSIONS This multicenter study revealed several key points concerning the diagnosis and management of early-stage PDAC, including screening of asymptomatic cases, importance of indirect imaging findings, application of cytology during endoscopic retrograde cholangiopancreatography, and the risk of carcinogenesis in the remnant pancreas.
Collapse
Affiliation(s)
- Atsushi Kanno
- Division of Gastroenterology, Tohoku University, Graduate School of Medicine, Japan.
| | - Atsushi Masamune
- Division of Gastroenterology, Tohoku University, Graduate School of Medicine, Japan
| | - Keiji Hanada
- Department of Gastroenterology, JA Onomichi General Hospital, Japan
| | | | - Yasuhiro Shimizu
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Japan
| | - Toshiharu Ueki
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Japan
| | - Osamu Hasebe
- Department of Gastroenterology, Nagano Municipal Hospital, Japan
| | - Takao Ohtsuka
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Masafumi Nakamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Mamoru Takenaka
- Department of Gastroenterology and Hepatology, Kindai University, Faculty of Medicine, Japan
| | - Masayuki Kitano
- Second Department of Internal Medicine, Wakayama Medical University, School of Medicine, Japan
| | | | | | - Koji Yoshida
- Department of Interventional Bilio-Pancreatology, Kawasaki Medical School, Japan
| | - Tamito Sasaki
- Department of Gastroenterology, Hiroshima Prefectural Hospital, Japan
| | - Masahiro Serikawa
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Japan
| | - Toru Furukawa
- Institute for Integrated Medical Sciences, Tokyo Women's Medical University, Japan; Department of Histopathology, Tohoku University, Graduate School of Medicine, Japan
| | - Akio Yanagisawa
- Department of Pathology, Kyoto Prefectural University of Medicine, Japan
| | - Tooru Shimosegawa
- Division of Gastroenterology, Tohoku University, Graduate School of Medicine, Japan
| |
Collapse
|
15
|
Minaga K, Takenaka M, Katanuma A, Kitano M, Yamashita Y, Kamata K, Yamao K, Watanabe T, Maguchi H, Kudo M. Needle Tract Seeding: An Overlooked Rare Complication of Endoscopic Ultrasound-Guided Fine-Needle Aspiration. Oncology 2017; 93 Suppl 1:107-112. [PMID: 29258068 DOI: 10.1159/000481235] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been widely used for diagnosis of both inflammatory and tumor lesions located in and adjacent to the gastrointestinal tract. EUS-FNA has been considered to be a safe technique with few complications, as shown in recent review articles in which EUS-FNA-related morbidity and mortality rates were reported to be <1%. It should be noted, however, that needle tract seeding, although uncommon, can occur after diagnostic EUS-FNA and that this complication affects the prognosis of patients. Although an accurate value for the frequency of needle tract seeding caused by EUS-FNA has not been reported, the numbers of case reports on needle tract seeding have been rapidly increasing, especially in Japan. These case reports regarding EUS-FNA-related needle tract seeding prompted us to reevaluate the safety of EUS-FNA because this complication may have a significant influence on patients' prognoses. In this review, we summarize the clinical features and outcomes of needle tract seeding after EUS on the basis of the previously reported cases and provide useful information to prevent and reduce this serious complication.
Collapse
Affiliation(s)
- Kosuke Minaga
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Hijioka S, Hosoda W, Matsuo K, Ueno M, Furukawa M, Yoshitomi H, Kobayashi N, Ikeda M, Ito T, Nakamori S, Ishii H, Kodama Y, Morizane C, Okusaka T, Yanagimoto H, Notohara K, Taguchi H, Kitano M, Yane K, Maguchi H, Tsuchiya Y, Komoto I, Tanaka H, Tsuji A, Hashigo S, Kawaguchi Y, Mine T, Kanno A, Murohisa G, Miyabe K, Takagi T, Matayoshi N, Yoshida T, Hara K, Imamura M, Furuse J, Yatabe Y, Mizuno N. Rb Loss and KRAS Mutation Are Predictors of the Response to Platinum-Based Chemotherapy in Pancreatic Neuroendocrine Neoplasm with Grade 3: A Japanese Multicenter Pancreatic NEN-G3 Study. Clin Cancer Res 2017; 23:4625-4632. [PMID: 28455360 DOI: 10.1158/1078-0432.ccr-16-3135] [Citation(s) in RCA: 127] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/19/2017] [Accepted: 04/24/2017] [Indexed: 02/06/2023]
Abstract
Purpose: Patients with pancreatic neuroendocrine neoplasm grade-3 (PanNEN-G3) show variable responses to platinum-based chemotherapy. Recent studies indicated that PanNEN-G3 includes well-differentiated neuroendocrine tumor with G3 (NET-G3). Here, we examined the clinicopathologic and molecular features of PanNEN-G3 and assessed the responsiveness to chemotherapy and survival.Experimental Design: A total of 100 patients with PanNEN-G3 were collected from 31 institutions, and after central review characteristics of each histologic subtype [NET-G3 vs. pancreatic neuroendocrine carcinoma (NEC-G3)] were analyzed, including clinical, radiological, and molecular features. Factors that correlate with response to chemotherapy and survival were assessed.Results: Seventy patients analyzed included 21 NETs-G3 (30%) and 49 NECs-G3 (70%). NET-G3 showed lower Ki67-labeling index (LI; median 28.5%), no abnormal Rb expression (0%), and no mutated KRAS (0%), whereas NEC-G3 showed higher Ki67-LI (median 80.0%), Rb loss (54.5%), and KRAS mutations (48.7%). Chemotherapy response rate (RR), platinum-based chemotherapy RR, and prognosis differed significantly between NET-G3 and NEC-G3. Chemotherapeutic outcomes were worse in NET-G3 (P < 0.001). When we stratified PanNEN-G3 with Rb and KRAS, PanNENs-G3 with Rb loss and those with mutated KRAS showed significantly higher RRs to platinum-based chemotherapy than those without (Rb loss, 80% vs. normal Rb, 24%, P = 0.006; mutated KRAS, 77% versus wild type, 23%, P = 0.023). Rb was a predictive marker of response to platinum-based chemotherapy even in NEC-G3 (P = 0.035).Conclusions: NET-G3 and NEC-G3 showed distinct clinicopathologic characteristics. Notably, NET-G3 does not respond to platinum-based chemotherapy. Rb and KRAS are promising predictors of response to platinum-based chemotherapy for PanNEN-G3, and Rb for NEC-G3. Clin Cancer Res; 23(16); 4625-32. ©2017 AACR.
Collapse
Affiliation(s)
- Susumu Hijioka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan.
