125 results on '"Satoru Motoyama"'
Search Results
2. Neoadjuvant Chemoradiotherapy Upregulates the Immunogenicity of Cold to Hot Tumors in Esophageal Cancer Patients
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Yushi Nagaki, MD, PhD, Satoru Motoyama, MD, PhD, Yusuke Sato, MD, PhD, Akiyuki Wakita, MD, PhD, Hiromu Fujita, MD, PhD, Kohei Kemuriyama, MD, Ryohei Sasamori, MD, Shu Nozaki, MD, Kyoko Nomura, MD, PhD, and Yoshihiro Minamiya, MD, PhD
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Surgery ,RD1-811 - Abstract
Objective:. To test the hypothesis that neoadjuvant chemoradiotherapy (NACRT) is more effective against hot esophageal squamous cell carcinoma (ESCC) and that it may upregulate tumor immunogenicity. Background:. There have been several recent reports showing the efficacy of immune check-point inhibitors (ICIs) against esophageal cancer, especially immunologically hot tumors. In addition, several studies have suggested that chemotherapy and radiotherapy may convert cold tumors to hot tumors. Methods:. Of 105 ESCC patients who underwent surgery after NACRT between 2010 and 2018 at our hospital, 99 whose biopsy tissue samples were obtained were enrolled. Based on immunohistochemical analysis, tumors that were FOXA1 (+) and/or EYA2 (+) were defined as hot tumors, others were cold tumors. We then investigated the association between tumor immunogenicity and clinicopathological features. Results:. The 29 patients with hot tumors before NACRT had a significantly better 5-year disease-specific survival (DSS) rate than the remaining 70 patients with cold tumors (85% vs 64%; P = 0.036). In a multivariate analysis, tumor immunogenicity was a significant independent predictor of DSS. Of 68 patients without a pathological complete response (non-pCR) in their primary tumor, 51 (75%) had hot tumors after NACRT. Moreover, 75% (36/48) of tumors that were cold before NACRT were converted to hot tumors after NACRT. Conclusions:. Patients with hot ESCC tumors treated with NACRT plus esophagectomy had a better prognosis than those with cold tumors. NACRT upregulated cold tumor immunogenicity to hot tumors, suggesting NACRT may increase the sensitivity of ESCC to adjuvant ICIs.
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- 2024
- Full Text
- View/download PDF
3. Robot-assisted thoracoscopic enucleation for a large esophageal leiomyoma: a case report
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Kohei Kemuriyama, Satoru Motoyama, Yusuke Sato, Akiyuki Wakita, Yushi Nagaki, Hiromu Fujita, Ryohei Sasamori, Kazuhiro Imai, Masaki Aokawa, and Yoshihiro Minamiya
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Robot-assisted thoracoscopic surgery ,Esophageal leiomyoma ,Enucleation ,Surgery ,RD1-811 - Abstract
Abstract Background Video-assisted thoracoscopic surgery (VATS) is being used to treat esophageal submucosal tumors (SMTs) all over the world. However, this technique is difficult when the tumor is large and located on the left side wall of the esophagus, within the upper mediastinum. This is because, with VATS, the surgical forceps have a limited range of motion. Robot-assisted thoracoscopic surgery (RATS) using the da Vinci surgical system may be extremely useful for enucleation of esophageal SMTs within the narrow upper mediastinum. Case presentation A female in her thirties experiencing epigastric pain visited our hospital and was diagnosed with a large esophageal leiomyoma within the upper mediastinum. From its size (10 cm), it was judged to have malignant potential. We performed SMT enucleation using RATS with a da Vinci surgical system Xi. This was our second case using this system. The patient was placed in the left lateral position. Four da Vinci trocars (8 mm) were inserted into the 10th, 7th, 5th and 3rd intercostal spaces (ICS), and an assist port was added in the 5th ICS. We opened the superior mediastinal pleura cranially and caudally from the arch of the azygos vein and expanded the superior mediastinum after dividing the azygos vein. We made an incision in the muscular layer of the esophagus and, using a monopolar hook and monopolar scissors, enucleated the esophageal tumor in a protective manner so as not to damage its capsule or mucosa while applying appropriate robot-specific counter traction. We then sewed up the muscularis using 4–0 Vicryl, inserting the endoscope into the thoracic esophagus to substitute for a bougie. In addition, the pleura was sutured using barbed suture. The surgical procedure was straightforward and smooth. The patient was discharged on postoperative day 4 with no surgical complications. The tumor was definitively diagnosed pathologically from paraffin sections as a benign esophageal leiomyoma. Conclusions RATS enables more delicate and precise esophageal SMT enucleation without surgical complications, though various challenges remain to be overcome.
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- 2021
- Full Text
- View/download PDF
4. SUVmax reduction predicts long-term survival in patients of non-pCR both in the tumor and lymph nodes after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma
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Yushi Nagaki, Satoru Motoyama, Yusuke Sato, Akiyuki Wakita, Hiromu Fujita, Yoshihiro Sasaki, Kazuhiro Imai, and Yoshihiro Minamiya
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ESCC ,NACRT ,non-pCR ,SUVmax ,Surgery ,RD1-811 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background A pathological complete response (pCR) after neoadjuvant chemoradiotherapy (NACRT) ensures long-term survival in esophageal squamous cell carcinoma (ESCC) patients following esophagectomy, but pCR patients are a minority. The aim here was to identify prognostic factors in patients with non-pCR ESCC after NACRT. Methods This is a retrospective study. Investigated were 5-year overall survival (OS), disease-specific survival (DSS), and relapse-free survival (RFS) among non-pCR ESCC patients divided into pT0N0, primary site pCR (pT0N+), lymph node pCR (pT+N0), and non-pCR in both the tumor and lymph node (pT+N+) subgroups after NACRT and esophagectomy. Focusing on the SUVmax reduction rate in the primary tumor in 88 patients who underwent FDG-PET before and after NACRT, we used univariate and multivariate Cox proportional hazard models to identify prognostic factors. Results Although there were no significant survival differences among non-pCR ESCC patients with pT0N+, pT+N0, or pT+N+, survival rate among pT+N+patients was the poorest. After setting a 60% cutoff for the SUVmax reduction rate in the tumor, RFS curves for non-pCR patients significantly differed between patients above the cutoff and those below it. For pT+N+ patients, the SUVmax reduction rate (
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- 2021
- Full Text
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5. Clinical benefits of adjuvant chemotherapy with carboplatin and gemcitabine in patients with non-small cell lung cancer: a single-center retrospective study
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Shinogu Takashima, Kazuhiro Imai, Maiko Atari, Tsubasa Matsuo, Katsutoshi Nakayama, Yusuke Sato, Satoru Motoyama, Hiroyuki Shibata, Kyoko Nomura, and Yoshihiro Minamiya
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Carboplatin ,Gemcitabine ,Adjuvant chemotherapy ,Lung cancer ,Surgery ,RD1-811 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Purpose In cases of non-small cell lung cancer (NSCLC), surgery remains the best option for cure, but surgery is of benefit only when the disease is localized. Although adjuvant chemotherapy reportedly has a significant beneficial effect on survival, the benefit of a carboplatin (CBDCA) regimen is unclear. We therefore investigated the efficacy and tolerability of CBDCA (area under the curve 5) plus gemcitabine (GEM, 1000 mg/m2) as adjuvant chemotherapy. Methods A total of 82 pStage IB-IIIA NSCLC patients who had undergone complete resection and received adjuvant chemotherapy were analyzed retrospectively. Among them, 65 patients received CBDCA + GEM and 17 received CDDP + VNR. Propensity score analysis generated 17 matched pairs of both groups. Results Sixty-five patients received CBDCA + GEM. Their 5-year relapse-free survival (RFS) and overall survival were 47.8% (median, 52.5 months) and 76.9% (median, 90.1 months), respectively. Toxicities, which included neutropenia, nausea/anorexia, fatigue, and vasculitis, were significantly milder than with CDDP + VNR. There were no significant differences in RFS between CBDCA + GEM and CDDP + VNR (p = 0.079) after matching for age, performance status, and pStage. Conclusion CBDCA + GEM was effective and well tolerated as adjuvant chemotherapy, with a manageable toxicity profile.
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- 2020
- Full Text
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6. Evaluation of metastatic lymph nodes in cN0 thoracic esophageal cancer patients with inconsistent pathological lymph node diagnosis
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Akiyuki Wakita, Satoru Motoyama, Yusuke Sato, Yuta Kawakita, Yushi Nagaki, Kaori Terata, Kazuhiro Imai, and Yoshihiro Minamiya
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False-negative lymph node ,Lymph node metastasis ,Esophageal cancer ,Surgery ,RD1-811 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Preoperative clinical diagnosis of lymph node (LN) metastasis and subsequent pathological diagnosis are often not in agreement. Detection of false-negative LNs is essential in selecting an optimal treatment strategy, and most importantly, the presence of false-negative LN is itself a significant prognostic indicator. Therefore, at present, there is an urgent need to establish more accurate and individualized evaluation methods for LN metastasis. Methods Of 213 cN0 patients who underwent curative esophagectomy without preoperative neoadjuvant treatment, 60 (28%) had LN metastasis diagnosed pathologically. There were 129 false-negative LNs, of which 85 were detectable by preoperative computed tomography (CT). We retrospectively investigated the distribution, frequency, and characteristics of pathologically positive nodes in patients with clinically N0 esophageal cancer. Results The paracardial region was the most frequent region of false-negative LNs, accounting for 26% (22 LNs) of the total incidence. False-negative LNs distributed widely from the neck to the abdomen in patients with a primary tumor in the middle thoracic esophagus. In patients with a primary tumor in the lower thoracic esophagus, four false-negative LNs were detected in the superior mediastinum. When the short-axis diameter, shape, and attenuation patterns of the LNs were used as criteria for metastasis diagnosis, they were insufficient for an accurate diagnosis. However, false-negative LNs in the most frequently occurring sites are characterized by smaller short-axis, suggesting that accurate diagnosis cannot be made unless the diagnostic criteria for the short-axis are reduced in addition to shape and attenuation. Conclusions Although restrictive to the most frequent regions of false-negative LNs occur, reducing size criterion and consideration of their shape and attenuation may contribute to improved diagnosis.
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- 2020
- Full Text
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7. Pectoralis Major Myocutaneous Flap Repair for Anastomotic Leakage after Esophageal Bypass Surgery
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Teiji Takahashi, Yusuke Sato, Yujiro Kato, Ouki Yasui, Satoru Motoyama, Hiroshi Imano, and Tomohiko Sasaki
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Pectoralis major myocutaneous flap ,medicine.medical_specialty ,Bypass surgery ,business.industry ,Anastomotic leakage ,Gastroenterology ,Medicine ,Surgery ,business - Published
- 2021
8. Robot-assisted thoracoscopic enucleation for a large esophageal leiomyoma: a case report
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Yoshihiro Minamiya, Masaki Aokawa, Kohei Kemuriyama, Akiyuki Wakita, Hiromu Fujita, Yusuke Sato, Yushi Nagaki, Kazuhiro Imai, Ryohei Sasamori, and Satoru Motoyama
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medicine.medical_specialty ,Endoscope ,RD1-811 ,business.industry ,Forceps ,Enucleation ,Mediastinum ,Case Report ,Robot-assisted thoracoscopic surgery ,Da Vinci Surgical System ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,surgical procedures, operative ,030220 oncology & carcinogenesis ,medicine ,Esophageal Leiomyoma ,030211 gastroenterology & hepatology ,Esophagus ,Azygos vein ,Esophageal leiomyoma ,business - Abstract
Background Video-assisted thoracoscopic surgery (VATS) is being used to treat esophageal submucosal tumors (SMTs) all over the world. However, this technique is difficult when the tumor is large and located on the left side wall of the esophagus, within the upper mediastinum. This is because, with VATS, the surgical forceps have a limited range of motion. Robot-assisted thoracoscopic surgery (RATS) using the da Vinci surgical system may be extremely useful for enucleation of esophageal SMTs within the narrow upper mediastinum. Case presentation A female in her thirties experiencing epigastric pain visited our hospital and was diagnosed with a large esophageal leiomyoma within the upper mediastinum. From its size (10 cm), it was judged to have malignant potential. We performed SMT enucleation using RATS with a da Vinci surgical system Xi. This was our second case using this system. The patient was placed in the left lateral position. Four da Vinci trocars (8 mm) were inserted into the 10th, 7th, 5th and 3rd intercostal spaces (ICS), and an assist port was added in the 5th ICS. We opened the superior mediastinal pleura cranially and caudally from the arch of the azygos vein and expanded the superior mediastinum after dividing the azygos vein. We made an incision in the muscular layer of the esophagus and, using a monopolar hook and monopolar scissors, enucleated the esophageal tumor in a protective manner so as not to damage its capsule or mucosa while applying appropriate robot-specific counter traction. We then sewed up the muscularis using 4–0 Vicryl, inserting the endoscope into the thoracic esophagus to substitute for a bougie. In addition, the pleura was sutured using barbed suture. The surgical procedure was straightforward and smooth. The patient was discharged on postoperative day 4 with no surgical complications. The tumor was definitively diagnosed pathologically from paraffin sections as a benign esophageal leiomyoma. Conclusions RATS enables more delicate and precise esophageal SMT enucleation without surgical complications, though various challenges remain to be overcome.
