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Hirahara N, Matsubara T, Kaji S, Hayashi H, Sasaki Y, Kawakami K, Hyakudomi R, Yamamoto T, Tajima Y. Novel inflammation-combined prognostic index to predict survival outcomes in patients with gastric cancer. Oncotarget 2023; 14:71-82. [PMID: 36719281 PMCID: PMC9888308 DOI: 10.18632/oncotarget.28353] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/16/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND We focused on the lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) and devised an inflammation-combined prognostic index (ICPI) as a prognostic marker of cancer-specific survival (CSS). METHODS We reviewed the clinicopathological data of 480 patients with gastric cancer undergoing curative laparoscopic gastrectomy between 2009 and 2019. This study examined the significance of LMR, NLR, PLR, and ICPI as cancer-specific prognostic markers. RESULTS In univariate analysis, tumor diameter, histological differentiation, pathological tumor-node-metastasis (pTNM) stage, LMR, NLR, PLR, C-reactive protein (CRP) level, carcinoembryonic antigen (CEA), and postoperative chemotherapy were significantly associated with CSS. In multivariate analysis, pTNM stage and CEA were the independent risk factors for CSS, although LMR, NLR, and PLR were not the independent risk factors for CSS. The ICPI formula was constructed using hazard ratios for three inflammation-based biomarkers with worse prognosis identified in the univariate analysis: LMR <4.315, NLR ≥2.344, and PLR ≥212.01, which were each scored as 1, with all remaining values pointed at 0. ICPI was calculated as follows: ICPI = 2.9 × LMR + 2.8 × NLR + 2.8 × PLR. The optimal cutoff value of ICPII was 2.9. On multivariate analysis, pTNM stage, CEA, and ICPI were independent prognostic factors for CSS. In the Kaplan-Meier survival analysis, CSS in the high ICPI group was significantly worse than that in the low ICPI group. CONCLUSION ICPI was devised as a novel predictive index for prognosis, and its usefulness was clarified.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Takeshi Matsubara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Shunsuke Kaji
- Department of Surgery, Matsue Red Cross Hospital, Matsue, Shimane 690-0886, Japan
| | - Hikota Hayashi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Yohei Sasaki
- Department of Surgery, Masuda Red Cross Hospital, Masuda, Shimane 698-8501, Japan
| | - Koki Kawakami
- Department of Surgery, Matsue Red Cross Hospital, Matsue, Shimane 690-0886, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
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Hirahara N, Matsubara T, Kaji S, Uchida Y, Hyakudomi R, Yamamoto T, Takai K, Sasaki Y, Kawakami K, Tajima Y. Correction: Influence of nutrition on stage-stratified survival in gastric cancer patients with postoperative complications. Oncotarget 2022; 13:1092-1093. [PMID: 36242539 PMCID: PMC9564358 DOI: 10.18632/oncotarget.28243] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Noriyuki Hirahara
- 1Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan,Correspondence to:Noriyuki Hirahara, email:
| | - Takeshi Matsubara
- 1Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Shunsuke Kaji
- 2Department of Surgery, Matsue Red Cross Hospital, Shimane, Matsue, Horomachi, Japan
| | - Yuki Uchida
- 1Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Ryoji Hyakudomi
- 1Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Tetsu Yamamoto
- 1Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Kiyoe Takai
- 1Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Yohei Sasaki
- 3Department of Surgery, Masuda Red Cross Hospital, Shimane, Masuda, Otoyoshi-cho, Japan
| | - Koki Kawakami
- 2Department of Surgery, Matsue Red Cross Hospital, Shimane, Matsue, Horomachi, Japan
| | - Yoshitsugu Tajima
- 1Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
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Hirahara N, Matsubara T, Kaji S, Hayashi H, Kawakami K, Sasaki Y, Takao S, Takao N, Hyakudomi R, Yamamoto T, Tajima Y. Feasibility study of adjuvant chemotherapy with S-1 after curative esophagectomy following neoadjuvant chemotherapy for esophageal cancer. BMC Cancer 2022; 22:718. [PMID: 35768866 PMCID: PMC9245214 DOI: 10.1186/s12885-022-09827-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite advances in surgical techniques, long-term survival after esophagectomy for esophageal cancer remains unacceptably low, and more effective perioperative chemotherapy is expected. However, an important concern regarding the application of postoperative adjuvant chemotherapy is treatment toxicity. We aimed to evaluate the feasibility of adjuvant chemotherapy with S-1 in patients after esophagectomy. METHODS We investigated the tolerability of a 2-week administration followed by 1-week rest regimen of S1 as postoperative adjuvant therapy in 20 patients with esophageal squamous cell carcinoma who received neoadjuvant chemotherapy (NAC) and 22 patients who did not receive NAC during 2011-2020. RESULTS In the non-NAC group, the mean and median relative dose intensity (RDI) were 78.7% and 99.4%, respectively, and 11 patients (50%) had altered treatment schedules. The corresponding rates in the NAC group were 77.9% and 100%, respectively, and nine patients (45%) had altered treatment schedules, with no significant difference among the groups. Moreover, 17 patients (77.2%) in the non-NAC group and 16 patients (80.0%) in the NAC group continued S-1 treatment as planned for one year postoperatively, with no significant difference in the S-1 continuation rate (p = 0.500). Seventeen of 22 patients (77.3%) and 15 of 20 patients (75.0%) experienced several adverse events in the non-NAC and NAC groups, respectively. The frequency, severity, and type of adverse events were consistent among patients with and without NAC. CONCLUSIONS S-1 could be safely and continuously administered as adjuvant chemotherapy for patients with esophageal cancer regardless of NAC. Long-term prognosis should be evaluated for S-1 to become the standard treatment after esophagectomy.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
| | - Takeshi Matsubara
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Shunsuke Kaji
- Department of Surgery, Matsue Red Cross Hospital, Horo-machi, Matsue, Shimane, 690-8506, Japan
| | - Hikota Hayashi
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Koki Kawakami
- Department of Surgery, Matsue Red Cross Hospital, Horo-machi, Matsue, Shimane, 690-8506, Japan
| | - Yohei Sasaki
- Department of Surgery, Masuda Red Cross Hospital, Otoyoshi-cho, Masuda, Shimane, 698-8501, Japan
| | - Satoshi Takao
- Department of Surgery, Unnan City Hospital, Daito-cho, Unnan, Shimane, 699-1221, Japan
| | - Natsuko Takao
- Department of Surgery, Izumo City General Medical Center, Nadabun-cho, Shimane, 691-0003, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
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Hirahara N, Matsubara T, Kaji S, Uchida Y, Hyakudomi R, Yamamoto T, Takai K, Sasaki Y, Kawakami K, Tajima Y. Influence of nutrition on stage-stratified survival in gastric cancer patients with postoperative complications. Oncotarget 2022; 13:183-197. [PMID: 35079325 PMCID: PMC8782615 DOI: 10.18632/oncotarget.28179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/06/2022] [Indexed: 11/25/2022] Open
Abstract
Background: We assessed the relationship between preoperative prognostic nutritional index (PNI) and short- and long-term outcomes among gastric cancer patients because the clinical significance of PNI in these patients remains controversial. Materials and Methods: We retrospectively reviewed the medical records of 434 consecutive patients who underwent curative laparoscopic gastrectomy for gastric cancer. Results: Patients with postoperative complications had a significantly poorer overall survival (OS) than those without. On multivariate analyses, postoperative complications were independently associated with PNI value and operative procedure type. In the low PNI group (n = 118), those with postoperative complications experienced significantly poorer OS than those without complications. Among the low PNI group with pTNM stage I and II disease, those with postoperative complications experienced significantly worse OS than those without complications. However, among the high PNI group and patients with stage II and III disease in the low PNI group, OS was similar with respect to postoperative complications. Conclusions: The present study confirmed that long-term prognosis was unaffected by postoperative complications in well-nourished gastric cancer patients. In addition, preoperative nutritional status and postoperative complications, may be crucial in determining the prognosis of gastric cancer, especially in early-stage cancer.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Takeshi Matsubara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Shunsuke Kaji
- Department of Surgery, Matsue Red Cross Hospital, Shimane, Matsue, Horomachi, Japan
| | - Yuki Uchida
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Kiyoe Takai
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Yohei Sasaki
- Department of Surgery, Masuda Red Cross Hospital, Shimane, Masuda, Otoyoshi-cho, Japan
| | - Koki Kawakami
- Department of Surgery, Matsue Red Cross Hospital, Shimane, Matsue, Horomachi, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
