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52. Crohn's Disease-Associated Anorectal Cancer Has a Poor Prognosis With High Local Recurrence: A Subanalysis of the Nationwide Japanese Study.

Author

Takayuki Ogino, Tsunekazu Mizushima, Makoto Fujii, Yuki Sekido, Hidetoshi Eguchi, Riichiro Nezu, Hiroki Ikeuchi, Uchino Motoi, Kitaro Futami, Kinya Okamoto, Hisashi Nagahara, Kazuhiro Watanabe, Koji Okabayashi, Kazutaka Yamada, Hiroki Ohge, Shinji Tanaka, Yusuke Mizuuchi, Yoshiki Ohkita, Yu Sato, and Hideki Ueno

Published
2023
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53. Correlation between Antimicrobial Resistance and the Hospital-Wide Diverse Use of Broad-Spectrum Antibiotics by the Antimicrobial Stewardship Program in Japan

Author

Ueda, Takashi, primary, Takesue, Yoshio, additional, Nakajima, Kazuhiko, additional, Ichiki, Kaoru, additional, Ishikawa, Kaori, additional, Yamada, Kumiko, additional, Tsuchida, Toshie, additional, Otani, Naruhito, additional, Takahashi, Yoshiko, additional, Ishihara, Mika, additional, Takubo, Shingo, additional, Iijima, Kosuke, additional, Ikeuchi, Hiroki, additional, Uchino, Motoi, additional, and Kimura, Takeshi, additional

Published
2023
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55. Effect of Biologics on the Risk of Advanced-Stage Inflammatory Bowel Disease-Associated Intestinal Cancer: A Nationwide Study

Author

Seishima, Ryo, primary, Okabayashi, Koji, additional, Ikeuchi, Hiroki, additional, Uchino, Motoi, additional, Futami, Kitaro, additional, Noguchi, Tatsuki, additional, Ohge, Hiroki, additional, Iseki, Yasuhito, additional, Watanabe, Kazuhiro, additional, Itabashi, Michio, additional, Okamoto, Kinya, additional, Toiyama, Yuji, additional, Ogino, Takayuki, additional, Nakamura, Masafumi, additional, Yamada, Kazutaka, additional, Wakai, Toshifumi, additional, Sato, Yu, additional, Kimura, Hideaki, additional, Takahashi, Kenichi, additional, Hida, Koya, additional, Kinugasa, Yusuke, additional, Ishida, Fumio, additional, Okuda, Junji, additional, Daito, Koji, additional, Koyama, Fumikazu, additional, Ueno, Hideki, additional, Yamamoto, Takayuki, additional, Yamamoto, Seiichiro, additional, Hanai, Tsunekazu, additional, Maemoto, Atsuo, additional, Arakaki, Junya, additional, Komori, Koji, additional, Akagi, Yoshito, additional, Shida, Dai, additional, Yamaguchi, Shigeki, additional, Matsuda, Keiji, additional, Maeda, Kiyoshi, additional, Noake, Toshihiro, additional, Nezu, Riichiro, additional, Sasaki, Shin, additional, Hasegawa, Junichi, additional, Sunami, Eiji, additional, Kanemitsu, Yukihide, additional, Katsumata, Kenji, additional, Uehara, Kei, additional, Kiyomatsu, Tomomichi, additional, Suto, Takeshi, additional, Kazama, Shinsuke, additional, Yamada, Takeshi, additional, Goi, Takenori, additional, Ishihara, Soichiro, additional, Ajioka, Yoichi, additional, and Sugihara, Kenichi, additional

Published
2023
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61. Oncological outcomes of Crohn's disease‐associated cancers focusing on disease behavior.