- Published
- 2021
9. Does Esophagectomy Provide a Survival Advantage to Patients Aged 80 Years or Older? Analyzing 5066 Patients in the National Database of Hospital-based Cancer Registries in Japan
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Yoshihiro Minamiya, Eri Maeda, Kaori Terata, Katsunori Iijima, Takahiro Higashi, Yusuke Sato, Hiromu Fujita, Kazuhiro Imai, Takatoshi Yoneya, Akiyuki Wakita, Yushi Nagaki, Satoru Motoyama, and Shigeto Koizumi
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medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,MEDLINE ,Cancer Care Facilities ,Japan ,Internal medicine ,medicine ,Humans ,Registries ,Stage (cooking) ,Survival rate ,Survival analysis ,Aged ,Neoplasm Staging ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Standard treatment ,Cancer ,Chemoradiotherapy ,medicine.disease ,Esophagectomy ,Survival Rate ,Surgery ,business - Abstract
OBJECTIVE To determine whether esophagectomy provides a survival advantage in octogenarians with resectable thoracic esophageal cancer. SUMMARY BACKGROUND DATA Elderly patients with thoracic esophageal cancer do not always receive the full standard treatment; however, advanced age alone should not preclude the use of effective treatment that could meaningfully improve survival. METHODS We retrieved the 2008-2011 data from the National Database of Hospital-based Cancer Registries from the National Cancer Center in Japan, divided the patients into a ≥75 group (75-79 years; n = 2,935) and a ≥80 group (80 years or older; n = 2,131), and then compared the patient backgrounds and survival curves. A multivariable Cox proportional hazards regression model was developed to compare the effects of esophagectomy and chemoradiotherapy in the two groups. RESULTS A significantly greater percentage of patients were treated with esophagectomy in the ≥75 group (34.6%) than the ≥80 group (18.4%). Among patients who received esophagectomy, the 3-year survival rate was 51.1% in the ≥75 group and 39.0% in the ≥80 group (P < 0.001). However, among patients who received chemoradiotherapy, there was no difference in survival curve between the two groups (P = 0.17). Multivariable Cox proportional hazard analysis revealed that esophagectomy for clinical Stage II-III patients was significantly associated to better survival (adjusted HR: 0.731) (95%CI: 0.645-0.829, p < 0.001) in the ≥75 group but not the ≥80 group when compared with CRT. CONCLUSIONS Many octogenarians do not necessarily get a survival benefit from esophagectomy. However, patients should be evaluated based on their overall health before ruling out surgery based on age alone.
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- 2020
10. Verification of the Optimal Interval Before Esophagectomy After Preoperative Neoadjuvant Chemoradiotherapy for Locally Advanced Thoracic Esophageal Cancer
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Satoru Motoyama, Yoshihiro Minamiya, Hiromu Fujita, Yushi Nagaki, Kaori Terata, Akiyuki Wakita, Yusuke Sato, and Kazuhiro Imai
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medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,03 medical and health sciences ,0302 clinical medicine ,Surgical oncology ,medicine ,Humans ,Pathological ,Neoadjuvant therapy ,Retrospective Studies ,business.industry ,Retrospective cohort study ,Chemoradiotherapy ,Chemoradiotherapy, Adjuvant ,Perioperative ,Esophageal cancer ,medicine.disease ,Neoadjuvant Therapy ,Surgery ,Esophagectomy ,Treatment Outcome ,Oncology ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business - Abstract
The interval between preoperative chemoradiotherapy and surgery reportedly affects perioperative outcomes and survival; however, the optimal interval in esophageal cancer patients remains uncertain. Our aim was to determine whether a prolonged interval between preoperative neoadjuvant chemoradiotherapy (NACRT) and esophagectomy affects the outcomes of esophageal cancer patients. A total of 131 patients with esophageal cancer received curative surgery following NACRT at Akita University Hospital between 2009 and 2017. We divided these patients into two groups based on the median interval from NACRT to esophagectomy, and compared the rates of pathological complete response (pCR), surgical outcomes, and survival. The median interval from NACRT to esophagectomy was 39 days (range 21–95). Of the 131 patients, 70 (53%) received esophagectomy after 39 days or more from completion of NACRT. There were no significant differences in the clinicopathological features, including pCR rates, between the two groups. Prolongation of the interval from NACRT to esophagectomy was significantly associated with an increased rate of anastomotic leakage and recurrent laryngeal nerve palsy (p = 0.0225 and p = 0.0022, respectively); however, no association with overall survival was detected. A prolonged interval between NACRT and esophagectomy had no impact on pCR rates or survival. However, delaying esophagectomy may increase the likelihood of surgical complications such as anastomotic leakage and recurrent laryngeal nerve palsy.
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- 2020
11. Expression and Malignant Potential of B4GALNT4 in Esophageal Squamous Cell Carcinoma
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Dai Shimizu, Koichi Sawaki, Masahiko Koike, Satoru Motoyama, Tsutomu Fujii, Hayato Baba, Mitsuro Kanda, Yusuke Sato, and Yasuhiro Kodera
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Messenger RNA ,Gene knockdown ,Lymphovascular invasion ,business.industry ,digestive system diseases ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,Downregulation and upregulation ,Antigen ,Cell culture ,Surgical oncology ,030220 oncology & carcinogenesis ,Cancer research ,Immunohistochemistry ,Medicine ,030211 gastroenterology & hepatology ,Surgery ,business - Abstract
β-1,4-N-Acetyl-galactosaminyltransferase 4 (B4GALNT4), an enzyme involved in ganglioside synthesis, is upregulated in many cancers. We examine B4GALNT4 expression and its relationship to prognosis in esophageal squamous cell carcinoma (ESCC). Expression of B4GALNT4 mRNA and B4GALNT4 protein was analyzed by quantitative reverse-transcription polymerase chain reaction (qRT-PCR) and immunohistochemistry, respectively, in 17 human ESCC cell lines and/or clinical specimens from two independent cohorts of 147 and 159 ESCC patients. The contributions of B4GALNT4 to proliferation, invasion, migration, and adhesion was evaluated in ESCC cells subjected to siRNA-mediated gene knockdown. Correlations between clinicopathological parameters and B4GALNT4 expression in clinical specimens were analyzed in both patient cohorts. B4GALNT4 mRNA expression levels varied widely in ESCC cell lines, regardless of differentiation status or the originating tissue. Knockdown of B4GALNT4 significantly suppressed the proliferation, invasion, migration, and adhesion of ESCC cell lines compared with control cells. B4GALNT4 mRNA was overexpressed in ESCC tissues compared with adjacent normal esophageal tissues. High mRNA expression was significantly associated with poor disease-free survival and hematogenous recurrence, and high B4GALNT4 protein expression was also significantly related to poor disease-specific survival. On multivariable analysis, high B4GALNT4 expression was an independent predictor of poor prognosis. In both patient cohorts, high B4GALNT4 expression did not correlate with known prognostic factors, such as disease stage, lymphovascular invasion, or squamous cell-carcinoma-related antigen level. B4GALNT4 influences the malignant behavior of ESCC cells. B4GALNT4 expression may serve as a novel prognostic marker, independent of established risk factors, for ESCC patients.
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- 2020
12. Decreases in the Psoas Muscle Index Correlate More Strongly with Survival than Other Prognostic Markers in Esophageal Cancer After Neoadjuvant Chemoradiotherapy Plus Esophagectomy
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Yoshihiro Minamiya, Kazuhiro Imai, Yuta Kawakita, Akiyuki Wakita, Yushi Nagaki, Yusuke Sato, and Satoru Motoyama
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Male ,Sarcopenia ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Aged ,Psoas Muscles ,business.industry ,Cancer ,Chemoradiotherapy, Adjuvant ,Middle Aged ,Esophageal cancer ,Vascular surgery ,Prognosis ,medicine.disease ,Neoadjuvant Therapy ,Cardiac surgery ,Esophagectomy ,Survival Rate ,Cardiothoracic surgery ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Surgery ,Esophageal Squamous Cell Carcinoma ,Neoplasm Recurrence, Local ,business ,Abdominal surgery - Abstract
Despite wide acknowledgement of the importance of sarcopenia and prognostic markers such as the neutrophil-to-lymphocyte ratio, the impact on cancer patient survival of the timing of sarcopenia’s emergence and its severity is not well understood, nor is the association between sarcopenia and prognostic markers. The aim of this study, therefore, was to investigate the effect of the severity and timing of changes in the psoas muscle index (PMI) on survival of advanced esophageal squamous cell carcinoma (ESCC) patients receiving neoadjuvant chemoradiotherapy (NACRT) plus esophagectomy and the association between PMI and known prognostic markers. Included in this study were 113 ESCC patients who underwent NACRT followed by esophagectomy. PMI and prognostic markers were measured at their initial visit, just before surgery (after NACRT), and 3 months postoperatively. All patients were classified into four groups according to the percent decrease in PMI after NACRT and after NACRT plus esophagectomy. Patients exhibiting a larger PMI decrease (≥20%) after NACRT plus esophagectomy had significantly poorer overall survival than those showing a smaller PMI decrease. Furthermore, multivariable analysis showed that a larger decrease in PMI after NACRT plus esophagectomy was a significant risk factor for overall (P
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- 2020
13. Salvage Robotic-Assisted Thoracoscopic Esophagectomy after Definitive Chemoradiotherapy for Clinical T4b Esophageal Cancer: A Case Report
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Ryohei Sasamori, Satoru Motoyama, Yusuke Sato, Akiyuki Wakita, Yushi Nagaki, Kazuhiro Imai, and Yoshihiro Minamiya
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Pulmonary and Respiratory Medicine ,Gastroenterology ,Surgery ,General Medicine ,Cardiology and Cardiovascular Medicine - Abstract
The advantages of salvage esophagectomy through robotic-assisted surgery for patients with clinically diagnosed tumor invasion of adjacent vital organs (cT4b) or patients with scar tissue from definitive chemoradiotherapy (dCRT) are still only rarely reported. A man in his 60s with middle thoracic esophageal cancer (cT4b [left main bronchus] N1 M0 cStage IIIC) received dCRT (60 Gy). After the chemoradiotherapy, upper gastrointestinal endoscopy revealed a residual primary tumor, and we performed robotic-assisted thoracoscopic subtotal esophagectomy and gastric tube reconstruction via a retrosternal route with three-field lymphadenectomy. Although it was difficult to dissect the tumor from adjacent organs, especially the left main bronchus and left inferior pulmonary vein, due to loss of the dissecting layer and scarring, R0 surgery was achieved. With robot-assisted thoracoscopic surgery, the high-magnification, high-resolution, and three-dimensional images; the stable surgical field with full countertraction made with the robotic arm forceps, which were readily adjusted; and the stable motion of the robotic arm without physiological tremor are considerable advantages for salvage esophagectomy for cT4b tumors. It goes without saying that sufficient experience with robot-assisted surgery and sufficient understanding and surgical skill in esophageal cancer surgery under suitable surgical indications and timing are required to make use of these advantages.
