248 results on '"Masakazu, Yamamoto"'
Search Results
2. Distal Bile Duct Metastasis after Colorectal Cancer Surgery: A Case Report
- Author
-
Kyohei Ogawa, Ryota Higuchi, Takehisa Yazawa, Shuichiro Uemura, Wataru Izumo, Toru Furukawa, Yoji Nagashima, Masakazu Yamamoto, and Hiroto Egawa
- Subjects
Gastroenterology ,Surgery - Published
- 2022
3. A case of pathologically complete response after preoperative chemotherapy in a pancreatic acinar cell carcinoma patient with portal vein tumor thrombosis
- Author
-
Wataru Izumo, Ryota Higuchi, Toru Furukawa, Takehisa Yazawa, Shuichiro Uemura, Yukiko Takayama, Kyoko Shimizu, Katsutoshi Tokushige, Hiroto Egawa, and Masakazu Yamamoto
- Subjects
Male ,Pancreatic Neoplasms ,Venous Thrombosis ,Carcinoma, Acinar Cell ,Portal Vein ,Antineoplastic Combined Chemotherapy Protocols ,Gastroenterology ,Humans ,General Medicine ,Aged - Abstract
Preoperative treatment is being proposed as a standard treatment for pancreatic ductal adenocarcinoma though few cases show a pathologically complete response. On the other hand, there is no consensus regarding preoperative chemotherapy for pancreatic acinar cell carcinoma (ACC). The present study described a rare case of ACC in the pancreatic head with portal vein tumor thrombosis (PVTT) treated with preoperative chemotherapy using modified FOLFIRINOX, which achieved a pathologically complete response. A 65-year-old man was referred for consideration of treatment strategy. Contrast-enhanced abdominal computed tomography revealed a pancreatic tumor and PVTT. The pancreatic tumor was diagnosed as ACC by an endoscopic ultrasound-guided fine-needle aspiration biopsy. Initially, the tumor was assessed as unresectable due to the presence of PVTT, and therefore, a chemotherapy using modified FOLFIRINOX was administered. After 14 courses of the chemotherapy, imaging studies revealed that the tumor and PVTT showed marked reduction in size; thus, the patient underwent pancreaticoduodenectomy with combined resection of the portal vein (PV). A pathological examination uncovered a complete degeneration of the primary tumor and the PV embolus without any residue of carcinoma. The patient did not receive adjuvant chemotherapy and survived with no evidence of recurrence for 33 months after surgery. The chemotherapy using modified FOLFIRINOX could give a complete response in patients with pancreatic ACC with PVTT.
- Published
- 2022
4. A Case of Postoperative Recurrence of Primary Malignant Melanoma of the Esophagus in the Liver with Complete Response with Nivolumab Therapy
- Author
-
Harushi Osugi, Yosuke Yagawa, Shinsuke Maeda, Kyohei Ogawa, Hiromi Onizuka, Kenji Kudo, Yukinori Toyoshima, Masakazu Yamamoto, and Kosuke Narumiya
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Melanoma ,Gastroenterology ,medicine.disease ,medicine.anatomical_structure ,Internal medicine ,Medicine ,Surgery ,Esophagus ,Nivolumab ,business ,Complete response - Published
- 2021
5. Automated recognition of objects and types of forceps in surgical images using deep learning
- Author
-
Michio Itabashi, Takahiro Okamoto, Shingo Kameoka, Masakazu Yamamoto, Yoshiko Bamba, and Shimpei Ogawa
- Subjects
Colon ,Mathematics and computing ,Computer science ,Science ,Forceps ,education ,Video Recording ,Convolutional neural network ,Article ,Pattern Recognition, Automated ,Intraoperative Period ,Deep Learning ,Medical research ,Software Design ,Image Processing, Computer-Assisted ,Surgical skills ,Humans ,Computer vision ,Digestive System Surgical Procedures ,Clip forceps ,Cancer ,Surgeons ,Multidisciplinary ,Grasping forceps ,business.industry ,Deep learning ,Rectum ,Gastroenterology ,Surgical Instruments ,Motor Skills ,Medicine ,Clinical Competence ,Artificial intelligence ,Precision and recall ,business ,Professional skills - Abstract
Background: Analysis of operative data with convolutional neural networks (CNNs) is expected to improve the knowledge and professional skills of surgeons. Identification of objects in videos recorded during surgery can be used for surgical skill assessment and surgical navigation. The objectives of this study were to recognize objects and types of forceps in surgical videos acquired during colorectal surgeries and evaluate detection accuracy.Methods: Images (n=1818) were extracted from 11 surgical videos for model training, and another 500 images were extracted from 6 additional videos for validation. The following 5 types of forceps were selected for annotation: ultrasonic scalpel, grasping, clip, angled (Maryland and right-angled), and spatula. IBM Visual Insights software was used, which incorporates the most popular open-source deep-learning CNN frameworks.Results: In total, 1039/1062 (97.8%) forceps were correctly identified among 500 test images. Calculated recall and precision values were as follows: grasping forceps, 98.1% and 98.0%; ultrasonic scalpel, 99.4% and 93.9%; clip forceps, 96.2% and 92.7%; angled forceps, 94.9% and 100%; and spatula forceps, 98.1% and 94.5%, respectively.Conclusions: Forceps recognition can be achieved with high accuracy using deep-learning models, providing the opportunity to evaluate how forceps are used in various operations.
- Published
- 2021
6. Lateral pelvic lymph nodes for rectal cancer: A review of diagnosis and management
- Author
-
Yuji Inoue, Kimitaka Tani, Hiroka Kondo, Yoshiko Bamba, Shimpei Ogawa, Shigeki Yamaguchi, Ryosuke Nakagawa, Hisako Aihara, Masakazu Yamamoto, Kurodo Koshino, Michio Itabashi, and Takeshi Ohki
- Subjects
medicine.medical_specialty ,Colorectal cancer ,medicine.medical_treatment ,Lateral pelvic lymph node metastasis ,Metastasis ,Lateral pelvic lymph node dissection ,Diagnosis ,medicine ,Risk factor ,Rectal cancer ,Lymph node ,Pelvis ,medicine.diagnostic_test ,Radiotherapy ,business.industry ,Gastroenterology ,Magnetic resonance imaging ,Minireviews ,medicine.disease ,Radiation therapy ,Treatment ,Dissection ,medicine.anatomical_structure ,Oncology ,Radiology ,business - Abstract
The current status and future prospects for diagnosis and treatment of lateral pelvic lymph node (LPLN) metastasis of rectal cancer are described in this review. Magnetic resonance imaging (MRI) is recommended for the diagnosis of LPLN metastasis. A LPLN-positive status on MRI is a strong risk factor for metastasis, and evaluation by MRI is important for deciding treatment strategy. LPLN dissection (LPLD) has an advantage of reducing recurrence in the lateral pelvis but also has a disadvantage of complications; therefore, LPLD may not be appropriate for cases that are less likely to have LPLN metastasis. Radiation therapy (RT) and chemoradiation therapy (CRT) have limited effects in cases with suspected LPLN metastasis, but a combination of preoperative CRT and LPLD may improve the treatment outcome. Thus, RT and CRT plus selective LPLD may be a rational strategy to omit unnecessary LPLD and produce a favorable treatment outcome.
- Published
- 2021
7. The outcomes of thrombotic microangiopathy after liver transplantation: A nationwide survey in Japan
- Author
-
Yasutsugu Takada, Masakazu Yamamoto, Susumu Eguchi, Hiroki Yamaue, and Mitsuhisa Takatsuki
- Subjects
medicine.medical_specialty ,Multivariate analysis ,Thrombotic microangiopathy ,medicine.medical_treatment ,Liver transplantation ,urologic and male genital diseases ,Gastroenterology ,Primary sclerosing cholangitis ,Japan ,hemic and lymphatic diseases ,Internal medicine ,Living Donors ,medicine ,Humans ,Renal replacement therapy ,neoplasms ,Retrospective Studies ,Cause of death ,Hepatology ,Thrombotic Microangiopathies ,business.industry ,medicine.disease ,female genital diseases and pregnancy complications ,digestive system diseases ,Liver Transplantation ,Transplantation ,Hepatocellular carcinoma ,Surgery ,business - Abstract
Background Although thrombotic microangiopathy (TMA) is recognized as one of the poor-prognosis factors after liver transplantation, the precise outcome of TMA is unclear. We sought to elucidate the factors affecting the outcome of TMA after liver transplantation in Japan, based on the data from a nationwide survey. Methods One hundred cases of post-transplant TMA were accumulated from 17 Japanese centers of which 2 cases were excluded because the cause of death was obviously not related to TMA (recurrence of original diseases as primary sclerosing cholangitis and hepatocellular carcinoma), and remaining 98 cases were enrolled in this study. The patient survival after the development of TMA and the factors that affected the patients' outcomes were retrospectively analyzed. Results All cases were living-donor liver transplant cases, and the 1-, 3-, and 5-year patient survival rates after transplantation were 66.9%, 64.6%, and 62.2%, respectively. In a multivariate analysis, the requirement of renal replacement therapy during TMA treatment was the only factor that was significantly related to poor outcome after the development of TMA. Conclusion The outcomes of TMA were generally poor. The progression of renal dysfunction despite intensive treatment might be the only factor related to the poor prognosis after the development of TMA.
- Published
- 2021
8. The utility of liver transplantation to treat acute liver failure caused by adult-onset Still’s disease: case reports
- Author
-
Masayoshi Harigai, Hiroto Egawa, Yuri Ogasawara, Tomomi Kogiso, Makiko Taniai, Akiko Omori, Yoshihito Kotera, Takaomi Sagawa, Katsutoshi Tokushige, Eri Sugano, Masakazu Yamamoto, and Naoko Konda
- Subjects
Adult ,medicine.medical_specialty ,Prednisolone ,medicine.medical_treatment ,Encephalopathy ,Liver transplantation ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Glucocorticoids ,Aged ,Subacute thyroiditis ,business.industry ,digestive, oral, and skin physiology ,Liver failure ,General Medicine ,Liver Failure, Acute ,Middle Aged ,Hepatology ,medicine.disease ,Colorectal surgery ,Liver Transplantation ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,business ,Still's Disease, Adult-Onset ,Abdominal surgery ,medicine.drug - Abstract
Adult-onset Still’s disease (AOSD) is an inflammatory condition commonly complicated by mild liver dysfunction. However, severe liver failure is rarely reported. We report three cases of severe acute hepatic failure (ALF) associated with AOSD. We encountered three cases of acute liver failure (ALF) with encephalopathy. Case 1 was a 75-year-old female, who was started on a steroid (prednisolone, PSL) to treat AOSD; this was gradually tapered. Two months later, severe ALF developed. She died despite an increase in the PSL dose and artificial liver support. Case 2 was a 26-year-old-female taking PSL 30 mg/day to treat subacute thyroiditis. PSL was tapered, and she received methyl PSL pulse therapy and artificial liver support, but this did not cure the ALF. Liver transplantation (LT) was performed 25 days later. Three years later, the same symptoms were observed and we diagnosed AOSD. Case 3 was a 56-year-old-female who met the AOSD criteria. PSL 50 mg/day was started and then tapered. Methyl PSL pulse therapy was prescribed to treat hemophagocytic syndrome, but she required LT on hospital day 13. In AOSD cases, ALF is rarely complicated; urgent LT should be considered only for patients with AOSD-related severe ALF.
- Published
- 2021
9. Association of day of the week with mortality after elective right hemicolectomy for colon cancer: Case analysis from the National Clinical Database
- Author
-
Masakazu Yamamoto, Kazuhiro Hanazaki, Hiroshi Hasegawa, Nao Ichihara, Hiroaki Miyata, Hideki Endo, Hiromichi Maeda, Kinji Kamiya, Kazuhiro Yoshida, Yasuyuki Seto, Yoshihiro Kakeji, Sunao Uemura, Yuko Kitagawa, and Hiroki Yamaue
- Subjects
medicine.medical_specialty ,RD1-811 ,Colorectal cancer ,Names of the days of the week ,medicine.medical_treatment ,RC799-869 ,elective surgical procedures ,Logistic regression ,Internal medicine ,medicine ,Clinical endpoint ,Colectomy ,hospital mortality ,business.industry ,Gastroenterology ,colonic neoplasms ,Original Articles ,Odds ratio ,Diseases of the digestive system. Gastroenterology ,colectomy ,medicine.disease ,Confidence interval ,treatment outcome ,Original Article ,Surgery ,business ,Elective Surgical Procedure - Abstract
Aim We aimed to investigate whether later weekdays are related to worse short‐term outcomes after elective right hemicolectomy for colon cancer. Methods We retrospectively analyzed adult patients who underwent elective right hemicolectomy for colon cancer between 2012 and 2017. Records lacking details about surgical mortality were excluded, and multiple imputation was performed for other missing data (variables). The primary endpoint was surgical mortality, defined as the sum of 30‐day mortality and in‐hospital deaths within 90 days postoperatively. Using 22 clinical variables, hierarchal logistic regression modeling with clustering of patients from the same institutes was performed. Results Of the 112 658 patients undergoing elective right hemicolectomy for colon cancer, the 30‐day mortality and surgical mortality were 0.6% and 1.1%, respectively. Surgery on Friday was less frequent, accounting for 17.1% of all cases. The occurrence of severe postoperative complications, anastomotic leakage, or unadjusted odds ratio for surgical mortality did not show significant differences between weekdays. A hierarchal logistic regression model identified 19 independent factors for surgical mortality. Adjusted odds ratios for surgical mortality were 1.01 (95% confidence interval: 0.83‐1.22, P = .915), 0.86 (95% confidence interval: 0.71‐1.05, P = .144), 0.86 (95% confidence interval: 0.71‐1.05, P = .408), and 0.83 (95% confidence interval: 0.68‐1.03, P = .176) for Tuesday, Wednesday, Thursday, and Friday, respectively, showing no significant differences. Conclusion This study did not identify an evident difference in surgical mortality between weekdays; a safe elective right hemicolectomy for colon cancer is being offered throughout the week in Japan., Weekday effect on mortality.