| | - Waki Hosoda
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Keitaro Matsuo
- Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Makoto Ueno
- Division of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Masayuki Furukawa
- Department of Hepato-Biliary-Pancreatology, National Kyushu Cancer Center, Fukuoka, Japan
| | - Hideyuki Yoshitomi
- Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Masafumi Ikeda
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tetsuhide Ito
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shoji Nakamori
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka National Hospital, Osaka, Japan
| | - Hiroshi Ishii
- Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yuzo Kodama
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto
| | - Chigusa Morizane
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Kenji Notohara
- Department of Anatomic Pathology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Hiroki Taguchi
- Digestive and Lifestyle Diseases, Department of Human and Environmental Sciences, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Masayuki Kitano
- Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Sayama, Japan
| | - Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Yoshiaki Tsuchiya
- Department of Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Izumi Komoto
- Department of Surgery, Kansai Electric Power Hospital, Osaka, Japan
| | - Hiroki Tanaka
- Department of Gastroenterology, Suzuka General Hospital, Suzuka, Japan
| | - Akihito Tsuji
- Department of Medical Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Syunpei Hashigo
- Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yoshiaki Kawaguchi
- Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Tetsuya Mine
- Department of Gastroenterology, Tokai University School of Medicine, Isehara, Japan
| | - Atsushi Kanno
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Go Murohisa
- Department of Gastroenterology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Katsuyuki Miyabe
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tadayuki Takagi
- Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Nobutaka Matayoshi
- Department of Surgery I, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tsukasa Yoshida
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Kazuo Hara
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masayuki Imamura
- Department of Neuroendocrine Tumor Center, Kansai Electric Power Hospital, Osaka, Japan
| | - Junji Furuse
- Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Yasushi Yatabe
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Nobumasa Mizuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| |
Collapse
|
17
|
Tanaka K, Tsuji K, Matsui T, Kang JH, Sakurai Y, Takiyama A, Shinohara T, Maguchi H. A case of extrahepatic growth-type hepatocellular carcinoma presenting with bleeding from colonic metastasis. Nihon Shokakibyo Gakkai Zasshi 2017; 114:691-699. [PMID: 28381784 DOI: 10.11405/nisshoshi.114.691] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A 60-year-old woman visited our hospital due to hematochezia. Colonoscopy revealed a 50-mm-diameter submucosal tumor with ulceration of the left side of the transverse colon, and magnetic resonance imaging (MRI) demonstrated the presence of small hepatic nodules. Submucosal tumor of the colon with liver metastasis was therefore diagnosed. To prevent tumor bleeding, we performed partial transverse colectomy. The histopathological diagnosis was moderately differentiated hepatocellular carcinoma presenting as a submucosal tumor with a high frequency of vascular invasion. Computed tomography (CT) angiography revealed a 40-mm-diameter confluent multinodular-type hepatocellular carcinoma with outward spread from segment II and multiple intrahepatic metastases. Our final diagnosis was hepatocellular carcinoma with hematogenous colon metastasis.
Collapse
|
18
|
Yane K, Katanuma A, Maguchi H, Takahashi K, Kin T. Reply to Moreels et al. Endoscopy 2017; 49:406. [PMID: 28351108 DOI: 10.1055/s-0043-101232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Kuniyuki Takahashi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Toshifumi Kin
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| |
Collapse
|
19
|
Yamaue H, Shimizu A, Hagiwara Y, Sho M, Yanagimoto H, Nakamori S, Ueno H, Ishii H, Kitano M, Sugimori K, Maguchi H, Ohkawa S, Imaoka H, Hashimoto D, Ueda K, Nebiki H, Nagakawa T, Isayama H, Yokota I, Ohashi Y, Shirasaka T. Multicenter, randomized, open-label Phase II study comparing S-1 alternate-day oral therapy with the standard daily regimen as a first-line treatment in patients with unresectable advanced pancreatic cancer. Cancer Chemother Pharmacol 2017; 79:813-823. [PMID: 28251282 DOI: 10.1007/s00280-017-3250-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 02/01/2017] [Indexed: 01/08/2023]
Abstract
PURPOSE Non-inferiority for overall survival (OS) following alternate-day treatment with the oral anticancer drug S-1 compared with standard daily treatment was assessed in Japanese patients with unresectable advanced pancreatic cancer in a multicenter, randomized, phase II study. This trial was registered at the UMIN Clinical Trials Registry (no. 000008604). METHODS Chemotherapy-naïve patients with locally advanced or metastatic pancreatic cancer were randomly assigned 2:1 to treatment with alternate-day (twice daily on alternate days from days 1 through 42 of a 42-day cycle) or daily (twice daily on days 1 through 28 of a 42-day cycle) treatment with S-1. The primary endpoint was OS. Secondary endpoints were progression-free survival (PFS), time to treatment failure, response rate, quality of life assessments, and safety. RESULTS A total of 190 patients were enrolled, of which 185 were included in the final analysis (alternate-day: 121; daily: 64). Median OS was 9.4 for the alternate-day group and 10.4 months for the daily group [hazard ratio (HR), 1.19; 95% credible interval, 0.86 to 1.64], indicating that non-inferiority of alternate-day treatment to daily treatment was not demonstrated. Median PFS was 3.0 for the alternate-day group and 4.2 months for the daily group (HR, 1.65; 95% credible interval, 1.20-2.29). The incidence of anorexia, fatigue, neutrophils, pigmentation, and pneumonitis was lower in alternate-day treatment compared with daily treatment. CONCLUSION S-1 for advanced pancreatic cancer should be taken daily as recommended, based on the decreased OS and PFS and marginal improvement in safety observed in the alternate-day group.
Collapse
Affiliation(s)
- Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama, 641-8510, Japan.
| | - Atsushi Shimizu
- Second Department of Surgery, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama, 641-8510, Japan
| | - Yasuhiro Hagiwara
- Department of Biostatistics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Hiroaki Yanagimoto
- Department of Surgery, Kansai Medical University, 2-5-1, Shin-machi, Hirakata, 573-1010, Japan
| | - Shoji Nakamori
- Department of Surgery, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan
| | - Hideki Ueno
- National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hiroshi Ishii
- Clinical Research Center, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto-machi, Matsuyama City, Ehime, 791-0280, Japan
| | - Masayuki Kitano
- Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan
| | - Kazuya Sugimori
- Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, 1-40 Maeda 1-jo 12-chome, Teine-ku, Sapporo, 006-8555, Japan
| | - Shinichi Ohkawa
- Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Hiroshi Imaoka
- Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan
| | - Daisuke Hashimoto
- Department of Gastroenterological Surgery, Kumamoto University Hospital, 1-1-1 Honjo, Kumamoto, 860-8556, Japan
| | - Kazuki Ueda
- Second Department of Internal Medicine y, Wakayama Medical University, School of Medicine, 811-1, Kimiidera, Wakayama, 641-8510, Japan
| | - Hiroko Nebiki
- Department of Gastroenterology, Osaka City General Hospital, 2-13-22 Miyakojima-hondori Miyakojima-ku, Osaka, 543-0021, Japan
| | - Tatsuya Nagakawa
- Department of Gastroenterology, Hokkaido P.W.F.A.C. Sapporo-Kosei General Hospital, 8-5 Kita 2 Jou Higashi, Chuo-ku, Sapporo, 060-0033, Japan
| | - Hiroyuki Isayama
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Isao Yokota
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yasuo Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, 1-13-27 Kasuga, Bunkyo-ku, Tokyo, 112-8551, Japan
| | - Tetsuhiko Shirasaka
- Kitasato Institute for Life Science, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan
| |
Collapse
|
20
|
Kanno S, Nosho K, Ishigami K, Yamamoto I, Koide H, Kurihara H, Mitsuhashi K, Shitani M, Motoya M, Sasaki S, Tanuma T, Maguchi H, Hasegawa T, Kimura Y, Takemasa I, Shinomura Y, Nakase H. MicroRNA-196b is an independent prognostic biomarker in patients with pancreatic cancer. Carcinogenesis 2017; 38:425-431. [DOI: 10.1093/carcin/bgx013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
|
21
|
Okusaka T, Miyakawa H, Fujii H, Nakamori S, Satoh T, Hamamoto Y, Ito T, Maguchi H, Matsumoto S, Ueno H, Ioka T, Boku N, Egawa S, Hatori T, Furuse J, Mizumoto K, Ohkawa S, Yamaguchi T, Yamao K, Funakoshi A, Chen JS, Cheng AL, Sato A, Ohashi Y, Tanaka M. Updated results from GEST study: a randomized, three-arm phase III study for advanced pancreatic cancer. J Cancer Res Clin Oncol 2017; 143:1053-1059. [PMID: 28210843 PMCID: PMC5427167 DOI: 10.1007/s00432-017-2349-y] [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: 10/05/2016] [Accepted: 01/24/2017] [Indexed: 01/05/2023]
Abstract
PURPOSE The GEST study showed non-inferiority of S-1 but not superiority of gemcitabine plus S-1 (GS) to gemcitabine alone for overall survival with the data by the cut-off date of 31st July in 2010 for chemo-naïve patients with advanced pancreatic cancer. We considered it important to determine whether S-1 maintains non-inferiority after a long-term follow-up in the GEST study and to obtain a firm positive conclusion. In addition, it may be an interesting challenge to explore the efficacious profile of GS in the long-term follow-up study. Using the data from the follow-up period, background and efficacy in patients from Taiwan and Japan, as well as the rates of tumor shrinkage in locally advanced and metastatic patients (Waterfall plot) were also analyzed. METHODS The results of the primary analysis were reconfirmed, and subset analysis of overall survival and progression-free survival was performed based on the overall survival data updated by the cut-off date of 31st July in 2011. RESULTS The median follow-up period was 29.8 months, and 795 deaths occurred (95.6%). The median overall survival was 8.8 months for gemcitabine, 9.7 months for S-1 (hazard ratio [HR], 0.96; 97.5% confidence interval [CI], 0.79-1.17), and 9.9 months for GS (HR 0.91; 97.5% CI 0.75-1.11). In patients with performance status (PS) 0, the median overall survival was 9.8 months for gemcitabine, 10.9 months for S-1, and 10.5 months for GS. In patients with PS 1, the median overall survival was 6.2 months for gemcitabine, 6.3 months for S-1, and 9.6 months for GS. CONCLUSION Our survey reconfirmed the non-inferiority of S-1 to gemcitabine and showed S-1 can be used as one of the standard treatment options for advanced pancreatic cancer. TRIAL REGISTRATION ClinicalTrials.gov: NCT00498225.