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Hirahara N, Matsubara T, Kaji S, Uchida Y, Yamamoto T, Hyakudomi R, Zotani H, Kawakami K, Sasaki Y, Tajima Y. A safe, reliable, and efficient robot-assisted port site closure for robot-assisted gastrectomy. Ann Med Surg (Lond) 2021; 71:103001. [PMID: 34840755 PMCID: PMC8606878 DOI: 10.1016/j.amsu.2021.103001] [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: 10/08/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction The overall incidence of port site hernias in laparoscopy and robot-assisted surgeries ranges from 0% to 5.2%. Sufficient port site closure is essential to reduce and prevent the occurrence of port site hernia. However, complete fascial closure of 8-mm robot-port site appears to be difficult. In this study, we propose a safe and reliable robot-assisted port-site closure for robot-assisted gastrectomy. Materials and methods The robotic arm was tilted 60–70° cranially or caudally to create a small gap between the port and the skin margin that was cut open for port insertion. While viewing through the robotic camera and grasping the polydioxanone (PDS) thread, the Lapa-Her-Closure was inserted into the peritoneal cavity through the gap. The Lapa-Her-Closure was removed after the PDS thread was grasped with robotic forceps. Subsequently, the Lapa-Her-Closure was inserted into the abdominal cavity by tilting the arm cranially or caudally, in contrast to the previous step. The PDS thread was inserted into the loop wire using robotic forceps. After tightening the loop wire and grasping the PDS thread, the Lapa-Her-Closure was removed, and the PDS thread was ligated to complete the abdominal wall closure, with total closure of the fascia and peritoneum. Results and conclusions We utilized this port site closure technique in 12 patients who underwent robot-assisted gastrectomy for gastric cancer. The procedure was accomplished safely and efficiently in all cases without any technical problems. In conclusion, our port site closure is safe, reliable, and efficient procedure that can be performed using basic surgical techniques. This study discusses a new approach in robot-assisted port site closure for robot-assisted gastrectomy. •Our study makes a significant contribution to the literature because it introduces a safe, reliable, and efficient approach of robot-assisted port site closure for robot-assisted gastrectomy to reduce the occurrence of hernias.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan
| | - Takeshi Matsubara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan
| | - Shunsuke Kaji
- Department of Surgery, Matsue Red Cross Hospital, Japan
| | - Yuki Uchida
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan
| | - Hitomi Zotani
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan
| | - Koki Kawakami
- Department of Surgery, Matsue Red Cross Hospital, Japan
| | - Yuhei Sasaki
- Department of Surgery, Matsue Red Cross Hospital, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan
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Hirahara N, Matsubara T, Kaji S, Uchida Y, Yamamoto T, Hyakudomi R, Takai K, Ishitobi K, Tajima Y. A safe and simple technique for nasogastric tube insertion in patients with thoracic esophageal cancer surgery. World J Surg Oncol 2021; 19:317. [PMID: 34732220 PMCID: PMC8564989 DOI: 10.1186/s12957-021-02428-7] [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: 05/14/2021] [Accepted: 10/22/2021] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Risk factors for anastomotic leakage include local factors such as excessive tension across anastomosis and increased intraluminal pressure on the gastric conduit; therefore, we consider the placement of a nasogastric tube to be essential in reducing anastomotic leakage. In this study, we devised a safe and simple technique to place an NGT during an end-to-side, automatic circular-stapled esophagogastrostomy. METHODS First, a 4-0 nylon thread is fixed in the narrow groove between the plastic and metal parts of the tip of the anvil head. After dissecting the esophagus, the tip of the NGT is guided out of the lumen of the cervical esophageal stump. The connecting nylon thread is applied to the anvil head with the tip of the NGT. The anvil head is inserted into the cervical esophageal stump, and a purse-string suture is performed on the esophageal stump to complete the anvil head placement. The main unit of the automated stapler is inserted through the tip of a reconstructed gastric conduit, and the stapler is subsequently fired and an end-to-side esophagogastrostomy is achieved. The main unit of the automated stapler is then pulled out from the gastric conduit, and the NGT comes out with the anvil head from the tip of the reconstructed gastric conduit. Subsequently, the nylon thread is cut. After creating an α-loop with the NGT outside of the lumen, the tip of the NGT is inserted into the gastric conduit along the lesser curvature toward the caudal side. Finally, the inlet of the automated stapler on the tip of the gastric conduit is closed with an automated linear stapler, and the esophagogastrostomy is completed. RESULTS We utilized this technique in seven patients who underwent esophagectomy for esophageal cancer; smooth and safe placement of the NGT was accomplished in all cases. CONCLUSION Our technique of NGT placement is simple, safe, and feasible.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
| | - Takeshi Matsubara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Shunsuke Kaji
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yuki Uchida
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Kiyoe Takai
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Kazunari Ishitobi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
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Hirahara N, Matsubara T, Kaji S, Yamamoto T, Hyakudomi R, Takai K, Ishitobi K, Uchida Y, Tajima Y. Phase II feasibility study of adjuvant chemotherapy with docetaxel/cisplatin/S-1 followed by S-1 for stage III gastric cancer. BMC Cancer 2021; 21:1073. [PMID: 34598694 PMCID: PMC8485556 DOI: 10.1186/s12885-021-08795-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 09/16/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the feasibility, safety, and efficacy of postoperative adjuvant chemotherapy with docetaxel/cisplatin/S-1 (DCS) following S-1 therapy in patients with stage III gastric cancer after curative gastrectomy. METHODS Patients with stage III gastric cancer who underwent D2 gastrectomy were enrolled. Adjuvant chemotherapy was initiated within 8 weeks of gastrectomy. The first cycle of chemotherapy consisted of S-1 monotherapy (day 1-14), followed by a 7-day rest period. Cycles 2 and 3 consisted of the following: S-1 (day 1-14) administration, followed by a 14-day rest period, and an intravenous infusion of cisplatin and docetaxel on days 1 and 15. After two cycles, S-1 was administered for up to 1 year. RESULTS Thirty patients were enrolled between 2014 and 2017. Febrile neutropenia of grade 3 or higher was the most common hematological toxicity with 4 patients (13.3%). Other hematological toxicities of grade 3 or higher were as follows: neutropenia in 3 (10.0%), leukopenia in 3 (10.0%), and anemia in 2 (6.7%) patients. Most frequent non-hematological toxicity of grade 3 was anorexia (n = 4, 13.3%) and general fatigue (n = 3, 10.0%); no grade 4 non-hematological toxicities were observed. Twenty-five patients (83.3%) completed two cycles of DCS treatment and 18 (60.0%) completed subsequent S-1 treatment for 1 year. The relative dose intensity of docetaxel and cisplatin was 0.86 and that of S-1 was 0.88. CONCLUSION The DCS regimen can be acceptable as an adjuvant chemotherapy and offers an effective postoperative treatment option for stage III gastric cancer patients. TRIAL REGISTRATION NUMBER UMIN000012785 . DATE OF REGISTRY 08/01/2014.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
| | - Takeshi Matsubara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Shunsuke Kaji
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Kiyoe Takai
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Kazunari Ishitobi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yuki Uchida
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
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Ozaki S, Kaji S, Nawa K, Imae T, Aoki A, Nakamoto T, Ohta T, Nozawa Y, Haga A, Nakagawa K. PD-0755 Training modality conversion models with small data and its application to MVCT to kVCT conversion. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07034-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hayashi H, Kawabata Y, Nishi T, Kishi T, Nakamura K, Kaji S, Fujii Y, Tajima Y. Accurate prediction of severe postoperative complications after pancreatic surgery: POSSUM vs E-PASS. J Hepatobiliary Pancreat Sci 2020; 28:156-164. [PMID: 33058549 DOI: 10.1002/jhbp.839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/08/2020] [Accepted: 09/20/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND/PURPOSE Few reports have evaluated the differences in the predictive accuracy between the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and estimation of physiologic ability and surgical stress (E-PASS) in pancreatic surgery. Thus, we evaluated the accuracy and similarity of POSSUM and E-PASS for the prediction of severe postoperative complications (PCs) after pancreatic surgery. METHODS We enrolled 343 consecutive patients who underwent pancreatic surgery in our department between April 2006 and September 2017. The difference in predictive values of POSSUM and E-PASS for the occurrence of PCs ≥ Clavien-Dindo grade IIIa (PCs-CD ≥ IIIa) was nonparametrically compared. The predictive accuracy and similarity of each tool was examined using the receiver operating characteristic (ROC) curve and linear regression analyses. RESULTS Forty-five patients developed PCs-CD ≥ IIIa. E-PASS had a significantly higher predictive value for estimating PCs-CD ≥ IIIa occurrence (P = .002) than did POSSUM. The area under the curve value in ROC analysis was significantly higher in E-PASS than in POSSUM (0.643 vs 0.543, P = .014), with a weak positive correlation in the predictive value between E-PASS and POSSUM (R2 = .333, P < .001). CONCLUSION Estimation of physiologic ability and surgical stress was useful for predicting severe PCs after pancreatic surgery and had a higher accuracy than POSSUM.