- Published
- 2021
10. Evaluation of preoperative prognostic factors in patients with resectable invasive intraductal papillary mucinous carcinoma
- Author
-
Toru Furukawa, Takehisa Yazawa, Masahiro Shiihara, Ryota Higuchi, Shuichiro Uemura, Masakazu Yamamoto, and Wataru Izumo
- Subjects
Male ,medicine.medical_specialty ,Multivariate analysis ,CA-19-9 Antigen ,Kaplan-Meier Estimate ,030230 surgery ,Risk Assessment ,Gastroenterology ,Disease-Free Survival ,03 medical and health sciences ,Pancreatectomy ,0302 clinical medicine ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Humans ,Medicine ,Mucinous carcinoma ,Neoplasm Invasiveness ,In patient ,Risk factor ,Aged ,Retrospective Studies ,Aged, 80 and over ,Tumor size ,business.industry ,Standard treatment ,Hazard ratio ,Middle Aged ,Prognosis ,medicine.disease ,Adenocarcinoma, Mucinous ,Pancreatic Neoplasms ,Survival Rate ,Chemotherapy, Adjuvant ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Preoperative Period ,Tubular Adenocarcinoma ,Female ,Surgery ,Neoplasm Recurrence, Local ,business ,Carcinoma, Pancreatic Ductal ,Follow-Up Studies - Abstract
Background Upfront surgery is the standard treatment for resectable invasive intraductal papillary mucinous carcinoma; however, recurrence is common. Therefore, we investigated the recurrence, surgical outcome, and preoperative prognostic factors for recurrence in patients with resectable invasive intraductal papillary mucinous carcinoma. Methods We analyzed 111 patients who underwent upfront surgery for resectable invasive intraductal papillary mucinous carcinoma between 2000 and 2017 and evaluated the relationship among clinicopathologic factors, recurrence, and outcomes. Results The 5-year recurrence-free survival and disease-specific survival rates were 61% and 74%, respectively. The median time to recurrence was 1.1 years. In multivariate analysis, carbohydrate antigen 19-9 ≥83 U/mL (hazard ratio: 2.8 and 3.1), tumor size ≥2.2 cm (hazard ratio: 3.5 and 4.7), and pathologic tubular adenocarcinoma grade 2 (hazard ratio: 3.1 and 5.2) were risk factors for a shorter recurrence-free survival and disease-specific survival, respectively. Lymph node metastasis (hazard ratio: 3.9) was also a risk factor for a shorter disease-specific survival. When examining outcomes according to preoperatively measurable factors (carbohydrate antigen 19-9 ≥83 U/mL and tumor size ≥2.2 cm), the 5-year recurrence rates in patients with none (n = 47), 1 (n = 46), and both (n = 18) risk factors were 17%, 48%, and 78%, respectively. Five-year disease-specific survival rates in patients with none, 1, and both preoperative risk factors were 95%, 69%, and 31%, respectively. Conclusion Carbohydrate antigen 19-9 ≥83 U/mL and tumor size ≥2.2 cm were independent preoperative risk factors for poor outcomes in patients with resectable invasive intraductal papillary mucinous carcinoma.
- Published
- 2020
11. A case of hemorrhage of hepatocellular carcinoma resembling a hepatic cyst arising from non-cirrhotic steatohepatitis
- Author
-
Satomi Saito, Takaomi Sagawa, Katsutoshi Tokushige, Akiko Omori, Masakazu Yamamoto, Yoshihito Kotera, Kyoko Shimizu, Masayuki Nakano, Tomomi Kogiso, Makiko Taniai, and Sho Yatsuji
- Subjects
Pathology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Hemorrhage ,Malignancy ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Cyst ,Aged ,medicine.diagnostic_test ,Cysts ,business.industry ,Liver Neoplasms ,Gastroenterology ,Magnetic resonance imaging ,General Medicine ,medicine.disease ,Fatty Liver ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Reticular connective tissue ,Female ,030211 gastroenterology & hepatology ,Hepatic Cyst ,Steatohepatitis ,medicine.symptom ,business - Abstract
A 70-year-old female was found to have multiple hepatic cysts at her annual checkup. In the posterior segment of the right lobe of the liver, an 81 × 67 mm circular cystic lesion was detected by contrast-enhanced computed tomography (CT). Magnetic resonance imaging (MRI) of the cyst revealed a solid component. The cyst had a capsule-like structure and non-uniform fluid accumulation suggested bleeding. Since the lesion was enlarged and malignancy could not be ruled out, it was surgically resected. Histopathologically, reticular fibers of the liver were seen in necrotic tissue and the lesion was diagnosed as a bleeding hepatocellular carcinoma (HCC). The non-cancerous liver tissue showed non-cirrhotic steatohepatitis. This was an unusual presentation of HCC.
- Published
- 2020
12. Clinical and anthropometric characteristics of non‐obese non‐alcoholic fatty liver disease subjects in Japan
- Author
-
Natsumi Oshida, Taeho Kim, Hideo Suzuki, Sechang Oh, Takashi Shida, Shunichi Ariizumi, Junichi Shoda, Kosuke Okada, Tomonori Isobe, Masakazu Yamamoto, Takahisa Watahiki, and Yoshikazu Okamoto
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Leptin ,Fatty liver ,nutritional and metabolic diseases ,medicine.disease ,digestive system ,Gastroenterology ,Obesity ,digestive system diseases ,Muscle atrophy ,Impaired glucose tolerance ,03 medical and health sciences ,0302 clinical medicine ,Infectious Diseases ,Insulin resistance ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,030211 gastroenterology & hepatology ,Steatosis ,medicine.symptom ,business ,Body mass index - Abstract
AIM The underlying mechanism of non-obese non-alcoholic fatty liver disease (NAFLD) has not been fully elucidated. We classified patients with NAFLD by sex and body mass index and compared their clinical features to clarify the background pathophysiology of non-obese NAFLD. METHODS A total of 404 patients with NAFLD were divided according to their body mass index (
- Published
- 2020
13. Prognostic Factors for Surgically Resected Intraductal Papillary Neoplasm of the Bile Duct: A Retrospective Cohort Study
- Author
-
Masakazu Yamamoto, Takehiro Ota, Wataru Izumo, Ryota Higuchi, Shuichiro Uemura, Takehisa Yazawa, Masahiro Shiihara, Yutaro Matsunaga, and Toru Furukawa
- Subjects
medicine.medical_specialty ,Multivariate analysis ,030230 surgery ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Surgical oncology ,Internal medicine ,medicine ,Humans ,Retrospective Studies ,business.industry ,Bile duct ,Carcinoma in situ ,Hazard ratio ,Cancer ,Retrospective cohort study ,Prognosis ,medicine.disease ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Oncology ,Dysplasia ,030220 oncology & carcinogenesis ,Surgery ,Bile Ducts ,Neoplasm Recurrence, Local ,business - Abstract
To date, postoperative prognostic factors for intraductal papillary neoplasm of the bile duct (IPNB) have not been well-established. This study aimed to examine the histopathologic features and postoperative prognosis of the two IPNB subclassifications, as well as factors affecting prognosis, based on the authors’ experience at a single institution. The study enrolled 83 patients who underwent surgical resection for pathologically diagnosed IPNB at the authors’ institution. The clinicopathologic features and postoperative outcomes for these patients were examined. The study also investigated postoperative prognostic factors for IPNB using uni- and multivariate analyses. More than half of the tumors (64%) diagnosed as IPNB were early-stage cancer (UICC Tis or T1). However, none were diagnosed as benign. The multivariate analysis showed that lymph node metastasis (hazard ratio [HR], 5.78; p = 0.002) and bile duct margin status with carcinoma in situ (D-CIS; HR, 5.10; p = 0.002) were independent prognostic factors, whereas MUC6 expression showed only a marginal influence on prediction of prognosis (HR, 0.32; p = 0.07). The tumor recurrence rate and the proportion of locoregional recurrence were significantly greater among the patients with D-CIS than among those with negative bile duct margins, including those patients with low-grade dysplasia. The patients with D-CIS showed a significantly poorer prognosis than those with negative bile duct margins (5-year survival, 38% versus 87%; p = 0.0002). Evaluation of resected IPNBs showed cancer in all cases. Avoiding positive biliary stumps during surgery, including resection of carcinoma in situ, would improve the prognosis for patients with IPNB.
- Published
- 2020
14. Impact of comorbidity and relative dose intensity on outcomes in diffuse large B-cell lymphoma patients treated with R-CHOP
- Author
-
Ikuko Suzuki, Katsushi Tajima, Shuhei Okuyama, Hiroaki Kumagai, Masakazu Yamamoto, Eijiro Omoto, Kouji Saitou, Riko Tsumanuma, and Shinji Satoh
- Subjects
Adult ,Male ,0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,animal structures ,Multivariate analysis ,Comorbidity ,Gastroenterology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Cyclophosphamide ,Aged ,Aged, 80 and over ,Hematology ,Poor risk ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Dose intensity ,Progression-Free Survival ,nervous system diseases ,Lymphoma ,Treatment Outcome ,030104 developmental biology ,Oncology ,Doxorubicin ,Vincristine ,030220 oncology & carcinogenesis ,Charlson comorbidity index ,Prednisone ,Female ,Lymphoma, Large B-Cell, Diffuse ,Rituximab ,business ,Diffuse large B-cell lymphoma ,psychological phenomena and processes - Abstract
Comorbidity and relative dose intensity (RDI) have been associated with survival in diffuse large B-cell lymphoma (DLBCL) patients, but both relationships remain unaddressed in the same patients. A retrospective review of consecutive DLBCL patients treated from January 2010 to October 2018 was performed. Data for the clinical characteristics of the patients, including the Charlson Comorbidity Index (CCI) and RDI, on their outcomes were evaluated. A total of 211 patients with a median age of 72 years (range 19–90 years) were analyzed. CCI ≥ 2 was associated with poor event-free survival (EFS) and overall survival (OS). RDI
- Published
- 2020
15. Des-gamma-carboxy prothrombin affects the survival of HCC patients with marginal liver function and curative treatment: ACRoS1402
- Author
-
Atsushi Kudo, Masafumi Katayama, Masahiro Shinoda, Minoru Tanabe, Masakazu Yamamoto, Shunichi Ariizumi, Itaru Endo, Yuko Kitagawa, Takehito Otsubo, and Takafumi Kumamoto
- Subjects
Male ,0301 basic medicine ,Cancer Research ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Cirrhosis ,medicine.medical_treatment ,Milan criteria ,Liver transplantation ,Gastroenterology ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Biomarkers, Tumor ,medicine ,Humans ,Protein Precursors ,Risk factor ,Aged ,business.industry ,Liver Neoplasms ,Hazard ratio ,General Medicine ,Middle Aged ,medicine.disease ,030104 developmental biology ,Oncology ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Female ,Prothrombin ,Liver function ,Hepatectomy ,business ,Biomarkers - Abstract
Considering the initial treatment of hepatocellular carcinoma (HCC), the best prognostic index for Child–Pugh classes B and C (CP-BC) patients has not been yet established. This study aimed to elucidate the risk factors for disease-free survival (DFS) and overall survival (OS) in multicenter patients with a poor liver functional reserve after curative treatment. Between April 2000 and April 2014, 212 CP-BC patients who received treatment in five high-volume centers in Japan were included in this study. CP-B and C patients were 206 and 6, respectively. Cox proportional hazard regression analyses for DFS and OS were performed to estimate the risk factors. The mean observation time was 1132 days. Mean Child–Pugh score and indocyanine green retention rate at 15 min were 7.5 and 31.5%, respectively. Histological chronic hepatitis and liver cirrhosis were observed in 20% and 74% patients, respectively. In the multivariate analysis, the risk factors for DFS were des-gamma-carboxy prothrombin (DCP) [hazard ratio (HR), 1.6; P = 0.012] and treatment without liver transplantation. Moreover, DCP was identified as an independent risk factor for OS (HR, 1.7; P = 0.01). Tumor size, number, tumor thrombus, Milan criteria, liver cirrhosis, and treatment without liver transplantation were not identified as risk factors for OS. The 5-year OS in patients with high serum DCP levels (
- Published
- 2020
16. Retrospective evaluation of risk factors of postoperative varices after pancreaticoduodenectomy with combined portal vein resection
- Author
-
Toru Furukawa, Ryota Higuchi, Wataru Izumo, Takehisa Yazawa, Shuichiro Uemura, Masakazu Yamamoto, and Masahiro Shiihara
- Subjects
Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Left gastric vein ,Jejunostomy ,Anastomosis ,Pancreaticoduodenectomy ,Varicose Veins ,Pancreatic Fistula ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Risk Factors ,medicine ,Humans ,Vein ,Aged ,Retrospective Studies ,Aged, 80 and over ,Hepatology ,Portal Vein ,business.industry ,Incidence ,Gastroenterology ,Middle Aged ,medicine.disease ,Surgery ,Pancreatic Neoplasms ,medicine.anatomical_structure ,Splenic Vein ,Splenic vein ,030220 oncology & carcinogenesis ,Inferior mesenteric vein ,Portal hypertension ,Female ,030211 gastroenterology & hepatology ,Tomography, X-Ray Computed ,Varices ,business ,Vascular Surgical Procedures - Abstract
Combined portal vein (PV) resection is performed for pancreatic head cancer to achieve clear resection margins. This can be complicated by the formation of varices due to sinistral portal hypertension after pancreaticoduodenectomy (PD) with combined PV resection. However, clinical strategies to prevent varices formation due to sinistral portal hypertension remain controversial. Moreover, the critical vein among splenic vein (SPV), inferior mesenteric vein, left gastric vein, or middle colonic vein requiring preservation to prevent the development of varices remains unclear.We retrospectively analyzed patients with pancreatic cancer who underwent PD with combined PV resection over 18 years at our institution. Varices were evaluated using enhanced computed tomography (CT) and endoscopy. Preoperative types of porto-mesenterico-splenic confluence, venous drainage, and venous resection types were determined by operative records and CT findings.Of the 108 subjects, the incidence of postoperative varices was observed in 24.1% of cases over 5.6 months. These varices were classified into five types based on location, as pancreaticojejunostomy anastomotic (11.5%), gastrojejunostomy anastomotic (11.5%), esophageal (11.5%), splenic hilar-gastric (23.1%), and right colonic (65.4%) varices. No case of variceal bleeding occurred. Multivariate analysis showed SPV ligation as the greatest risk factor of varices (P 0.001), with a higher incidence of left-sided varices in patients with all the SPV venous drainage sacrificed (60%) than in the others (16.7%). Therefore, sacrificing all the SPV venous drainage was the only independent risk factor of varices (P = 0.049).Preservation of SPV venous drainage should be considered during SPV ligation to prevent post-PD varices.