- Published
- 2021
14. PET-Uptake Reduction into Lymph Nodes After Neoadjuvant Therapy is Highly Predictive of Prognosis for Patients Who have Thoracic Esophageal Squamous Cell Carcinoma Treated with Chemoradiotherapy Plus Esophagectomy
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Kazuhiro Imai, Akiyuki Wakita, Eri Maeda, Yusuke Sato, Yoshihiro Sasaki, Yoshihiro Minamiya, Kohei Kemuriyama, Satoru Motoyama, Hiromu Fujita, and Yushi Nagaki
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medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Standardized uptake value ,Gastroenterology ,Surgical oncology ,Fluorodeoxyglucose F18 ,Internal medicine ,Medicine ,Humans ,Stage (cooking) ,Neoadjuvant therapy ,business.industry ,Perioperative ,Chemoradiotherapy ,Prognosis ,Neoadjuvant Therapy ,Esophagectomy ,Treatment Outcome ,Oncology ,Carcinoma, Squamous Cell ,Surgery ,Lymph ,Esophageal Squamous Cell Carcinoma ,Lymph Nodes ,Radiopharmaceuticals ,business - Abstract
Patients with 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET)-positive lymph nodes before treatment have a poor prognosis after esophagectomy. This study investigated whether FDG uptake into lymph nodes on FDG-PET (PET-N) during the pre- or posttreatment stage is more predictive of survival for thoracic esophageal squamous cell carcinoma (TESCC) patients who received neoadjuvant chemoradiotherapy (NACRT) followed by esophagectomy. Of 129 TESCC patients with clinical lymphatic metastasis who underwent curative-intent esophagectomy after NACRT between 2010 and 2018, 97 who received PET before and after NACRT were enrolled in the study. The study defined lymph nodes with a maximum standardized uptake value (SUVmax) greater than 2.5 on FDG-PET before NACRT as cPET-N(+) and after NACRT as CRT-cPET-N(+). Both the cPET-N(+) and CRT-cPET-N(–) patients were defined as PET-N responders. Survival was analyzed using the Kaplan-Meier method and Cox proportional hazard models. No significant difference in survival was detected between the cPET-N(+) and cPET-N(–) patients. However, the CRT-cPET-N(–) patients had significantly better 5-year overall survival (OS) and disease-specific survival (DSS) than the CRT-cPET-N (+) patients. The PET-N responders had significantly better 5-year OS and DSS than the PET-N non-responders, and PET-N response was an independent prognostic factor for 5-year DSS. The PET-N response is a highly predictive prognostic marker for TESCC patients who undergo NACRT followed by esophagectomy. The PET-N response may help clinicians to establish a strategy for perioperative treatments that improves survival for patients with lymph node metastasis in TESCC.
- Published
- 2021
15. SUVmax reduction predicts long-term survival in patients of non-pCR both in the tumor and lymph nodes after neoadjuvant chemoradiotherapy in esophageal squamous cell carcinoma
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Akiyuki Wakita, Yoshihiro Sasaki, Satoru Motoyama, Yusuke Sato, Hiromu Fujita, Yushi Nagaki, Kazuhiro Imai, and Yoshihiro Minamiya
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medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,lcsh:Surgery ,lcsh:RC254-282 ,Gastroenterology ,Surgical oncology ,Internal medicine ,medicine ,Humans ,Survival rate ,Lymph node ,Pathological ,NACRT ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Research ,ESCC ,Retrospective cohort study ,SUVmax ,lcsh:RD1-811 ,Chemoradiotherapy ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,Prognosis ,Primary tumor ,Neoadjuvant Therapy ,Esophagectomy ,medicine.anatomical_structure ,Oncology ,Head and Neck Neoplasms ,Carcinoma, Squamous Cell ,Surgery ,Lymph ,Esophageal Squamous Cell Carcinoma ,Lymph Nodes ,non-pCR ,Neoplasm Recurrence, Local ,business - Abstract
Background A pathological complete response (pCR) after neoadjuvant chemoradiotherapy (NACRT) ensures long-term survival in esophageal squamous cell carcinoma (ESCC) patients following esophagectomy, but pCR patients are a minority. The aim here was to identify prognostic factors in patients with non-pCR ESCC after NACRT. Methods This is a retrospective study. Investigated were 5-year overall survival (OS), disease-specific survival (DSS), and relapse-free survival (RFS) among non-pCR ESCC patients divided into pT0N0, primary site pCR (pT0N+), lymph node pCR (pT+N0), and non-pCR in both the tumor and lymph node (pT+N+) subgroups after NACRT and esophagectomy. Focusing on the SUVmax reduction rate in the primary tumor in 88 patients who underwent FDG-PET before and after NACRT, we used univariate and multivariate Cox proportional hazard models to identify prognostic factors. Results Although there were no significant survival differences among non-pCR ESCC patients with pT0N+, pT+N0, or pT+N+, survival rate among pT+N+patients was the poorest. After setting a 60% cutoff for the SUVmax reduction rate in the tumor, RFS curves for non-pCR patients significantly differed between patients above the cutoff and those below it. For pT+N+ patients, the SUVmax reduction rate ( Conclusion Because ESCC patients with SUVmax reduction rates of
- Published
- 2021
16. Phase II trial of induction chemotherapy with carboplatin and paclitaxel plus bevacizumab in patients with stage IIIA to IV nonsquamous non-small cell lung cancer
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Masaaki Sano, Satoru Motoyama, Hajime Saito, Kazuhiro Sato, Yoshihiro Minamiya, Taku Nakagawa, Hiroyuki Shibata, Kimito Orino, Ikuo Matsuzaki, Kyoko Nomura, Katsutoshi Nakayama, Kazuhiro Imai, and Yusuke Sato
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Male ,Oncology ,medicine.medical_specialty ,Lung Neoplasms ,Paclitaxel ,Bevacizumab ,medicine.medical_treatment ,Phases of clinical research ,Carboplatin ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Surgical oncology ,Carcinoma, Non-Small-Cell Lung ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Combined Modality Therapy ,Lung cancer ,Aged ,Neoplasm Staging ,Chemotherapy ,business.industry ,Induction chemotherapy ,Induction Chemotherapy ,General Medicine ,Middle Aged ,medicine.disease ,Survival Rate ,Treatment Outcome ,chemistry ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Surgery ,business ,medicine.drug - Abstract
Surgery remains the best curative treatment option for non-small cell lung cancer (NSCLC), but is of benefit only to patients with localized disease. A meta-analysis showed a significant beneficial effect of induction chemotherapy on survival, but there is still no clear evidence. This phase II study was conducted to establish whether induction chemotherapy with carboplatin (CBDCA) and paclitaxel (PTX) plus bevacizumab prior to surgery reduces the risk of progression. The subjects of this study were 29 patients with treatment-naive nonsquamous NSCLC (clinical stages IIIA to IV). Patients received PTX (200 mg/m2), CBDCA (area under the curve, 5), and bevacizumab (15 mg/kg) followed by surgery. Chemotherapy was repeated every 3 weeks for up to six cycles. The overall response rate was 72.4%. Of the 29 patients, ten underwent surgery after the induction chemotherapy and complete resection was achieved in 7 (70%). The median progression-free-survival (PFS) time and the 3-year PFS rate were 0.92 years and 16.2%, respectively. The median overall survival (OS) time and the 3-year OS rate were 1.96 years and 44.9%, respectively. Combined modality therapy with surgery after induction chemotherapy with CBDCA and PTX plus bevacizumab is clinically feasible and tolerable for patients with unknown or negative molecular profiles.
- Published
- 2019
17. Salvage Robotic-Assisted Thoracoscopic Esophagectomy after Definitive Chemoradiotherapy for Clinical T4b Esophageal Cancer: A Case Report
- Author
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Yoshihiro Sasaki, Ryohei Sasamori, Kazuhiro Imai, Kohei Kemuriyama, Yusuke Sato, Yoshihiro Minamiya, Hiromu Fujita, Yushi Nagaki, Akiyuki Wakita, and Satoru Motoyama
- Subjects
medicine.medical_specialty ,business.industry ,Robotic assisted ,Medicine ,Thoracoscopic esophagectomy ,Definitive chemoradiotherapy ,Esophageal cancer ,business ,medicine.disease ,Surgery - Abstract
BackgroundAlthough twenty years have passed since the start of robot-assisted thoracoscopic esophagectomy, salvage esophagectomy by robotic-assisted surgery has not yet been introduced by almost surgeons. Theoretically, robot-assisted thoracoscopic esophagectomy (RATE) increases operative precision and maneuverability within the narrow space of the mediastinum. However, surgeons have doubted that RATE is indicated for patients with tumor invasion of adjacent vital organs clinically (cT4b) or patients with scar tissue from definitive chemoradiotherapy. Herein, we report our case of salvage RATE for cT4b thoracic esophageal cancer which invaded to the left main bronchus before definitive chemoradiotherapy.Case presentationA man in his 60’s with middle thoracic esophageal cancer [cT4b (left main bronchus) N1 M0 cStage IIIC] received definitive chemoradiotherapy (fluorouracil and cisplatin, total radiation dose of 60 Gy). After the chemoradiotherapy, upper gastrointestinal endoscopy revealed a residual primary tumor, and we performed robotic-assisted thoracoscopic subtotal esophagectomy and gastric tube reconstruction via a retrosternal route with three-field lymphadenectomy. Although it was difficult to dissect the tumor from adjacent organs, especially in the left main bronchus and pericardium, due to the scarring after definitive chemoradiotherapy, R0 surgery was achieved. With RATE, the high-resolution three-dimensional images, stable surgical field and stable motion are considerable advantages for salvage esophagectomy for cT4b tumors. At present (30 months after surgery), the patient’s performance status is 0 and he is alive without a recurrence. ConclusionsRobot-assisted thoracoscopic esophagectomy provided considerable advantages for salvage esophagectomy after definitive chemoradiotherapy for a cT4b tumor.
- Published
- 2021
18. 255 OUTCOME OF ADDITIONAL ESOPHAGECTOMY AFTER NON-CURATIVE ENDOSCOPIC SUBMUCOSAL DISSECTION FOR C-MM-SM1ESOPHAGEAL CANCER
- Author
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Akiyuki Wakita, H Fujita, Satoru Motoyama, Yusuke Sato, Yoshihiro Minamiya, and Yushi Nagaki
- Subjects
medicine.medical_specialty ,Esophagectomy ,business.industry ,medicine.medical_treatment ,Gastroenterology ,medicine ,Cancer ,General Medicine ,Endoscopic submucosal dissection ,medicine.disease ,business ,Surgery - Abstract
For patients diagnosed cT1(MM-SM1)N0 esophageal cancer, we perform endoscopic submucosal dissection (ESD) as a primary treatment. Furthermore, additional treatments were performed for the patients diagnosed pT1b(SM) in resected tumor by ESD. Our aim of this study is to investigate whether additional esophagectomy after non-curative ESD can be considered a valid treatment. Methods Forty-four patients who received esophagectomy with lymph node (LN) dissection in neck, mediastinum and upper abdomen as additional surgery after non-curative ESD between 2006 and 2019 were enrolled. Histological examination revealed that squamous cell carcinoma in 41 and adenocarcinoma in 3 patients. We examined the rate of pathological LN metastasis and outcomes of patients received esophagectomy. Results The cT was LPM in 9(20%), MM-SM1 in 35 (80%) patients. However, the pT was MM in 3(7%), SM1 in 14 (32%) and SM2 in 27 (61%) patients. Lymphatic invasion was positive in 32 (73%) and venous invasion was positive in 16(36%) patients. Seven patients had pathological metastatic LN (1–2 LNs/case) (total 10 metastatic LNs). The metastatic LNs existed in neck, mediastinum and upper abdomen. The recurrences were occurred in 2 patients (No.106recL LN and No. 112ao-A LN). One patient died by esophageal cancer (LN recurrence, 38 months alive). One patient died of gastric tube ulcer perforation (16 months). Conclusion We showed that esophagectomy with extended LN dissection is sufficient as additional treatment for the patients treated non-curative ESD. To expand the indications of ESD for pSM esophageal cancer, new methods are needed, such as the risk diagnosis of LN metastasis using genetic analysis.