Author

Yamamoto, Akira, Toiyama, Yuji, Ikeuchi, Hiroki, Uchino, Motoi, Futami, Kitaro, Okamoto, Kinya, Ogino, Takayuki, Ishihara, Soichiro, Ajioka, Yoichi, and Sugihara, Kenichi

Subjects
CROHN'S disease, CANCER patients, OVERALL survival, DISEASE risk factors
Abstract

Background: The overall risk of colorectal cancer in Crohn's disease (CD) is higher than in the general population, and CD‐associated cancer (CDAC) has poorer prognosis than sporadic cancer. Developing treatment strategies for improving the prognosis of CDAC, we evaluated the characteristics of CDAC according to the underlying disease behavior, namely stricturing and penetrating. Methods: This multicenter retrospective study comprises 316 CDAC patients who underwent surgery between 1985 and 2019. Clinicopathological findings including disease behavior and oncological outcomes were investigated. Results: There was no association between the preoperative course of CDAC patients and disease behavior; however, postoperative information revealed distinctly different characteristics between CDAC patients with stricturing behavior and those with penetrating behavior (stricturing with lymphatic invasion and peritoneal dissemination recurrence, and penetrating with histologically poorly differentiated and local recurrence). Oncological outcome of patients with CDAC was distinctly different according to disease behavior, as penetrating provided a poor outcome (overall survival [OS]: p = 0.02; relapse‐free survival [RFS]: p = 0.002) whereas stricturing had no effect. Furthermore, penetrating behavior was identified as one of the independent risk factors for poor OS and RFS (OS: hazard ratio [HR] 1.89, 95% confidence interval [CI] 1.16–3.09, p = 0.01; RFS: HR 2.15, 95% CI 1.28–3.63, p = 0.004). Conclusions: Our study highlights the different characteristics of CDAC according to the underlying disease behavior and substantiates the poor prognosis of CDAC patients with penetrating behavior. Treatment planning including screening, surgical procedures, and postoperative treatment, with awareness of these findings, may contribute to improved prognosis for CDAC patients. [ABSTRACT FROM AUTHOR]

Published
2023
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62. The Comprehensive Complication Index in Ulcerative Colitis: A Comparison with the Clavien-Dindo Classification

Author

Horio, Yuki, Uchino, Motoi, Igeta, Masataka, Nagano, Kentaro, Kusunoki, Kurando, Kuwahara, Ryuichi, Sato, Toshiyuki, Shinzaki, Shinichiro, and Ikeuchi, Hiroki

Abstract

Introduction:The comprehensive complication index (CCI), which weights all postoperative complications according to severity and integrates them into a single formula, has been reported as a new evaluation system. We aimed to compare the CCI with the Clavien-Dindo Classification (CDC) to patients with ulcerative colitis (UC). Methods:Patients who underwent initial surgery for UC from April 2012 to March 2020 were included. The patients were classified into a length of stay (LOS) >30 days group or an LOS ≤30 days group. We performed a multivariate analysis of risk factors for LOS >30 days in the model with the factors identified in the univariate analysis plus the CCI (the CCI model) and plus CDC (the CDC model). An ROC curve was used to test the difference in the area under the curve (AUC) between the CCI model and the CDC model. Results:The median LOS was 21 days (IQR: 16–29 days), and the rate of LOS >30 days was 119/588 (20.2%). In the CCI model, age at the time of surgery (odds ratio [OR] = 1.24, 95% confidence interval [CI] 1.07–1.45, p= 0.01), ASA score ≥3 (OR = 1.94, 95% CI:1.00–3.76, p= 0.04), and CCI (OR = 1.07, 95% CI: 1.05–1.09; p< 0.01) were identified as independent risk factors for LOS >30 days. The AUC value of the CCI model (0.86) was significantly better in relation to LOS >30 days than that of the CDC model (0.82) (p= 0.02). Conclusion:The CCI was a better measure of LOS than was the CDC and was found to be a useful indicator in UC.

Published
2023
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63. The Impacts of Laparoscopic Restorative Proctocolectomy for Ulcerative Colitis: Systematic Review and Meta-Analysis

Author

Uchino, Motoi, Ikeuchi, Hiroki, Horio, Yuki, Kuwahara, Ryuichi, Kusunoki, Kurando, Nagano, Kentaro, Kimura, Kei, Kataoka, Kozo, Beppu, Naohito, and Ikeda, Masataka