- Published
- 2020
17. Current Status of Decompression Therapy with Preoperative Decompression Tube (Ileus Tube) for Obstructive Colorectal Cancer
- Author
-
Masakazu Yamamoto, Kurodo Koshino, Shimpei Ogawa, Takeshi Ohki, Kimitaka Tani, Ryosuke Nakagawa, Michio Itabashi, Hisako Aihara, Yoshiko Bamba, and Yuji Inoue
- Subjects
medicine.medical_specialty ,Ileus ,Colorectal cancer ,business.industry ,Decompression ,Gastroenterology ,medicine ,Surgery ,Tube (fluid conveyance) ,Current (fluid) ,medicine.disease ,business - Published
- 2020
18. Anatomical Versus Non-anatomical Resection for Hepatocellular Carcinoma, a Propensity-matched Analysis Between Taiwanese and Japanese Patients
- Author
-
Hsing-Ju Wu, Masakazu Yamamoto, Pei-Yi Chu, Charles Chung-Wei Lin, Shunichi Ariizumi, Hon Phin Wong, Dev-Aur Chou, Ming-Tsung Lee, and Shih-Wei Huang
- Subjects
Pharmacology ,Cancer Research ,medicine.medical_specialty ,Tumor size ,business.industry ,medicine.disease ,Gastroenterology ,General Biochemistry, Genetics and Molecular Biology ,Resection ,Resectable Hepatocellular Carcinoma ,Hepatocellular carcinoma ,Internal medicine ,Propensity score matching ,Extrahepatic metastasis ,medicine ,Anatomical resection ,Overall survival ,business - Abstract
BACKGROUND/AIM The aim of the study was to compare the outcomes of anatomical resection (AR) versus non-anatomical resection (NAR) for Japanese and Taiwanese patients with single, resectable hepatocellular carcinoma (HCC). PATIENTS AND METHODS A propensity score matched (PSM) analysis was performed to compare the outcomes of the AR group to those of the NAR group. Tumor size
- Published
- 2020
19. Comparison of patients with invasive intraductal papillary mucinous carcinoma and invasive ductal carcinoma of the pancreas: a pathological type- and stage-matched analysis
- Author
-
Wataru Izumo, Toru Furukawa, Masakazu Yamamoto, Ryota Higuchi, Yutaro Matsunaga, Takehisa Yazawa, Masahiro Shiihara, and Shuichiro Uemura
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Adenocarcinoma ,03 medical and health sciences ,Pancreatectomy ,0302 clinical medicine ,medicine ,Humans ,Mucinous carcinoma ,Neoplasm Invasiveness ,Stage (cooking) ,skin and connective tissue diseases ,Pathological ,Aged ,Neoplasm Staging ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Gastroenterology ,Middle Aged ,medicine.disease ,Invasive ductal carcinoma ,Adenocarcinoma, Mucinous ,Pancreatic Neoplasms ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Pancreas ,business ,Carcinoma, Pancreatic Ductal - Abstract
Objective: We compared the pathological features and stage-matched outcomes of patients with invasive intraductal papillary mucinous carcinoma (IPMC) and invasive ductal carcinoma (IDC) of ...
- Published
- 2019
20. 390 STRATEGY FOR TREATMENT OF EARLY ADENOCARCINOMA (T1) OF THE ESOPHAGOGASTRIC JUNCTION ACCORDING TO LYMPH NODE METASTASIS STATUS AND VASCULAR INVASION
- Author
-
Masakazu Yamamoto, Kosuke Narumiya, Shinsuke Maeda, Kyohei Ogawa, Yukinori Toyoshima, Kenji Kudo, Hiroko Ide, and Harushi Osugi
- Subjects
Pathology ,medicine.medical_specialty ,business.industry ,Gastroenterology ,medicine ,Adenocarcinoma ,General Medicine ,Lymph node metastasis ,Esophagogastric junction ,medicine.disease ,business ,Vascular invasion - Abstract
Incidence of adenocarcinoma of the esophagogastric junction is increasing in Japan. However, in early cases (T1), there is no consensus on treatment strategy. The purpose of this study was to determine the optimal range of resection and lymph node dissection according to lymph node metastasis status and vascular invasion in early adenocarcinoma (T1) of the esophagogastric junction. Methods We investigated patient characteristics, surgical procedures, recurrence pattern, and optimum extent of lymph node dissection in 22 patients who underwent surgery in our hospital from 2000 to 2016 and were diagnosed with early adenocarcinoma of the esophagogastric junction (by Nishi’s classification). Results Four patients with lymph node metastasis, the depth of invasion was sm2 and lymphatic invasion was positive (ly1–ly3, focal lymphatic invasion to prominent lymphatic invasion). In all cases, the site of lymph node metastasis was the lesser gastric curvature. None of the patients developed postoperative lymph node recurrence. An examination of the outcomes revealed that the metastases were hematogenous in all patients with a depth of invasion of sm2 and a positive venous invasion (v1, focal vascular invasion). Conclusion We conclude that transhiatal esophagectomy should be selected as a minimal requirement, and that dissection of the abdominal lymph node (particularly on the lesser curvature side of the superior part of the stomach) is sufficient, for patients with early adenocarcinoma of the esophagogastric junction. In cases where the depth of invasion is sm2 or greater and vascular invasion is present, patients may require adjuvant therapy regardless of lymph node metastasis status.
- Published
- 2021
21. 815 PL02.09 THE BEST PRACTICE OF RECONSTRUCTION METHODS AFTER ESOPHAGECTOMY WITHOUT STOMACH
- Author
-
Yosuke Yagawa, Masakazu Yamamoto, Kosuke Narumiya, Hiroko Ide, Kyohei Ogawa, Harushi Osugi, Kenji Kudo, Noriyuki Toyoshima, and Shinnsuke Maeda
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,Esophagectomy ,business.industry ,medicine.medical_treatment ,Best practice ,General surgery ,Stomach ,Gastroenterology ,medicine ,General Medicine ,business ,Reconstruction method - Abstract
Generally we use the stomach after esophagectomy as an organ of reconstruction. But we could not use it after we performed gastrectomy. We investigated the usefulness of the reconstruction with pedicled jejunum or pedicled right colon. Methods We performed esophagectomy from 2000 to 2015.15 patients use the reconstruction with pedicled jejunum as a A.10 patients use the reconstruction with pedicled right colon as a B. We study (1) background (2) complication. Results Average Age A:67.1 B:65.5 location (upper:middle:Lower) A:0:14:1 B:1:4:5 depth of tumor invasion (T1:T2:T3:T4) A:9:3:3:0 B:3:5:2 Stage (0:I:II:III:IVa) A:2:6:4:3:0 B:0:1:3:4:2 Reconstruction route (posterior mediastinal:retrosternal:antethoracic) A:4:2:9 B:0:5:5 The reason of the gastrectomy (ulcer: cancer) A 10:5 B 0:10 (distal gastrectomy:total gastrectomy) A:15:0 B:4:6 Reconstruction (BillrothI: BillrothII: Roux-Y) A:12:3:0 B:2:2:6 Complication (leakage)A:B = 3:0 (ileus)A:B = 2:0(weight loss)A:B = 10:0 (diarrhea)A:B = 3:5. Conclusion The best practice of reconstruction method is a reconstruction with pedicled jejunum without stomach. We can use the jejunum without damage of the vessel in the mesenteri of the jejunum.
- Published
- 2021
22. 389 THE BEST PRACTICE OF RECONSTRUCTION METHODS AFTER ESOPHAGECTOMY WITHOUT STOMACH
- Author
-
Harushi Osugi, Yukinori Toyoshima, Shinsuke Maeda, Kenji Kudo, Kyohei Ogawa, Masakazu Yamamoto, Kosuke Narumiya, and Hiroko Ide
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,Esophagectomy ,business.industry ,medicine.medical_treatment ,Best practice ,General surgery ,Stomach ,Gastroenterology ,medicine ,General Medicine ,business ,Reconstruction method - Abstract
Generally we use the stomach after esophagectomy as an organ of reconstruction. But we could not use it after we performed gastrectomy. We investigated the usefulness of the reconstruction with pedicled jejunum or pedicled right colon. Methods We performed esophagectomy from 2000 to 2015.15 patients use the reconstruction with pedicled jejunum as a A.10 patients use the reconstruction with pedicled right colon as a B.We study (1) background (2) complication. Results Average Age A:67.1 B:65.5 location(upper:middle:Lower)A:0:14:1 B:1:4:5 depth of tumor invasion (T1:T2:T3:T4)A:9:3:3:0 B:3:5:2 Stage(0:I:II:III:IVa)A:2:6:4:3:0 B:0:1:3:4:2 Reconstruction route(posterior mediastinal:retrosternal:antethoracic)A:4:2:9 B:0:5:5 The reason of the gastrectomy (ulcer: cancer)A 10:5 B 0:10 (distal gastrectomy:total gastrectomy)A:15:0 B:4:6 Reconstruction(BillrothI法:BillrothII法:Roux-Y) A:12:3:0 B:2:2:6 Complication (leakage)A:B = 3:0. (ileus)A:B = 2:0(weight loss)A:B = 10:0 (diarrhea)A:B = 3:5. Conclusion The best practice of reconstruction method is a reconstruction with pedicled jejunum without stomach. We can use the jejunum without damage of the vessel in the mesenteri of the jejunum. I want to show you our video.
- Published
- 2021
23. Diabetes Mellitus and/or Nonalcoholic Steatohepatitis-related Hepatocellular Carcinoma Showed Favorable Surgical Outcomes After Hepatectomy
- Author
-
Jing Liang, Masayuki Nakano, Shunichi Ariizumi, and Masakazu Yamamoto
- Subjects
Adult ,Male ,Nonalcoholic steatohepatitis ,Cancer Research ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,medicine.medical_treatment ,Alcoholic hepatitis ,Gastroenterology ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Non-alcoholic Fatty Liver Disease ,Risk Factors ,Diabetes mellitus ,Internal medicine ,medicine ,Hepatectomy ,Humans ,In patient ,Risk factor ,neoplasms ,Survival rate ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Liver Neoplasms ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,digestive system diseases ,Survival Rate ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,Oncology ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Female ,business - Abstract
Background/aim Diabetes mellitus (DM) is known as an important risk factor for hepatocellular carcinoma (HCC). However, surgical outcomes in patients with DM and HCC have not been evaluated in detail. Patients and methods We retrospectively studied 177 patients with type 2 DM who underwent curative hepatectomy for HCC. Surgical outcomes after curative hepatectomy and prognostic factors were evaluated among 75 patients with DM and/or nonalcoholic steatohepatitis (NASH)-related HCC and 102 patients with DM and viral or alcoholic hepatitis (VAH)-related HCC. Results The 5-year survival rate and 5-year recurrence-free survival rate were significantly higher in the DM and/or NASH-related HCC group (87% and 51%) than in the DM and VAH-related HCC group (68%: p=0.0001 and 26%: p=0.0002). Multivariate analysis showed DM and/or NASH-related HCC to be significant independent prognostic factors for overall survival and recurrence-free survival. Conclusion Patients with DM and/or NASH-related HCC showed more favorable surgical outcomes after hepatectomy in patients with DM and HCC.