- Published
- 2020
19. Lower local recurrence rate after robot-assisted thoracoscopic esophagectomy than conventional thoracoscopic surgery for esophageal cancer
- Author
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Satoru Motoyama, Yoshihiro Minamiya, Shinogu Takashima, Akiyuki Wakita, Yusuke Sato, Hiromu Fujita, Ryohei Sasamori, Yushi Nagaki, Kazuhiro Imai, and Kohei Kemuriyama
- Subjects
Adult ,Male ,medicine.medical_specialty ,Esophageal Neoplasms ,Science ,Anastomosis ,Article ,03 medical and health sciences ,0302 clinical medicine ,Robotic Surgical Procedures ,Paraaortic lymph nodes ,Recurrence ,medicine ,Thoracoscopic esophagectomy ,Humans ,Lymph node ,Aged ,Neoplasm Staging ,Aged, 80 and over ,Multidisciplinary ,business.industry ,Thoracic Surgery, Video-Assisted ,Incidence (epidemiology) ,Oesophageal cancer ,Mediastinum ,Esophageal cancer ,Middle Aged ,medicine.disease ,Prognosis ,Surgery ,Tumor Burden ,Esophagectomy ,medicine.anatomical_structure ,Treatment Outcome ,030220 oncology & carcinogenesis ,Surgical oncology ,Medicine ,030211 gastroenterology & hepatology ,Female ,Lymph ,business - Abstract
The oncological advantages of robot-assisted thoracoscopic esophagectomy (RATE) over conventional thoracoscopic esophagectomy (TE) for thoracic esophageal cancer have yet to be verified. In this study, we retrospectively analyzed clinical data to compare the incidences of recurrence within the surgical field after RATE and TE as an indicator of local oncological control. Among 121 consecutive patients with thoracic esophageal or esophagogastric junction cancers for which thoracoscopic surgery was indicated, 51 were treated with RATE while 70 received TE. The number of lymph nodes dissected from the mediastinum, duration of the thoracic portion of the surgery, and morbidity due to postoperative complications did not differ between the two groups. However, the rate of overall local recurrence within the surgical field was significantly (P = 0.039) higher in the TE (9%) than the RATE (0%) group. Lymph node recurrence within the surgical field occurred in left recurrent nerve, left tracheobronchial, left main bronchus and thoracic paraaortic lymph nodes, which were all difficult to approach to dissect. The other two local failures occurred around the anastomotic site. This study indicates that using RATE enabled the incidence of recurrence within the surgical field to be reduced, though there were some limitations.
- Published
- 2020
20. Trends in the evolution to robot-assisted minimally invasive thoracoscopic esophagectomy
- Author
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Hiromu Fujita, Satoru Motoyama, Kazuhiro Imai, Yuta Kawakita, Akiyuki Wakita, Jiajia Liu, Yushi Nagaki, Yoshihiro Minamiya, and Yusuke Sato
- Subjects
medicine.medical_specialty ,business.industry ,Esophagectomy ,medicine.medical_treatment ,Medicine ,Thoracoscopic esophagectomy ,Esophageal cancer ,business ,medicine.disease ,Surgery - Published
- 2020
21. IGF2BP3 Expression Correlates With Poor Prognosis in Esophageal Squamous Cell Carcinoma
- Author
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Kaori Terata, Satoru Motoyama, Hiromu Fujita, Akiyuki Wakita, Kazuhiro Imai, Yoshihiro Minamiya, Yushi Nagaki, Eri Maeda, and Yusuke Sato
- Subjects
Oncology ,Adult ,Male ,Poor prognosis ,medicine.medical_specialty ,Esophageal Neoplasms ,Adjuvant chemotherapy ,medicine.medical_treatment ,Clinical Decision-Making ,Esophageal squamous cell carcinoma ,Risk Assessment ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Esophagus ,Esophageal tumors ,Risk Factors ,Internal medicine ,Biomarkers, Tumor ,Medicine ,Humans ,In patient ,Aged ,Neoplasm Staging ,Aged, 80 and over ,Preoperative Therapy ,business.industry ,Age Factors ,RNA-Binding Proteins ,Esophageal cancer ,Middle Aged ,medicine.disease ,Prognosis ,Esophagectomy ,Chemotherapy, Adjuvant ,Tissue Array Analysis ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Surgery ,Female ,Esophageal Squamous Cell Carcinoma ,Neoplasm Recurrence, Local ,business - Abstract
Background Insulin-like growth factor-II mRNA binding protein 3 (IGF2BP3) is an oncofetal RNA-binding protein normally involved in cell growth and migration during the early stages of embryogenesis. However, it is also expressed in various cancers, and the relationship between IGF2BP3 and the clinicopathological features and prognosis of esophageal squamous cell carcinoma patients is not fully understood. Our aim in this study was to determine whether IGF2BP3 expression status correlates with prognosis in patients with advanced thoracic esophageal squamous cell carcinoma. Methods The IGF2BP3 expression statuses of 177 patients treated with esophagectomy without preoperative therapy were evaluated immunohistochemically using tissue microarray analysis. The relationships between IGF2BP3 expression status and clinicopathological features and survival were then assessed using appropriate statistics. Results Among 177 esophageal tumors, 122 (68.9%) expressed high levels of IGF2BP3. In patients undergoing surgery alone, IGF2BP3-high expression was significantly associated with a poorer prognosis. By contrast, there were no significant associations between IGF2BP3 expression and clinicopathological features or outcomes in patients treated with surgery plus postoperative adjuvant chemotherapy. Conclusions IGF2BP3 positivity in advanced thoracic esophageal squamous cell carcinoma is associated with adverse clinical outcomes in patients treated with surgery alone.
- Published
- 2020
22. Evaluation of metastatic lymph nodes in cN0 thoracic esophageal cancer patients with inconsistent pathological lymph node diagnosis
- Author
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Kazuhiro Imai, Yuta Kawakita, Yoshihiro Minamiya, Kaori Terata, Yusuke Sato, Yushi Nagaki, Akiyuki Wakita, and Satoru Motoyama
- Subjects
Male ,Esophageal Neoplasms ,medicine.medical_treatment ,Esophageal cancer ,Metastasis ,0302 clinical medicine ,Surgical oncology ,Lymph node ,False Negative Reactions ,Aged, 80 and over ,integumentary system ,Middle Aged ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Prognosis ,Primary tumor ,medicine.anatomical_structure ,Oncology ,Esophagectomy ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,030211 gastroenterology & hepatology ,Female ,Radiology ,Adult ,medicine.medical_specialty ,lcsh:Surgery ,lcsh:RC254-282 ,Risk Assessment ,False-negative lymph node ,03 medical and health sciences ,Preoperative Care ,medicine ,Humans ,Esophagus ,Aged ,Neoplasm Staging ,Retrospective Studies ,Lymph node metastasis ,business.industry ,Research ,nutritional and metabolic diseases ,lcsh:RD1-811 ,medicine.disease ,Abdomen ,Lymph Node Excision ,Surgery ,Lymph Nodes ,business ,Tomography, X-Ray Computed - Abstract
Background Preoperative clinical diagnosis of lymph node (LN) metastasis and subsequent pathological diagnosis are often not in agreement. Detection of false-negative LNs is essential in selecting an optimal treatment strategy, and most importantly, the presence of false-negative LN is itself a significant prognostic indicator. Therefore, at present, there is an urgent need to establish more accurate and individualized evaluation methods for LN metastasis. Methods Of 213 cN0 patients who underwent curative esophagectomy without preoperative neoadjuvant treatment, 60 (28%) had LN metastasis diagnosed pathologically. There were 129 false-negative LNs, of which 85 were detectable by preoperative computed tomography (CT). We retrospectively investigated the distribution, frequency, and characteristics of pathologically positive nodes in patients with clinically N0 esophageal cancer. Results The paracardial region was the most frequent region of false-negative LNs, accounting for 26% (22 LNs) of the total incidence. False-negative LNs distributed widely from the neck to the abdomen in patients with a primary tumor in the middle thoracic esophagus. In patients with a primary tumor in the lower thoracic esophagus, four false-negative LNs were detected in the superior mediastinum. When the short-axis diameter, shape, and attenuation patterns of the LNs were used as criteria for metastasis diagnosis, they were insufficient for an accurate diagnosis. However, false-negative LNs in the most frequently occurring sites are characterized by smaller short-axis, suggesting that accurate diagnosis cannot be made unless the diagnostic criteria for the short-axis are reduced in addition to shape and attenuation. Conclusions Although restrictive to the most frequent regions of false-negative LNs occur, reducing size criterion and consideration of their shape and attenuation may contribute to improved diagnosis.
- Published
- 2020
23. Comparison of the incidences of anastomotic leakage when PDSII or LACLON are used in esophago-gastric conduit handsewn anastomosis after esophagectomy
- Author
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Yoshihiro Minamiya, Kazuhiro Imai, Yuta Kawakita, Yushi Nagaki, Akiyuki Wakita, Yusuke Sato, Kaori Terata, and Satoru Motoyama
- Subjects
Male ,medicine.medical_specialty ,Esophageal Neoplasms ,Polymers ,medicine.medical_treatment ,lcsh:Medicine ,Anastomotic Leak ,Adenocarcinoma ,Anastomosis ,Article ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Japan ,Risk Factors ,medicine ,Humans ,Prospective Studies ,lcsh:Science ,Prospective cohort study ,Aged ,Aged, 80 and over ,Multidisciplinary ,business.industry ,Incidence ,Oesophageal cancer ,Gastric conduit ,Incidence (epidemiology) ,Anastomosis, Surgical ,lcsh:R ,Gastroenterology ,Odds ratio ,Middle Aged ,University hospital ,Surgery ,Esophagectomy ,Anastomotic leakage ,030220 oncology & carcinogenesis ,Female ,lcsh:Q ,030211 gastroenterology & hepatology ,Esophageal Squamous Cell Carcinoma ,business - Abstract
The incidence of anastomotic leakage after esophagectomy remains around 10%. It was previously reported that PDSII rapidly loses tensile strength at pH 1.0 and pH 8.5. By contrast, LACLON degradation is reportedly insensitive to pH. We therefore compared LACLON with PDSII for esophago-gastric conduit, layer-to-layer, handsewn anastomosis. Between January 2016 and January 2020, 90 patients who received posterior mediastinal gastric conduit reconstruction with layer-to-layer handsewn anastomosis (51 using PDSII and 39 using LACLON) at Akita University Hospital were enrolled. The incidence of anastomotic leakage was significantly lower in the LACLON (2.6%, 1/39 patients) than PDSII group (15.7%, 8/51 patients) (p = 0.0268). Multivariable logistic analysis showed the risk of anastomotic leakage was significantly greater with PDSII than LACLON (odds ratio 11.01; 95% CI 1.326–277.64; p = 0.024). The percentages of time the pH was higher than 8 on the gastric conduit side of the anastomosis were 3.1%, 5.7%, 20.9% and 80.5%, respectively, in the four most recent patients. The present study showed that pH at the anastomosis soon after esophagectomy tends to be alkaline rather than acidic, which raises the possibility that this alkalinity facilitates the deterioration of surgical sutures including PDSII.