Abstract

Introduction:Laparoscopic surgery (LAP) is now recognized as the standard procedure for colorectal surgery. However, the standard surgery for ulcerative colitis (UC) is total proctocolectomy with ileal pouch anal anastomosis (IPAA), which may be an overly complex procedure to complete laparoscopically. We conducted this systematic review and meta-analysis to evaluate the efficacy as well as the advantages and disadvantages of LAP-IPAA in patients with UC stratified by the outcome of interest. Method:We performed a systematic literature review by searching the PubMed/MEDLINE, the Cochrane Library, and the Japan Centra Reuvo Medicina databases from inception until January 2023. Meta-analyses were performed for surgical outcomes, including morbidity and surgical course, to evaluate the efficacy of LAP-IPAA. Results:A total of 707 participants, including 341 LAP and 366 open surgery (OPEN) patients in 9 observational studies and one randomized controlled study, were included. From the results of the meta-analyses, the odds ratio (OR) of total complications in LAP was 1.12 (95% CI: 0.58–2.17, p= 0.74). The OR of mortality for LAP was 0.38 (95% CI: 0.08–1.92, p= 0.24). Although the duration of surgery was extended in LAP (mean difference (MD) 118.74 min (95% CI: 91.67–145.81), p< 0.01) and hospital stay were not shortened, the duration until oral intake after surgery was shortened in LAP (MD −2.10 days (95% CI: −3.52–0.68), p= 0.004). Conclusions:During IPAA for UC, a similar morbidity rate was seen for LAP and OPEN. Although LAP necessitates extended surgery, there may be certain advantages to this procedure, including easy visibility during the surgical procedure or a shortened time to oral intake after surgery.

Published
2023
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68. Have advances in medical therapy for ulcerative colitis impacted surgical treatment?

Author

Kuwahara, Ryuichi, Ikeuchi, Hiroki, Horio, Yuki, Minagawa, Tomohiro, Kusunoki, Kurando, and Uchino, Motoi

Abstract

Aim: The purpose of this study was to examine how the clinical characteristics, indications for surgery, and postoperative course of ulcerative colitis (UC) surgical patients changed before and after the introduction of biological agents. Methods: Patients who underwent surgery for UC at Hyogo Medical University between 2000 and 2019 were included in the study; those who underwent surgery between 2000 and 2009 were included in the early group (n = 864), and those who underwent surgery between 2010 and 2019 were included in the late group (n = 834); each study factor was retrospectively compared. Results: The mean ages at surgery (y) were 39.7 ± 15.1 y in the early group and 46.7 ± 17.8 y in the late group (P <.01). Antitumor necrosis factor agents were used (%) in 2 (0.2) patients in the early group and 317 (38.0) patients in the late group (P <.01). The number of cancer or dysplasia patients for whom surgery was indicated was significantly higher in the late group (11%/26%, P =.01). With regard to surgery in elderly individuals, the number of elderly patients (65 y and older) undergoing surgery was significantly higher in the late group (8.0%/18.6%, P <.01). For emergency surgery, the mortality rates were 16.7% (2/12) in the early surgery group and 15.7% (8/51) in the late surgery group (P =.61). Conclusion: The characteristics of UC patients requiring surgery in Japan have changed. The distribution of surgical indications changed, and the number of patients with cancer and dysplasia requiring surgery increased. The prognosis of elderly patients who underwent emergency surgery was poor. [ABSTRACT FROM AUTHOR]

Published
2023
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72. Validation of Vancomycin Area under the Concentration—Time Curve Estimation by the Bayesian Approach Using One-Point Samples for Predicting Clinical Outcomes in Patients with Methicillin-Resistant Staphylococcus aureus Infections

Author

Ueda, Takashi, primary, Takesue, Yoshio, additional, Nakajima, Kazuhiko, additional, Ichiki, Kaoru, additional, Ishikawa, Kaori, additional, Yamada, Kumiko, additional, Tsuchida, Toshie, additional, Otani, Naruhito, additional, Takahashi, Yoshiko, additional, Ishihara, Mika, additional, Takubo, Shingo, additional, Ikeuchi, Hiroki, additional, Uchino, Motoi, additional, Kimura, Toshimi, additional, Matsumoto, Kazuaki, additional, Oda, Kazutaka, additional, and Kimura, Takeshi, additional

Published
2022
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75. A consensus statement on health‐care transition for childhood‐onset inflammatory bowel disease patients

Author

Kumagai, Hideki, primary, Shimizu, Toshiaki, additional, Iwama, Itaru, additional, Hagiwara, Shin‐Ichiro, additional, Kudo, Takahiro, additional, Takahashi, Michiko, additional, Saito, Takeshi, additional, Kunisaki, Reiko, additional, Uchino, Motoi, additional, Hiraoka, Sakiko, additional, Naganuma, Makoto, additional, Sugimoto, Ken, additional, Miyoshi, Jun, additional, Shibuya, Tomoyoshi, additional, and Hisamatsu, Tadakazu, additional

Published
2022
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80. Machine learning‑based radiomics models accurately predict Crohn's disease‑related anorectal cancer.

