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1. Effect of acute kidney injury and overall survival in patients with postoperative head and neck cancer who received chemoradiotherapy with cisplatin: A supplementary analysis of the phase II/III trial of JCOG1008

Author

Yoshinori Imamura, Naomi Kiyota, Makoto Tahara, Takeshi Kodaira, Ryuichi Hayashi, Hiroshi Nishino, Yukinori Asada, Hiroki Mitani, Shigemichi Iwae, Naoki Nishio, Yusuke Onozawa, Nobuhiro Hanai, Akira Ohkoshi, Hiroki Hara, Nobuya Monden, Masato Nagaoka, Shujiro Minami, Ryo Kitabayashi, Keita Sasaki, Akihiro Homma, and the Head and Neck Cancer Study Group of the Japan Clinical Oncology Group (JCOG‐HNCSG)

Subjects
acute kidney injury, cisplatin, head and neck cancer, overall survival, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background In a randomized phase II/III trial (JCOG1008), weekly cisplatin (40 mg/m2) was non‐inferior to 3‐weekly cisplatin (100 mg/m2) for postoperative high‐risk head and neck cancer. We investigated how acute kidney injury (AKI), a major dose‐limiting toxicity effect of cisplatin, affects overall survival (OS). Methods We analyzed 251 patients from JCOG1008 receiving chemoradiotherapy. AKI was defined based on AKI Network criteria (serum creatinine increase of ≥0.3 mg/dL or ≥1.5‐fold [≥ stage I]) within 30 days after completing chemoradiotherapy. OS in the two arms was compared according to AKI development using the log‐rank test. Results The total incidence of AKI was lower in the weekly arm than in the 3‐weekly arm (38/122 [31.1%] vs. 56/129 [43.4%]). Additionally, stage II/III AKI occurred less frequently in the weekly arm than in the 3‐weekly arm (8/122 [6.6%] vs. 19/129 [14.7%]). Cisplatin doses were similar in the weekly arm for patients with and without AKI (median, 238.6 mg/m2 vs. 239.2 mg/m2; p = 0.94), but lower in the 3‐weekly arm for those who developed AKI (median, 276.3 mg/m2 vs. 297.4 mg/m2; p = 0.007). In the weekly arm, there was no difference in OS between patients with and without AKI (hazard ratio [HR], 1.06; 95% confidence interval [CI], 0.53 to 2.10). However, in the 3‐weekly arm, patients with AKI had poorer OS than those without AKI (HR, 1.83; 95% CI, 1.04 to 3.21). Conclusions In this supplementary analysis of JCOG1008 data, AKI impacted the OS of patients with head and neck cancer undergoing postoperative chemoradiotherapy in the 3‐weekly arm but not in the weekly arm. Our results further endorse the utilization of weekly cisplatin at 40 mg/m2 in this setting.

Published
2024
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2. Transoral surgery for superficial head and neck cancer: National Multi‐Center Survey in Japan

Author

Chikatoshi Katada, Manabu Muto, Satoshi Fujii, Tetsuji Yokoyama, Tomonori Yano, Akihito Watanabe, Toshiro Iizuka, Shigetaka Yoshinaga, Ichiro Tateya, Hiroki Mitani, Yuichi Shimizu, Akiko Takahashi, Tomoyuki Kamijo, Noboru Hanaoka, Makoto Abe, Akihiro Shiotani, Koichi Kano, Yukinori Asada, Tamotsu Matsuhashi, Hirohito Umeno, Kenji Okami, Kenichi Goda, Shinichiro Hori, Yoichiro Ono, Shuji Terai, Yasuaki Nagami, Kenichi Takemura, Kenro Kawada, Mizuo Ando, Naoto Shimeno, Akihito Arai, Yasutoshi Sakamoto, Masaaki Ichinoe, Tetsuo Nemoto, Masahiro Fujita, Hidenobu Watanabe, Tadakazu Shimoda, Atsushi Ochiai, Takakuni Kato, and Ryuichi Hayashi