Collapse
Affiliation(s)
- Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - H Miyakawa
- Division of Biliopancreatology, Sapporo Kosei General Hospital, Sapporo, Japan
| | - H Fujii
- Division of Clinical Oncology, Jichi Medical University, Tochigi, Japan
| | - S Nakamori
- Hepato-Biliary-Pancreatic Surgery, Osaka National Hospital, Osaka, Japan
| | - T Satoh
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Hamamoto
- Keio Cancer Center, Keio University Hospital, Tokyo, Japan
| | - T Ito
- Department of Medicine and Bioreguratory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - H Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - S Matsumoto
- Department of Medical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - H Ueno
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - T Ioka
- Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - N Boku
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - S Egawa
- Department of Surgery, Tohoku University, Sendai, Japan
| | - T Hatori
- Department of Surgery and Digestive Diseases Center, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - J Furuse
- Department of Medical Oncology, Kyorin University School of Medicine, Tokyo, Japan
| | - K Mizumoto
- Kyushu University Hospital Cancer Center, Fukuoka, Japan
| | - S Ohkawa
- Division of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - T Yamaguchi
- Department of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - K Yamao
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - A Funakoshi
- Division of Pancreatology, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - J S Chen
- Division of Hematology-Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan, Republic of China
| | - A L Cheng
- Department of Oncology, National Taiwan University Hospital, and National Taiwan University Cancer Center, Taipei, Taiwan, Republic of China
| | - A Sato
- Department of Medical Oncology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Y Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan
| | - M Tanaka
- Department of Surgery, Shimonoseki City Hospital, Shimonoseki, Japan
| |
Collapse
|
22
|
Miyazawa M, Katsuda M, Maguchi H, Katanuma A, Ishii H, Ozaka M, Yamao K, Imaoka H, Kawai M, Hirono S, Okada KI, Yamaue H. Phase II clinical trial using novel peptide cocktail vaccine as a postoperative adjuvant treatment for surgically resected pancreatic cancer patients. Int J Cancer 2017; 140:973-982. [PMID: 27861852 DOI: 10.1002/ijc.30510] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 10/24/2016] [Indexed: 12/18/2022]
Abstract
We investigated peptide cocktail vaccine OCV-C01 containing epitope peptides derived from KIF20A, vascular endothelial growth factor receptor (VEGFR)1 and VEGFR2 combined with gemcitabine in the adjuvant treatment for resected pancreatic cancer patients. A single-arm multicenter phase II study was performed on 30 patients with pancreatic ductal carcinoma who underwent pancreatectomy. At each 28-day treatment cycle, patients received weekly subcutaneous injection of OCV-C01 for 48 weeks and gemcitabine was administered intravenously at 1,000 mg/m2 on days 1, 8 and 15 for 24 weeks. Patients were followed for 18 months. The primary endpoint was disease-free survival (DFS) and secondary endpoints included safety, overall survival (OS) and immunological assays on peptide-specific cytotoxic T lymphocyte (CTL) activity and KIF20A expression in resected pancreatic cancer. The median DFS was 15.8 months [95% confidence interval (CI), 11.1-20.6] and the DFS rate at 18 months was 34.6% (95% CI, 18.3-51.6). The median OS was not reached and the OS rate at 18 months was 69.0% (95% CI, 48.8-82.5). The administration of OCV-C01 was well tolerated. In the per protocol set, there were significant differences in DFS between patients with KIF20A-specific CTL responses and without (p = 0.027), and between patients with KIF20A expression and without (p = 0.014). In addition, all four patients who underwent R0 resection with KIF20A expression had no recurrence of pancreatic cancer with KIF20A-specific CTL responses. OCV-C01 combined with gemcitabine was tolerable with a median DFS of 15.8 months, which was favorable compared with previous data for resected pancreatic cancer.
Collapse
Affiliation(s)
- Motoki Miyazawa
- Second Department of Surgery, Wakayama Medical University School of Medicine, Japan
| | - Masahiro Katsuda
- Second Department of Surgery, Wakayama Medical University School of Medicine, Japan
| | | | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Japan
| | - Hiroshi Ishii
- Department of Gastroenterology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Japan
| | - Masato Ozaka
- Department of Gastroenterology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Japan
| | - Kenji Yamao
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | - Hiroshi Imaoka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | - Manabu Kawai
- Second Department of Surgery, Wakayama Medical University School of Medicine, Japan
| | - Seiko Hirono
- Second Department of Surgery, Wakayama Medical University School of Medicine, Japan
| | - Ken-Ichi Okada
- Second Department of Surgery, Wakayama Medical University School of Medicine, Japan
| | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University School of Medicine, Japan
| |
Collapse
|
23
|
Matsubayashi H, Takaori K, Morizane C, Maguchi H, Mizuma M, Takahashi H, Wada K, Hosoi H, Yachida S, Suzuki M, Usui R, Furukawa T, Furuse J, Sato T, Ueno M, Kiyozumi Y, Hijioka S, Mizuno N, Terashima T, Mizumoto M, Kodama Y, Torishima M, Kawaguchi T, Ashida R, Kitano M, Hanada K, Furukawa M, Kawabe K, Majima Y, Shimosegawa T. Familial pancreatic cancer: Concept, management and issues. World J Gastroenterol 2017; 23:935-948. [PMID: 28246467 PMCID: PMC5311103 DOI: 10.3748/wjg.v23.i6.935] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 09/07/2016] [Accepted: 01/18/2017] [Indexed: 02/06/2023] Open
Abstract
Familial pancreatic cancer (FPC) is broadly defined as two first-degree-relatives with pancreatic cancer (PC) and accounts for 4%-10% of PC. Several genetic syndromes, including Peutz-Jeghers syndrome, hereditary pancreatitis, hereditary breast-ovarian cancer syndrome (HBOC), Lynch syndrome, and familial adenomatous polyposis (FAP), also have increased risks of PC, but the narrowest definition of FPC excludes these known syndromes. When compared with other familial tumors, proven genetic alterations are limited to a small proportion (< 20%) and the familial aggregation is usually modest. However, an ethnic deviation (Ashkenazi Jewish > Caucasian) and a younger onset are common also in FPC. In European countries, “anticipation” is reported in FPC families, as with other hereditary syndromes; a trend toward younger age and worse prognosis is recognized in the late years. The resected pancreases of FPC kindred often show multiple pancreatic intraepithelial neoplasia (PanIN) foci, with various K-ras mutations, similar to colorectal polyposis seen in the FAP patients. As with HBOC patients, a patient who is a BRCA mutation carrier with unresectable pancreatic cancer (accounting for 0%-19% of FPC patients) demonstrated better outcome following platinum and Poly (ADP-ribose) polymerase inhibitor treatment. Western countries have established FPC registries since the 1990s and several surveillance projects for high-risk individuals are now ongoing to detect early PCs. Improvement in lifestyle habits, including non-smoking, is recommended for individuals at risk. In Japan, the FPC study group was initiated in 2013 and the Japanese FPC registry was established in 2014 by the Japan Pancreas Society.