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Affiliation(s)
- Hikota Hayashi
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Yasunari Kawabata
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Takeshi Nishi
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Takashi Kishi
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Kosuke Nakamura
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Shunsuke Kaji
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Yusuke Fujii
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, Izumo, Japan
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Hirahara N, Tajima Y, Fujii Y, Kaji S, Kawabata Y, Hyakudomi R, Yamamoto T. High Preoperative Prognostic Nutritional Index Is Associated with Less Postoperative Complication-Related Impairment of Long-Term Survival After Laparoscopic Gastrectomy for Gastric Cancer. J Gastrointest Surg 2020; 24:2852-2855. [PMID: 32705617 DOI: 10.1007/s11605-020-04737-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/01/2020] [Indexed: 01/31/2023]
Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yusuke Fujii
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Shunsuke Kaji
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yasunari Kawabata
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
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11
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Hirahara N, Matsubara T, Kaji S, Kawabata Y, Hyakudomi R, Yamamoto T, Uchida Y, Ishitobi K, Takai K, Tajima Y. Glasgow prognostic score is a better predictor of the long-term survival in patients with gastric cancer, compared to the modified Glasgow prognostic score or high-sensitivity modified Glasgow prognostic score. Oncotarget 2020; 11:4169-4177. [PMID: 33227100 PMCID: PMC7665228 DOI: 10.18632/oncotarget.27796] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 08/31/2020] [Accepted: 10/17/2020] [Indexed: 12/21/2022] Open
Abstract
Background: Inflammation influences cancer progression by increasing catabolism and impairing nutrient absorption. We compared the prognostic ability of three inflammation-based prognostic scoring systems—the Glasgow prognostic score (GPS), modified GPS (mGPS), and high-sensitivity mGPS (HS-mGPS)—in gastric cancer patients. Materials and Methods: We retrospectively examined 434 curatively resected gastric cancer patients to evaluate the prognostic ability of scoring systems for overall survival (OS) and cancer-specific survival (CSS). Results: OS analysis identified the following independent prognostic factors: GPS model: pathological stage (pStage, p < 0.001), carcinoembryonic antigen (CEA, p = 0.004), and GPS 1 (hazard ratio [HR], 1.929; 95% confidence interval [CI], 1.152-3.228; p = 0.013); mGPS model: body mass index (BMI, p = 0.027), pStage (p < 0.001), and CEA (p < 0.001); HS-mGPS model: BMI (p = 0.029), pStage (p < 0.001), and CEA (p = 0.003). mGPS and HS-mGPS were not independent prognostic factors for OS. CSS analysis of the GPS model identified pStage (p < 0.001), CEA (p = 0.015), and GPS 1 (HR; 2.095, 95% CI; 1.025–4.283; p = 0.043) and 2 (HR, 2.812; 95% CI, 1.111–7.116; p = 0.029) as independent prognostic factors; however, mGPS and HS-mGPS were not independent prognostic factors for CSS. Log-rank tests demonstrated significant differences in OS among patients with GPS 0 vs. 1 (p < 0.001) and 0 vs. 2 (p < 0.001) and in CSS among the three GPS (0 vs. 1; p = 0.005, 0 vs. 2; p < 0.001, 1 vs. 2; p = 0.009). Conclusions: GPS most reliably predicts long-term survival of gastric cancer patients.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Takeshi Matsubara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Shunsuke Kaji
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Yasunari Kawabata
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Yuki Uchida
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Kazunari Ishitobi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Kiyoe Takai
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
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12
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Toyota T, Morimoto T, Kitai T, Park M, Sasaki Y, Kim K, Ehara N, Kobori A, Kinoshita M, Kaji S, Furukawa Y, Kimura T. Biodegradable-polymer versus durable-polymer drug eluting stents for coronary artery disease: systematic review and a meta-analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Biodegradable polymer drug-eluting stents (BP-DES) has been developed to overcome the potential drawbacks of the first-generation durable polymer drug-eluting stents (DP-DES). However, it is still under debate whether BP-DES is associated with superior efficacy and safety over DP-DES.
Purpose
We sought to compare the effects of BP-DES and DP-DES in patients with coronary artery disease.
Methods
We performed systematic review and a meta-analysis of randomized controlled trials comparing BP-DES and DP-DES on clinical outcomes in patients with coronary artery disease using CE-mark approved drug-eluting stents (DES) with at least 1-year follow-up. We included 32 studies involving 39,686 patients (BP-DES: 21,439 patients, and DP-DES: 18,247 patients). Primary outcome measure was target vessel failure (TVF; equivalent to the composite of cardiac death, target-vessel myocardial infarction, or ischemia-driven target vessel revascularization). We performed subgroup analysis according to the DP-DES generations (newer-generation DP-DES: 15,179patients, and first-generation DP-DES: 3,068 patients), and the effects of newer-generation DP-DES was compared with the BP-DES according to the BP-DES strut thickness (Ultra-thin strut [<80μm]: 7,572 patients, Thin-strut [80–100μm]: 5,465 patients, and Thick-strut [≥80μm]: 5,876 patients).
Results
The odds for TVF was not significantly different between the BP-DES group and the DP-DES group in the entire study population (odds ratio [OR] 0.96, 95% confidence interval [CI] [0.90–1.02], P=0.20). The odds for TVF was significantly low in the BP-DES group relative to the first-generation DP-DES group, however the odds were comparable between the BP-DES group and the newer-generation DP-DES group (BP-DES versus first-generation DP-DES: OR 0.82, 95% CI [0.73–0.92], P<0.001, and BP-DES versus newer-generation DP-DES: OR 1.00, 95% CI [0.93–1.08], P=0.99). We also found no significant differences between the BP-DES and newer-generation DP-DES, in all subgroups stratified by the BP-DES strut thickness (Ultra-thin strut BP-DES versus newer-generation DP-DES: OR 0.88, 95% CI [0.76–1.02], P=0.10, Thin-strut BP-DES versus newer-generation DP-DES: OR 1.01, 95% CI [0.90–1.13], P=0.89, and Thick strut BP-DES versus newer-generation DP-DES: OR 1.11, 95% CI [0.99–1.25], P=0.08).
Conclusions
In this meta-analysis of randomized controlled trials evaluating clinical outcomes, there was no significant differences between BP-DES and DP-DES. We found beneficial effects of BP-DES relative to the first-generation DP-DES, however, there was no statistical differences between BP-DES and newer-generation DP-DES, irrespective of the BP-DES strut thickness.
Pooled odds ratios for clinical outcomes
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Toyota
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - T Morimoto
- Hyogo College of Medicine, Department of Clinical Epidemiology, Nishinomiya, Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - M Park
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - Y Sasaki
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - K Kim
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - N Ehara
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - A Kobori
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - M Kinoshita
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - S Kaji
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - Y Furukawa
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - T Kimura
- Kyoto University Graduate School of Medicine, Department of Cardiovascular Medicine, Kyoto, Japan
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13
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Hirahara N, Matsubara T, Fujii Y, Kaji S, Hyakudomi R, Yamamoto T, Uchida Y, Miyazaki Y, Ishitobi K, Kawabata Y, Tajima Y. Geriatric nutritional risk index as a prognostic marker of pTNM-stage I and II esophageal squamous cell carcinoma after curative resection. Oncotarget 2020; 11:2834-2846. [PMID: 32754301 PMCID: PMC7381097 DOI: 10.18632/oncotarget.27670] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 06/20/2020] [Indexed: 12/12/2022] Open
Abstract
The geriatric nutritional risk index (GNRI) is associated with mortality in several malignancies. We retrospectively analyzed whether the GNRI can predict long-term outcomes in 191 patients with esophageal squamous cell carcinoma (ESCC) after curative esophagectomies by evaluating their cancer-specific survival (CSS). In multivariate analyses, serum albumin (hazard ratio [HR], 2.498; p = 0.0043), GNRI (HR, 1.941; p = 0.0181), pathological tumor-node-metastasis (pTNM) stage (HR, 3.884; p < 0.0001), and tumor differentiation (HR, 2.307; p = 0.0066) were independent prognostic factors for CSS. In pTNM stage I, multivariate analysis identified C-reactive protein (HR, 7.172; p = 0.0483) and GNRI (HR, 5.579; p = 0.0291) as independent prognostic factors for CSS. In univariate analyses in pTNM stages II and III, only low GNRI (p = 0.0095) and low serum albumin levels (p = 0.0119), respectively, were significantly associated with worse CSS. In patients with low GNRI, CSS was significantly worse than in those with normal GNRI (p = 0.0011), especially in pTNM stages I (p = 0.0044) and II (p = 0.0036) groups, but not in stage III group (p = 0.5099). Preoperative GNRI may sort patients into low- or high-risk groups for shorter CSS, especially in those with pTNM stage I and II ESCC.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Takeshi Matsubara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Yusuke Fujii
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Shunsuke Kaji
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Yuki Uchida
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Yoshiko Miyazaki
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Kazunari Ishitobi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Yasunari Kawabata
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane 693-8501, Japan
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14
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Hirahara N, Matsubara T, Fujii Y, Kaji S, Kawabata Y, Hyakudomi R, Yamamoto T, Taniura T, Tajima Y. Comparison of the prognostic value of immunoinflammation-based biomarkers in patients with gastric cancer. Oncotarget 2020; 11:2625-2635. [PMID: 32676164 PMCID: PMC7343633 DOI: 10.18632/oncotarget.27653] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 05/04/2020] [Accepted: 06/05/2020] [Indexed: 01/16/2023] Open
Abstract
Background: Systemic immune-inflammation index (SII)—comprising platelet, neutrophil, and lymphocyte count—is an objective and reliable biomarker for predicting the prognosis in cancer patients because it comprehensively reflects the balance between host inflammatory and immune responses. In this study, we clarified the prognostic impact of immunoinflammation-based indices, i. e. SII, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR), in gastric cancer patients.