Subjects
head and neck cancer, larynx preservation, pharyngeal cancer, superficial cancer, transoral surgery, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Head and neck cancers, especially in hypopharynx and oropharynx, are often detected at advanced stage with poor prognosis. Narrow band imaging enables detection of superficial cancers and transoral surgery is performed with curative intent. However, pathological evaluation and real‐world safety and clinical outcomes have not been clearly understood. The aim of this nationwide multicenter study was to investigate the safety and efficacy of transoral surgery for superficial head and neck cancer. We collected the patients with superficial head and neck squamous cell carcinoma who were treated by transoral surgery from 27 hospitals in Japan. Central pathology review was undertaken on all of the resected specimens. The primary objective was effectiveness of transoral surgery, and the secondary objective was safety including incidence and severity of adverse events. Among the 568 patients, a total of 662 lesions were primarily treated by 575 sessions of transoral surgery. The median tumor diameter was 12 mm (range 1–75) endoscopically. Among the lesions, 57.4% were diagnosed as squamous cell carcinoma in situ. The median procedure time was 48 minutes (range 2–357). Adverse events occurred in 12.7%. Life‐threatening complications occurred in 0.5%, but there were no treatment‐related deaths. During a median follow‐up period of 46.1 months (range 1–113), the 3‐year overall survival rate, relapse‐free survival rate, cause‐specific survival rate, and larynx‐preservation survival rate were 88.1%, 84.4%, 99.6%, and 87.5%, respectively. Transoral surgery for superficial head and neck cancer offers effective minimally invasive treatment. Clinical trials registry number: UMIN000008276.

Published
2021
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3. Comparison of the efficacy and safety of the <scp>EXTREME</scp> regimen for treating recurrent or metastatic head and neck squamous cell carcinoma in older and younger adult patients

Author

Junichi Tomomatsu, Makiko Ono, Hiroki Mitani, Naomi Hayashi, Naoki Fukuda, Mayu Yunokawa, Xiaofei Wang, Yu Fujiwara, Akihiro Ohmoto, Kenji Nakano, Shunji Takahashi, Yasuyoshi Sato, and Tetsuya Urasaki

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, Drug-Related Side Effects and Adverse Reactions, Cetuximab, Nutritional Status, chemotherapy, Risk Assessment, Severity of Illness Index, cancer care, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Adverse effect, Geriatric Assessment, Aged, Retrospective Studies, Squamous Cell Carcinoma of Head and Neck, business.industry, Incidence, Patient Selection, Incidence (epidemiology), Hazard ratio, Head and neck cancer, Age Factors, biomarkers, Chemoradiotherapy, Original Articles, Middle Aged, medicine.disease, Head and neck squamous-cell carcinoma, Progression-Free Survival, Confidence interval, Clinical trial, Regimen, nutrition, Oncology, Chemotherapy, Adjuvant, Head and Neck Neoplasms, Female, Original Article, head and neck cancer, Fluorouracil, Cisplatin, Neoplasm Recurrence, Local, business
Abstract

Background Head and neck squamous cell carcinoma (HNSCC) is a geriatric cancer. However, older adult patients are frequently underrepresented in large clinical trials. Aims The aim of this study is to assess the efficacy and safety of the EXTREME regimen (platinum + fluorouracil + cetuximab) in older and younger adult patients with HNSCC. Methods and results Patients with recurrent or metastatic HNSCC treated with the EXTREME regimen were retrospectively analyzed. We compare the efficacy and safety in older (aged ≥70 years) younger (aged

Published
2020

4. Indwelling voice prosthesis insertion after total pharyngolaryngectomy with free jejunal reconstruction

Author

Akira Seto, Hiroyuki Yonekawa, Ryousuke Kamiyama, Takeharu Kanazawa, Hiroki Mitani, Toru Sasaki, Takahiro Asakage, Kiyoshi Misawa, Kazuyoshi Kawabata, Wataru Shimbashi, and Hirofumi Fukushima

Subjects
medicine.medical_specialty, business.industry, Head and neck cancer, General Medicine, Total pharyngolaryngectomy, medicine.disease, Voice prosthesis, Surgery, Resection, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Chart review, Medicine, In patient, 030223 otorhinolaryngology, Complication, business, Standard therapy
Abstract

Objectives Total pharyngolaryngectomy with free jejunal reconstruction is often performed in patients with hypopharyngeal carcinoma. However, postoperative speechlessness significantly decreases patient quality of life. We investigated whether Provox® insertion could preserve speech after total pharyngolaryngectomy with free jejunal reconstruction. Study Design Retrospective chart review. Methods A total of 130 cases of secondary Provox® insertions after total pharyngolaryngectomy with free jejunal reconstruction were analyzed. Communication outcomes were compared using the Head and Neck Cancer Understandability of Speech Subscale. Outcomes and complications associated with insertion site (jejunal insertion vs. esophageal insertion) and adjuvant irradiation therapy were also evaluated. Results Provox® insertion had favorable communication outcomes in 102 cases (78.4%). Neither the insertion site nor irradiation affected the communication outcome. Complications were observed in 20 cases (15.4%). Local infection was the most common complication. Free jejunal insertion, in which the resection range was enlarged, had a lower complication rate than did esophageal insertion, and its complication rate was unaffected by previous irradiation. For all patients, the hospitalization duration and duration of speechlessness were 13.4 days and 14.6 months, respectively. Patients receiving jejunal insertions had a significantly shorter hospitalization duration than did those receiving esophageal insertions. Unlike Provox®2, Provox®Vega significantly reduced the complication rate to zero. Conclusion For jejunal inserson of a Provox® prosthetic, a sufficient margin can be maintained during total pharyngolaryngectomy and irradiation can be performed, and satisfactory communication outcomes were observed. Provox® insertion after total pharyngolaryngectomy with free jejunal reconstruction should be considered the standard therapy for voice restoration. Level of Evidence 4.