Collapse
|
24
|
Nagai K, Yane K, Katanuma A, Takahashi K, Kin T, Yamazaki H, Maguchi H. Successful less-invasive endoscopic treatment for bile leakage from choledochojejunostomy site using short-type single-balloon enteroscopy. Endoscopy 2017; 48 Suppl 1:E140-1. [PMID: 27078628 DOI: 10.1055/s-0042-105208] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Kazumasa Nagai
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | | | - Toshifumi Kin
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Hajime Yamazaki
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| |
Collapse
|
25
|
Koga H, Katanuma A, Kin T, Yane K, Maguchi H. Successful removal of a surgical clip eroded into the hepaticojejunostomy site by use of a short-type single-balloon enteroscope. VideoGIE 2017; 2:14-15. [PMID: 29905247 PMCID: PMC5990422 DOI: 10.1016/j.vgie.2016.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Hideaki Koga
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Toshifumi Kin
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| |
Collapse
|
26
|
Yane K, Katanuma A, Maguchi H, Takahashi K, Kin T, Ikarashi S, Sano I, Yamazaki H, Kitagawa K, Yokoyama K, Koga H, Nagai K, Nojima M. Short-type single-balloon enteroscope-assisted ERCP in postsurgical altered anatomy: potential factors affecting procedural failure. Endoscopy 2017; 49:69-74. [PMID: 27760436 DOI: 10.1055/s-0042-118301] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background and study aims Short-type single-balloon enteroscope (short SBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) is a promising alternative treatment in postsurgical altered anatomy. However, it is technically demanding, and factors affecting its technical difficulty have not yet been clarified. This study aimed to examine the procedural success rate of short SBE-assisted ERCP and the potential factors affecting procedural failure. Patients and methods A total of 117 consecutive patients (203 procedures) with surgically altered anatomy underwent ERCP using prototype short SBEs. The procedural success rate of short SBE-assisted ERCP and the potential factors affecting procedural failure were examined retrospectively. Results The enteroscopy success rate and procedural success rate were 92.6 % (95 % confidence interval [CI] 88.1 % - 95.8 %) and 81.8 % (95 %CI 75.8 % - 86.8 %), respectively. Multivariate analyses indicated that pancreatic indication (odds ratio [OR] 4.35, 95 %CI 1.67 - 11.4), first ERCP attempt (OR 6.03, 95 %CI 2.17 - 16.8), and no transparent hood (OR 4.61, 95 %CI 1.48 - 14.3) were potential risk factors for procedural failure. Conclusions Short SBE-assisted ERCP was effective in postsurgical altered anatomy. This large case series suggested the potential factors affecting procedural failure.
Collapse
Affiliation(s)
- Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Kuniyuki Takahashi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Toshifumi Kin
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Satoshi Ikarashi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Itsuki Sano
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Hajime Yamazaki
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Koh Kitagawa
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Kensuke Yokoyama
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Hideaki Koga
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Kazumasa Nagai
- Center for Gastroenterology, Teine-Keijinkai Hospital, Teine-ku, Sapporo, Japan
| | - Masanori Nojima
- Center for Translational Research, Institute of Medical Science Hospital, University of Tokyo, Tokyo, Japan
| |
Collapse
|
27
|
Sano I, Katanuma A, Yane K, Kin T, Nagai K, Yamazaki H, Koga H, Kitagawa K, Yokoyama K, Ikarashi S, Takahashi K, Maguchi H, Omori Y, Shinohara T. Pancreatic Metastasis from Rectal Cancer that was Diagnosed by Endoscopic Ultrasonography-guided Fine Needle Aspiration (EUS-FNA). Intern Med 2017; 56:301-305. [PMID: 28154274 PMCID: PMC5348454 DOI: 10.2169/internalmedicine.56.7213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Pancreatic metastasis from colorectal cancer is rare, and there have been only a few reports of its preoperative diagnosis by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) with immunohistochemical staining. We herein describe the case of a 77-year-old woman in whom a solitary mass in the pancreatic tail was detected 11 years after rectal cancer resection. The patient also had a history of pulmonary tumor resection. We performed EUS-FNA and a histopathological examination showed adenocarcinoma with CD20+, CD7-, and CDX2+ (similar to her rectal cancer). EUS-FNA enabled a histopathological examination, including immunohistochemical staining, which helped to confirm the diagnosis of pancreatic and pulmonary metastasis from rectal cancer.
Collapse
Affiliation(s)
- Itsuki Sano
- Center for Gastroenterology, Teine-Keijinkai Hospital, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Yamazaki H, Tsuboya T, Katanuma A, Kodama Y, Tauchi S, Dohke M, Maguchi H. Lack of Independent Association Between Fatty Pancreas and Incidence of Type 2 Diabetes: 5-Year Japanese Cohort Study. Diabetes Care 2016; 39:1677-83. [PMID: 27422578 DOI: 10.2337/dc16-0074] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 06/25/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Previous cross-sectional studies have shown that attenuation in the pancreas seen on unenhanced computed tomography (CT) scans was inversely correlated with histologic pancreatic fat, and that fatty pancreas was associated with type 2 diabetes mellitus (T2DM). However, no longitudinal study has evaluated whether fatty pancreas increases the incidence of T2DM. We conducted a cohort study to investigate the association between fatty pancreas and the incidence of T2DM. RESEARCH DESIGN AND METHODS A total of 813 participants without diabetes underwent health checks by unenhanced CT scanning in 2008 and 2009, and were observed for a median follow-up period of 5.06 (interquartile range 3.01-5.92) years. Attenuation in three regions of the pancreas seen on an unenhanced CT scan was measured, and the mean pancreatic attenuation was calculated to evaluate fatty pancreas at baseline; the more severe the fatty pancreas, the lower the mean pancreatic attenuation. The incident T2DM hazard ratios (HRs) for the association between fatty pancreas and T2DM incidence were estimated by Cox proportional hazards models adjusted for age, sex, BMI, liver attenuation seen on unenhanced CT scan, and alcohol intake of ≥20 g/day. RESULTS T2DM occurred in 62 participants (7.6%) during the follow-up period. The higher pancreas attenuation (i.e., less pancreatic fat) at baseline was associated with decreased T2DM incidence in a univariate analysis (crude HR 0.97 [95% CI 0.96-0.99]); and fatty pancreas (lower pancreas attenuation) was positively associated with increased T2DM incidence. However, the association was substantially explained by the confounders (multivariate HR 1.00 [95% CI 0.98-1.02]). CONCLUSIONS Fatty pancreas was not independently associated with future T2DM.