- Published
- 2020
24. Laparoscopic Transhiatal Surgery for Multiple Epiphrenic Esophageal Diverticula
- Author
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Yujiro Kato, Ouki Yasui, Teiji Takahashi, Tomohiko Sasaki, and Satoru Motoyama
- Subjects
medicine.medical_specialty ,business.industry ,Gastroenterology ,Medicine ,Surgery ,business - Published
- 2018
25. A Surgically Treated Case of Delayed Refractory Chyloperitoneum Developed after Gastrectomy against Advanced Gastric Cancer
- Author
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Masakatsu Nakamura, Satoru Motoyama, Tomohiko Sasaki, Yuta Kawakita, Yusuke Sato, and Hiromu Fujita
- Subjects
medicine.medical_specialty ,Refractory ,business.industry ,medicine.medical_treatment ,medicine ,Gastrectomy ,Advanced gastric cancer ,business ,Surgery - Published
- 2018
26. EDITOR'S NOTE
- Author
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Satoru Motoyama
- Subjects
Gastroenterology ,Surgery - Published
- 2021
27. Sphingosine-1-phosphate/sphingosine kinase 1-dependent lymph node metastasis in esophageal squamous cell carcinoma
- Author
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Hajime Saito, Yoshihiro Minamiya, Akiyuki Wakita, Souichi Koyota, Satoru Motoyama, Jiajia Liu, Yusuke Sato, and Yuta Kawakita
- Subjects
Male ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Esophageal Neoplasms ,Gene Expression ,Lymph node metastasis ,Esophageal squamous cell carcinoma ,Mice ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Sphingosine ,Surgical oncology ,Internal medicine ,medicine ,Animals ,Humans ,Molecular Targeted Therapy ,RNA, Messenger ,Sphingosine-1-phosphate ,Aged ,biology ,business.industry ,General Medicine ,Middle Aged ,Esophageal cancer ,medicine.disease ,Disease Models, Animal ,Phosphotransferases (Alcohol Group Acceptor) ,030104 developmental biology ,chemistry ,Sphingosine kinase 1 ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Cancer research ,biology.protein ,Female ,Surgery ,Lysophospholipids ,business - Abstract
To establish whether Sphingosine-1-phosphate (S1P) and sphingosine kinase 1 (SphK1) contribute to lymph node metastasis in esophageal squamous cell carcinoma.Immunohistochemical analysis of SphK1 expression was performed using a tissue microarray containing 177 thoracic squamous cell esophageal cancer specimens resected at surgery, to investigate the association between intratumoral SphK1 expression and lymph node metastasis. Serum S1P levels and intratumoral SphK1 mRNA and protein expression were also evaluated in mice with vs. mice without lymph node metastasis in a murine lymph node metastasis model.Among 177 esophageal cancer patients, 127 (72%) were defined as being SphK1-positive. In univariate and multivariate analyses, SphK1 expression status was a significant factor contributing to lymph node metastasis and poorer 5-year overall survival. In the murine lymph node metastasis model, there was no difference in tumor volume or weight between the lymph node metastasis-negative and lymph node metastasis-positive groups. However, levels of SphK1 mRNA and protein and serum S1P levels were all much higher in the metastasis-positive group.S1P/SphK1 may be novel targets for inhibiting lymph node metastasis in esophageal squamous cell carcinoma, and may provide the basis for a therapeutic strategy to suppress lymph node metastasis.
- Published
- 2017
28. New PET/CT criterion for nodal staging in non-small cell lung cancer: measurement of the ratio of section area of standard uptake values ≥2.5/lymph node section area
- Author
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Yoshitaro Saito, Koichi Ishiyama, Manabu Hashimoto, Satoru Motoyama, Yoshihiro Minamiya, Hayato Konno, Hajime Saito, Kazuhiro Imai, Yusuke Sato, and Satoshi Fujishima
- Subjects
Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung Neoplasms ,Standardized uptake value ,Nodal staging ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Carcinoma, Non-Small-Cell Lung ,Positron Emission Tomography Computed Tomography ,medicine ,Humans ,In patient ,Postoperative Period ,Pneumonectomy ,Lung cancer ,Lymph node ,Aged ,Neoplasm Staging ,PET-CT ,Receiver operating characteristic ,business.industry ,General Medicine ,medicine.disease ,medicine.anatomical_structure ,ROC Curve ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Female ,Surgery ,Lymph Nodes ,Radiology ,Non small cell ,Cardiology and Cardiovascular Medicine ,Nuclear medicine ,business - Abstract
The aim of the present study was to use surgical and histological results to develop a simple noninvasive technique for improving nodal staging using preoperative PET/CT in patients with resectable non-small cell lung cancer (NSCLC). Preoperative PET/CT findings (163 patients) and pathological diagnoses after surgical resection were evaluated. Using PET/CT images, lymph node section area (SA), the maximum standardized uptake value (SUVmax), SA of SUV ≥2.5 and ≥3.0 were drawn freehand and measured using caliper software. Receiver operating characteristic (ROC) curves were then used to analyze those data. Based on ROC analyses, the cut-off values for SA of SUV ≥2.5, SA of SUV ≥3.0, SUV ≥2.5 SA/node SA and SUV ≥3.0 SA/node SA for diagnosis of lymph node metastasis were 200 mm2, 30 mm2, 1.0 and 0.4. SUV ≥2.5 SA/node SA ≥1.0 had the highest negative predictive value, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of nodal staging were 61.1, 73.4, 36.7, 88.2 and 70.9%. When diagnosing nodal staging based a lymph node SUV ≥2.5 SA/node SA ratio of ≥1.0, it can be an effective criterion for use to determine surgical indications.
- Published
- 2017
29. A Case of Ruptured Aneurysm of the Proper Esophageal Artery with Symptomatic Mediastinal Hematoma
- Author
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Satoru Motoyama, Satoshi Takahashi, Yusuke Sato, Kazuhiro Imai, Hajime Saito, Jiajia Liu, Yoshihiro Minamiya, Tomohiko Sasaki, and Kei Yoshino
- Subjects
medicine.medical_specialty ,Contrast Media ,Aneurysm, Ruptured ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Esophagus ,Ethiodized Oil ,0302 clinical medicine ,Aneurysm ,Hematoma ,medicine.artery ,Humans ,Medicine ,Thoracic aorta ,Radiology, Nuclear Medicine and imaging ,Esophageal arteries ,cardiovascular diseases ,Aged ,Aorta ,business.industry ,Arterial Embolization ,Angiography ,Mediastinum ,030208 emergency & critical care medicine ,Enbucrilate ,medicine.disease ,Embolization, Therapeutic ,Surgery ,medicine.anatomical_structure ,cardiovascular system ,Female ,Radiology ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Bronchial artery - Abstract
Mediastinal aneurysms are rare but potentially life-threatening. Among these, bronchial artery aneurysms are most frequently reported, whereas up to now aneurysms of the proper esophageal artery had never been reported. A 69-year-old woman was referred to our hospital for treatment of a massive mediastinal hematoma. Enhanced computed tomography and selective proper esophageal arteriography revealed a 5-mm aneurysm in the proper esophageal artery that arises from the thoracic aorta at the Th8 level and has an anastomotic branch with the bronchial artery peripherally. Transcatheter arterial embolization was successfully performed using a mixture of N-butyl cyanoacrylate and lipiodol (1:3 ratio, 0.3 ml). Post-embolization angiography showed no filling into the aneurysm. The patient recovered with no complications and was discharged on the 25th post-procedure day.
- Published
- 2016
30. Novel Candidate Biomarkers of Chemoradiosensitivity in Esophageal Squamous Cell Carcinoma: A Systematic Review
- Author
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Yoshihiro Minamiya, Hajime Saito, Yusuke Sato, and Satoru Motoyama
- Subjects
Vascular Endothelial Growth Factor A ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Esophageal Neoplasms ,NF-E2-Related Factor 2 ,Favorable prognosis ,Esophageal squamous cell carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Lithostathine ,Biomarkers, Tumor ,medicine ,Carcinoma ,Humans ,Severe toxicity ,business.industry ,Cancer ,Chemoradiotherapy ,Esophageal cancer ,medicine.disease ,Receptors, Interleukin-6 ,digestive system diseases ,Ki-67 Antigen ,030104 developmental biology ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Biomarker (medicine) ,Surgery ,Esophageal Squamous Cell Carcinoma ,business - Abstract
There is no doubt that, along with surgery, chemoradiotherapy is an important treatment for esophageal squamous cell carcinoma (ESCC). Patients who respond well to chemoradiotherapy obtain great benefits toward overcoming their cancer, and so a more favorable prognosis. On the other hand, patients who do not respond well have wasted valuable time and experienced severe toxicity and seriously diminished quality of life, only to have their cancer recur with an unfavorable prognosis. For this reason, a reliable biomarker of chemoradiosensitivity in ESCC has long been sought. In this review, we will enumerate recently reported candidate biomarkers of chemoradiosensitivity in ESCC that have the potential for future clinical application.
- Published
- 2016
31. Contents Vol. 56, 2016
- Author
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Carlos Barrios, Juan Carlos García-Valdecasas, Katharina D'Herde, Constantino Fondevila, Rikard Ambrus, Morten Bo Søndergaard Svendsen, Francesca Tozzi, Josep Fuster, Michael Patrick Achiam, Henrik Thorlacius, Antonio B. Martín-Ballester, José Miguel Lloris-Carsí, Wim Ceelen, Víctor Molina, Druckerei Stückle, Piet Pattyn, Hanna Sternby, Tom Van Hoof, Ulvi Mehmet Meral, Joana Ferrer, Satz Mengensatzproduktion, David Saavedra, Dolores Cejalvo-Lapeña, Mehmet Fatih Can, John F. Steffensen, Satoru Motoyama, Hajime Saito, Lars Bo Svendsen, Sara Regnér, David Calatayud, Yoshihiro Minamiya, Jaime Sampson, David García-Cerdá, Erich K. Odermatt, Wouter Willaert, Nisa Cem Oren, Dorthe Johansen, Christiane Freytag, Aylin Ozturk Meral, Beatriz Prieto-Moure, Hannes Hartman, Mihai-Calin Pavel, Rune B Strandby, Ümit Alakuş, Eylem Cagiltay, Santiago Sánchez-Cabús, Yusuke Sato, Orhan Üreyen, and Murat Urkan
- Subjects
Traditional medicine ,business.industry ,Physiology ,Medicine ,Surgery ,business - Published
- 2016
32. CXCL10 Expression Status is Prognostic in Patients with Advanced Thoracic Esophageal Squamous Cell Carcinoma
- Author
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Hiroshi Nanjo, Yoshihiro Minamiya, Yusuke Sato, Satoru Motoyama, Kei Yoshino, Akiyuki Wakita, Tomohiko Sasaki, Yushi Nagaki, Hajime Saito, Kazuhiro Imai, and Jiajia Liu
- Subjects
Male ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Esophageal Neoplasms ,Angiogenesis ,medicine.medical_treatment ,Immunoenzyme Techniques ,03 medical and health sciences ,0302 clinical medicine ,Surgical oncology ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Biomarkers, Tumor ,medicine ,Carcinoma ,Humans ,CXCL10 ,Neoplasm Invasiveness ,Survival rate ,Aged ,Neoplasm Staging ,Tissue microarray ,business.industry ,Thoracic Neoplasms ,Prognosis ,medicine.disease ,Combined Modality Therapy ,Chemokine CXCL10 ,Esophagectomy ,Survival Rate ,030104 developmental biology ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Immunohistochemistry ,Female ,Surgery ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
CXCL10, a member of the CXC chemokine family, is known to mediate chemotaxis, apoptosis, angiogenesis, and cell growth. It is also reportedly involved in tumor development and can affect prognosis in several cancers. However, the precise relationship between CXCL10 and the prognosis of patients with esophageal squamous cell carcinoma (ESCC) is not fully understood. We used ESCC tissue microarrays containing samples from 177 patients to test whether the CXCL10 expression status, determined using immunohistochemical analysis, is predictive of prognosis. We also tested whether CXCL10 expression status could serve as a clinically useful marker for evaluating the need for adjuvant chemotherapy after surgery. We found that high CXCL10 expression in clinical samples was an independent prognostic factor and was predictive of a favorable 5-year overall survival and disease-specific survival (p = 0.0102 and 0.0332, respectively). Additionally, no significant difference was detected between patients in the CXCL10-high group treated with surgery alone and those treated with surgery followed by adjuvant chemotherapy. In the CXCL10-low group, on the other hand, patients treated with surgery followed by adjuvant chemotherapy had better 5-year overall survival than those treated with surgery alone. High CXCL10 expression is an independent prognostic factor and has the potential to serve as a clinically useful marker of the need for adjuvant chemotherapy after surgery in patients with advanced thoracic ESCC.