Results: In multivariate analysis, the American Society of Anesthesiologists physical status (ASA-PS) (hazard ratio [HR]: 3.366, p < 0.001), tumor differentiation (HR: 1.705, p = 0.020), pathological Tumor, Node, Metastasis (pTNM) stage (HR: 2.160, p = 0.008), and carcinoembryonic antigen (CEA) (HR: 1.964, p = 0.003) were independent prognostic factors for OS in all patients. Further, multivariate analysis revealed that age (HR: 2.088, p = 0.040), ASA-PS (HR: 2.339, p = 0.043), tumor differentiation (HR: 1.748, p = 0.044), and pTNM stage (HR: 2.114, p = 0.024) were independent prognostic factors for OS among patients without inflammation; SII was not a prognostic factor for OS. Meanwhile, body mass index (HR: 5.055, p = 0.011), ASA-PS (HR: 3.403, p = 0.007), and SII (HR: 4.208, p = 0.026) were independent prognostic factors for OS among patients with inflammation.
Materials and Methods: We performed a retrospective review of 412 patients who underwent curative laparoscopic gastrectomy. The prognostic value of SII was compared between a low SII group (SII<661.9) and high SII group (SII≥661.9). We analyzed the predictive ability of immunoinflammation-based indices for overall survival (OS) based on a C-reactive protein (CRP) level of 0.5.
Conclusions: Compared to NLR and PLR, SII is the most significant prognostic biomarker for OS, especially in gastric cancer patients with inflammation.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane 693-8501, Japan
| | - Takeshi Matsubara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane 693-8501, Japan
| | - Yusuke Fujii
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane 693-8501, Japan
| | - Shunsuke Kaji
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane 693-8501, Japan
| | - Yasunari Kawabata
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane 693-8501, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane 693-8501, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane 693-8501, Japan
| | - Takahito Taniura
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane 693-8501, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane 693-8501, Japan
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15
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Kartika AV, Iizasa H, Ding D, Kanehiro Y, Tajima Y, Kaji S, Yanai H, Yoshiyama H. Application of Biopsy Samples Used for Helicobacter pylori Urease Test to Predict Epstein-Barr Virus-Associated Cancer. Microorganisms 2020; 8:microorganisms8060923. [PMID: 32570907 PMCID: PMC7355529 DOI: 10.3390/microorganisms8060923] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/04/2020] [Accepted: 06/13/2020] [Indexed: 12/12/2022] Open
Abstract
Persistent gastric mucosal damage caused by Helicobacter pylori infection is a major risk factor for gastric cancer (GC). The Epstein-Barr virus (EBV) is also associated with GC. Most patients with EBV-associated GC are infected with H. pylori in East Asia. However, very few reports have described where and when both H. pylori and EBV infect the gastric mucosa. To clarify this, old biopsy samples used for the rapid urease test (RUT) were applied to count EBV genomic DNA (gDNA) copies using DNA probe quantitative polymerase chain reaction. DNA extracted from the gastric biopsy samples of 58 patients with atrophic gastritis was used to analyze the correlation between the degree of atrophic gastritis and the copy number of EBV gDNA. EBV was detected in 44 cases (75.9%), with viral copy numbers ranging from 12.6 to 4754.6. A significant correlation was found between patients with more than 900 copies of EBV gDNA and those with a more severe grade of atrophic gastritis (p = 0.041). This study shows that EBV can be detected in RUT samples in a manner that reduces patient burden.
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Affiliation(s)
- Andy Visi Kartika
- Department of Microbiology, Faculty of Medicine, Shimane University, 89-1 Enya, Izumo, Shimane 693-8504, Japan; (A.V.K.); (H.I.); (D.D.); (Y.K.); (S.K.)
- Department of Pathology Anatomy, Faculty of Medicine, University of Muslim Indonesia, Jl. Urip Sumoharjo KM.5, Makassar, Sulawesi 90231, Indonesia
| | - Hisashi Iizasa
- Department of Microbiology, Faculty of Medicine, Shimane University, 89-1 Enya, Izumo, Shimane 693-8504, Japan; (A.V.K.); (H.I.); (D.D.); (Y.K.); (S.K.)
| | - Dan Ding
- Department of Microbiology, Faculty of Medicine, Shimane University, 89-1 Enya, Izumo, Shimane 693-8504, Japan; (A.V.K.); (H.I.); (D.D.); (Y.K.); (S.K.)
- Department of Neurobiology, Key Laboratory of Craniocerebral Disease, Ningxia Medical University, 1160 Shengli St, Xingqing District, Yinchuan 750004, Ningxia, China
| | - Yuichi Kanehiro
- Department of Microbiology, Faculty of Medicine, Shimane University, 89-1 Enya, Izumo, Shimane 693-8504, Japan; (A.V.K.); (H.I.); (D.D.); (Y.K.); (S.K.)
| | - Yoshitsugu Tajima
- Department of digestive and general surgery, Faculty of Medicine, Shimane University, 89-1 Enya, Izumo, Shimane 693-8504, Japan;
| | - Shunsuke Kaji
- Department of Microbiology, Faculty of Medicine, Shimane University, 89-1 Enya, Izumo, Shimane 693-8504, Japan; (A.V.K.); (H.I.); (D.D.); (Y.K.); (S.K.)
- Department of digestive and general surgery, Faculty of Medicine, Shimane University, 89-1 Enya, Izumo, Shimane 693-8504, Japan;
| | - Hideo Yanai
- Department of Clinical Research, National Hospital Organization Kanmon Medical Center, 1-1 Chofu-Sotoura, Shimonoseki, Yamaguchi 752-8510, Japan
- Correspondence: (H.Y.); (H.Y.); Tel.: +81-83-241-1199 (H.Y.); +81-853-20-2146 (H.Y.)
| | - Hironori Yoshiyama
- Department of Microbiology, Faculty of Medicine, Shimane University, 89-1 Enya, Izumo, Shimane 693-8504, Japan; (A.V.K.); (H.I.); (D.D.); (Y.K.); (S.K.)
- Correspondence: (H.Y.); (H.Y.); Tel.: +81-83-241-1199 (H.Y.); +81-853-20-2146 (H.Y.)
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Hirahara N, Matsubara T, Fujii Y, Kaji S, Hyakudomi R, Yamamoto T, Uchida Y, Miyazaki Y, Ishitobi K, Kawabata Y, Tajima Y. Preoperative geriatric nutritional risk index is a useful prognostic indicator in elderly patients with gastric cancer. Oncotarget 2020; 11:2345-2356. [PMID: 32595832 PMCID: PMC7299529 DOI: 10.18632/oncotarget.27635] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 05/25/2020] [Indexed: 12/28/2022] Open
Abstract
Background: The geriatric nutritional risk index (GNRI) was developed to evaluate the prognosis in elderly hospitalized patients at risk of malnutrition and related morbidity and mortality. This study aimed to evaluate the relationship between preoperative GNRI and long-term outcomes in elderly gastric cancer patients. Materials and Methods: We retrospectively reviewed 297 consecutive patients aged ≥ 65 years who underwent laparoscopic gastrectomy with R0 resection and evaluated their overall survival (OS) and cancer-specific survival (CSS). Results: In the univariate analyses, OS was significantly associated with the American Society of Anesthesiologists Physical Status (ASA-PS), tumor size, tumor differentiation, pathological stage, carcinoembryonic antigen (CEA), C-reactive protein, postoperative complications, and GNRI, whereas in the univariate analyses of CSS, ASA-PS, tumor size, tumor differentiation, pathological stage, CEA, postoperative adjuvant chemotherapy, and GNRI were significantly associated with poor prognosis. In the multivariate analysis, ASA-PS, tumor differentiation, pathological stage, and GNRI were significant independent prognostic factors of OS, whereas ASA-PS, pathological stage, and CEA were significant independent prognostic factors of CSS. Conclusions: GNRI is significantly associated with OS and CSS in elderly gastric cancer patients and is an independent predictor of OS. It is a simple, cost-effective, and promising nutritional index for predicting OS in elderly patients.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Takeshi Matsubara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Yusuke Fujii
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Shunsuke Kaji
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Yuki Uchida
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Yoshiko Miyazaki
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Kazunari Ishitobi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Yasunari Kawabata
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
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Kawabata Y, Hayashi H, Kaji S, Fujii Y, Nishi T, Tajima Y. Laparoscopic versus open radical antegrade modular pancreatosplenectomy with artery-first approach in pancreatic cancer. Langenbecks Arch Surg 2020; 405:647-656. [PMID: 32524466 DOI: 10.1007/s00423-020-01887-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/22/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND An artery-first approach for pancreatic cancer (PC) is challenging to perform laparoscopically and is mainly performed using an open approach. The aims of this study were to assess the safety and feasibility of laparoscopic radical antegrade modular pancreatosplenectomy (RAMPS) with an artery-first approach (L-aRAMPS) as compared with open aRAMPS (O-aRAMPS) in resectable PC using matched-pair analysis. METHODS Artery-first approach is an early dissection of the superior mesenteric artery (SMA) from behind the pancreas body as the first surgical step. Data on L-aRAMPS and O-aRAMPS, performed between July 2013 and November 2019, were collected retrospectively. Additionally, the spatial characteristics of the splenic artery were analyzed using computed tomography. RESULTS Thirty L-aRAMPS and 33 O-aRAMPS for resectable PC were included. After matching, 15 L-aRAMPS were compared with 15 O-aRAMPS. Median intraoperative blood loss and hospital stay were significantly improved in L-aRAMPS compared to O-aRAMPS (30 vs. 220 g, p < 0.001; 12 vs. 16 days, p = 0.049). The overall morbidity was similar in both study groups. The total number of lymph nodes dissected and those harvested from around the SMA and R0 resection was similar in both study groups. We classified the width of the cross section of the pancreas body into three equal parts: the upper, middle, and lower parts of the pancreas; 63% of the splenic artery origin was located in middle and lower parts of the pancreas body. CONCLUSION L-aRAMPS is technically safe and oncologically feasible to secure favorable surgical outcomes for resectable PC patients.