Published
2017

5. A Clinical Study of Pharyngolaryngectomy with Total Esophagectomy

Author

Hiroki Mitani, Hiroyuki Yonekawa, Wataru Shimbashi, Toru Sasaki, Aya Ebina, Kazuyoshi Kawabata, Yuh Koizumi, Hirofumi Fukushima, Akira Seto, and Ryosuke Kamiyama

Subjects
Male, medicine.medical_specialty, Esophageal Neoplasms, Ileus, medicine.medical_treatment, Fistula, Laryngectomy, Clinical study, Postoperative Complications, Japan, Pharyngectomy, medicine, Humans, Aged, Neoplasm Staging, Retrospective Studies, Hypopharyngeal Neoplasms, business.industry, Total esophagectomy, General surgery, Hypopharyngeal cancer, Middle Aged, Plastic Surgery Procedures, Esophageal cancer, Prognosis, medicine.disease, Surgery, Esophagectomy, Survival Rate, Otorhinolaryngology, Quality of Life, Thyroidectomy, Neck Dissection, Female, business, Thoracic esophageal cancer
Abstract

Patients with advanced hypopharyngeal or cervical esophageal cancer have a comparatively high risk of also developing thoracic esophageal cancer. Pharyngolaryngectomy with total esophagectomy is highly invasive, and few reports about it exist. We examined the postoperative complications and respective countermeasures and prognoses of patients who underwent pharyngolaryngectomy with total esophagectomy.Case series with chart review.Department of Head and Neck Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Japan.We examined the postoperative complications and respective countermeasures and prognoses of 40 patients who underwent pharyngolaryngectomy with total esophagectomy in our hospital.Postoperative complications were observed in 23 patients (57.5%) and consisted of 8 groups: tracheal region necrosis in 5 patients; neck abscess formation/wound infection in 5; fistula in 4; tracheostomy suture leakage in 2; ileus in 2; lymphorrhea in 2; pulmonary complications in 2; and other complications, including hemothorax, tracheoinnominate artery fistula, temporary cardiac arrest due to intraoperative mediastinum operation, methicillin-resistant Staphylococcus aureus enteritis, and sepsis, in 1 patient each. A lethal complication-brachiocephalic vein hemorrhage due to tracheostomy suture leakage and hemorrhagic shock due to tracheoinnominate artery fistula-occurred in 2 (5%) patients. The crude 5-year survival rate was 48.6%.Serious postoperative complications were related to tracheostomaplasty. Although pharyngolaryngectomy with total esophagectomy is highly invasive, we believe that our outlined treatment method is the most appropriate for cases of advanced hypopharyngeal or cervical esophageal cancer that also requires concurrent surgery for esophageal cancer.

Published
2015

6. Environmental isolation ofCryptococcus neoformansandCryptococcus gattiifrom living trees in Guindy National Park, Chennai, South India

Author

D. Prabu, Thangam Menon, C. P. Girish Kumar, Yuzuru Mikami, and Hiroki Mitani

Subjects
Cryptococcus neoformans, biology, National park, Syzygium, Cinnamomum aromaticum, India, Cryptococcus gattii, Dermatology, General Medicine, Isolation (microbiology), biology.organism_classification, Wood, Infectious Diseases, Eucalyptus globulus, visual_art, Botany, Environmental Microbiology, visual_art.visual_art_medium, Bark, Woody plant
Abstract

We report for the first time the environmental isolation of Cryptococcus neoformans from decaying wood and bark debris of living trees in Guindy National Park, Chennai, South India. Of the 40 trees screened, four isolates of Cryptococcus species were recovered of which two were Cryptococcus gattii, one was C. neoformans and one was untypable. The isolation of C. neoformans from Eucalyptus globulus and C. gattii from Cassia marginata in this study constitutes the first record of the natural occurrence of C. neoformans varieties in these tree species anywhere in the world. The isolation of C. gattii from Syzygium cumini represents the first isolation from South India.

Published
2010

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