- Published
- 2019
24. Survival Benefit of and Indications for Adjuvant Chemotherapy for Resected Colorectal Liver Metastases—a Japanese Nationwide Survey
- Author
-
Kiyoshi Hasegawa, Toru Beppu, Ken Tabuchi, Tatsuro Yamaguchi, Kenichi Sugihara, Itaru Endo, Satoshi Morita, Goro Honda, Masaru Miyazaki, Katsunori Sakamoto, Michio Itabashi, Masakazu Yamamoto, Yojiro Hashiguchi, Shin Kobayashi, Keiichi Takahashi, Kenjiro Kotake, and Yoshihito Kotera
- Subjects
Oncology ,medicine.medical_specialty ,Adjuvant chemotherapy ,medicine.medical_treatment ,Nationwide survey ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Internal medicine ,medicine ,Hepatectomy ,Humans ,Retrospective Studies ,business.industry ,Liver Neoplasms ,Hazard ratio ,Gastroenterology ,Prognosis ,medicine.disease ,Primary tumor ,Survival benefit ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Propensity score matching ,Cohort ,030211 gastroenterology & hepatology ,Surgery ,Colorectal Neoplasms ,business - Abstract
The survival benefit of and indications for adjuvant chemotherapy (AC) for colorectal liver metastases (CRLM) remain unclear. Patients who were diagnosed with liver-limited CRLM between 2005 and 2007 and subsequently underwent R0 resection without preoperative chemotherapy were identified in a Japanese nationwide survey. This overall cohort was divided into synchronous and metachronous CRLM cohorts. In each of the three cohorts, the patients that were given AC were matched with those treated with surgery alone via 1:1 propensity score (PS) matching. Recurrence-free survival (RFS) and overall survival (OS) after the initial hepatectomy were compared. The median follow-up period was 79.4 months and the overall, synchronous, and metachronous cohorts included 1145, 498, and 647 patients, respectively. After the PS matching, the patients’ demographics were well balanced. AC was effective in terms of both RFS and OS in the overall cohort (RFS hazard ratio [HR] 0.784, p = 0.045; OS HR 0.716, p = 0.028) and synchronous cohort (RFS HR 0.677, p = 0.027; OS HR 0.642, p = 0.036), whereas AC was not effective in the metachronous cohort (RFS HR 0.875, p = 0.378; OS HR 0.881, p = 0.496). However, in the metachronous cohort, AC was effective in terms of OS in the subgroup that exhibited disease-free intervals of ≤ 1 year after primary tumor resection (RFS HR 0.667, p = 0.068; OS HR 0.572, p = 0.042). Adjuvant chemotherapy has a survival benefit for patients with resected CRLM. Synchronous CRLM is a favorable indication for AC, whereas in metachronous CRLM, the use of AC should be individualized according to each patient’s risk factors.
- Published
- 2019
25. Near-Comprehensive Resequencing of Cancer-Associated Genes in Surgically Resected Metastatic Liver Tumors of Gastric Cancer
- Author
-
Masakazu Yamamoto, Naoki Ikari, Toru Furukawa, Akiko Serizawa, and Shohei Mitani
- Subjects
Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Somatic cell ,medicine.medical_treatment ,DNA Mutational Analysis ,Gastroenterology ,Pathology and Forensic Medicine ,Metastasis ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,Stomach Neoplasms ,Internal medicine ,Biomarkers, Tumor ,Hepatectomy ,Humans ,Medicine ,PTEN ,Aged ,Retrospective Studies ,Cause of death ,Aged, 80 and over ,Sanger sequencing ,biology ,business.industry ,Liver Neoplasms ,High-Throughput Nucleotide Sequencing ,Cancer ,Middle Aged ,Prognosis ,medicine.disease ,030104 developmental biology ,030220 oncology & carcinogenesis ,Mutation ,symbols ,biology.protein ,Female ,Gastrectomy ,business ,Follow-Up Studies - Abstract
Liver metastasis is a major cause of death in patients with gastric cancer. The molecular alterations in clinically resected liver metastases of gastric cancer were evaluated to identify candidate biomarkers and therapeutic targets. Seventy-four patients, including 37 with liver metastasis who underwent gastrectomy and hepatectomy for gastric cancer and 37 without liver metastasis who underwent gastrectomy for gastric cancer, were studied. Next-generation resequencing was performed for 412 cancer-associated genes in metastatic and/or primary tumors from 30 patients and somatic mutations in TP53, LRP1B, PIK3CA, ADAMTS20, PAX7, FN1, FOXO3, WRN, PTEN, ETV4, and RNF213 were found in metastatic tumors. TP53 mutations were studied by Sanger sequencing in the remaining patients; the number of patients with TP53 mutations in metastatic tumors was significantly higher among those with liver metastasis (86.5%, 32/37) versus those without liver metastasis (40.5%; 15/37; P 0.0001). TP53 mutations in metastatic liver tumors and corresponding primary tumors were identical in 96.9% (31/32), including some patients with heterogeneous primary tumor components. Immunohistochemical analyses showed aberrant p53 expression in tumors with TP53 mutations. In silico functional evaluations indicated functional loss of missense-mutated TP53. Thus, the p53 pathway may facilitate the development of biomarkers and therapeutic approaches to treat gastric cancer metastases to the liver.
- Published
- 2019
26. Inflammatory hepatocellular adenoma in a patient with Turner’s syndrome: A case report
- Author
-
Hiroto Egawa, Takaaki Kato, Masakazu Yamamoto, Shingo Yamashita, Satoshi Nemoto, Shunichi Ariizumi, Akiko Omori, Yoshihito Kotera, and Shota Aoyama
- Subjects
congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Liver tumor ,endocrine system diseases ,Oral contraceptive pill ,medicine.medical_treatment ,urologic and male genital diseases ,Gastroenterology ,Article ,GS, glutamine synthetase ,Benign tumor ,03 medical and health sciences ,OCPs, oral contraceptive pills ,0302 clinical medicine ,RHV, right hepatic vein ,Internal medicine ,Case report ,IHCA, inflammatory hepatocellular adenoma ,Medicine ,TAE, trans-catheter arterial embolization ,Gb-EOB-MRI, gadoxetic acid ethoxybenzyl magnetic resonance imaging ,UHCA, unclassified hepatocellular adenoma ,HRT, hormone replacement therapy ,business.industry ,Turner’s syndrome ,b-HCA, β-catenin muted hepatocellular adenoma ,H-HCA, HNF1A-muted hepatocellular adenoma ,Hepatocellular adenoma ,medicine.disease ,digestive system diseases ,CT, computed tomography ,HCA, hepatocellular adenoma ,LFABP, liver fatty acid-binding protein ,Hormone replacement therapy ,Transgender hormone therapy ,Surgical resection ,030220 oncology & carcinogenesis ,Pill ,CRP, C-reactive protein ,Inflammatory Hepatocellular Adenoma ,TS, Turner’s syndrome ,030211 gastroenterology & hepatology ,Surgery ,Hepatectomy ,business ,MRI, magnetic resonance imaging - Abstract
Highlights • Contraceptive pill induced hepatocellular adenoma with Turner’s syndrome patient is extremely rare. • However Turner’s syndrome patient requires a lifetime hormone replacement therapy. • Proper diagnosis and treatment plan is necessary for hepatocellular adenoma., Introduction Hepatocellular adenoma (HCA) is a rare benign tumor and is related to the use of an oral contraceptive pill. Turner’s syndrome requires various hormone replacement therapies, including the pill which is used as a female hormone replacement therapy. Herein we report a case of Turner’s syndrome with HCA treated by liver segmentectomy. Presentation of case A 36-year-old woman with Turner’s syndrome was treated with oral contraceptive pills as a female hormone replacement therapy for 20 years. She presented with fatigue and liver tumor. Liver tumors in the posterior lobe measuring 60 mm and 10 mm in diameter were detected on CT; hence, she was referred to our department. Both the tumors showed high intensity in the arterial phase, iso-intensity in the portal and late phases, and low intensity in the hepatobiliary phase on Gb-EOB-MRI. She was diagnosed with multiple HCAs and underwent segmentectomy Section 7. Pathologically, both the tumors were diagnosed as HCAs, and inflammatory markers were detected by immunohistochemistry. Thirteen months postoperatively, she was doing well and there was no evidence of recurrence of HCA without the pill. Discussion There is only one report of HCA in patients with TS (Espat et al., 2000). We reported a case of multiple HCAs in a patient with TS underwent hepatectomy. Conclusion With the use of the contraceptive pill as a long-term female hormone replacement therapy for Turner’s syndrome, careful attention is required for HCA.
- Published
- 2019
27. Insurance Coverage and Introduction of Robotic-Assisted Rectal Surgery
- Author
-
Shimpei Ogawa, Masakazu Yamamoto, Takeshi Ohki, Michio Itabashi, and Yuji Inoue
- Subjects
medicine.medical_specialty ,business.industry ,Robotic assisted ,General surgery ,Gastroenterology ,Medicine ,Surgery ,Rectal surgery ,business ,Insurance coverage - Published
- 2019
28. Hepatocellular carcinoma after direct-acting antiviral drug treatment in patients with hepatitis C virus
- Author
-
Katsutoshi Tokushige, Hiroto Egawa, Makiko Taniai, Kazuhisa Kodama, Masakazu Yamamoto, Satoshi Katagiri, Tomomi Kogiso, and Takaomi Sagawa
- Subjects
Ledipasvir ,medicine.medical_specialty ,Elbasvir ,Daclatasvir ,Hepatology ,Sofosbuvir ,business.industry ,Gastroenterology ,digestive system diseases ,Ombitasvir ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,chemistry ,Grazoprevir ,Paritaprevir ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Asunaprevir ,030211 gastroenterology & hepatology ,business ,medicine.drug - Abstract
Background and Aim Given the use of direct-acting antivirals (DAAs) to treat hepatitis C virus (HCV), their effects on hepatocarcinogenesis should be determined. Methods This study enrolled 349 patients with HCV who underwent DAA treatment at our hospital between 2014 and 2018. Their median age was 65 years, and 184 were male; 301 cases were of HCV serotype 1, and 48 were of serotype 2. The DAA treatment was daclatasvir/asunaprevir in 107 cases, sofosbuvir (SOF)/ledipasvir in 147 cases, ritonavir-boosted ombitasvir/paritaprevir in 28 cases, elbasvir/grazoprevir in 19 cases, and SOF/ribavirin in 48 cases. The patients' histories included hepatocellular carcinoma (HCC) in 45 cases, liver transplant (LT) in 10 cases, and kidney transplant (KT) in 17 cases. Results Sustained virological responses occurred in 335 cases (96%). DAA treatment was initiated a median of 16.3 months after HCC treatment. After DAA treatment, 15 cases (33%) had recurrence of HCC after a median of 11.6 months, and 3 cases (1%) developed de novo HCC. Six LT patients and one KT patient had HCC; however, no HCC was observed after DAA. The incidence of HCC was significantly higher in patients with multiple HCC treatments in the Cox hazard model (hazard ratio 1.664, 95% confidence interval 1.134-2.441, P < 0.01). Surgical resection or LT reduced the risk of HCC. Conclusions DAA did not increase the rate of HCC, even in immunosuppressed patients. However, careful follow-up for HCC recurrence is required in previously treated cases.