Collapse
Affiliation(s)
- Hajime Yamazaki
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Toru Tsuboya
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Akio Katanuma
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Yoshihisa Kodama
- Department of Radiology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Shinichi Tauchi
- Department of Radiology, Keijinkai Maruyama Clinic, Sapporo, Japan
| | - Mitsuru Dohke
- Department of Health Checkup and Promotion, Keijinkai Maruyama Clinic, Sapporo, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| |
Collapse
|
29
|
Maguchi H, Katanuma A, Takahashi K. The differences between intrahepatic cholangiocarcinoma and hilar cholangiocarcinoma -from diagnosis and biliary drainage points of view. Nihon Shokakibyo Gakkai Zasshi 2016; 113:1533-40. [PMID: 27593362 DOI: 10.11405/nisshoshi.113.1533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
30
|
Katanuma A, Maguchi H, Yane K, Kin T, Ikarashi S, Yamazaki H, Kitagawa K, Koga H, Yokoyama K, Sano I, Nagai K, Takahashi K. [Current advancement of balloon-enteroscopy-assisted ERCP]. Nihon Shokakibyo Gakkai Zasshi 2016; 113:603-13. [PMID: 27052390 DOI: 10.11405/nisshoshi.113.603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Akio Katanuma
- Center for Gastroenterology, Teine-Kenjinkai Hospital
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Kitagawa K, Katanuma A, Yane K, Kin T, Maguchi H. Tornado effect: accidental removal of a biliary metallic stent on winding around a stent retriever. Gastrointest Endosc 2016; 83:1289-90. [PMID: 26713874 DOI: 10.1016/j.gie.2015.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 12/14/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Koh Kitagawa
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Toshifumi Kin
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| |
Collapse
|
32
|
Sho M, Shimizu A, Yanagimoto H, Nakamori S, Okusaka T, Ishii H, Kitano M, Sugimori K, Maguchi H, Ohkawa S, Imaoka H, Hashimoto D, Ueda K, Nebiki H, Nagakawa T, Isayama H, Hagiwara Y, Ohashi Y, Shirasaka T, Yamaue H. Multicenter randomized phase II study comparing alternate-day oral therapy using S-1 with the standard regimen as a first-line treatment for patients with locally advanced and metastatic pancreatic cancer: PAN-01 study. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.4107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Masayuki Sho
- Department of Surgery, Nara Medical University, Kashihara, Japan
| | - Atsushi Shimizu
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | | | - Shoji Nakamori
- Department of Hepatobiliary and Pancreatic Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Ishii
- National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Masayuki Kitano
- Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Japan
| | - Kazuya Sugimori
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Shinichi Ohkawa
- Division of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Hiroshi Imaoka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Daisuke Hashimoto
- Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Kazuki Ueda
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiroko Nebiki
- Department of Gastroenterology, Osaka City General Hospital, Osaka, Japan
| | - Tatsuya Nagakawa
- Second Department of Gastroenterology, Hokkaido P.W.F.A.C. Sapporo-Kosei General Hospital, Hokkaido, Japan
| | - Hiroyuki Isayama
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuhiro Hagiwara
- Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Yasuo Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan
| | | | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| |
Collapse
|
33
|
Yamaue H, Miyazawa M, Katsuda M, Maguchi H, Ishii H, Yamao K, Kawai M, Hirono S, Okada KI, Shimizu A, Kitahata Y. Phase II clinical trial using novel peptide vaccine cocktail as a postoperative adjuvant treatment for surgically resected pancreatic cancer patients. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e14587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Motoki Miyazawa
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Masahiro Katsuda
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Hiroshi Ishii
- National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | | | - Manabu Kawai
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Seiko Hirono
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Ken-Ichi Okada
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Atsushi Shimizu
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Yuji Kitahata
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| |
Collapse
|
34
|
Karasaki H, Ono Y, Koizumi K, Andoh K, Asahara S, Yokochi T, Takahashi K, Maguchi H, Yamada M, Ogata M, Sugitani A, Kono T, Nagashima K, Mizukami Y. Cell-free DNA genotyping using digital PCR for early detection of pancreatic neoplasm. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.4_suppl.tps464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS464 Background: Pancreatic ductal adenocarcinoma (PDA) is still a dismal disease, and there is an urgent need to establish novel tool for early diagnosis of the tumor. There are two main types of pathologically and genetically distinct precursors for PDA — pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasia (IPMN). Non-invasive markers for these precursor lesions have the potential to predict subsequent invasive tumor. Methods: Circulating cell-free DNA (cfDNA) released from tumor cells into the blood has been intensively studied as a novel way to monitor the genetic changes. To detect the cfDNA representing for the initiation and progression of PDA could be of the candidate for them. The role of cfDNA genotyping targeting the major driver mutations in these precursors, such as KRAS and GNAS, are currently under investigation in Japanese patients who have pancreatic tumors (UMIN000012810). The major technical challenge is to specifically detect the small fraction of tumor-derived DNA in patient plasma and urine. Since sequencing of target mutant alleles in cfDNA has a limitation to detect very low frequency variants, we sought to establish protocols for super-sensitive and absolute quantification of the “key drivers” for pancreatic tumor using a droplet digital PCR platform (Bio-Rad; QX200). The primary endpoint of this multi-center prospective analysis is to evaluate whether such an approach can appropriately monitor the risk of IPMN progression and detect localized early-stage PDA. Thirty cases of PDA and 90 cases of IPMN have been enrolled thus far. Detailed protocol for the study and improved technical points to quantify low-frequency variants will be discussed.
Collapse
Affiliation(s)
- Hidenori Karasaki
- Center for Clinical and Biomedical Research, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Yusuke Ono
- Center for Clinical and Biomedical Research, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | | | | | | | | | | | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Masataka Yamada
- Department of Gastroenterology, Sibetsu City Hospital, Sibetsu, Japan
| | - Munehiko Ogata
- Center for Clinical and Biomedical Research, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Ayumu Sugitani
- Center for Clinical and Biomedical Research, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Toru Kono
- Center for Clinical and Biomedical Research, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Kazuo Nagashima
- Center for Clinical and Biomedical Research, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Yusuke Mizukami
- Center for Clinical and Biomedical Research, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| |
Collapse
|
35
|
Mitsuhashi K, Nosho K, Sukawa Y, Matsunaga Y, Ito M, Kurihara H, Kanno S, Igarashi H, Naito T, Adachi Y, Tachibana M, Tanuma T, Maguchi H, Shinohara T, Hasegawa T, Imamura M, Kimura Y, Hirata K, Maruyama R, Suzuki H, Imai K, Yamamoto H, Shinomura Y. Association of Fusobacterium species in pancreatic cancer tissues with molecular features and prognosis. Oncotarget 2016; 6:7209-20. [PMID: 25797243 PMCID: PMC4466679 DOI: 10.18632/oncotarget.3109] [Citation(s) in RCA: 235] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 01/08/2015] [Indexed: 01/17/2023] Open
Abstract
Recently, bacterial infection causing periodontal disease has attracted considerable attention as a risk factor for pancreatic cancer. Fusobacterium species is an oral bacterial group of the human microbiome. Some evidence suggests that Fusobacterium species promote colorectal cancer development; however, no previous studies have reported the association between Fusobacterium species and pancreatic cancer. Therefore, we examined whether Fusobacterium species exist in pancreatic cancer tissue. Using a database of 283 patients with pancreatic ductal adenocarcinoma (PDAC), we tested cancer tissue specimens for Fusobacterium species. We also tested the specimens for KRAS, NRAS, BRAF and PIK3CA mutations and measured microRNA-21 and microRNA-31. In addition, we assessed epigenetic alterations, including CpG island methylator phenotype (CIMP). Our data showed an 8.8% detection rate of Fusobacterium species in pancreatic cancers; however, tumor Fusobacterium status was not associated with any clinical and molecular features. In contrast, in multivariate Cox regression analysis, compared with the Fusobacterium species-negative group, we observed significantly higher cancer-specific mortality rates in the positive group (p = 0.023). In conclusion, Fusobacterium species were detected in pancreatic cancer tissue. Tumor Fusobacterium species status is independently associated with a worse prognosis of pancreatic cancer, suggesting that Fusobacterium species may be a prognostic biomarker of pancreatic cancer.