- Published
- 2015
33. Hepatic Stellate Cells Play a Functional Role in Exacerbating Ischemia-Reperfusion Injury in Rat Liver
- Author
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Hiroshi Uchinami, Tomokazu Takahashi, Satoru Motoyama, Masato Yoshioka, Naohiko Otsuka, Yuzo Yamamoto, and Yasuhiko Nakagawa
- Subjects
Male ,medicine.medical_specialty ,Kupffer Cells ,Ischemia ,Rats, Sprague-Dawley ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Gliotoxin ,Internal medicine ,Glial Fibrillary Acidic Protein ,medicine ,Hepatic Stellate Cells ,Animals ,Liver injury ,Glial fibrillary acidic protein ,biology ,Chemistry ,Microcirculation ,medicine.disease ,Rats ,Endocrinology ,Liver ,Apoptosis ,030220 oncology & carcinogenesis ,Reperfusion Injury ,biology.protein ,Hepatic stellate cell ,030211 gastroenterology & hepatology ,Surgery ,Perfusion ,Reperfusion injury - Abstract
Purpose: The involvement of hepatic stellate cells (HSCs) with ischemia-reperfusion (I/R) injury in rat liver was examined using gliotoxin, which is known to induce HSC apoptosis. Methods: Male Sprague-Dawley rats were used. HSC was represented by a glial fibrillary acidic protein (GFAP)-positive cell. Liver ischemia was produced by cross-clamping the hepatoduodenal ligament. The degree of I/R injury was evaluated by a release of aminotransferases. Sinusoidal diameter and sinusoidal perfusion rates were examined using intravital fluorescence microscopy. Results: Gliotoxin significantly decreased the number of GFAP-positive cells 48 h after dosing (2.50 ± 0.19% [mean ± SD] in the nontreated group vs. 1.91 ± 0.46% in the gliotoxin-treated group). Liver damage was significantly suppressed by the pretreatment with gliotoxin. Sinusoidal diameters in zone 3 were wider in the gliotoxin group (10.25 ± 0.35 µm) than in the nontreated group (8.21 ± 0.50 µm). The sinusoidal perfusion rate was maintained as well in the gliotoxin group as in normal livers, even after I/R. Conclusions: Pretreatment with gliotoxin significantly reduced the number of HSCs in the liver and further suppressed liver injury following I/R. It is strongly suggested that HSCs play a functional role in exacerbating the degree of I/R injury of the liver.
- Published
- 2018
34. Salvage esophagectomy under bilateral thoracotomy after definitive chemoradiotherapy for aorta T4 thoracic esophageal squamous cell carcinoma: Report of a case
- Author
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Yushi Nagaki, Kei Yoshino, Kazuhiro Imai, Hajime Saito, Akiyuki Wakita, Yusuke Sato, Tomohiko Sasaki, Satoru Motoyama, and Yoshihiro Minamiya
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Esophageal cancer ,DCF, docetaxel plus 5-fluorouracil and cisplatin ,Case Report ,medicine.artery ,medicine ,Thoracotomy ,SUV, standardized uptake volume ,Aorta ,business.industry ,Chemoradiotherapy ,Definitive chemoradiotherapy ,medicine.disease ,CRT, chemoradiotherapy ,Salvage esophagectomy ,Surgery ,PET-CT, positron emission tomography-computed tomography ,medicine.anatomical_structure ,Esophagectomy ,business ,Respiratory tract - Abstract
Highlights • The following case report describes the therapeutic course of a patient diagnosed with advanced thoracic esophageal squamous cell carcinoma invading the descending aorta. This is the first report of a salvage esophagectomy through a right thoracotomy followed by observation of the aortic invasion site through a left thoracotomy in a patient with T4b locally advanced esophageal squamous cell carcinoma., Introduction The surgical technique for esophagectomy to treat esophageal malignancies has been improved over the past several decades. Nevertheless, it remains extremely difficult to surgically treat patients with locally advanced T4b tumors invading the aorta or respiratory tract. Presentaion of case A 37-year-old Japanese man was diagnosed with T4b (descending aorta) N2M0, Stage IIIC middle thoracic esophageal squamous cell carcinoma. He was initially treated with definitive CRT followed by 3 courses of DCF. After the DCF, CT showed that the main tumor had shrunk and appeared to have separated from the descending aorta. Therefore we decided to perform a salvage esophagectomy. Because we needed the ability to closely observe the site of invasion to determine whether aortic invasion was still present, half the esophageal resection was performed under right thoracotomy, but the final resection at the invasion site was performed under left thoracotomy. Consequently, the thoracic esophagus was safely removed and aortic replacement was avoided. The patient has now survived more than 30 months after the salvage esophagectomy with no additional treatment for esophageal cancer and no evidence of recurrent disease. Discussion Because this and the previously reported procedures, each have particular advantages and disadvantages, one must contemplate and select an approach based on the situation for each individual patient. Conclusion Salvage esophagectomy through a right thoracotomy followed by careful observation of the invasion site for possible aortic replacement through a left thoracotomy is an optional procedure for these patients.
- Published
- 2015
35. Trichosporon Fungemia Which Developed in a Patient Undergoing Salvage Esophagectomy for Advanced Thoracic Esophageal Cancer
- Author
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Tomohiko Sasaki, Satoru Motoyama, Yusuke Sato, Yoshihiro Minamiya, Akiyuki Wakita, and Kei Yoshino
- Subjects
medicine.medical_specialty ,biology ,business.industry ,Gastroenterology ,medicine.disease ,biology.organism_classification ,Salvage esophagectomy ,Surgery ,Trichosporon ,medicine ,business ,Thoracic esophageal cancer ,Fungemia - Published
- 2015
36. Evaluation of postoperative pregabalin for attenuation of postoperative shoulder pain after thoracotomy in patients with lung cancer, a preliminary result
- Author
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Toshiaki Nishikawa, Yoshihiro Minamiya, Yusuke Sato, Kazuhiro Imai, Toru Goyagi, Tetsu Kimura, Yukako Imai, Takashi Horiguchi, Satoru Motoyama, and Hajime Saito
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung Neoplasms ,Visual analogue scale ,medicine.medical_treatment ,Pregabalin ,Pilot Projects ,Postoperative Complications ,Shoulder Pain ,Surgical oncology ,medicine ,Humans ,Thoracotomy ,Lung cancer ,gamma-Aminobutyric Acid ,Aged ,Pain Measurement ,Analgesics ,Pain, Postoperative ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Cardiac surgery ,Surgery ,Cardiothoracic surgery ,Anesthesia ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Somnolence ,medicine.drug - Abstract
Thirty-one to 97 % of patients who undergo thoracotomy for lung cancer experience ipsilateral shoulder pain, marring the otherwise excellent relief provided by thoracic epidural analgesia. The aim of this study was to test whether the addition of pregabalin to the treatment for shoulder pain would provide a significant benefit. Twenty patients undergoing thoracic surgery for lung cancer were enrolled in the control group between May 2012 and December 2012, and 20 patients were enrolled in the pregabalin group between January 2013 and July 2013, consecutively. All patients had standard pre- and intraoperative care. Patients received pregabalin 150 mg po POD 1 and then non-steroidal anti-inflammatory drugs (NSAIDs) po 2 h later (pregabalin group), or they received only NSAIDs po at exactly the same times (control group). Pain severity was then measured using a 100-mm visual analog scale (VAS) scoring system. The VAS scores indicated that patients in the pregabalin group had significantly less shoulder pain on postoperative day (POD) 2 than those in the control group (control: 27.9 ± 28.1 vs. pregabalin: 11.8 ± 14.4; p = 0.030). No differences in pain were observed between the two groups on other POD. There were significant differences on only POD 2 in the patients with shoulder pain immediately after surgery. Three of the pregabalin-treated patients showed mild somnolence. Postoperative administration of pregabalin provided significant relief of postoperative shoulder pain during earlier POD after thoracic surgery for lung cancer when received multimodal analgesia in combination with NSAIDs.
- Published
- 2014
37. Ultrasound-guided intranodal lipiodol lymphangiography from the groin is useful for assessment and treatment of post-esophagectomy chylothorax in three cases
- Author
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Koichi Ishiyama, Yusuke Sato, Akiyuki Wakita, Masayoshi Yamamoto, Jiajia Liu, Hajime Saito, Yoshihiro Minamiya, Kentaro Yamada, Manabu Hashimoto, Kazuhiro Imai, Yuta Kawakita, and Satoru Motoyama
- Subjects
medicine.medical_specialty ,CT, computerized tomography ,Lipiodol ,medicine.medical_treatment ,UICC, the Union for International Cancer Control ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Case Series ,LAG, lipiodol lymphangiography ,Intranodal lymphangiography ,Groin ,business.industry ,CDDP, cisplatin ,Chylothorax ,medicine.disease ,Postoperative chylothorax ,Ultrasound guided ,POD, postoperative day ,Surgery ,medicine.anatomical_structure ,Esophagectomy ,030220 oncology & carcinogenesis ,Procedure Duration ,5-FU, 5-fluorouracil ,Radiology ,business ,medicine.drug - Abstract
Highlights • Three cases of postoperative chylothorax were successfully diagnosed or cured by intranodal lipiodol lymphangiography. • It is a minimally invasive and easily performed procedure and we recommend an early performance of this procedure. • A therapeutic strategy for postoperative chylothorax is proposed., Introduction Ultrasound-guided intranodal lipiodol lymphangiography (LAG) from the groin is a recently introduced technique for diagnosing and treating postoperative chylothorax. The benefits of this technique include reduced technical difficulty and shorter procedure duration, as compared to traditional pedal LAG. Although these benefits may eventually increase utilization of intranodal LAG, reports are still few. Presentation of cases Herein, we report three cases of post-esophagectomy chylothorax in whom ultrasound-guided intranodal lipiodol LAG from the groin were successfully performed with no complications. Leak points were clearly identified in the three cases. Cure was obtained in one case by the LAG only. Surgical ligations were performed after LAG in two cases and cures were achieved. Discussion If LAG successfully cured chylothorax, chest drain output would decrease dramatically and the leaked lipiodol could be confirmed near the leak point in plain computerized tomography (CT) in the following 1-2 days. But if LAG failed to cure, chest drain output would be unchanged and the leaked lipiodol would be found diffusing in the surrounding. Conclusion Ultrasound-guided intranodal lipiodol LAG from the groin is a minimally invasive and easily performed procedure with high diagnostic and therapeutic value for postoperative chylothorax. If LAG failed to cure, conservative management is often insufficient and surgical ligation should be performed as soon as possible.