- Published
- 2018
29. Outcomes of 1,639 hepatectomies for non-colorectal non-neuroendocrine liver metastases: a multicenter analysis
- Author
-
Junji Yamamoto, Shoji Nakamori, Masato Nagino, Toshifumi Wakai, Masaru Konishi, Keiji Sano, Tetsushige Mimura, Hiroki Yamaue, Masaru Miyazaki, Tadahiro Takada, Keiichi Kubota, Itaru Endo, Masakazu Yamamoto, Michiaki Unno, and Naohiro Sata
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Gastric carcinoma ,030230 surgery ,Gastroenterology ,Metastasis ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Hepatectomy ,Humans ,Stromal tumor ,Survival analysis ,Aged ,Retrospective Studies ,Aged, 80 and over ,Hepatology ,business.industry ,Mortality rate ,Liver Neoplasms ,Middle Aged ,medicine.disease ,Survival Analysis ,Primary tumor ,030220 oncology & carcinogenesis ,Female ,Surgery ,Ovarian cancer ,business - Abstract
Background Whether non-colorectal non-neuroendocrine liver metastasis (NCNNLM) should be treated surgically remains unclear. Methods Data regarding 1,639 hepatectomies performed between 2001 and 2010 for 1,539 patients with NCNNLM were collected from 124 institutions. Patient characteristics, types of primary tumor, characteristics of liver metastases, and post-hepatectomy outcomes were analyzed. Results The five most frequent primary tumors were gastric carcinoma (540 patients [35%]), gastrointestinal stromal tumor (204 patients [13%]), biliary carcinoma (150 patients [10%]), ovarian cancer (107 patients [7%]), and pancreatic carcinoma (77 patients [5%]). R0/1 hepatectomy was achieved in 90% of patients, with 1.5% in-hospital mortality rate. Overall and disease-free survival rates of 1,465 patients included in survival analysis were 41% and 21%, respectively, at 5 years, and 28% and 15%, respectively, at 10 years. Five-year survival associated with the five frequent primary tumors were 32%, 72%, 17%, 52%, and 31%, respectively, and factors predictive of a poor outcome differed by the primary tumor type. Conclusions Our data indicated that hepatectomy is safe for NCNNLM and that patient prognoses vary depending on the type of primary tumors. Indications for hepatectomy should be determined with reference to survival rates and risk factors specific to each of the various types of primary tumor.
- Published
- 2018
30. Phase II study of neoadjuvant chemotherapy with S-1 plus oxaliplatin for gastric cancer clinical T4 or N2-3
- Author
-
Akiko Serizawa, Masakazu Yamamoto, Hidekazu Kuramochi, Masaho Ota, Kazuomi Suzuki, Sho Kotake, Shunichi Ito, Satoshi Katagiri, Kiyoaki Taniguchi, and Takuji Yamada
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Phases of clinical research ,Adenocarcinoma ,Gastroenterology ,Stomach Neoplasms ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Clinical endpoint ,Humans ,Prospective Studies ,Stage (cooking) ,Adverse effect ,Aged ,Tegafur ,Aged, 80 and over ,Chemotherapy ,business.industry ,Standard treatment ,Cancer ,Hematology ,General Medicine ,Middle Aged ,medicine.disease ,Prognosis ,Neoadjuvant Therapy ,Oxaliplatin ,Drug Combinations ,Oxonic Acid ,Oncology ,Female ,business ,medicine.drug ,Follow-Up Studies - Abstract
Background: In Japan, the standard treatment for stage II or III gastric cancer is D2 gastrectomy followed by administration of S-1 for one year. However, patients with stage III disease have unsatisfactory survival rates. The purpose of this study was to evaluate the efficacy and safety of neoadjuvant chemotherapy consisting of S-1 and oxaliplatin for advanced gastric cancer.Methods: Patients with cT4 or cN2–3 gastric cancer were scheduled to receive two courses of chemotherapy (130 mg/m2 oxaliplatin on Day 1, 80 mg/m2 S-1 per day twice daily for 14 days) followed by surgery. The primary endpoint was the R0 resection rate. The secondary endpoints were rates of completion of protocol treatment, pathological response, and adverse events; and 3-year overall survival, 5-year overall survival, and 5-year recurrence-free survival.Results: Between May 2016 and March 2019, 30 patients were enrolled in the study, all of whom completed the protocol treatment. The R0 resection rate (primary endpoint) was 93.3% (95% confidence interval: 77.9–99.2). The pathological response rate was 63.3%. Grade 3–4 toxicities included anemia (3.3%), anorexia (6.7%), and fatigue (3.3%). Relative dose intensities were 91.2% and 94.2% for S-1 and oxaliplatin, respectively.Conclusions: Neoadjuvant S-1 and oxaliplatin is highly effective, achieving an acceptable R0 resection rate with relatively few severe toxicities and good compliance. Trial registration information:Registry name: A prospective intervention study on the availability of preoperative SOX therapy for T4 or N2-3 gastric cancerTrial ID: UMIN: UMIN000024656URL: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000028365
- Published
- 2021
31. Drain Lipase Levels and Decreased Rate of Drain Amylase Levels as Independent Predictors of Pancreatic Fistula with Nomogram After Pancreaticoduodenectomy
- Author
-
Masahiro Shiihara, Jiro Shimazaki, Masakazu Yamamoto, Shuji Suzuki, Wataru Izumo, Mitsugi Shimoda, Yukio Oshiro, and Kiyotaka Nishida
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,030230 surgery ,Gastroenterology ,Pancreaticoduodenectomy ,03 medical and health sciences ,Pancreatic Fistula ,0302 clinical medicine ,Postoperative Complications ,Risk Factors ,Internal medicine ,Medicine ,Humans ,Retrospective Studies ,Univariate analysis ,business.industry ,Hazard ratio ,Retrospective cohort study ,Lipase ,Nomogram ,medicine.disease ,Nomograms ,Pancreatic fistula ,030220 oncology & carcinogenesis ,Amylases ,Drainage ,Surgery ,business ,Complication ,Abdominal surgery - Abstract
Pancreaticoduodenectomy (PD) has recently been improved due to its increased safety. However, postoperative pancreatic fistula (POPF) remains a lethal complication of PD. Identifying novel clinicophysiological risk factors for POPF during the early post-PD period would help improve patient morbidity and mortality. Therefore, this retrospective study aimed to evaluate possible risk factors during the early postoperative period after pancreaticoduodenectomy (PD). Data from 349 patients who underwent PD between 2007 and 2012 were examined retrospectively. All patients were classified into 2 groups: group A, patients without fistulae or biochemical leaks (288 patients), and group B, those with grade B or C POPF (61 patients). Data on various clinicophysiological parameters, including serum and drain laboratory data, were collected. Univariate and multivariate analyses were performed to evaluate POPF predictors. A predictive nomogram was established for these results. Univariate analysis showed that various serum and drain-related factors, such as white blood cell count, C-reactive protein levels, drain amylase (DAMY) levels, and drain lipase (DLIP) levels, were possible POPF risk factors. Multivariate analysis confirmed that postoperative day (POD) 1 DLIP levels (hazard ratio, 15.393; p = 0.037) and decreased rate (POD3/1) of DAMY levels (hazard ratio, 4.415; p = 0.028) were independent risk factors. Further, POD1 DLIP levels and decreased rate of DAMY levels were significantly lower in group A than in group B. The accuracy of nomogram was 0.810. POD1 DLIP levels (> 245 U/mL) and decreased rate of DAMY levels (> 0.44) were POPF risk factors, making them possible biomarkers for POPF.
- Published
- 2021
32. Cholangio-venous reflux of biliary contents through paracellular pathways between hepatocytes in patients with acute cholangitis
- Author
-
Yukiko Nagamachi, Masakazu Yamamoto, Ryota Higuchi, Masahiro Yoshida, Tadahiro Takada, Hajime Takikawa, Norimasa Sawada, and Shuji Isaji
- Subjects
0301 basic medicine ,Indocyanine Green ,medicine.medical_specialty ,genetic structures ,Cholangitis ,Bone canaliculus ,Gastroenterology ,Clinical study ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Cholangiography ,Internal medicine ,Medicine ,Humans ,In patient ,Biliary Tract ,Hepatology ,medicine.diagnostic_test ,business.industry ,Reflux ,030104 developmental biology ,chemistry ,030220 oncology & carcinogenesis ,Paracellular transport ,Venous reflux ,Hepatocytes ,Surgery ,business ,Indocyanine green - Abstract
Background We re-analyzed data on cholangio-venous reflux from a clinical study conducted prospectively on 22 patients in 1974. Method Direct cholangiography was performed with indocyanine green (ICG) mixed into UrographinR under monitoring of intrabiliary pressure, and the participants were allocated to three groups according to whether ICG leakage into the blood, signs of infection, or both, were present. Results The intrabiliary pressure of 6 patients negative for both ICG leakage and signs of infection was approximately 19.5 (median, [range 18 to 22]) cmH2 O. In contrast, for the 5 patients positive for ICG leakage but negative for signs of infection, the intrabiliary pressure was higher (median 32.0 [range 27 to 41) cmH2 O]. The 11 patients positive for both ICG leakage and signs of infection had the highest intrabiliary pressure (median 48.0 [range 33 to 77] cmH2 O). Our analyses revealed that, as the intrabiliary pressure increased, the status of ICG leakage and signs of infection appeared in a stepwise fashion. Conclusion Our findings suggest that the tight junctions sealing the bile canaliculi deteriorated with increasing intrabiliary pressure, resulting in reflux of the biliary contents into the vascular system via paracellular pathways between hepatocytes.
- Published
- 2021
33. Hepatocellular adenoma, approximately half and predominantly inflammatory subtype, in 38 Japanese patients with several differences in age, gender, and clinical background factors from Western populations
- Author
-
Mitsuhiko Moriyama, Koshi Matsumoto, Hiroshi Matsumura, Masahiro Ogawa, Masakazu Yamamoto, Noriko Kinukawa, Hiroaki Kanda, Hiroshi Hano, Seisyu Hayashi, Asami Izu, Tadatoshi Takayama, Syunichi Ariizumi, Masahiko Sugitani, Koyu Suzuki, Masayuki Nakano, Yukio Morishita, Shintaro Yamazaki, Takashi Yao, and Naoya Nakamura
- Subjects
medicine.medical_specialty ,Cirrhosis ,Hepatology ,business.industry ,Hepatocellular adenoma ,medicine.disease ,Gastroenterology ,Obesity ,Infectious Diseases ,Internal medicine ,Hepatocellular carcinoma ,Diabetes mellitus ,Epidemiology ,medicine ,Glycogen storage disease ,Immunohistochemistry ,business - Abstract
Aim Hepatocellular adenoma (HCA) has a lower prevalence in Japan than in Western countries and HCA subtypes have been reported for only a few Japanese patients. We analyzed HCA subtype data 38 patients from 23 hospitals in Japan in order to examine character and difference between Western countries. Methods To confirm HCA and to analyze subtypes, we performed immunohistochemical examinations. Results Thirty-eight cases were found to have HCA without cirrhosis. The male/female ratio was 18/20. Ages ranged from 15 to 79 (average, 43.2) years. Male and elder patients are not rare, furthermore, most of elder patients are male. Glycogen storage disease, past history of medicament use, hepatitis B virus surface antigen-positivity, antihepatitis C virus -positivity, diabetes mellitus, obesity, lipid metabolism disorder and alcoholism were present in of 6, 8, 1, 1, 6, 6, 4, and 6 cases, respectively. As to HCA subtypes, HNF1alpha-inactivated HCA, beta-catenin activated HCA (b-HCA), inflammatory HCA (IHCA) and unclassified HCA (U-HCA) accounted for nine (23.7%), four (10.5%), 17 (44.7%) and eight (21.1%) cases, respectively. Two cases showed coexistence of HCA and hepatocellular carcinoma (HCC) at surgery, and another had HCC which had been detected 23 years after HCA diagnosis. The HCA subtype of one of the former cases was U-HCA, while the remaining two had b-HCA and U-HCA. Conclusions In Japanese HCA cases, the proportions of U-HCA, male and elder cases were slightly higher than in Western countries, and most of elder patients were male. IHCA was however common regardless of race, and was assumed to be the predominant subtype of HCA.
- Published
- 2020
34. Evaluation of the significance of adjuvant chemotherapy in patients with stage ⅠA pancreatic ductal adenocarcinoma
- Author
-
Ryota Higuchi, Masahiro Shiihara, Masakazu Yamamoto, Toru Furukawa, Takehisa Yazawa, Yutaro Matsunaga, Wataru Izumo, and Shuichiro Uemura
- Subjects
Oncology ,Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Pancreatic ductal adenocarcinoma ,Adjuvant chemotherapy ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Antineoplastic Agents ,Deoxycytidine ,Disease-Free Survival ,Pancreaticoduodenectomy ,03 medical and health sciences ,0302 clinical medicine ,Pancreatectomy ,Internal medicine ,Pancreatic cancer ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,In patient ,Stage (cooking) ,Aged ,Neoplasm Staging ,Retrospective Studies ,Tegafur ,Aged, 80 and over ,Hepatology ,business.industry ,Standard treatment ,Gastroenterology ,Middle Aged ,medicine.disease ,Gemcitabine ,digestive system diseases ,Pancreatic Neoplasms ,Drug Combinations ,Oxonic Acid ,Treatment Outcome ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,business ,Carcinoma, Pancreatic Ductal ,Follow-Up Studies - Abstract
Although adjuvant chemotherapy is considered a standard treatment for resected pancreatic ductal adenocarcinoma (PDAC), its utility in stage ⅠA patients is unclear. We aimed to investigate the recurrence rate, surgical outcome, prognostic factors, effectiveness of adjuvant chemotherapy, and determination of groups in whom adjuvant chemotherapy is effective in patients with stage ⅠA PDAC.We retrospectively analyzed 73 patients who underwent pancreatectomy and were pathologically diagnosed with stage ⅠA PDAC between 2000 and 2018. We evaluated the relation between clinicopathological factors, recurrence rates, and outcomes such as the recurrence-free and disease-specific survival rates (RFS and DSS, respectively).The 5-year RFS and DSS rates were 52% and 58%, respectively. In multivariate analysis, a platelet-to-lymphocyte ratio (PLR) ≥ 170, prognostic nutrition index (PNI) 47.5, and pathological grade 2 or 3 constituted risk factors for a shorter DSS (hazard ratios: 4.7, 4.6, and 4.1, respectively). Patients with 0-1 of these risk factors (low-risk group; n = 47) had significantly higher 5-year DSS rates than those with 2-3 risk factors (high-risk group; n = 26) (80% vs. 23%; P 0.001). Patients in the low-risk group showed similar 5-year RFS rates regardless of whether they received or not adjuvant chemotherapy (75% vs 70%, respectively; P = 0.49). Contrarily, high-risk patients who underwent adjuvant chemotherapy had higher 5-year RFS rates than those who did not receive adjuvant chemotherapy (32% vs 0%; P = 0.045).In stage IA PDAC, adjuvant chemotherapy seems to be effective only in a subgroup of high-risk patients.