Author

Horio, Yuki, Ikeda, Jota, Matsumoto, Kentaro, Okada, Shinichiro, Nagano, Kentaro, Kusunoki, Kurando, Kuwahara, Ryuichi, Kimura, Kei, Kataoka, Kozo, Beppu, Naohito, Uchino, Motoi, Ikeda, Masataka, Okadome, Takeshi, Yamakado, Koichiro, and Ikeuchi, Hiroki

Subjects
MACHINE learning, CROHN'S disease, FEATURE extraction, SUPPORT vector machines, CANCER diagnosis
Abstract

The radiological diagnosis of Crohn's disease (CD)-related anorectal cancer is difficult; it is often found in advanced stages and has a poor prognosis because of the difficulty of curative surgery. However, there are no studies on predicting the diagnosis of CD-related cancer. The present study aimed to develop a predictive model to diagnose CD cancerous lesions more accurately in a way that can be interpreted by clinicians. Patients with CD who developed anorectal CD lesions at Hyogo Medical University (Nishinomiya, Japan) between March 2009 and June 2022 were included in the present study. T2-weighted and T1-weighted magnetic resonance (MR) images were utilized for our analysis. Images of anorectal lesions were segmented using open-source 3D Slicer software, and radiomic features were extracted using PyRadiomics. Six machine learning models were investigated and compared: i) Support vector machine; ii) naive Bayes; iii) random forest; iv) light gradient boosting machine; v) extremely randomized trees; vi) and regularized greedy forest (RGF). SHapley Additive exPlanations (SHAP) values were calculated to assess the extent to which each radiomic feature contributed to the model's predictions compared to baseline, represented as the average of the model's predictions for all test data. The T2-weighted images of 28 patients with anorectal cancer and 40 non-cancer patients were analyzed and the contrast-enhanced T1-weighted images of 22 cancer and 40 non-cancer patients. The model with the highest area under the curve (AUC) was the RGF-based model constructed using T2-weighted image features, achieving an AUC of 0.944 (accuracy, 0.862; recall, 0.830). The SHAP-based model explanation suggested a strong association between the diagnosis of CD-related anorectal cancer and features such as complex lesion texture; greater pixel separation within the same coronal cross-section; larger, randomly distributed clumps of pixels with the same signal intensity; and a more spherical lesion shape on T2-weighted images. The MRI radiomics-based RGF model demonstrated outstanding performance in predicting CD-related anorectal cancer. These results may affect the diagnosis and surveillance strategies of CD-related colorectal cancer. [ABSTRACT FROM AUTHOR]

Published
2024
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83. Effect of Changing Surgical Instruments Before Wound Closure to Prevent Wound Infection in Lower GI Surgery: A Randomized Controlled Trial

Author

Kuwahara, Ryuichi, primary, Uchino, Motoi, additional, Ikeuchi, Hiroki, additional, Bando, Toshihiro, additional, Sasaki, Hirofumi, additional, Yasuhara, Michiko, additional, Kimura, Kei, additional, Goto, Yoshiko, additional, Horio, Yuki, additional, Minagawa, Tomohiro, additional, Ikeda, Masataka, additional, Ueda, Takashi, additional, and Takesue, Yoshio, additional

Published
2021
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97. Additional file 1 of Clinical efficacy and safety in patients treated with teicoplanin with a target trough concentration of 20 μg/mL using a regimen of 12 mg/kg for five doses within the initial 3 days

Author

Ueda, Takashi, Takesue, Yoshio, Nakajima, Kazuhiko, Ichiki, Kaoru, Ishikawa, Kaori, Takai, Yoshiko, Yamada, Kumiko, Tsuchida, Toshie, Naruhito Otani, Takahashi, Yoshiko, Ishihara, Mika, Takubo, Shingo, Ikeuchi, Hiroki, Uchino, Motoi, and Kimura, Takeshi