- Published
- 2016
38. Rapid Immunohistochemistry With Thyroid Transcription Factor-1 for Pulmonary Adenocarcinoma
- Author
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Yoichi Akagami, Ryuta Nakamura, Hajime Saito, Yuko Hiroshima, Satoshi Fujishima, Hayato Konno, Nobuyasu Kurihara, Yusuke Sato, Maiko Atari, Yoshihiro Minamiya, Satoru Motoyama, and Hiroshi Nanjo
- Subjects
0301 basic medicine ,Pulmonary and Respiratory Medicine ,Pathology ,medicine.medical_specialty ,Lung Neoplasms ,medicine.medical_treatment ,Thyroid Nuclear Factor 1 ,Adenocarcinoma of Lung ,Adenocarcinoma ,Diagnosis, Differential ,03 medical and health sciences ,Pneumonectomy ,0302 clinical medicine ,Predictive Value of Tests ,Biomarkers, Tumor ,Medicine ,Humans ,Lung cancer ,Lung ,Retrospective Studies ,business.industry ,Thoracic Surgery, Video-Assisted ,Nuclear Proteins ,Reproducibility of Results ,Retrospective cohort study ,medicine.disease ,Immunohistochemistry ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Predictive value of tests ,Surgery ,Differential diagnosis ,Cardiology and Cardiovascular Medicine ,business ,Transcription Factors - Abstract
Background Intraoperative pathologic diagnosis of solitary pulmonary tumors to differentiate between metastatic and primary lung cancer is extremely important to determine the appropriate range of excision. Accurate intraoperative pathologic evaluation may be often difficult, however, and needs additional immunohistochemical (IHC) evaluation to support the diagnosis. Although conventional IHC is a powerful tool for diagnosis, its clinical use is limited intraoperatively because of time constraints. To address this issue, we developed a device that enables complete and rapid IHC (R-IHC) analyses within 20 minutes. We aimed to evaluate the discriminative ability of the R-IHC with anti-thyroid transcription factor-1 (TTF-1) antibody, which is a highly specific IHC marker for primary lung adenocarcinoma. Methods A total of 61 pulmonary tumors that were resected at our institute from May 2011 to September 2013 were retrospectively examined. The samples were sectioned, labeled with anti-TTF-1 antibody using the R-IHC method, and pathologically evaluated. The standard used for evaluation was conventional IHC with TTF-1. Results With the R-IHC procedure, analyses were completed within 20 minutes, with a diagnostic accuracy of 96.7% (59 of 61). Among the 47 primary lung adenocarcinomas, the R-IHC detected 31 (66%) tumors that were positive for TTF-1, with a positive predictive value of 100% (31 of 31). Conclusions Our newly developed method of R-IHC with anti-TTF-1 antibody was useful for diagnosing and differentiation of solitary pulmonary tumors. This technology may prove to be an important supplement to standard intraoperative pathologic diagnosis in routine practice.
- Published
- 2016
39. EDITOR'S NOTE
- Author
-
Satoru Motoyama
- Subjects
Gastroenterology ,Surgery - Published
- 2019
40. C-reactive protein inhibits lymphangiogenesis and resultant lymph node metastasis of squamous cell carcinoma in mice
- Author
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Satoru Motoyama, Yusuke Sato, Hajime Saito, Katsuyuki Murata, Yoshihiro Minamiya, Tomohiko Sasaki, Kei Yoshino, Jun-ichi Ogawa, and Goichi Matsumoto
- Subjects
Pathology ,medicine.medical_specialty ,Mice ,Cell Line, Tumor ,medicine ,Carcinoma ,Animals ,Lymphangiogenesis ,Lung cancer ,Lymph node ,Mice, Inbred C3H ,biology ,business.industry ,C-reactive protein ,Cancer ,medicine.disease ,C-Reactive Protein ,medicine.anatomical_structure ,Lymphatic Metastasis ,Carcinoma, Squamous Cell ,biology.protein ,Immunohistochemistry ,Female ,Surgery ,Lymph Nodes ,Lymph ,business - Abstract
Lymph node involvement is the most important prognostic factor in many solid cancers. Recently, we found that patients with esophageal and lung cancer carrying the C-reactive protein (CRP) 1846T/T genotype, which is associated with lower serum CRP levels, are more likely to have lymph node metastasis. We hypothesized that host CRP directly inhibits lymph node metastasis.We inoculated NR-S1M metastatic cells subcutaneously into the backs of C3H/HeN mice. Concurrently, 1 μg of recombinant mouse CRP or phosphate-buffered saline was injected subcutaneously every 3 days for 5 weeks, after which the mice were killed for evaluation. We evaluated lymph node metastasis and lymphangiogenesis in the implanted tumor by using immunohistochemical analysis with anti-pancytokeratin and antilymphatic vessel endothelial hyaluronan receptor-1 antibodies.There was no substantial difference in tumor size between the 2 groups but the lymph nodes were smaller in the CRP group than the control group (P.044). Immunohistochemical analysis confirmed inguinal lymph node metastasis in 70% (14/20) of control mice, but in only 30% (3/10) of mice in the CRP group. Moreover, the metastatic area within lymph nodes was less in the CRP group (P.042) and tumoral lymphangiogenesis was decreased in the CRP group (P.037).CRP appears to inhibit tumoral lymphangiogenesis and lymph node metastasis in mice. These findings suggest that by inhibiting lymph node metastasis, CPR may have therapeutic potential for use against cancer.
- Published
- 2013
41. Inhibition of Hsp90 and 70 sensitizes melanoma cells to hyperthermia using ferromagnetic particles with a low Curie temperature
- Author
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Naoko Takahashi, Hajime Saito, Aki Ito, Kazutaka Mitobe, Shinogu Takashima, Kazuhiro Imai, Yoshihiro Minamiya, Tomoyuki Miyagawa, Satoru Motoyama, and Jun-ichi Ogawa
- Subjects
Hyperthermia ,Lactams, Macrocyclic ,Apoptosis ,Hsp90 inhibitor ,Mice ,In vivo ,Heat shock protein ,Benzoquinones ,medicine ,Animals ,Humans ,HSP70 Heat-Shock Proteins ,HSP90 Heat-Shock Proteins ,Melanoma ,Protein kinase B ,business.industry ,Hyperthermia, Induced ,Hematology ,General Medicine ,medicine.disease ,Hsp70 ,Gene Expression Regulation, Neoplastic ,Oncology ,Magnets ,Cancer research ,Quercetin ,Surgery ,business - Abstract
Heat shock protein (Hsp) 90 is a key regulator of various oncogene products and cell-signaling molecules, while Hsp70 protects against heat-induced apoptosis. We previously described a system in which hyperthermia was produced using thermosensitive ferromagnetic particles (FMPs) with a Curie temperature (T c) of 43 °C to mediate automatic temperature control, and demonstrated its antitumor effect in a mouse melanoma model. In the present study, the antitumor effects of combining Hsp90 inhibitor (17DMAG) and Hsp70 inhibitor (quercetin) with FMP-mediated hyperthermia were examined. Expressions of Hsp90/70 and Akt were evaluated using Western blotting in vitro. In an in vivo study, melanoma cells were subcutaneously injected into the backs of C57BL/6 mice. FMPs were then injected into the resultant tumors, and the mice were divided into groups treated with quercetin and/or 17DMAG with/without hyperthermia. When exposed to a magnetic field, the temperature of tissues containing FMPs increased and stabilized at the T c. The TUNEL method was used to determine whether hyperthermia induced apoptosis within tumors. In the group pretreated with hyperthermia + quercetin + 17DMAG, Akt expression was reduced in vitro, the incidence of apoptosis within tumors was greater, and tumor growth was significantly suppressed 20 days after FMP injection in vivo, compared with other treatment groups. The survival rates among tumor-bearing mice observed for a period of 40 days were significantly higher in the hyperthermia + quercetin + 17DMAG group. Combining Hsp90/70 inhibition with hyperthermia appears to increase their antitumor effects. Thus, the combination of FMP-mediated, self-regulating hyperthermia with Hsp90/70 inhibition has important implications for cancer treatment.
- Published
- 2013
42. A Case of Laparoscopic Surgery in a Young Man with Severe Reflux Esophagitis
- Author
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Kuniaki Kuribayashi, Satoru Motoyama, Yusuke Sato, Kei Yoshino, Tomohiko Sasaki, and Akiyuki Wakita
- Subjects
Laparoscopic surgery ,medicine.medical_specialty ,business.industry ,General surgery ,medicine.medical_treatment ,medicine ,Reflux esophagitis ,business ,Surgery - Published
- 2013
43. Management of Intersegmental Plane on Pulmonary Segmentectomy Concerning Postoperative Complications
- Author
-
Yoshihiro Minamiya, Maiko Atari, Nobuyasu Kurihara, Yusuke Sato, Satoshi Fujishima, Satoru Motoyama, Hayato Konno, and Hajime Saito
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Lung Neoplasms ,Vital Capacity ,030204 cardiovascular system & hematology ,Pulmonary function testing ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Suture (anatomy) ,Risk Factors ,Forced Expiratory Volume ,medicine ,Humans ,Stage (cooking) ,Fibrin glue ,Lung cancer ,Pneumonectomy ,Lung ,Aged ,Retrospective Studies ,Sutures ,business.industry ,Odds ratio ,Middle Aged ,Surgical Mesh ,medicine.disease ,Surgery ,Respiratory Function Tests ,030228 respiratory system ,Pneumothorax ,Anesthesia ,Propensity score matching ,Multivariate Analysis ,Pleura ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background For primary lung cancer, anatomic pulmonary segmentectomy may have a functional advantage over lobectomy; however, persistent air leak or delayed pneumothorax after segmentectomy is prevalent and increases surgical morbidity. To prevent pulmonary complications after pulmonary segmentectomy, we used 2 methods for the involved intersegmental plane: coverage using polyglycolic acid mesh and fibrin glue (mesh cover) or closing it by suturing the pleural edge (pleural suture). We aimed to compare postoperative pulmonary function and complications between the 2 groups. Methods A total of 133 patients who underwent pulmonary segmentectomy for stage IA non-small cell lung cancer were analyzed retrospectively. A pulmonary function test, including vital capacity and forced expiratory volume in 1 second, was performed preoperatively and at 1 and 6 months postoperatively. Propensity score analysis generated 2 matched pairs of 46 patients in the pleural suture and mesh cover groups. Results In each group, there was no significant difference in the recovery rate of vital capacity and forced expiratory volume in 1 second at 1 and 6 months postoperatively. Compared with the pleural suture group, the mesh cover group had higher incidence of prolonged air leak (8.7% versus 0%; p = 0.042), delayed pneumothorax (10.9% versus 2.2%; p = 0.051). On logistic regression analysis, management of intersegmental plane by either mesh cover or pleural suture was the only independent factor related to pulmonary complications (prolonged air leak or delayed pneumothorax) after pulmonary segmentectomy (odds ratio: 5.26, p = 0.047; odds ratio: 13.39, p = 0.018, respectively). Conclusions Pleural suturing of the involved intersegmental plane during pulmonary segmentectomy appeared to be an acceptable method to reduce postoperative pulmonary complications.