Collapse
Affiliation(s)
- Kei Mitsuhashi
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Katsuhiko Nosho
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yasutaka Sukawa
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Yasutaka Matsunaga
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Miki Ito
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiroyoshi Kurihara
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shinichi Kanno
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hisayoshi Igarashi
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takafumi Naito
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yasushi Adachi
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Mami Tachibana
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tokuma Tanuma
- Department of Gastroenterology, Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan.,Department of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Hiroyuki Maguchi
- Department of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | | | - Tadashi Hasegawa
- Department of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masafumi Imamura
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yasutoshi Kimura
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Koichi Hirata
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Reo Maruyama
- Department of Molecular Biology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiromu Suzuki
- Department of Molecular Biology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kohzoh Imai
- The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Yamamoto
- Department of Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yasuhisa Shinomura
- Department of Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kawasaki, Japan
| |
Collapse
|
36
|
Kimura Y, Tsuji K, Matsui T, Tanaka K, Kang JH, Yoshino Y, Kodama Y, Sakurai Y, Maguchi H, Nakashima O. A case of synchronous double cancer of liver metastasis of thymoma and hepatocellular carcinomas, 10 years after achieving sustained virological response treated with peginterferon/ribavirin in chronic hepatitis C virus infection. ACTA ACUST UNITED AC 2016. [DOI: 10.2957/kanzo.57.252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yushi Kimura
- Center for Gastroenterology, Teine Keijinkai Hospital
| | | | | | | | - Jong-Hon Kang
- Center for Gastroenterology, Teine Keijinkai Hospital
| | - Yuki Yoshino
- Center for Gastroenterology, Teine Keijinkai Hospital
| | | | - Yasuo Sakurai
- Center for Gastroenterology, Teine Keijinkai Hospital
| | | | - Osamu Nakashima
- Department of Clinical Laboratory Medicine, Kurume University Hospital
| |
Collapse
|
37
|
Matsumoto K, Katanuma A, Maguchi H, Takahashi K, Osanai M, Yane K, Kin T, Takaki R, Matsumori T, Gon K, Tomonari A, Nojima M. Performance of novel tissue harmonic echo imaging using endoscopic ultrasound for pancreatic diseases. Endosc Int Open 2016; 4:E42-50. [PMID: 26793784 PMCID: PMC4713188 DOI: 10.1055/s-0034-1393367] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND STUDY AIMS Recently, tissue harmonic echo (THE) imaging has advanced with the development of a new endoscopic ultrasound (EUS) monitor/processing unit. With this new technology, penetration (THE-P) and resolution (THE-R) images can be obtained. The aim of this study was to investigate the performance of this novel THE imaging using a new processing unit for pancreatic diseases. PATIENTS AND METHODS Fifty patients with pancreatic lesions (38 cystic, 12 solid) were retrospectively analyzed. At each examination, 3 EUS images of the same pancreatic lesion were obtained using B-mode, THE-P mode, and THE-R mode imaging. Each set of EUS images was randomly arranged and evaluated independently by 4 physicians blinded to the imaging technique. Images were compared using a Likert scale 5-point grading system for each parameter. RESULTS For cystic lesions, THE-P mode images were significantly superior to conventional B-mode images for visualizing the boundary, septum, nodules, and total image quality (P < 0.05). THE-R mode images were significantly superior to conventional B-mode images for visualizing the boundary, septum, and total image quality (P < 0.05). However, for solid lesions, there was no significant difference in all the evaluation points between THE-P and conventional B-mode images. THE-R mode images were inferior to conventional B-mode images for visualizing the boundary, internal structure, and total image quality (P < 0.05). CONCLUSIONS For pancreatic cystic lesions, THE mode images provided better lesion characterization than conventional B-mode images. Further research is required to determine if this improvement will result in improved EUS diagnostics.
Collapse
Affiliation(s)
| | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | | | - Manabu Osanai
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Toshifumi Kin
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Ryo Takaki
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Tomoaki Matsumori
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Katsushige Gon
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Akiko Tomonari
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Masanori Nojima
- Center for Translational Research, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
38
|
Kodama Y, Matsui T, Tsuji K, Sakurai Y, Kang JH, Nagai K, Tanaka K, Tomonari A, Maguchi H. Is drug-eluting bead transcatheter arterial chemoembolization (TACE) associated with better tumor response than conventional TACE in meta-analysis? Hepatol Res 2015; 45:1258-9. [PMID: 25589249 DOI: 10.1111/hepr.12485] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/06/2015] [Accepted: 01/06/2015] [Indexed: 01/14/2023]
Affiliation(s)
| | - Takeshi Matsui
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Kunihiko Tsuji
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | | | - Jong-Hon Kang
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Kazumasa Nagai
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Kazunari Tanaka
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Akiko Tomonari
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| |
Collapse
|
39
|
Yane K, Maguchi H, Katanuma A, Takahashi K, Osanai M, Kin T, Takaki R, Matsumoto K, Gon K, Matsumori T, Tomonari A, Nojima M. Feasibility, efficacy, and predictive factors for the technical success of endoscopic nasogallbladder drainage: a prospective study. Gut Liver 2015; 9:239-46. [PMID: 25287172 PMCID: PMC4351032 DOI: 10.5009/gnl14070] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND/AIMS Several studies have shown the useful-ness of endoscopic nasogallbladder drainage (ENGBD) in patients with acute cholecystitis. However, the procedure is difficult, and factors that affect technical success have not yet been clarified. We conducted a prospective study to eval-uate the technical feasibility, efficacy, and predictive factors for the technical success of ENGBD in patients with acute cholecystitis. METHODS All patients with moderate or severe acute cholecystitis who were enrolled underwent ENGBD between April 2009 and April 2011. Patients with surgically altered anatomy or pancreatobiliary malignancies were ex-cluded. The primary outcomes included technical success, clinical success, and complications. Factors that could affect the technical success were also examined. RESULTS Of the 27 patients who underwent ENGBD during the study period, technical success was achieved in 21 (78%) and clinical improvement was achieved in 20 (95%). Early complications were encountered in four patients (15%). Gallbladder wall thickness (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.08 to 2.47) and age (OR, 1.16; 95% CI, 1.00 to 1.35) were effective predictors of technical failure. CONCLUSIONS ENGBD was effective in resolving acute cholecystitis; however, this modality was technically challenging and had a limited suc-cess rate. Because of technical difficulties, ENGBD should be reserved for limited indications. (Gut Liver, 2015;9239-246).