- Published
- 2020
35. Evaluation of the validity of pancreatectomy for very elderly patients with pancreatic ductal adenocarcinoma
- Author
-
Masahiro Shiihara, Wataru Izumo, Ryota Higuchi, Shuichiro Uemura, Takehisa Yazawa, Yutaro Matsunaga, Toru Furukawa, and Masakazu Yamamoto
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,030230 surgery ,Adenocarcinoma ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Pancreatectomy ,Internal medicine ,Medicine ,Humans ,Risk factor ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Hazard ratio ,Odds ratio ,Vascular surgery ,medicine.disease ,Prognosis ,Pancreatic Neoplasms ,Survival Rate ,Cardiothoracic surgery ,030220 oncology & carcinogenesis ,Surgery ,Neoplasm Recurrence, Local ,business ,Abdominal surgery ,Carcinoma, Pancreatic Ductal - Abstract
The role of pancreatectomy for very elderly patients with pancreatic adenocarcinoma is controversial. This study aimed to clarify the validity of pancreatic resection in octogenarian patients with pancreatic ductal adenocarcinoma. We compared 31 patients aged ≥ 80 years and 548 patients aged < 80 years who underwent pancreatectomy for pancreatic ductal adenocarcinoma and evaluated the relationship between age, clinicopathological factors, recurrence, and outcomes. Postoperative mortality, morbidity, and completion of adjuvant chemotherapy rates did not differ between groups. There were no significant differences in median recurrence–free survival, disease-specific survival, and overall survival between groups (1.0, 2.3, and 2.2 years in patients ≥ 80 years and 1.2, 2.8, and 2.7 years in patients < 80 years; P = 0.67, 0.47, and 0.46, respectively). The median time from recurrence to death of octogenarian patients was significantly shorter than that of younger patients (0.6 vs. 1.1 years, P = 0.0070). In multivariate analysis, age ≥ 80 years (hazard ratio, 1.5), resection of other organs (hazard ratio, 1.8), pathological grade 2/3 (hazard ratio, 1.6), and failure to implement of treatment after recurrence (hazard ratio, 3.6) were independent risk factors for a short time from recurrence to death. Furthermore, age ≥ 80 years (odds ratio, 0.32) was an independent risk factor for the implementation of treatment after recurrence. Pancreatectomy for octogenarians may be acceptable, but median survival time from recurrence to death was shorter due to lower rates of implementation of treatment after recurrence in octogenarian patients.
- Published
- 2020
36. Risk factors for bile leakage: Latest analysis of 10 102 hepatectomies for hepatocellular carcinoma from the Japanese national clinical database
- Author
-
Yo-ichi Yamashita, Hiroaki Miyata, Yuko Kitagawa, Yoshihiro Kakeji, Masakazu Yamamoto, Hideo Baba, Hiroki Yamaue, and Hiroyuki Yamamoto
- Subjects
Male ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Bile leakage ,Logistic regression ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Japan ,Risk Factors ,Diabetes mellitus ,Internal medicine ,medicine ,Bile ,Hepatectomy ,Humans ,Hepatology ,business.industry ,Liver Neoplasms ,Albumin ,Odds ratio ,medicine.disease ,Confidence interval ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,030211 gastroenterology & hepatology ,Surgery ,business ,Right anterior - Abstract
BACKGROUND/PURPOSE The aim of this study was to identify risk factors for bile leakage in hepatic resections without biliary reconstructions using the large Japanese national clinical database (NCD). METHODS A total of 10 102 patients who had undergone hepatic resection involving more than one segment without biliary reconstructions for hepatocellular carcinoma during 2015-2017 were enrolled. Risk factors for bile leakage, with special reference to the type of hepatic resection, were identified by multivariable logistic regression analysis. RESULTS Bile leakage occurred in 726 patients (7.2%). Risk factors for bile leakage were as follows: male sex (odds ratio [OR] 1.28, 95% confidence interval [CI] 1.04-1.58), diabetes mellitus (+) (OR 1.19, 95% CI 1.01-1.39), hemoglobin
- Published
- 2020
37. Prognostic Factors of Preoperative Examinations for Non-occlusive Mesenteric Ischemia: A Multicenter Retrospective Project Study Conducted by the Japanese Society for Abdominal Emergency Medicine
- Author
-
Masaji Tani, Takashi Shimazui, Akira Furukawa, Hiroshi Kondo, Masakazu Yamamoto, Takafumi Yukaya, Shuji Suzuki, and Kentaro Kawai
- Subjects
Adult ,Male ,medicine.medical_specialty ,Abdominal pain ,Adolescent ,medicine.medical_treatment ,Gastroenterology ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Japan ,Internal medicine ,Preoperative Care ,medicine ,Humans ,Societies, Medical ,Aged ,Retrospective Studies ,Aged, 80 and over ,Univariate analysis ,business.industry ,Mortality rate ,Bowel resection ,Middle Aged ,medicine.disease ,Prognosis ,Systemic inflammatory response syndrome ,Blood pressure ,Mesenteric ischemia ,030220 oncology & carcinogenesis ,Mesenteric Ischemia ,Emergency Medicine ,030211 gastroenterology & hepatology ,Surgery ,Base excess ,Female ,medicine.symptom ,business - Abstract
Non-occlusive mesenteric ischemia (NOMI) has a high mortality rate, but the analyses of preoperative prognostic factors for improving survival in patients suspected of having NOMI are scarce. We aimed to analyze the prognostic factors of preoperative examinations for NOMI. The clinical data of 224 patients with NOMI were retrospectively collected for a multicenter survey. Clinicophysiological factors were compared between the survivors and non-survivors (N = 107/117) and between the operative and non-operative cases (N = 180/44) by univariate analysis using chi-square test and multivariate analysis using Cox proportional hazard models. In the operative cases, the prognostic operative factors were also analyzed. The overall mortality rate for NOMI was 52.2%. There were 129 male and 95 female patients. The mean age was 71.23 (14–94) years. Univariate analysis showed that cardiovascular complication, shock, abdominal pain, average blood pressure, systemic inflammatory response syndrome, aspartic aminotransferase, alanine transaminase, creatine phosphokinase, lactate dehydrogenase, base excess, prothrombin time-international normalized ratio, D-dimer, and fibrinogen degradation products were independent prognostic factors. Multivariate analysis showed that average blood pressure and base excess were independent prognostic factors. Among patients undergoing surgery, those with bowel resection had better prognosis than those without bowel resection, but those with long bowel resection had worse prognosis than those with short resection. Additional postoperative treatment was not effective compared with operation alone (P = 0.011). Prognostic factors of preoperative examinations for NOMI were average blood pressure and base excess. Patients with long bowel resection should be carefully monitored owing to their poor prognosis.
- Published
- 2020
38. New metastasectomy criteria for peritoneal metastasis of hepatocellular carcinoma -A study of the Japanese Society of Hepato-Biliary-Pancreatic Surgery
- Author
-
Masakazu Yamamoto, Hidetoshi Eguchi, Hiroki Yamaue, Hiroya Iida, Kiyoshi Hasegawa, Masaji Tani, Minoru Tanabe, and Tsukasa Aihara
- Subjects
medicine.medical_specialty ,Peritoneal metastasis ,Carcinoma, Hepatocellular ,Hepatocellular carcinoma ,medicine.medical_treatment ,Seeding ,Peritoneal metastasectomy ,Dissemination ,030230 surgery ,Gastroenterology ,Disease-Free Survival ,Pancreatic surgery ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Internal medicine ,medicine ,Humans ,Survival rate ,Peritoneal Neoplasms ,Retrospective Studies ,Hepatology ,business.industry ,Liver Neoplasms ,Metastasectomy ,medicine.disease ,digestive system diseases ,Survival Rate ,030220 oncology & carcinogenesis ,Conventional PCI ,Peritoneal Cancer Index ,Surgery ,Hepatectomy ,business - Abstract
Background:Peritoneal metastasis of hepatocellular carcinoma (HCC) is rare. We investigated patients who underwent peritoneal metastasectomy in a multicenter study in Japan., Methods:The study included 92 patients with HCC who underwent resection for peritoneal metastasis between January 2007 and December 2013. We investigated background and operative factors, as well as overall and recurrence-free survival rates. Patients were classified according to the extent of peritoneal metastasis using the peritoneal cancer index (PCI) and the completeness of cytoreduction (CC) scores to examine whether peritoneal metastasectomy contributed to survival., Results:The mean maximum tumor size was 4.1 cm. Forty patients (43.5%) had multiple peritoneal metastases. Peritoneal metastasectomy and hepatectomy were performed simultaneously in 48 patients (52.2%). Overall, the 5-year survival rate after resection was 36.0%, and the recurrence-free survival rate was 13.0%. Multivariate analysis revealed that a PCI scores of ≤6 + CC scores of 0 was an independent prognostic factor. The 5-year survival rate when this criteria was met was 43%, which was significantly better than that in those who did not meet this criteria (p < 0.001)., Conclusions:Peritoneal metastasectomy of HCC appears to contribute to improved survival of patients with a PCI scores of ≤6, without remnant tumors.
- Published
- 2020
39. Evaluation of allowable pancreatic resection rate depending on preoperative risk factors for new-onset diabetes mellitus after distal pancreatectomy
- Author
-
Wataru Izumo, Ryota Higuchi, Masahiro Shiihara, Takehisa Yazawa, Masakazu Yamamoto, and Shuichiro Uemura
- Subjects
Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Gastroenterology ,Pancreaticoduodenectomy ,Impaired glucose tolerance ,Diabetes Complications ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Insulin resistance ,Pancreatectomy ,Risk Factors ,Internal medicine ,medicine ,Diabetes Mellitus ,Humans ,Risk factor ,Pancreas ,Aged ,Retrospective Studies ,Aged, 80 and over ,Glycated Hemoglobin ,Hepatology ,business.industry ,Incidence (epidemiology) ,Incidence ,Odds ratio ,Glucose Tolerance Test ,Middle Aged ,medicine.disease ,Impaired fasting glucose ,Survival Analysis ,Pancreatic Neoplasms ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Preoperative Period ,030211 gastroenterology & hepatology ,Female ,Insulin Resistance ,business ,Follow-Up Studies - Abstract
Although more patients have long-term survival after pancreatectomy, the details of pancreatogenic diabetes mellitus (DM) are still unclear. We aimed to investigate the incidence of new-onset DM (NODM) after distal pancreatectomy (DP) and to clarify the risk factors, including allowable pancreatic resection rate (PR), for NODM.The incidence, onset time, and risk factors for NODM were retrospectively evaluated in 150 patients who underwent DP without preoperative DM and with5 years of postoperative follow-up between 2005 and 2015.The incidence rate of NODM was 39%, and 60% of this incidence was noted within 6 months postoperatively. In the multivariate analysis, hemoglobin A1c ≥ 5.8% (odds ratio [OR] 7.6), impaired glucose tolerance and/or impaired fasting glucose (OR 4.2), homeostasis model assessment of insulin resistance ≥1.4 (OR 5.5), and insulinogenic index0.7 (OR 3.9) were the preoperative risk factors for NODM. Based on these four preoperative risk factors of NODM, we made the new scoring system to predict the NODM after DP. The NODM incidence was 0%, 8%, 48%, 60%, and 86% in patients with risk scores 0 (n = 25), 1 (n = 36), 2 (n = 33), 3 (n = 35), and 4 (n = 21), respectively. PRs ≥42.1% and ≥30.9% were allowable in the preoperative risk-score 0-1 and 2-4 groups. In the former group, the NODM incidence for PR ≥ 42.1% and42.1% was significantly different (20% vs 0%, P 0.05). In the latter group, the NODM incidence for PR ≥ 30.9% vs30.9% was significantly different (75% vs 23%, P 0.05).We clarified the preoperative risk factors and allowable PR for NODM and recommended the use of a risk scoring system for predicting NODM preoperatively.