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Affiliation(s)
- Yasunari Kawabata
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enyacho, Izumo, Shimane, 693-8501, Japan.
| | - Hikota Hayashi
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enyacho, Izumo, Shimane, 693-8501, Japan
| | - Shunsuke Kaji
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enyacho, Izumo, Shimane, 693-8501, Japan
| | - Yusuke Fujii
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enyacho, Izumo, Shimane, 693-8501, Japan
| | - Takeshi Nishi
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enyacho, Izumo, Shimane, 693-8501, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enyacho, Izumo, Shimane, 693-8501, Japan
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18
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Hirahara N, Tajima Y, Fujii Y, Kaji S, Yamamoto T, Hyakudomi R, Taniura T, Kawabata Y. Comprehensive Analysis of Red Blood Cell Distribution Width as a Preoperative Prognostic Predictor in Gastric Cancer. Anticancer Res 2019; 39:3121-3130. [PMID: 31177157 DOI: 10.21873/anticanres.13448] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND/AIM The aim of the current study was to investigate the impact of the preoperative red cell distribution width (RDW) value on the overall survival (OS) and cancer-specific survival (CSS) of gastric cancer patients. PATIENTS AND METHODS A total of 366 gastric cancer patients who underwent curative gastrectomy were retrospectively reviewed. Among them, RDW was evaluated in 165 non-elderly and 201 elderly patients. RESULTS Multivariate analysis revealed that pathological stage (pStage), RDW, and carcinoembryonic antigen (CEA), were independent prognostic factors of OS, while pStage and RDW were independent prognostic factors of CSS. In non-elderly patients, based on the multivariate analysis, pStage, adjuvant chemotherapy, and RDW were identified as independent prognostic factors of OS. In elderly patients, RDW was identified as independent prognostic factors of OS and CSS. CONCLUSION Preoperative RDW is a promising independent prognostic factor in gastric cancer.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Yusuke Fujii
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Shunsuke Kaji
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Takahito Taniura
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | - Yasunari Kawabata
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Japan
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Hirahara N, Tajima Y, Fujii Y, Kaji S, Yamamoto T, Hyakudomi R, Taniura T, Miyazaki Y, Kishi T, Kawabata Y. Preoperative Prognostic Nutritional Index Predicts Long-Term Surgical Outcomes in Patients with Esophageal Squamous Cell Carcinoma. World J Surg 2018; 42:2199-2208. [PMID: 29290069 PMCID: PMC5990565 DOI: 10.1007/s00268-017-4437-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background The purpose of the present study is to investigate the utility of prognostic nutritional index (PNI) as a simple and readily available marker in esophageal squamous cell carcinoma (ESCC). Methods We retrospectively analyzed 169 patients who underwent potentially curative esophagectomy, for histologically verified ESCC. We decided to set the optimal cutoff value for preoperative PNI levels at 49.2, based on the cancer-specific survival (CSS) and the overall survival (OS) by receiver operating characteristic curve analysis. Results Multivariate logistic regression analysis identified that TNM pStage III [hazard ratio (HR) 3.261, p < 0.0001] and PNI < 49.2 (HR 3.887, p < 0.0001) were confirmed as independent poor predictive factors for CSS, and age >70 (HR 2.024, p < 0.0042), TNM pStage III (HR 2.510, p = 0.0002), and PNI < 49.2 (HR 2.248, p = 0.0013) were confirmed as independent poor predictive factors for OS. In non-elderly patients, TNM pStage III (CSS; HR 3.488, p < 0.0001, OS; HR 2.615, p = 0.0007) and PNI < 49.2 (CSS; HR 3.849, p < 0.0001, OS; HR 2.275, p = 0.001) were confirmed as independent poor predictive factors for CSS, and OS when multivariate logistic regression analysis was applied. But in elderly patients, univariate analyses demonstrated that the TNM pStage III was the only significant risk factor for CSS (HR 3.701, p = 0.0057) and OS (HR 1.974, p = 0.0224). Conclusions The PNI was a significant and independent predictor of CSS and OS of ESCC patients after curative esophagectomy. The PNI was cost-effective and readily available, and it could act as a marker of survival.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yusuke Fujii
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Shunsuke Kaji
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Takahito Taniura
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yoshiko Miyazaki
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Takashi Kishi
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yasunari Kawabata
- Department of Digestive and General Surgery, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
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20
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Hirahara N, Tajima Y, Fujii Y, Yamamoto T, Hyakudomi R, Taniura T, Kaji S, Kawabata Y. Preoperative Prognostic Nutritional Index Predicts Long-term Outcome in Gastric Cancer: A Propensity Score-matched Analysis. Anticancer Res 2018; 38:4735-4746. [PMID: 30061243 DOI: 10.21873/anticanres.12781] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 06/12/2018] [Accepted: 06/13/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND/AIM Recent evidence suggests that preoperative malnutrition may lead to poor survival in cancer patients. This study aimed to determine the ability of the prognostic nutritional index (PNI) to predict survival in gastric cancer patients. PATIENTS AND METHODS Two hundred and eighteen patients who had undergone laparoscopic gastrectomy were retrospectively reviewed via propensity score-matched analysis. RESULTS In multivariate analysis of overall patients, pTNM stage, carcinoembryonic antigen, and PNI were independent predictors of overall survival (OS), and pTNM stage and PNI were independent predictors of cancer-specific survival (CSS). Among the 92 non-elderly patients, pTNM stage and PNI were independent predictors of OS, and pTNM stage, PNI, and adjuvant chemotherapy were independent predictors of CSS in multivariate analysis. On the other hand, among the 126 elderly patients, low PNI value was identified as a significant predictor of shorter OS in univariate analysis. CONCLUSION PNI is associated with OS and CSS in gastric cancer patients, especially non-elderly patients.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Yusuke Fujii
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Takahito Taniura
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Shunsuke Kaji
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
| | - Yasunari Kawabata
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane, Japan
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Azumi Y, Tani T, Ishibashi K, Konda T, Sumida T, Sasaki Y, Ota M, Kim K, Kitai T, Yamane T, Kobori A, Ehara N, Kinoshita M, Kaji S, Furukawa Y. 1470Impact of left atrial enlargement on very long-term outcomes in patients with hypertrophic cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1470] [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: 11/13/2022] Open
Affiliation(s)
- Y Azumi
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - T Tani
- Kobe City College of Nursing, kobe, Japan
| | - K Ishibashi
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - T Konda
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - T Sumida
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - Y Sasaki
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - M Ota
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - K Kim
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - T Yamane
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - A Kobori
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - N Ehara
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - M Kinoshita
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - S Kaji
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - Y Furukawa
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
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22
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Ota M, Kitai T, Horita R, Azumi Y, Matsumoto Y, Ishizu K, Sasaki Y, Kim K, Yamane T, Kobori A, Ehara N, Kinoshita M, Kaji S, Furukawa Y. P3418A detailed assessment of geometric height of normal aortic cusps by 3-dimensional transesophageal echocardiography: implications for aortic valve repair surgery. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3418] [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: 11/12/2022] Open
Affiliation(s)
- M Ota
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - R Horita
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - Y Azumi
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - Y Matsumoto
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - K Ishizu
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - Y Sasaki
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - K Kim
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - T Yamane
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - A Kobori
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - N Ehara
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - M Kinoshita
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - S Kaji
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - Y Furukawa
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
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Nagano M, Ota M, Kitai T, Konda T, Sasaki S, Kobori A, Kaji S, Furukawa Y. P3829Long-term serial changes in left atrial volume and function after catheter ablation for atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3829] [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: 11/14/2022] Open
Affiliation(s)
- M Nagano
- Kobe City Medical Center General Hospital, Clinical Laboratory, Kobe, Japan
| | - M Ota
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - T Konda
- Kobe City Medical Center General Hospital, Clinical Laboratory, Kobe, Japan
| | - S Sasaki
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - A Kobori
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - S Kaji
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
| | - Y Furukawa
- Kobe City Medical Center General Hospital, Cardiovascular Medicine, Kobe, Japan
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Fujii Y, Tajima Y, Kaji S, Kishi T, Miyazaki Y, Taniura T, Hirahara N. Complete abdominal wound and anastomotic leak with diffuse peritonitis closure achieved by an abdominal vacuum sealing drainage in a critical ill patient: a case report. BMC Surg 2018; 18:41. [PMID: 29907107 PMCID: PMC6003133 DOI: 10.1186/s12893-018-0375-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 06/05/2018] [Indexed: 02/07/2023] Open
Abstract
Background Negative pressure wound therapy (NPWT) is a widely accepted technique to treat local infectious wounds of the skin, subcutaneous tissue, fascia, or muscle. Recently, several reports describing the efficacy of NPWT for various types of fistulas and anastomotic leaks have been published. We herein describe a patient with an open abdominal wound due to colonic anastomotic leakage and diffuse peritonitis, in whom abdominal vacuum sealing (AVS) as a modified NPWT was useful for the management of this complex wound. Case presentation A 32-year-old man was admitted to our hospital with late presenting traumatic diaphragmatic hernia and strangulated ileum complicated by necrosis of the ileum and transverse colon. He had a history of cervical spinal cord injury due to suicide attempt 14 years earlier and, as a result of cervical spinal cord injury, he was paralyzed in the lower body. The patient underwent an urgent hernia repair and bowel resection. Postoperatively, he developed severe septic shock. On postoperative day (POD) 6, wound dehiscence due to colonic anastomotic leakage with diffuse peritonitis was diagnosed, but he was unable to undergo re-operation because of refractory severe septic shock combined with neurogenic shock due to the cervical cord injury. The patient was treated with AVS therapy. He gradually recovered from septic shock, and the anastomotic leakage healed after a 2-month period. The wound dehiscence was also reduced. The patient resumed oral intake on POD 112 and was discharged on POD 190. Conclusions Although surgical repair would be the best method for the treatment of diffuse peritonitis due to gastrointestinal perforation or anastomotic leakage, our case suggests that AVS with ‘conventional’ drainage is a treatment of choice for open abdominal wounds even in the presence of diffuse peritonitis caused by intestinal anastomotic leakage, especially in patients with poor general medical condition.