Collapse
Affiliation(s)
- Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo
| | | | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo
| | | | - Manabu Osanai
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo
| | - Toshifumi Kin
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo
| | - Ryo Takaki
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo
| | | | - Katsushige Gon
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo
| | | | - Akiko Tomonari
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo
| | - Masanori Nojima
- Division of Advanced Medicine Promotion, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| |
Collapse
|
40
|
Yane K, Katanuma A, Maguchi H, Takahashi K, Kin T. Endoscopic retrieval of a proximally migrated biliary stent after pancreaticoduodenectomy by use of a short-type single-balloon enteroscope. Gastrointest Endosc 2015; 82:959. [PMID: 26141955 DOI: 10.1016/j.gie.2015.05.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 05/31/2015] [Indexed: 02/08/2023]
Affiliation(s)
- Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | | | - Toshifumi Kin
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| |
Collapse
|
41
|
Yamazaki H, Tsuboya T, Tsuji K, Dohke M, Maguchi H. Independent Association Between Improvement of Nonalcoholic Fatty Liver Disease and Reduced Incidence of Type 2 Diabetes. Diabetes Care 2015; 38:1673-9. [PMID: 26156527 DOI: 10.2337/dc15-0140] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 06/15/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Only a few studies have evaluated the long-term effects of nonalcoholic fatty liver disease (NAFLD) on type 2 diabetes mellitus (T2DM), and none have examined whether NAFLD improvement reduces T2DM incidence. We investigated the association between NAFLD improvement and T2DM incidence. RESEARCH DESIGN AND METHODS Between 2000 and 2012, 4,604 participants who underwent a health check twice with >10 years between were enrolled. Exclusion criteria were positive hepatitis B surface antigen, positive hepatitis C antibody, ethanol intake >20 g/day, and diabetes. The 3,074 eligible participants were divided into an NAFLD group (n = 728) and a non-NAFLD group (n = 2,346) according to ultrasonography-detected fatty liver. The NAFLD group was categorized into an improved group (n = 110) and a sustained NAFLD group (n = 618) based on fatty liver disappearance at the second visit. Incident T2DM odds ratios (ORs) were estimated by logistic regression models adjusted for age, sex, BMI, impaired fasting glucose, family history of diabetes, dyslipidemia, hypertension, and physical exercise. RESULTS T2DM occurred in 117 participants (16.1%) in the NAFLD group and 72 (3.1%) in the non-NAFLD group. NAFLD at baseline was associated with T2DM incidence (multivariate OR 2.37 [95% CI 1.60-3.52]). T2DM occurred in 7 participants (6.4%) in the improved group and in 110 (17.8%) in the sustained NAFLD group. NAFLD improvement was associated with reduced T2DM incidence (multivariate OR 0.27 [95% CI 0.12-0.61]). CONCLUSIONS NAFLD improvement is associated with T2DM incidence reduction.
Collapse
Affiliation(s)
- Hajime Yamazaki
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Toru Tsuboya
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kunihiko Tsuji
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Mitsuru Dohke
- Department of Health Checkup and Promotion, Keijinkai Maruyama Clinic, Sapporo, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| |
Collapse
|
42
|
Kin T, Katanuma A, Takahashi K, Osanai M, Yane K, Ikarashi S, Sen-yo M, Minami R, Sano I, Yamazaki H, Maguchi H. Successful reintervention of biliary stent occlusion after biliary and duodenal stenting by using argon plasma coagulation. Gastrointest Endosc 2015; 82:407. [PMID: 25922253 DOI: 10.1016/j.gie.2015.02.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Accepted: 02/18/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Toshifumi Kin
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | | | - Manabu Osanai
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Satoshi Ikarashi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Manabu Sen-yo
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Ryuki Minami
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Itsuki Sano
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Hajime Yamazaki
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Hokkaido, Japan
| |
Collapse
|
43
|
Tomonari A, Katanuma A, Matsumori T, Yamazaki H, Sano I, Minami R, Sen-yo M, Ikarashi S, Kin T, Yane K, Takahashi K, Shinohara T, Maguchi H. Resected tumor seeding in stomach wall due to endoscopic ultrasonography-guided fine needle aspiration of pancreatic adenocarcinoma. World J Gastroenterol 2015; 21:8458-8461. [PMID: 26217099 PMCID: PMC4507117 DOI: 10.3748/wjg.v21.i27.8458] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 02/10/2015] [Accepted: 03/27/2015] [Indexed: 02/06/2023] Open
Abstract
Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) is a useful and relatively safe tool for the diagnosis and staging of pancreatic cancer. However, there have recently been several reports of tumor seeding after EUS-FNA of adenocarcinomas. A 78-year-old man was admitted to our hospital due to upper gastric pain. Examinations revealed a 20 mm mass in the pancreatic body, for which EUS-FNA was performed. The cytology of the lesion was adenocarcinoma, and the stage of the cancer was T3N0M0. The patient underwent surgery with curative intent, followed by adjuvant chemotherapy with S-1. An enlarging gastric submucosal tumor was found on gastroscopy at 28 mo after surgery accompanied by a rising level of CA19-9. Biopsy result was adenocarcinoma, consistent with a pancreatic primary tumor. Tumor seeding after EUS-FNA was strongly suspected. The patient underwent surgical resection of the gastric tumor with curative intent. The pathological result of the resected gastric specimen was adenocarcinoma with a perfectly matched mucin special stain result with the previously resected pancreatic cancer. This is the first case report of tumor seeding after EUS-FNA which was surgically resected and inspected pathologically.
Collapse
|
44
|
Yane K, Katanuma A, Maguchi H, Takahashi K, Osanai M, Kin T, Ikarashi S, Minami R, Sen-yo M, Sano I, Yamazaki H. Successful re-intervention with metal stent trimming using argon plasma coagulation after endoscopic ultrasound-guided hepaticogastrostomy. Endoscopy 2015; 46 Suppl 1 UCTN:E391-2. [PMID: 25254594 DOI: 10.1055/s-0034-1377388] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | | | - Manabu Osanai
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Toshifumi Kin
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Satoshi Ikarashi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Ryuki Minami
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Manabu Sen-yo
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Itsuki Sano
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Hajime Yamazaki
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| |
Collapse
|
45
|
Kin T, Katanuma A, Yane K, Takahashi K, Osanai M, Takaki R, Matsumoto K, Gon K, Matsumori T, Tomonari A, Maguchi H, Shinohara T, Nojima M. Diagnostic ability of EUS-FNA for pancreatic solid lesions with conventional 22-gauge needle using the slow pull technique: a prospective study. Scand J Gastroenterol 2015; 50:900-7. [PMID: 25732902 DOI: 10.3109/00365521.2014.983155] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) using the slow pull technique (SP-FNA) has recently attracted attention as an effective tissue acquisition technique. However, efficacy of SP-FNA with a 22-gauge conventional needle remains unclear. The aim of this study is to evaluate the diagnostic ability of SP-FNA with a 22-gauge needle. MATERIAL AND METHODS Patients with a pancreatic solid lesion were prospectively enrolled in this study. SP-FNA was performed at two needle passes with a 22-gauge needle. One dedicated pathologist evaluated the obtained samples in terms of quantity (Grade 0: scant; Grade 1: inadequate; Grade 2: adequate), quality (Grade 0: poor; Grade 1: moderate; Grade 2: good), and blood contamination (Grade 0: significant; Grade 1: moderate; Grade 2: low), and provided a pathological diagnosis. Additional EUS-FNA was performed by applying suction (SA-FNA). The evaluation points were as follows: diagnostic accuracy of SP-FNA compared with that of SA-FNA, and the quantity, quality, and blood contamination level of SP-FNA-obtained samples. RESULTS We enrolled 40 cases. The diagnostic accuracy of SP-FNA was 90% (36/40). There was no significant difference in the accuracy between SP-FNA and SA-FNA (90% vs. 90%, p = 1.000). The samples obtained using SP-FNA were assessed as Grade 2 for quantity in 29 cases (73%), quality in 31 (78%), and blood contamination in 25 (63%). CONCLUSIONS Adequate, high-quality, and unsubstantially blood-contaminated samples could be obtained using SP-FNA. The diagnostic ability of SP-FNA was 90%, which appeared to be similar to that of SA-FNA.