- Published
- 2020
40. Risk factors for pancreatic fistula grade C after pancreatoduodenectomy: A large prospective, multicenter Japan-Taiwan collaboration study
- Author
-
Hiroki Yamaue, Sohei Satoi, Toshio Shimokawa, Shoji Nakamori, Manabu Kawai, Yoshiaki Murakami, Shinjiro Kobayashi, Yan Shen Shan, Tsann Long Hwang, Masakazu Yamamoto, Kazuyuki Kawamoto, Yi Ming Shyr, Ippei Matsumoto, Ryosuke Amano, Hiroyoshi Matsukawa, Kazuhisa Uchiyama, Chie Kitami, Fuyuhiko Motoi, Hiroyuki Nitta, Seiko Hirono, Chih Po Hsu, Satoshi Hirano, Hideyuki Yoshitomi, Takehiro Okabayashi, and Yuichi Nagakawa
- Subjects
medicine.medical_specialty ,Multivariate analysis ,Taiwan ,030230 surgery ,Gastroenterology ,Pancreaticoduodenectomy ,03 medical and health sciences ,Pancreatic Fistula ,0302 clinical medicine ,Postoperative Complications ,Japan ,Risk Factors ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Risk factor ,Prospective cohort study ,Hepatology ,business.industry ,Mortality rate ,medicine.disease ,medicine.anatomical_structure ,Pancreatic fistula ,030220 oncology & carcinogenesis ,Operative time ,Surgery ,business ,Complication ,Pancreas - Abstract
BACKGROUND/PURPOSE Grade C postoperative pancreatic fistula (POPF), as defined by International Study Group of Pancreatic Fistula (ISGPF), is the most life-threatening complication after pancreatoduodenectomy (PD). This study aims to evaluate risk factors for Grade C POPF after PD. METHODS This is a prospective, multicenter study based in Japan and Taiwan. Between December 2014 and May 2017, 3022 patients were enrolled in this study and 2762 patients were analyzed. We analyzed risk factors of Grade C POPF based on the updated 2016 ISGPF scheme (organ failure, reoperation, and/or death). RESULTS Among 2762 patients, 46 patients (1.7%) developed Grade C POPF after PD. The mortality rate of the 46 patients with Grade C POPF was 37.0%. On the multivariate analysis, six independent risk factors for Grade C POPF were found; BMI ≥ 25.0 kg/m2 , chronic steroid use, preoperative serum albumin
- Published
- 2020
41. Importance of each high-risk stigmata and worrisome features as a predictor of high-grade dysplasia in intraductal papillary mucinous neoplasms of the pancreas
- Author
-
Masakazu Yamamoto, Toru Furukawa, Wataru Izumo, Ryota Higuchi, Shuichiro Uemura, Takehisa Yazawa, and Masahiro Shiihara
- Subjects
Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,education ,Gastroenterology ,Risk Assessment ,Young Adult ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,medicine ,Odds Ratio ,Humans ,Cyst ,Aged ,Retrospective Studies ,Aged, 80 and over ,Hepatology ,Intraductal papillary mucinous neoplasm ,business.industry ,Incidence (epidemiology) ,Incidence ,Odds ratio ,Middle Aged ,medicine.disease ,Pancreatic Neoplasms ,Pancreatitis ,Dysplasia ,Pancreatectomy ,Female ,business ,Carcinoma, Pancreatic Ductal - Abstract
Background High-risk stigmata (HRS) and ‘worrisome features’ (WFs) are defined as predictive factors for malignancies of intraductal papillary mucinous neoplasms (IPMNs). We performed this study to determine the importance and odds ratio (OR) of each HRS and WFs as predictors for high-grade dysplasia (HGD). Methods We analyzed 295 patients who underwent pancreatectomy for branch duct and mixed-type IPMN, and evaluated the association between HRS and WFs (as defined by the ‘2017 Fukuoka Consensus Guidelines’) and HGD. Results The proportions of patients with low-grade dysplasia (LGD), HGD, and invasive carcinoma were 47%, 28%, and 25%, respectively. Multivariate analysis comparing patients with LGD and HGD using all HRS and WFs revealed that an enhancing mural nodule ≥5 mm (OR: 4.1), pancreatitis (OR: 2.2), and thickened/enhancing cyst walls (OR: 2.2) were independent predictive factors for HGD. Based on the OR (the former factor is two points and the latter two factors are each one point), the incidence of HGD in patients with none (n = 43), one (n = 82), two (n = 25), three (n = 52), and four (n = 19) of these predictive factors were 9%, 26%, 52%, 62%, and 63%, respectively. Assuming a score of one or higher as a surgical indication, the sensitivity, specificity, positive predict value, and negative predict value of HGD were 95, 38, 44, and 91%. Conclusions Our derived scoring system using more important factors in HRS and WFs may be useful for predicting HGD and determining surgical indications of IPMN.
- Published
- 2020
42. Long-term outcome of liver resection for colorectal metastases in the presence of extrahepatic disease: A multi-institutional Japanese study
- Author
-
Katsunori Sakamoto, Kenichi Sugihara, Kenjiro Kotake, Masakazu Yamamoto, Goro Honda, Tatsuro Yamaguchi, Toru Beppu, Yoshihito Kotera, Kota Sahara, Yu Sawada, Itaru Endo, Kensei Yamaguchi, Michio Itabashi, Masaru Miyazaki, Keiichi Takahashi, Soichiro Natsume, Shin Kobayashi, Hirotoshi Kobayashi, Ken Tabuchi, Kiyoshi Hasegawa, Yojiro Hashiguchi, and Satoshi Morita
- Subjects
medicine.medical_specialty ,Liver tumor ,Multivariate analysis ,Colorectal cancer ,medicine.medical_treatment ,Disease ,030230 surgery ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Internal medicine ,medicine ,Hepatectomy ,Humans ,Lymph node ,Retrospective Studies ,Lung ,Hepatology ,business.industry ,Liver Neoplasms ,medicine.disease ,Prognosis ,Primary tumor ,medicine.anatomical_structure ,Liver ,030220 oncology & carcinogenesis ,Surgery ,business ,Colorectal Neoplasms - Abstract
Background/purpose The purpose of the present study was to assess long-term outcomes following liver resection for colorectal liver metastases (CRLM) with concurrent extrahepatic disease and to identify the preoperative prognostic factors for selection of operative candidates. Methods In this retrospective, multi-institutional study, 3820 patients diagnosed with CRLM during 2005-2007 were identified using nationwide survey data. Data of identified patients with concurrent extrahepatic lesions were analyzed to estimate the impact of liver resection on overall survival (OS) and to identify preoperative, prognostic indicators. Results Three- and 5-year OS rates after liver resection in 251 CRLM patients with extrahepatic disease (lung, n = 116; lymph node, n = 51; peritoneal, n = 37; multiple sites, n = 23) were 50.2% and 32.0%, respectively. Multivariate analysis revealed that a primary tumor in the right colon, lymph node metastasis from the primary tumor, serum carbohydrate antigen (CA) 19-9 level >37 UI/mL, the site of extrahepatic disease, and residual liver tumor after hepatectomy were associated with higher mortality. We proposed a preoperative risk scoring system based on these factors that adequately discriminated 5-year OS after liver resection in training and validation datasets. Conclusions Performing R0 liver resection for colorectal liver metastases with treatable extrahepatic disease may prolong survival. Our proposed scoring system may help select appropriate candidates for liver resection.
- Published
- 2020
43. Risk factors and characteristics of young patients with the biliary tract carcinoma: results of a project study for biliary surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery
- Author
-
Masakazu Yamamoto, Shoji Kubo, Kyohei Ariake, Akihiko Horiguchi, Michiaki Unno, Hiroki Yamaue, and Hiroshi Yoshida
- Subjects
medicine.medical_specialty ,Subgroup analysis ,intrahepatic ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Risk Factors ,Internal medicine ,medicine ,Carcinoma ,Humans ,Choledochal cysts ,Retrospective Studies ,Hepatology ,business.industry ,Pancreatic Ducts ,Cancer ,Retrospective cohort study ,Original Articles ,medicine.disease ,Biliary Tract Neoplasms ,Pancreaticobiliary maljunction ,Biliary tract ,030220 oncology & carcinogenesis ,Etiology ,biliary tract ,030211 gastroenterology & hepatology ,Surgery ,Original Article ,business ,cholangiocarcinoma ,pancreaticobiliary maljunction - Abstract
Purpose This study aimed to elucidate the characteristics of biliary tract carcinoma (BTC) in young patients. Methods This is a nationwide multicenter, retrospective cohort study supervised by the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery (JSHBPS). Clinicopathological data of patients aged, Highlight Ariake and colleagues elucidated that the most frequent factor associated with biliary tract carcinoma in young patients was pancreaticobiliary maljunction. Further analysis revealed that the distribution of cancer‐associated factors differed dramatically depending on the site of biliary tract carcinoma, suggesting that each site has a different mechanism of cancer development.
- Published
- 2020
44. Propensity score-matched analysis of internal stent vs external stent for pancreatojejunostomy during pancreaticoduodenectomy: Japanese-Korean cooperative project
- Author
-
Wataru Izumo, Sun Whe Kim, Hongbeom Kim, Ki Byung Song, Sohei Satoi, Masakazu Yamamoto, Toshio Shimokawa, Sang-Jae Park, Song Cheol Kim, Seiko Hirono, Seong Ho Choi, Jin-Young Jang, Hiroki Yamaue, Joo Seop Kim, Sae Byeol Choi, Michiaki Unno, Joon Seong Park, Hee Chul Yu, Masayuki Sho, Tae Ho Hong, Dong Sup Yoon, Manabu Kawai, Takumi Fukumoto, Young Joon Ahn, Jin Seok Heo, Katsuhiko Uesaka, Tsutomu Fujii, Ryosuke Amano, Masafumi Nakamura, and Ryo Ashida
- Subjects
Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Pancreaticoduodenectomy ,Cohort Studies ,03 medical and health sciences ,Pancreatic Fistula ,0302 clinical medicine ,Postoperative Complications ,Japan ,Pancreaticojejunostomy ,Republic of Korea ,medicine ,Clinical endpoint ,Humans ,In patient ,Propensity Score ,Aged ,Aged, 80 and over ,Hepatology ,business.industry ,Incidence (epidemiology) ,Incidence ,Gastroenterology ,Pancreatic Ducts ,Stent ,Middle Aged ,equipment and supplies ,medicine.disease ,Surgery ,Clinical trial ,Treatment Outcome ,Pancreatic fistula ,030220 oncology & carcinogenesis ,Propensity score matching ,030211 gastroenterology & hepatology ,Female ,Stents ,business - Abstract
Several studies comparing internal and external stents have been conducted with the aim of reducing pancreatic fistula after PD. There is still no consensus, however, on the appropriate use of pancreatic stents for prevention of pancreatic fistula. This multicenter large cohort study aims to evaluate whether internal or external pancreatic stents are more effective in reduction of clinically relevant pancreatic fistula after pancreaticoduodenectomy (PD).We reviewed 3149 patients (internal stent n = 1,311, external stent n = 1838) who underwent PD at 20 institutions in Japan and Korea between 2007 and 2013. Propensity score matched analysis was used to minimize bias from nonrandomized treatment assignment. The primary endpoint was the incidence of clinically relevant pancreatic fistula. This study was registered on the UMIN Clinical Trials Registry (UMIN000032402).After propensity score matched analysis, clinically relevant pancreatic fistula occurred in more patients in the external stents group (280 patients, 28.7%) than in patients in the internal stents group (126 patients, 12.9%) (OR 2.713 [95% CI, 2.139-3.455]; P 0.001). In subset analysis of a high-risk group with soft pancreas and no dilatation of the pancreatic duct, clinically relevant pancreatic fistula occurred in 90 patients (18.8%) in internal stents group and 183 patients (35.4%) in external stents group. External stents were significantly associated with increased risk for clinically relevant pancreatic fistula (OR 2.366 [95% CI, 1.753-3.209]; P 0.001).Propensity score matched analysis showed that, regarding clinically relevant pancreatic fistula after PD, internal stents are safer than external stents for pancreaticojejunostomy.
- Published
- 2020
45. Six autoantibodies as potential serum biomarkers of hepatocellular carcinoma: A prospective multicenter study
- Author
-
Katsuhiko Yanaga, Shunichi Arizumi, Masahiro Shinoda, Shigeki Wakiyama, Masakazu Yamamoto, Katsumi Amikura, Osamu Aramaki, Takeshi Aoki, Hideaki Shimada, Tadatoshi Takayama, Rei Okada, Yuichiro Otsuka, Masahiko Murakami, Taiga Wakabayashi, and Hironori Kaneko
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,Carcinoma, Hepatocellular ,Kaplan-Meier Estimate ,Gastroenterology ,Risk Assessment ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Antigen ,Serum biomarkers ,Antigens, Neoplasm ,Internal medicine ,medicine ,Biomarkers, Tumor ,Humans ,Prospective Studies ,Aged ,Autoantibodies ,Neoplasm Staging ,business.industry ,Liver Neoplasms ,Autoantibody ,Middle Aged ,medicine.disease ,Prognosis ,digestive system diseases ,Titer ,Oncology ,Multicenter study ,ROC Curve ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Case-Control Studies ,Biomarker (medicine) ,Feasibility Studies ,Female ,business ,Follow-Up Studies - Abstract
Serum autoantibodies have been reported to react with tumor-associated antigen (TAA) in various cancers. This multicenter study evaluated the diagnostic and prognostic value of six autoantibodies against a panel of six hepatocellular carcinoma (HCC)-associated antigens, including Sui1, p62, RalA, p53, NY-ESO-1 and c-myc. A total of 160 patients with HCC and 74 healthy controls were prospectively enrolled from six institutions. Serum antibody titers were determined by enzyme-linked immunosorbent assays. The sensitivities were 19% for Sui1, 18% for p62, 17% for RalA, 11% for p53, 10% for NY-ESO-1 and 9% for c-myc. Overall sensitivity of the TAA panel (56%) was higher than that of α-fetoprotein (41%, P < .05). The combined sensitivity of the TAA panel and α-fetoprotein was significantly higher than that of α-fetoprotein alone (P < .001). The difference in overall survival of TAA panel-positive and panel-negative patients was significant when the Stage I/II patients were combined (P = .023). Overall survival was worse in NY-ESO-1 antibody-positive than in NY-ESO-1 antibody-negative patients (P = .002). Multivariate analysis found that positivity for the TAA panel was independently associated with poor prognosis (P = .030). This TAA panel may have diagnostic and prognostic value in the patients with HCC.