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Affiliation(s)
- Yusuke Fujii
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enyacho, Izumo, Shimane, 693-8501, Japan.
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enyacho, Izumo, Shimane, 693-8501, Japan
| | - Shunsuke Kaji
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enyacho, Izumo, Shimane, 693-8501, Japan
| | - Takashi Kishi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enyacho, Izumo, Shimane, 693-8501, Japan
| | - Yoshiko Miyazaki
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enyacho, Izumo, Shimane, 693-8501, Japan
| | - Takahito Taniura
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enyacho, Izumo, Shimane, 693-8501, Japan
| | - Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1, Enyacho, Izumo, Shimane, 693-8501, Japan
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Hirahara N, Tajima Y, Fujii Y, Kaji S, Yamamoto T, Hyakudomi R, Taniura T, Kawabata Y. Prognostic nutritional index as a predictor of survival in resectable gastric cancer patients with normal preoperative serum carcinoembryonic antigen levels: a propensity score matching analysis. BMC Cancer 2018. [PMID: 29534689 PMCID: PMC5850976 DOI: 10.1186/s12885-018-4201-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background An ideal tumor marker should be capable of being detected at any stage of the disease. However, gastric cancer patients do not always have elevated serum carcinoembryonic antigen (CEA) levels, even in advanced cases. Recently, several studies have investigated the associations between preoperative PNI and postoperative long-term outcomes. In this study, we focused on the significance of the prognostic nutritional index (PNI) as a potential predictor of survival in resectable gastric cancer patients with normal preoperative serum CEA levels. Methods We retrospectively conducted cohort study to evaluate the PNI as a predictor of survival in 368 resectable gastric cancer patients who underwent potentially curative gastrectomy at our institute between January 2010 and December 2016. We selected 218 patients by propensity score matching to reduce biases due to the different distributions of co-variables among the comparable groups. Results In the multivariate analysis, pStage (hazard ratio [HR]: 14.003, 95% confidence interval [CI]: 5.033–44.487; p < 0.001), PNI (HR: 2.794, 95% CI: 1.352–6.039; p < 0.001) were identified as independent prognostic factors of CSS in 218 propensity matched gastric cancer patients. The Kaplan-Meier analysis demonstrated that low PNI patients had a significantly poorer cancer specific survival (CSS) than high PNI patients (p = 0.008). Among 166 propensity matched gastric cancer patients with normal preoperative serum CEA levels, multivariate analysis demonstrated that pStage (HR: 7.803, 95% CI: 3.015–24.041; p < 0.001) and PNI (HR: 3.078, 95% CI: 1.232–8.707; p = 0.016) were identified as independent prognostic factors of CSS. And Kaplan-Meier analysis demonstrated that low PNI had a significantly poorer CSS than high PNI value (p = 0.011). Conclusions This study demonstrates that a low preoperative PNI value is a potential independent risk factor for poorer CSS in patients with gastric cancer, even in those with normal serum CEA levels.
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Affiliation(s)
- Noriyuki Hirahara
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
| | - Yoshitsugu Tajima
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yusuke Fujii
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Shunsuke Kaji
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Tetsu Yamamoto
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Ryoji Hyakudomi
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Takahito Taniura
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Yasunari Kawabata
- Department of Digestive and General Surgery, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
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Fujii Y, Hirahara N, Kaji S, Miyazaki Y, Kishi T, Taniura T, Hyakudomi R, Yamamoto T, Nishi T, Hayashi H, Kawabata Y, Tajima Y. [Prolonged Survival Following Chemotherapy in Bone Marrow Carcinomatosis Due to Esophagogastric Junctional Carcinoma - A Case Report]. Gan To Kagaku Ryoho 2017; 44:1949-1951. [PMID: 29394830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A 60s-year-old Japanese male underwent curative resection for an advanced adenocarcinoma of the esophagogastric junction(Stage III C), followed by adjuvant chemotherapy.Twenty -one months later, he was admitted to our hospital with a complaint of marked decline in activities of daily living(ADL).The patient was diagnosed with pancytopenia, disseminated intravascular coagulation(DIC), multiple lymph node and bone metastases, and bone marrow carcinomatosis.After completing a sufficient informed consent process, he received chemotherapy along with blood transfusion, and then DIC, pancytopenia, and ADL of the patient improved.However, the lack of response of pancytopenia and DIC to transfusion relapsed and his ADL worsened after the second course of chemotherapy.It was difficult to administer additional chemotherapy in the patient and he died 24 months after surgery.There is no established treatment for disseminated carcinomatosis of the bone marrow, and the prognosis of these patients without treatment is reported to be only one month.Our case with prolonged survival following chemotherapy and blood transfusion may support the clinical usefulness of chemotherapy for bone marrow carcinomatosis from esophagogastric junctional carcinoma.