- Published
- 2016
44. Contents Vol. 33, 2016
- Author
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Naoto Todo, Beat Gloor, Hajime Saito, Taku Aoki, Motoi Uchino, Kei Hirose, Yasuaki Nakajima, Mitsuru Ishizuka, Zhao Shen Li, Hiromi Rakugi, Keiichi Kubota, Juozas Pundzius, Tomohiko Sasaki, Makoto Yamasaki, Guan Way Lua, Bangmao Wang, Yusuke Sato, Jiajia Liu, Antanas Gulbinas, Tatsuyuki Kawano, Kei Yoshino, Hua Wang, Tsunekazu Mizushima, Guohui Jiao, Masayuki Fukuda, Akiyuki Wakita, Feng Liu, Takayuki Shimizu, Katsumasa Saito, Martin Müller, Xin Gang Shi, Hiroki Ikeuchi, Daiki Harimaya, Darius Pranys, Kestutis Urbonas, Kenro Kawada, Daniel Candinas, Fredrik Brännström, Giedre Smailyte, Kazuhiro Imai, Xin Chen, Yutaka Tokairin, Hiroshi Takano, Yuichiro Doki, Yuta Kawakita, Satoru Motoyama, Yukako Mokutani, Masato Kato, Toshihiro Bando, Ulf Gunnarsson, Yoshihiro Minamiya, Masaki Mori, Teruhiro Chohno, Akira Nakata, Tao Wang, Eng Soon Tan, Giedrius Barauskas, Yoshio Takesue, Werner Druck Medien Ag, Zhongqing Zheng, and Thomas Malinka
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,General surgery ,Gastroenterology ,medicine ,Surgery ,business - Published
- 2016
45. Outcomes of patients receiving additional esophagectomy after endoscopic resection for clinically mucosal, but pathologically submucosal, squamous cell carcinoma of the esophagus
- Author
-
Satoru Motoyama, Tamotsu Matsuhashi, Akiyuki Wakita, Tomohiko Sasaki, Koichi Ishiyama, Yoshihiro Minamiya, Yusuke Sato, Hajime Saito, Jun-ichi Ogawa, Mario Jin, Hirohide Ohnishi, Hiroshi Nanjo, and Kei Yoshino
- Subjects
Male ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Esophagus ,medicine ,Carcinoma ,Humans ,Prospective Studies ,Survival rate ,Lymph node ,Aged ,Mucous Membrane ,business.industry ,Mediastinum ,General Medicine ,Middle Aged ,Esophageal cancer ,medicine.disease ,Surgery ,Esophagectomy ,Survival Rate ,Treatment Outcome ,medicine.anatomical_structure ,Carcinoma, Squamous Cell ,Lymph Node Excision ,Female ,Esophagoscopy ,Lymph ,business - Abstract
This study investigated the actual rate or extent of lymph node metastasis or the survival outcomes among patients that underwent esophagectomy with lymph node dissection after ESD for clinical mucosal, but pathological submucosal, esophageal cancer. Seventeen patients that received esophagectomy with two- or three-field lymph node dissection as additional treatment after ESD for clinical mucosal, but pathological submucosal, esophageal cancer between 2006 and 2010 were analyzed. The rate and extent of lymph node metastasis and the patient outcomes were determined. The tumor depths were diagnosed as SM1 in 8 (47 %) patients and SM2 in 9 (53 %), based on the analyses of resected specimens. Lymphatic invasion was evident in 13 (76 %) patients, while venous invasion was detected in 5 (29 %). Five (29 %) patients had pathologically detected lymph node involvement. Seven (0.8 %) of the 890 dissected nodes showed cancer involvement. Three patients had one involved node in the mediastinum or abdomen, and 2 patients had 2 involved nodes in the abdomen. The patients were followed up for 11–71 months (median 23 months), and all were alive without recurrence at the final follow-up. Twenty-nine percent of the patients diagnosed with clinically mucosal, but pathologically submucosal, thoracic squamous cell esophageal cancer after ESD had 1–2 cancer-involved lymph nodes in the lower mediastinum and abdomen. Esophagectomy with lymph node dissection is therefore considered to be a necessary and effective additional treatment for these patients.
- Published
- 2012
46. CMV reactivation caused by methylprednisolone therapy for ARDS after esophagectomy
- Author
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Yusuke Sato, Satoru Motoyama, Akiyuki Wakita, Kiyotomi Maruyama, Jun-ichi Ogawa, Tomohiko Sasaki, and Key Yoshino
- Subjects
Ganciclovir ,medicine.medical_specialty ,ARDS ,medicine.medical_treatment ,Esophageal cancer ,Methylprednisolone ,Gastroenterology ,Internal medicine ,medicine ,Lymph node ,business.industry ,Steroid therapy ,CMV ,virus diseases ,Retrospective cohort study ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Esophagectomy ,Cardiothoracic surgery ,Original Article ,business ,medicine.drug - Abstract
Background Cytomegalovirus (CMV) infection is endemic worldwide. Although CMV reactivation often becomes a serious problem in immunocompromised patients, the prevalence of CMV reactivation caused by methylprednisolone therapy for ARDS after esophagectomy has yet to be determined. Method Among 175 consecutive patients with thoracic squamous cell esophageal cancer who underwent esophagectomy with extensive lymph node dissection at Akita University Hospital between 2007 and 2010, 11 patients (6.3 %) diagnosed with ARDS during the acute phase of esophagectomy were enrolled and treated with steroid pulse therapy, high-dose (15–20 mg/kg/day) administration and tapering in this retrospective study. Results Seven of the 11 patients (63.6 %) were diagnosed with CMV reactivation based on CMV antigenemia assayed 19.1 days after the start of methylprednisolone administration and were treated with ganciclovir for 39.6 days. Six of the 7 patients (85.7 %) diagnosed with CMV reactivation were administered a total methylprednisolone dose of more than 4,000 mg. Though there was no significant difference between patients with and without CMV reactivation, there was a tendency that patients with CMV reactivation showed a lower minimum number of lymphocytes during the acute phase of esophagectomy (p = 0.051, Student’s t test, average 223.3 and 298.0/μl, respectively). Conclusion Though the number of study patients is small, the prevalence of CMV reactivation caused by high-dose methylprednisolone therapy for ARDS after esophagectomy is remarkably high. This result strikes a note of warning concerning the management of these patients and suggests the importance of screenings for CMV reactivation so as to make an accurate diagnosis and initiate treatment in a timely manner.
- Published
- 2012
47. Tumoral CRP expression in thoracic esophageal squamous cell cancers is associated with poor outcomes
- Author
-
Yudai Hinai, Satoru Motoyama, Yusuke Sato, Shuetsu Usami, Toshinobu Nakatsu, Kiyotomi Maruyama, Yoshihiro Minamiya, Hajime Saito, Katsuyuki Murata, Jun-ichi Ogawa, and Masatomo Miura
- Subjects
Adult ,Male ,Oncology ,medicine.medical_specialty ,Esophageal Neoplasms ,Neoplasm Recurrence ,Surgical oncology ,Internal medicine ,Carcinoma ,Humans ,Medicine ,Survival rate ,Aged ,Squamous cell cancer ,business.industry ,General Medicine ,Middle Aged ,Esophageal cancer ,Prognosis ,medicine.disease ,Immunohistochemistry ,Survival Rate ,C-Reactive Protein ,Cancer cell ,Carcinoma, Squamous Cell ,Female ,Surgery ,Neoplasm Recurrence, Local ,business - Abstract
Cancer cells reportedly produce C-reactive protein (CRP) locally within tumors. The aim of this study was to determine whether tumoral CRP is associated with clinical outcome and recurrence in thoracic esophageal squamous cell cancer.The subjects included 73 Japanese patients with thoracic esophageal squamous cell cancer (pathological Stage IIA-IV) that had not been treated preoperatively with either chemotherapy or radiotherapy. Tumoral CRP expression in resected specimens of tumor tissue was assessed by immunohistochemistry. The survival rate following surgery, the rates and patterns of recurrence, and the serum CRP levels before treatment and at recurrence were analyzed in patients with and without tumoral CRP expression.Fifty-nine percent of the study participants (43/73) were positive for tumoral CRP expression, and the remaining 41% (30/73) were negative. No significant difference in clinicopathological factors was observed between the tumoral CRP-positive and CRP-negative groups; however, patients expressing tumoral CRP showed significantly poorer survival and recurrence rates. A multivariate analysis showed that tumoral CRP expression was an independent factor contributing to the likelihood of a poor outcome.Tumoral CRP is associated with a poor outcome in thoracic esophageal squamous cell cancer. Tumoral CRP could therefore be an important target for the treatment of this disease.
- Published
- 2012
48. A case of strangulation ileus due to a jejunostomy complicated by acute pancreatitis occurring after esophagectomy
- Author
-
Jun-ichi Ogawa, Satoru Motoyama, Shuetsu Usami, Toshinobu Nakatsu, Kiyotomi Maruyama, and Yusuke Sato
- Subjects
medicine.medical_specialty ,Ileus ,Esophagectomy ,business.industry ,medicine.medical_treatment ,Jejunostomy ,medicine ,Acute pancreatitis ,medicine.disease ,business ,Surgery - Published
- 2012
49. Esophageal Cancer Patients Have a High Incidence of Severe Periodontitis and Preoperative Dental Care Reduces the Likelihood of Severe Pneumonia after Esophagectomy
- Author
-
Kazuhiro Imai, Yuta Kawakita, Jiajia Liu, Naoto Todo, Masayuki Fukuda, Kei Yoshino, Satoru Motoyama, Tomohiko Sasaki, Hiroshi Takano, Daiki Harimaya, Akiyuki Wakita, Yoshihiro Minamiya, Yusuke Sato, Akira Nakata, and Hajime Saito
- Subjects
Male ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,macromolecular substances ,030230 surgery ,Preoperative care ,Severe periodontitis ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Severity of illness ,Preoperative Care ,medicine ,Humans ,Dental Care ,Periodontitis ,Aged ,Retrospective Studies ,business.industry ,Gastroenterology ,Retrospective cohort study ,Pneumonia ,Esophageal cancer ,Middle Aged ,Protective Factors ,medicine.disease ,Surgery ,Esophagectomy ,stomatognathic diseases ,030220 oncology & carcinogenesis ,Tooth Extraction ,Female ,business - Abstract
Background: Poor oral health is a risk factor for causing upper aerodigestive tract tumors, including esophageal cancer. Our aim was to determine the periodontitis rate in our cohort of esophageal cancer patients. We also analyzed whether preoperative dental examination and care reduces the likelihood of severe pneumonia after esophagectomy. Study Design: Between 2003 and 2014, 529 esophageal cancer patients received esophagectomy at Akita University Hospital. We studied 232 patients who had preoperative dental examinations and care (dental care group) retrospectively and assessed the severity of their periodontitis. The dental care group was compared to 297 patients who did not have preoperative dental care (control group) with respect to the incidence of severe pneumonia after esophagectomy. Results: Ninety-one patients (39.2%) in the dental care group were diagnosed with slight periodontitis and 69 (29.7%) were diagnosed with severe periodontitis. Among all the patients, 69 patients (13.0%) were diagnosed with grade 3B postoperative severe pneumonia. The dental care group had a significantly lower incidence of severe pneumonia than the control group. Moreover, multivariable logistic regression analysis revealed that anastomotic leakage, preoperative dental care, gender and %VC were correlated significantly with the occurrence of postoperative severe pneumonia. Conclusion: Preoperative dental examination and care by a dentist are essential to reduce the likelihood of postoperative severe pneumonia in esophageal cancer patients.
- Published
- 2015
50. Outcomes of endoscopic and surgical resection for a second primary cancer in the residual cervical esophagus after thoracic esophagectomy
- Author
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Yoshihiro Minamiya, Tamotsu Matsuhashi, Kiyotomi Maruyama, Hajime Saito, Reijiro Saito, Jun-ichi Ogawa, Hirohide Ohnishi, Yusuke Sato, Shuetsu Usami, Toshinobu Nakatsu, Kei Yoshino, Mario Jin, and Satoru Motoyama
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Cancer ,General Medicine ,Esophageal cancer ,medicine.disease ,Malignancy ,Surgery ,Endoscopy ,Radiation therapy ,Esophagectomy ,Carcinoma ,Medicine ,business ,Chemoradiotherapy - Abstract
Patients who have received subtotal esophagectomy for thoracic esophageal cancer must be closely monitored for second primary malignancies. The purpose of this study is to review and assess patients who developed a second primary esophageal cancer in the residual cervical esophagus. Between 1996 and 2010, 10 patients were diagnosed in our hospital with esophageal squamous cell cancer in the residual cervical esophagus after undergoing thoracic esophagectomy and were treated with endoscopic or surgical resection. Data from these patients were reviewed retrospectively. Seven of the 10 patients (70%) had multiple primary carcinoma lesions at the time of their esophagectomy. A second primary cancer in the residual cervical esophagus was detected in eight patients during follow-up endoscopic examinations while the patients were still asymptomatic. Seven of the patients underwent endoscopic resection for a superficial cancer. None of those patients experienced any complications, and all are currently alive and cancer-free. The remaining three patients underwent resection of the cervical esophagus with regional lymph node dissection. Two of those patients experienced severe complications; one subsequently died (hospital death) from pneumonia, 12 months after surgery, while the other died from recurrence of his cancer. The third patient is alive and cancer-free. Early detection of a second primary malignancy in the residual cervical esophagus followed by endoscopic resection is the best treatment strategy for patients who previously received subtotal esophagectomy for thoracic esophageal cancer. Surgical resection puts patients at high risk of mortality or morbidity.
- Published
- 2011
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