- Published
- 2020
46. Comparison of Clinicopathological Features of Biliary Neuroendocrine Carcinoma with Adenocarcinoma
- Author
-
Masakazu Yamamoto, Ryota Higuchi, Wataru Izumo, Masahiro Shiihara, Toru Furukawa, Takehisa Yazawa, and Shuichiro Uemura
- Subjects
Adult ,Male ,medicine.medical_specialty ,Kaplan-Meier Estimate ,Gastroenterology ,Metastasis ,Cholangiocarcinoma ,Bile Ducts, Extrahepatic ,Internal medicine ,Medicine ,Humans ,Neuroendocrine carcinoma ,Risk factor ,Pathological ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Bile duct ,Hazard ratio ,Cancer ,Middle Aged ,medicine.disease ,Prognosis ,digestive system diseases ,Carcinoma, Neuroendocrine ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Adenocarcinoma ,Surgery ,Female ,business - Abstract
Objective: This study aimed to demonstrate the clinical features and postoperative outcomes of extrahepatic bile duct (EHBD) neuroendocrine carcinoma (NEC) and compared with those of adenocarcinoma. Methods: We retrospectively analyzed patients with EHBD cancer operated in our institution between 1995 and 2015. Results: Of 475 patients, 468 had adenocarcinoma, while 7 had NEC/mixed adenoneuroendocrine carcinoma (MANEC) in this study. There were no notable preoperative and pathological features in patients with NEC/MANEC. However, patients with NEC/MANEC had a higher recurrence rate (51.8 vs. 100%, p = 0.016), poorer relapse-free survival (RFS) time (the median RFS time: 35 vs. 12 months, p = 0.006), and poorer overall survival (OS) time (the median OS time: 60 vs. 19 months, p = 0.078) than those with adenocarcinoma. Furthermore, patients with NEC/MANEC had higher rates of liver metastasis (11.9 vs. 85.7%, p < 0.001) than those with adenocarcinoma. In multivariable regression analysis, pathological type with NEC/MANEC was a risk factor for poorer RFS (p = 0.022, hazard ratio: 6.09). Conclusions: Patients with NEC/MANEC have high malignant potential and poor outcomes. It is necessary to develop an effective approach and postoperative adjuvant treatment for patients with NEC/MANEC.
- Published
- 2020
47. A Comparison of the Pathological Types of Undifferentiated Carcinoma of the Pancreas
- Author
-
Ryota Higuchi, Wataru Izumo, Toru Furukawa, Masahiro Shiihara, and Masakazu Yamamoto
- Subjects
Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Lymph node metastasis ,Kaplan-Meier Estimate ,Gastroenterology ,Giant Cells ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Text mining ,Internal medicine ,Internal Medicine ,Carcinoma ,medicine ,Humans ,Pathological ,Pancreas ,Aged ,Aged, 80 and over ,Hepatology ,business.industry ,Middle Aged ,medicine.disease ,Prognosis ,Pancreatic Neoplasms ,Survival Rate ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,Undifferentiated carcinoma ,business ,Spindle cell carcinoma - Abstract
OBJECTIVES This study aimed to identify the detailed clinicopathological features of undifferentiated carcinoma of the pancreas (UCP). METHODS We investigated clinical, imaging features and the prognoses of 261 patients; 8 were our patients, and the remainder were identified by searching English-language articles in PubMed. RESULTS We classified patients with UCP into 3 types based on pathological findings: osteoclast-like giant cell-associated carcinoma, pleomorphic cell carcinoma (PLC), and spindle cell carcinoma. There were no remarkable differences in clinical, radiological features between these 3 types. However, PLCs were significantly more likely to be unresectable than were the other 2 types (P < 0.001). Patients with osteoclast-like giant cell-associated carcinoma achieved the best overall survival (OS) rates (P < 0.001), whereas those with spindle cell carcinoma had significantly longer OS rates than did those with PLC (P = 0.004). These OS patterns were maintained when considering only those patients who underwent resection. Patients with PLC had both lower curative resection and high lymph node metastasis rates (P = 0.029, P = 0.023). Patients who underwent resection had more favorable prognoses than did those who did not. CONCLUSIONS Surgery is the first choice for resectable UCP. Pleomorphic cell carcinoma is particularly malignant; postoperative treatment should be introduced immediately.
- Published
- 2020
48. Characteristics of hepatocellular carcinoma arising from Fontan-associated liver disease
- Author
-
Masakazu Yamamoto, Tomomi Kogiso, Takaomi Sagawa, Katsutoshi Tokushige, Etsuko Hashimoto, and Hisashi Sugiyama
- Subjects
medicine.medical_specialty ,Cirrhosis ,Hepatology ,business.industry ,Incidence (epidemiology) ,medicine.medical_treatment ,medicine.disease ,Gastroenterology ,digestive system diseases ,Fontan procedure ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Infectious Diseases ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Internal medicine ,Medicine ,030211 gastroenterology & hepatology ,Polysplenia ,business ,Transcatheter arterial chemoembolization ,neoplasms ,Survival rate - Abstract
AIM Hepatocellular carcinoma (HCC) can arise from Fontan-associated liver disease (FALD); this is known as FALD-HCC. The clinical features of FALD-HCC are unclear. Thus, we examined the incidence and clinical characteristics of FALD-HCC. METHODS From 1972 to 2019, 122 patients developed liver disease after undergoing Fontan procedures. HCC was diagnosed in 12 (9.8%) FALD patients. We compared FALD-HCC and non-HCC patients. RESULTS The incidence of HCC was 0.8% and 2.9% in FALD 10 and 20 years after the Fontan procedure, respectively. The median age of patients at diagnosis of HCC was 32.5 years (range 20.6-46.1 years), and seven of the 12 patients were men. Patients with FALD-HCC had a higher incidence of liver cirrhosis and polysplenia than non-HCC patients. Liver tumors were detected as single nodules in eight patients, and the median diameter was 47 mm (range 11-105 mm). HCC was treated by surgical resection in two patients, transcatheter arterial chemoembolization or chemotherapy in three patients, and proton beam therapy in four patients. Three patients could not be treated because of their poor condition. Four patients died of liver/cardiac failure and HCC, and HCC was controlled in three patients. The survival rate after 25 years was significantly lower in patients with FALD-HCC than non-HCC patients (68.6% vs. 97.9%, respectively; P
- Published
- 2020
49. Significance of a preoperative tumor marker gradient for predicting microvascular invasion in cases of hepatocellular carcinoma
- Author
-
Shinjiro Kobayashi, Itaru Endo, Takuya Minagawa, Masahiro Shinoda, Satoshi Matsumura, Kazuhisa Takeda, Taizo Hibi, Satoshi Koizumi, Masakazu Yamamoto, Minoru Tanabe, Takehito Otsubo, and Shingo Yamashita
- Subjects
Cancer Research ,medicine.medical_specialty ,Oncogene ,business.industry ,medicine.medical_treatment ,Cancer ,Retrospective cohort study ,Articles ,Cell cycle ,medicine.disease ,Molecular medicine ,Gastroenterology ,digestive system diseases ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Internal medicine ,Medicine ,030211 gastroenterology & hepatology ,Hepatectomy ,business ,neoplasms ,Tumor marker - Abstract
Although vascular invasion is an important factor in the progression and treatment of hepatocellular carcinoma (HCC), it remains difficult to determine, on the basis of preoperative imaging alone, whether vascular invasion, especially microvascular invasion, has occurred. The current retrospective study enrolled 292 patients who, between 2004 and 2014, underwent curative hepatectomy as an initial treatment for HCC. The patients were divided between those with (n=70) and those without (n=222) microvascular invasion. Whether tumor-marker-based prediction of microvascular invasion was possible was assessed by comparing the preoperative serum α-fetoprotein (AFP) and prothrombin induced by vitamin K absence or antagonist-II concentrations between two groups of patients. The AFP concentration was significantly higher in patients with microvascular invasion compared with patients without microvascular invasion (P=0.0019). Stepwise logistic regression analysis demonstrated the AFP concentration and the logarithmic conversion ratio of the AFP gradient (log AFP grad) to be useful (P=0.0019; 0.0424) for predicting microvascular invasion. The serum AFP concentration and log AFP grad appear to be clinically useful in predicting microvascular invasion in patients with HCC.
- Published
- 2020
50. Risk prediction for malignant intraductal papillary mucinous neoplasm of the pancreas: logistic regression versus machine learning
- Author
-
Youngmin Han, Sohei Satoi, Masakazu Yamamoto, Yoo Seok Yoon, C.L. Wolfgang, Hongbeom Kim, Alex B. Blair, Satoshi Hirano, Yuichi Nagakawa, Yi Ming Shyr, Taesung Park, Marc G. Besselink, Hyung Il Seo, Yasuhiro Shimizu, Jin-Young Jang, Michael D. Kluger, Jun Chul Chung, Takashi Hatori, Ippei Matsumoto, Goro Honda, Wooil Kwon, Ki Byung Song, Ho-Seong Han, Sungyoung Lee, Wenhui Lou, Roberto Valente, Yoonhyeong Byun, Ryota Higuchi, Seiko Hirono, Hiroki Yamaue, Fuyuhiko Motoi, Matthias Löhr, Shin E. Wang, Wookyeong Song, Wonho Choo, Jae Seung Kang, Gloria H. Su, Jin Seok Heo, Hiroaki Nagano, Nadine C.M. van Huijgevoort, Giovanni Marchegiani, Chanhee Lee, Ching-Yao Yang, Sang Geol Kim, Claudio Bassi, Seungyeoun Lee, Roberto Salvia, Marco Del Chiaro, Jin He, Dong Wook Choi, Seong Ho Choi, Chang Moo Kang, Hee Chul Yu, Yinmo Yang, Yasushi Hashimoto, Tsutomu Fujii, Song Cheol Kim, Yoo Jin Choi, Jae Do Yang, Woo Jung Lee, Masayuki Sho, Surgery, CCA - Imaging and biomarkers, Amsterdam Gastroenterology Endocrinology Metabolism, and Graduate School
- Subjects
0301 basic medicine ,Male ,Pancreatic Intraductal Neoplasms ,lcsh:Medicine ,computer.software_genre ,Logistic regression ,Main duct ,Machine Learning ,0302 clinical medicine ,malignant ,Risk Factors ,IPMN , malignant, regression ,Diagnosis, Computer-Assisted ,lcsh:Science ,Mathematics ,Interpretability ,Multidisciplinary ,Gastroenterology ,Middle Aged ,Prognosis ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Female ,regression ,Pancreas ,Algorithms ,Machine learning ,Cross-validation ,Article ,03 medical and health sciences ,IPMN ,medicine ,Humans ,Model development ,Aged ,Retrospective Studies ,Intraductal papillary mucinous neoplasm ,business.industry ,lcsh:R ,medicine.disease ,030104 developmental biology ,Logistic Models ,Test set ,lcsh:Q ,Artificial intelligence ,Pancreatic Cyst ,business ,computer - Abstract
Most models for predicting malignant pancreatic intraductal papillary mucinous neoplasms were developed based on logistic regression (LR) analysis. Our study aimed to develop risk prediction models using machine learning (ML) and LR techniques and compare their performances. This was a multinational, multi-institutional, retrospective study. Clinical variables including age, sex, main duct diameter, cyst size, mural nodule, and tumour location were factors considered for model development (MD). After the division into a MD set and a test set (2:1), the best ML and LR models were developed by training with the MD set using a tenfold cross validation. The test area under the receiver operating curves (AUCs) of the two models were calculated using an independent test set. A total of 3,708 patients were included. The stacked ensemble algorithm in the ML model and variable combinations containing all variables in the LR model were the most chosen during 200 repetitions. After 200 repetitions, the mean AUCs of the ML and LR models were comparable (0.725 vs. 0.725). The performances of the ML and LR models were comparable. The LR model was more practical than ML counterpart, because of its convenience in clinical use and simple interpretability.
- Published
- 2020
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.