Collapse
Affiliation(s)
- Toshifumi Kin
- Center for Gastroenterology, Teine-Keijinkai Hospital , 1-40/1-12 Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555 , Japan
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Matsui T, Kang JH, Matsubayashi K, Yamazaki H, Nagai K, Sakata H, Tsuji K, Maguchi H. Rare case of transfusion-transmitted hepatitis E from the blood of a donor infected with the hepatitis E virus genotype 3 indigenous to Japan: Viral dynamics from onset to recovery. Hepatol Res 2015; 45:698-704. [PMID: 25041213 DOI: 10.1111/hepr.12390] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 07/07/2014] [Accepted: 07/07/2014] [Indexed: 12/13/2022]
Abstract
AIM The transfusion transmission of hepatitis E can occur even in non-endemic areas in the world as autochthonous hepatitis E has been increasingly reported in developed countries where the hepatitis E virus (HEV) is not prevalent. We investigated the post-transfusion transmission of hepatitis E in a patient by molecularly confirming its presence, and characterized the viral kinetics of HEV in this case. METHODS A Japanese man underwent re-thoracotomy for hemostasis followed by platelet transfusion. After the transfusion, the blood donor was found to be HEV positive. The donated blood was re-examined and was found to contain HEV. Throughout the prospective follow up of the patient, we analyzed the viral kinetics, chronological anti-HEV antibody level changes and disease progression during the entire course of HEV infection from transfusion until the end of viremia. RESULTS Sequence analysis of the strains isolated from both the donor and the patient who contracted acute hepatitis E showed an identical match for 326 nucleotides in open reading frame 1. Two strains belonged to HEV genotype 3 indigenous to Japan. CONCLUSION To the best of our knowledge, this is the first detailed report on the entire natural course of hepatitis E from viral transmission, then clearance, to replication preceding liver injury caused by HEV genotype 3, which is responsible for autochthonous infection in developed countries. The findings provide valuable insights into the mechanism of the transfusion transmission of HEV and subsequent viral dynamics.
Collapse
Affiliation(s)
- Takeshi Matsui
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.,Department of Virology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Jong-Hon Kang
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | | | - Hajime Yamazaki
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Kazumasa Nagai
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | | | - Kunihiko Tsuji
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| |
Collapse
|
47
|
Yanagimoto H, Okusaka T, Ishii H, Furuse J, Ohkawa S, Fukutomi A, Ioka T, Sho M, Nakamori S, Kitano M, Sugimori K, Maguchi H, Imaoka H, Baba H, Shimizu A, Yokota I, Ohashi Y, Yamaue H. Interim safety analysis of a randomized phase II trial comparing alternate-day oral therapy using S-1 with the standard regimen as a first-line treatment for patients with advanced pancreatic cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e15267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Ishii
- Department of Gastroenterology,Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Junji Furuse
- Department of Medical Oncology, Kyorin University School of Medicine, Tokyo, Japan
| | - Shinichi Ohkawa
- Division of Hepato-Biliary and Pancreatic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | | | - Tatsuya Ioka
- Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, Kashihara, Japan
| | - Shoji Nakamori
- Department of Hepatobiliary and Pancreatic Surgery, Osaka National Hospital, Osaka-Shi, Japan
| | | | | | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | | | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Atsushi Shimizu
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| | - Isao Yokota
- Department of Biostatistics, The University of Tokyo, Tokyo, Japan
| | | | - Hiroki Yamaue
- Second Department of Surgery, Wakayama Medical University, Wakayama, Japan
| |
Collapse
|
48
|
Yamaue H, Tsunoda T, Tani M, Miyazawa M, Yamao K, Mizuno N, Okusaka T, Ueno H, Boku N, Fukutomi A, Ishii H, Ohkawa S, Furukawa M, Maguchi H, Ikeda M, Togashi Y, Nishio K, Ohashi Y. Randomized phase II/III clinical trial of elpamotide for patients with advanced pancreatic cancer: PEGASUS-PC Study. Cancer Sci 2015; 106:883-90. [PMID: 25867139 PMCID: PMC4520640 DOI: 10.1111/cas.12674] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 04/01/2015] [Accepted: 04/08/2015] [Indexed: 12/15/2022] Open
Abstract
Gemcitabine is a key drug for the treatment of pancreatic cancer; however, with its limitation in clinical benefits, the development of another potent therapeutic is necessary. Vascular endothelial growth factor receptor 2 is an essential target for tumor angiogenesis, and we have conducted a phase I clinical trial using gemcitabine and vascular endothelial growth factor receptor 2 peptide (elpamotide). Based on the promising results of this phase I trial, a multicenter, randomized, placebo-controlled, double-blind phase II/III clinical trial has been carried out for pancreatic cancer. The eligibility criteria included locally advanced or metastatic pancreatic cancer. Patients were assigned to either the Active group (elpamotide + gemcitabine) or Placebo group (placebo + gemcitabine) in a 2:1 ratio by the dynamic allocation method. The primary endpoint was overall survival. The Harrington–Fleming test was applied to the statistical analysis in this study to evaluate the time-lagged effect of immunotherapy appropriately. A total of 153 patients (Active group, n = 100; Placebo group, n = 53) were included in the analysis. No statistically significant differences were found between the two groups in the prolongation of overall survival (Harrington–Fleming P-value, 0.918; log–rank P-value, 0.897; hazard ratio, 0.87, 95% confidence interval [CI], 0.486–1.557). Median survival time was 8.36 months (95% CI, 7.46–10.18) for the Active group and 8.54 months (95% CI, 7.33–10.84) for the Placebo group. The toxicity observed in both groups was manageable. Combination therapy of elpamotide with gemcitabine was well tolerated. Despite the lack of benefit in overall survival, subgroup analysis suggested that the patients who experienced severe injection site reaction, such as ulceration and erosion, might have better survival. Phase II/III trial of elpamotide was performed to evaluate the clinical effect for advanced pancreatic cancer. Despite the lack of benefit in OS, sub-group analysis suggested that the patients with severe ISR might have better survival.
Collapse
Affiliation(s)
- Hiroki Yamaue
- Second Department of Surgery Wakayama Medical University, Wakayama, Japan
| | - Takuya Tsunoda
- Second Department of Surgery Wakayama Medical University, Wakayama, Japan
| | - Masaji Tani
- Second Department of Surgery Wakayama Medical University, Wakayama, Japan
| | - Motoki Miyazawa
- Second Department of Surgery Wakayama Medical University, Wakayama, Japan
| | - Kenji Yamao
- Department of Gastroenterology Aichi Cancer Center Hospital, Aichi, Japan
| | - Nobumasa Mizuno
- Department of Gastroenterology Aichi Cancer Center Hospital, Aichi, Japan
| | - Takuji Okusaka
- Hepatobiliary and Pancreatic Oncology Division National Cancer Center Hospital, Tokyo, Japan
| | - Hideki Ueno
- Hepatobiliary and Pancreatic Oncology Division National Cancer Center Hospital, Tokyo, Japan
| | - Narikazu Boku
- Department of Gastroenterology Shizuoka Cancer Center, Shizuoka, Japan
| | - Akira Fukutomi
- Department of Gastroenterology Shizuoka Cancer Center, Shizuoka, Japan
| | - Hiroshi Ishii
- Hepatobiliary and Pancreatic Division Cancer Institute Hospital, Tokyo, Japan
| | - Shinichi Ohkawa
- Hepatobiliary and Pancreatic Medical Oncology Division Kanagawa Cancer Center Hospital, Kanagawa, Japan
| | - Masayuki Furukawa
- Department of Gastroenterology National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology Teine-Keijinkai Hospital, Hokkaido, Japan
| | - Masafumi Ikeda
- Division of Hepatobiliary and Pancreatic Oncology National Cancer Center Hospital East, Chiba, Japan
| | - Yosuke Togashi
- Dept Genome Biology Kinki University School of Medicine, Osaka, Japan
| | - Kazuto Nishio
- Dept Genome Biology Kinki University School of Medicine, Osaka, Japan
| | - Yasuo Ohashi
- Department of Integrated Science and Engineering for Sustainable society Chuo University, Tokyo, Japan
| |
Collapse
|
49
|
Sen-yo M, Maguchi H. [Role of endoscopic retrograde cholangiography for cancer of the biliary tract]. Nihon Rinsho 2015; 73 Suppl 3:506-509. [PMID: 25857076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
50
|
Takahashi K, Maguchi H. [Diagnosis of malignant IPMN and tumor extension]. Nihon Rinsho 2015; 73 Suppl 3:227-233. [PMID: 25857021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|