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Affiliation(s)
- Yusuke Fujii
- Dept. of Digestive and General Surgery, Shimane University Faculty of Medicine
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Maki T, Choi Y, Miyamoto N, Shindo A, Kaji S, Takahashi R, Lo E, Arai K. A-kinase anchor protein 12 is indispensable for oligodendrocyte maturation in white matter. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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28
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Kaji S, Maki T, Uemura N, Takahashi R. Elucidating alpha-synuclein pathology of multiple system atrophy using primary oligodendrocyte culture. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Uemura M, Ihara M, Maki T, Nakagomi T, Kaji S, Uemura K, Matsuyama T, Kinoshita A, Takahashi R. Pericyte-derived bone morphogenetic protein 4 underlies white matter damage after chronic hypoperfusion. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Watanabe H, Morimoto T, Shiomi H, Yoshikawa Y, Kato T, Saito N, Shizuta S, Yamaji K, Ando K, Kaji S, Furukawa Y, Akao M, Nakagawa Y, Kadota K, Kimura T. P489Post-discharge myocardial infarction after percutaneous coronary intervention: incidence, risk factors, size distribution and its prognostic significance. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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31
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Matsumoto Y, Kobori A, Sasaki Y, Murai R, Ota M, Kim K, Yamane T, Ehara N, Kinoshita M, Kaji S, Furukawa Y. P350Impact of the properties of ablation catheters on ATP-guided pulmonary vein isolation. Europace 2017. [DOI: 10.1093/ehjci/eux141.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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32
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Shirai K, Kaji S, Kawanami T, Hirasawa S. Development of Measurement System Using Evanescent Waves for Characterizing Colloidal Liquids in Heat Transfer Applications. Int J CMEM 2017. [DOI: 10.2495/cmem-v5-n1-34-43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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33
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Terashima M, Hatakeyama K, Kusuhara M, Makuuchi R, Tokunaga M, Tanizawa Y, Bando E, Kawamura T, Hikage M, Kaji S, Ohshima K, Ohnami S, Urakami K, Yamaguchi K. Genetic analysis of gastric cancer with distinctive family history. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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34
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Makuuchi R, Hatakeyama K, Terashima M, Kusuhara M, Tokunaga M, Tanizawa Y, Bando E, Kawamura T, Hikage M, Kaji S, Ohshima K, Urakami K, Yamaguchi K. New approach to gastric cancer classification based on TP53 mutation. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw371.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Makuuchi R, Sugisawa N, Kaji S, Hikage M, Tokunaga M, Tanizawa Y, Bando E, Kawamura T, Terashima M. Enhanced recovery after surgery for gastric cancer and an assessment of preoperative carbohydrate loading. Eur J Surg Oncol 2016; 43:210-217. [PMID: 27554250 DOI: 10.1016/j.ejso.2016.07.140] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 07/25/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND We previously reported on the feasibility of enhanced recovery after surgery (ERAS) protocol for gastric cancer with a prospective phase II study, but the superiority of this approach over non-ERAS perioperative management remains unclear. Preoperative carbohydrate loading, an important element of the ERAS protocol, has been shown to reduce insulin resistance, but its effects on clinical endpoints in gastric cancer surgery remain controversial. The aim of this study was to clarify the efficacy of the ERAS protocol for gastric cancer surgery, with particular focus on preoperative carbohydrate loading. METHODS In this ERAS case-control study, we enrolled 121 patients as a case group and 259 patients undergoing gastrectomy for gastric cancer with our conventional perioperative management as a control group. Matched-pair analysis was performed to balance the patients' characteristics for comparison analysis. RESULTS After matching, 108 patients were included in each group. Postoperative hospital stay was significantly shorter in the ERAS group than in the control group (8 days vs. 9 days, p < 0.001), while the incidence of Clavien-Dindo classification grade II or more postoperative complication was similar between the groups (11.1% vs. 15.7%, p = 0.325). No significant differences were found in serum albumin level, body weight, or grip strength between the groups before surgery and at 1 week and 1 month after surgery. CONCLUSION Use of the ERAS protocol for gastric cancer shortened the length of postoperative hospital stay without increasing complications. Preoperative carbohydrate loading didn't improve the postoperative nutritional status or maintain the muscle strength postoperatively.
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Affiliation(s)
- R Makuuchi
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - N Sugisawa
- Department of Surgery, Tohoku University Graduate School of Medicine, 2-1, Seiryo-Machi, Aoba-Ku, Sendai-Shi, Miyagi, 980-8575, Japan
| | - S Kaji
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - M Hikage
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - M Tokunaga
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Y Tanizawa
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - E Bando
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - T Kawamura
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - M Terashima
- Division of Gastric Surgery, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan.
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Shibayama H, Kaji S, Nishida D, Hirata S, Katada F, Sato S, Fukutake T. Long-term complications of Parkinson'/INS;s disease —/INS; 15th year, 20th year, and beyond/INS;; A hospital-based observational study. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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37
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Sunaga T, Suzuki S, Kogo M, Kurihara T, Kaji S, Koike N, Harada N, Suzuki M, Kiuchi Y. The association between neutropenia and prognosis in stage III colorectal cancer patients receiving adjuvant chemotherapy. Eur J Cancer Care (Engl) 2013; 23:394-400. [PMID: 24033646 DOI: 10.1111/ecc.12120] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2013] [Indexed: 01/14/2023]
Abstract
Neutropenia during chemotherapy has been reported to be a predictor of better survival in patients with several types of cancer, although there are no reports on stage III colorectal cancer (CRC). The purpose of this study was to examine the association between neutropenia and prognosis in stage III CRC patients receiving adjuvant chemotherapy consisting of oral uracil and tegafur (UFT) plus leucovorin (LV). We retrospectively analysed 123 patients with stage III CRC who received UFT/LV as adjuvant chemotherapy. The end-point was disease-free survival (DFS). Survival curves of the two categories (neutropenia absent vs. present) were estimated using the Kaplan-Meier method and compared by the log-rank test. We estimated the hazard ratio (HR) for DFS according to neutropenia after adjustment for covariates by multivariate analyses using Cox's regression analysis. A total of 33 (26.8%) patients experienced neutropenia. Patients without neutropenia showed a significantly lower DFS than those with neutropenia (3-year DFS 57.3% vs. 81.2%, P = 0.0213). By multivariate analysis, neutropenia and histological type were independent prognostic factors, with HR of 0.410 (neutropenia absent vs. present, P = 0.045) and 4.793 (well to moderately differentiated vs. poorly differentiated, P = 0.004) respectively. We demonstrated that neutropenia occurring during adjuvant chemotherapy consisting of UFT/LV may be a prognostic factor of recurrence in stage III CRC patients.
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Affiliation(s)
- T Sunaga
- Department of Pharmacy, Hachioji Digestive Disease Hospital, Tokyo, Japan; Department of Pharmacy Education, Showa University School of Pharmacy, Tokyo, Japan
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38
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Ehara N, Furukawa Y, Kaji S, Kinoshita M, Kobori A, Tani T, Kitai T, Kim K, Morimoto T, Kimura T. Effect of preoperative diabetic treatment on long-term cardiovascular outcomes in diabetic patients undergoing coronary revascularization therapy. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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39
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Nakazawa H, Kaji S, Ishii S. Oscillatory Electric Potential on the Olfactory Epithelium Observed during the Breeding Migration Period in the Japanese Toad, Bufo japonicus. Zoolog Sci 2012; 17:293-300. [PMID: 18494581 DOI: 10.2108/jsz.17.293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/1999] [Accepted: 10/12/1999] [Indexed: 11/17/2022]
Abstract
Japanese toad (Bufo japonicus) tracks the route to and from the breeding sites using the olfactory cues from the migration route and not from the destination (). We recorded a slow extracellular potential change (electro-olfactogram or EOG) evoked on the olfactory epithelium by applying an olfactory stimulus with an air stream. In September toads, only a simple typical EOG that is common in various vertebrate species was observed. Oscillatory potential changes (OSC) superimposed on the typical EOG were observed in the breeding season when studied throughout a year. There were no sexual differences in the occurrence and the amplitude of the OSC. Oscillatory potentials were observed also from the olfactory nerve of the brain. The OSC in the olfactory epithelium remained even after denervation. In addition, it was suggested that there are multiple sites of OSC initiation in the olfactory epithelium. These results suggest an intimate relationship between OSC appearance and the breeding migration in the toad.
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40
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Kitai T, Honda S, Okada Y, Tani T, Kim K, Kaji S, Ehara N, Kinoshita M, Kobori A, Yamamuro A, Kita T, Furukawa Y. Clinical outcomes in non-surgically managed patients with very severe versus severe aortic stenosis. Heart 2011; 97:2029-32. [DOI: 10.1136/heartjnl-2011-300137] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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41
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Kitai T, Kaji S, Yamamuro A, Tani T, Tamita K, Kinoshita M, Ehara N, Kobori A, Nasu M, Okada Y, Furukawa Y. Clinical Outcomes of Medical Therapy and Timely Operation in Initially Diagnosed Type A Aortic Intramural Hematoma: A 20-Year Experience. Circulation 2009; 120:S292-8. [DOI: 10.1161/circulationaha.108.843615] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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42
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Mori M, Togami K, Fujita H, Inoue D, Kimura T, Shimoji S, Nagai Y, Tabata S, Kurata M, Ito K, Hashimoto H, Matsushita A, Nagai K, Kaji S, Takahashi T. Successful allogeneic bone marrow transplantation for chronic myelomonocytic leukemia complicated by refractory aortitis. Bone Marrow Transplant 2009; 45:796-7. [PMID: 19718069 DOI: 10.1038/bmt.2009.228] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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43
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Watanabe N, Akasaka T, Yamaura Y, Akiyama M, Kaji S, Saito Y, Yoshida K. Intramyocardial coronary flow characteristics in patients with hypertrophic cardiomyopathy: non-invasive assessment by transthoracic Doppler echocardiography. Heart 2003; 89:657-8. [PMID: 12748226 PMCID: PMC1767688 DOI: 10.1136/heart.89.6.657] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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44
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45
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Kume T, Saito Y, Watanabe N, Akiyama M, Kaji S, Kamiyama N, Akasaka T, Yoshida K, Fukuhiro Y, Tanemoto K. [Thrombus entrapped in a patent foramen ovale of the atrial septum]. Kyobu Geka 2002; 55:754-7. [PMID: 12174618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
A 59-year-old women was referred to our hospital due to severe dyspnea and shock status 12 days after intracranial hematoma evacuation for the hypertensive right putaminal hemorrhage. Transthoracic echocardiography revealed right ventricular dilatation and floating structures in the right atrium. Transesophageal echocardiography demonstrated a large, snake-like structure crossing her foramen ovale of the interatrial septum, and impending paradoxical embolism was diagnosed. She did not receive any anticoagulation and surgery due to recent cerebral hemorrhage. Follow-up TEE showed complete disappearance of the thrombus in the atrium two weeks after the onset. Phlebogram of deep vein demonstrated several thrombus in her leg. She underwent placement of inferior vena cava filter and was discharged from our hospital without any symptom of paradoxical embolism.
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Affiliation(s)
- T Kume
- Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan
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46
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Watanabe N, Akasaka T, Yamaura Y, Akiyama M, Koyama Y, Kamiyama N, Neishi Y, Kaji S, Saito Y, Yoshida K. Noninvasive detection of total occlusion of the left anterior descending coronary artery with transthoracic Doppler echocardiography. J Am Coll Cardiol 2001; 38:1328-32. [PMID: 11691503 DOI: 10.1016/s0735-1097(01)01556-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the value of transthoracic Doppler echocardiography (TTDE) for the noninvasive detection of total left anterior descending coronary artery (LAD) occlusion. BACKGROUND Total coronary occlusion is associated with an adverse long-term prognosis, and mechanical revascularization may be required for the patient with total coronary occlusion. However, a noninvasive diagnosis of total coronary occlusion before coronary angiography (CAG) has been difficult, especially in patients without clinical signs. METHODS We studied 103 consecutive patients who underwent CAG for the evaluation of coronary artery disease. The study group consisted of 16 patients with total LAD occlusion (group A) and 87 patients without total LAD occlusion (group B). Coronary flow velocity in the mid-portion of the LAD was recorded by TTDE. RESULTS Adequate spectral Doppler recordings of diastolic flow in the LAD were obtained in 98 study patients (95%; 15 patients in group A and 83 patients in group B). In group A, retrograde LAD flow was obtained in 14 (93%) of 15 patients. The mean diastolic velocity of the retrograde flow was 21.0 +/- 6.1 cm/s. In group B, antegrade LAD flow was obtained in all 83 patients (100%). The mean diastolic velocity of the antegrade flow was 21.5 +/- 7.1 cm/s. Retrograde LAD flow by TTDE had a sensitivity of 93% and a specificity of 100% for the detection of total LAD occlusion. CONCLUSIONS Retrograde flow in the LAD by TTDE is a highly sensitive and specific finding that can be used to noninvasively diagnose total LAD occlusion.
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Affiliation(s)
- N Watanabe
- Department of Cardiology, Kawasaki Medical School, Kurashiki, Japan.
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47
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Kaji S, Akasaka T, Yoshida K. Noninvasive coronary imaging. J Cardiol 2001; 37 Suppl 1:51-6. [PMID: 11433828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Noninvasive imaging of the coronary arteries is one of the most important but challenging goals in medical imaging. Recent methods being developed for visualization of the coronary arteries include transthoracic and transesophageal echocardiography, electron-beam computed tomography, and magnetic resonance imaging. Transesophageal echocardiography is a feasible noninvasive technique for imaging the left main coronary artery and detecting hemodynamically significant luminal obstruction. Recent technological advances in transthoracic Doppler echocardiography provide measurement of coronary flow velocity in the distal portion of left anterior descending artery, which is useful for the assessment of coronary flow reserve, and therefore coronary stenosis and restenosis after coronary intervention in left anterior descending artery lesions. Electron-beam computed tomography is a cross-sectional imaging technique with high spatial and temporal resolution. It is possible for image acquisition to be triggered by the patient's electrocardiogram and this technique is well suited to cardiac imaging. Electron-beam computed tomography might be useful to detect or rule out high-grade coronary artery stenoses and occlusions, when image quality is adequate. Recent improvements and progress in coronary magnetic resonance angiography stem from the use of respiratory motion compensation and fast imaging methods. The most commonly used breath-hold method was developed with a fast segmented two-dimensional sequence on thin sections oriented to capture the coronary vessel inplane. Sensitivity and specificity of coronary magnetic resonance angiography in detecting significant coronary artery disease are 90% and 92% using this method.
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Affiliation(s)
- S Kaji
- Division of Cardiology, Kawasaki Medical School, Matsushima 577, Kurashiki, Okayama 701-0192, Japan
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48
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Kaji S, Yang PC, Kerr AB, Tang WH, Meyer CH, Macovski A, Pauly JM, Nishimura DG, Hu BS. Rapid evaluation of left ventricular volume and mass without breath-holding using real-time interactive cardiac magnetic resonance imaging system. J Am Coll Cardiol 2001; 38:527-33. [PMID: 11499748 DOI: 10.1016/s0735-1097(01)01399-7] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The purpose of this study was to validate cardiac measurements derived from real-time cardiac magnetic resonance imaging (MRI) as compared with well-validated conventional cine MRI. BACKGROUND Although cardiac MRI provides accurate assessment of left ventricular (LV) volume and mass, most techniques have been relatively slow and required electrocardiogram (ECG) gating over many heart beats. A newly developed real-time MRI system allows continuous real-time dynamic acquisition and display without cardiac gating or breath-holding. METHODS Fourteen healthy volunteers and nine patients with heart failure underwent real-time and cine MRI in the standard short-axis orientation with a 1.5T MRI scanner. Nonbreath-holding cine MRI was performed with ECG gating and respiratory compensation. Left ventricular end-diastolic volume (LVEDV), left ventricular endsystolic volume (LVESV), ejection fraction (EF) and LV mass calculated from the images obtained by real-time MRI were compared to those obtained by cine MRI. RESULTS The total study time including localization for real-time MRI was significantly shorter than cine MRI (8.6 +/- 2.3 vs. 24.7 +/- 3.5 min, p < 0.001). Both imaging techniques yielded good quality images allowing cardiac measurements. The measurements of LVEDV, LVESV, EF and LV mass obtained with real-time MRI showed close correlation with those obtained with cine MRI (LVEDV: r = 0.985, p < 0.001; LVESV: r = 0.994, p < 0.001; EF: r = 0.975, p < 0.001; LV mass: r = 0.977, p < 0.001). CONCLUSIONS Real-time MRI provides accurate measurements of LV volume and mass in a time-efficient manner with respect to image acquisition.
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Affiliation(s)
- S Kaji
- Department of Medicine, Stanford University, California, USA
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49
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Heeschen C, Jang JJ, Weis M, Pathak A, Kaji S, Hu RS, Tsao PS, Johnson FL, Cooke JP. Nicotine stimulates angiogenesis and promotes tumor growth and atherosclerosis. Nat Med 2001; 7:833-9. [PMID: 11433349 DOI: 10.1038/89961] [Citation(s) in RCA: 579] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We provide anatomic and functional evidence that nicotine induces angiogenesis. We also show that nicotine accelerates the growth of tumor and atheroma in association with increased neovascularization. Nicotine increased endothelial-cell growth and tube formation in vitro, and accelerated fibrovascular growth in vivo. In a mouse model of hind-limb ischemia, nicotine increased capillary and collateral growth, and enhanced tissue perfusion. In mouse models of lung cancer and atherosclerosis, we found that nicotine enhanced lesion growth in association with an increase in lesion vascularity. These effects of nicotine were mediated through nicotinic acetylcholine receptors at nicotine concentrations that are pathophysiologically relevant. The endothelial production of nitric oxide, prostacyclin and vascular endothelial growth factor might have a role in these effects.
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Affiliation(s)
- C Heeschen
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
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50
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Okamoto M, Nagata I, Murakami J, Kaji S, Iitsuka T, Hoshika T, Matsuda R, Tazawa Y, Shiraki K, Hino S. Prospective reevaluation of risk factors in mother-to-child transmission of hepatitis C virus: high virus load, vaginal delivery, and negative anti-NS4 antibody. J Infect Dis 2000; 182:1511-4. [PMID: 11023474 DOI: 10.1086/315883] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2000] [Revised: 07/24/2000] [Indexed: 12/24/2022] Open
Abstract
Of 21,791 pregnant women screened in Tottori Prefecture, Japan, 127 (0.58%) were positive for anti-hepatitis C virus (HCV) antibody and 84 (0.39%) were positive for HCV RNA. Of 84 children followed up for at least 6 months, 7 (8%) were infected. All of them were born to 26 mothers with a high virus load (HVL; >/=2.5x106 RNA copies/mL [27%]), compared with 0 of 58 children born to non-HVL mothers (P<.001). Because all the infected children were vaginally delivered, the infection rate among 16 vaginally delivered children born to the HVL mothers was as high as 44%. The prevalence of anti-NS4 antibody in the mothers with an infectious HVL was significantly lower than that in the mothers with a noninfectious HVL (P=.048). Analysis of our results suggests that maternal HVL, vaginal delivery, and negative anti-NS4 antibody are significant risk factors for the mother-to-child transmission of HCV.
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Affiliation(s)
- M Okamoto
- Department of Pediatrics, Faculty of Medicine, Tottori University, Yonago, Japan
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