Abstract

Additional file 1: Tables S1–4. were available as Supplementary data. The availability of data was presented within the additional supporting files. (PPTX 52 kb)

Published
2020
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99. Frequent mutations that converge on the NFKBIZ pathway in ulcerative colitis

Author

90839721, 90322651, 20515514, 00789638, 40511829, 80646373, 40883707, 20772403, 70335454, 40402127, 10252462, 10379092, 90335266, Kakiuchi, Nobuyuki, Yoshida, Kenichi, Uchino, Motoi, Kihara, Takako, Akaki, Kotaro, Inoue, Yoshikage, Kawada, Kenji, Nagayama, Satoshi, Yokoyama, Akira, Yamamoto, Shuji, Matsuura, Minoru, Horimatsu, Takahiro, Hirano, Tomonori, Goto, Norihiro, Takeuchi, Yasuhide, Ochi, Yotaro, Shiozawa, Yusuke, Kogure, Yasunori, Watatani, Yosaku, Fujii, Yoichi, Kim, Soo Ki, Kon, Ayana, Kataoka, Keisuke, Yoshizato, Tetsuichi, Nakagawa, Masahiro M., Yoda, Akinori, Nanya, Yasuhito, Makishima, Hideki, Shiraishi, Yuichi, Chiba, Kenichi, Tanaka, Hiroko, Sanada, Masashi, Sugihara, Eiji, Sato, Taka-aki, Maruyama, Takashi, Miyoshi, Hiroyuki, Taketo, Makoto Mark, Oishi, Jun, Inagaki, Ryosaku, Ueda, Yutaka, Okamoto, Shinya, Okajima, Hideaki, Sakai, Yoshiharu, Sakurai, Takaki, Haga, Hironori, Hirota, Seiichi, Ikeuchi, Hiroki, Nakase, Hiroshi, Marusawa, Hiroyuki, Chiba, Tsutomu, Takeuchi, Osamu, Miyano, Satoru, Seno, Hiroshi, Ogawa, Seishi, 90839721, 90322651, 20515514, 00789638, 40511829, 80646373, 40883707, 20772403, 70335454, 40402127, 10252462, 10379092, 90335266, Kakiuchi, Nobuyuki, Yoshida, Kenichi, Uchino, Motoi, Kihara, Takako, Akaki, Kotaro, Inoue, Yoshikage, Kawada, Kenji, Nagayama, Satoshi, Yokoyama, Akira, Yamamoto, Shuji, Matsuura, Minoru, Horimatsu, Takahiro, Hirano, Tomonori, Goto, Norihiro, Takeuchi, Yasuhide, Ochi, Yotaro, Shiozawa, Yusuke, Kogure, Yasunori, Watatani, Yosaku, Fujii, Yoichi, Kim, Soo Ki, Kon, Ayana, Kataoka, Keisuke, Yoshizato, Tetsuichi, Nakagawa, Masahiro M., Yoda, Akinori, Nanya, Yasuhito, Makishima, Hideki, Shiraishi, Yuichi, Chiba, Kenichi, Tanaka, Hiroko, Sanada, Masashi, Sugihara, Eiji, Sato, Taka-aki, Maruyama, Takashi, Miyoshi, Hiroyuki, Taketo, Makoto Mark, Oishi, Jun, Inagaki, Ryosaku, Ueda, Yutaka, Okamoto, Shinya, Okajima, Hideaki, Sakai, Yoshiharu, Sakurai, Takaki, Haga, Hironori, Hirota, Seiichi, Ikeuchi, Hiroki, Nakase, Hiroshi, Marusawa, Hiroyuki, Chiba, Tsutomu, Takeuchi, Osamu, Miyano, Satoru, Seno, Hiroshi, and Ogawa, Seishi

Abstract

Chronic inflammation is accompanied by recurring cycles of tissue destruction and repair and is associated with an increased risk of cancer1, 2, 3. However, how such cycles affect the clonal composition of tissues, particularly in terms of cancer development, remains unknown. Here we show that in patients with ulcerative colitis, the inflamed intestine undergoes widespread remodelling by pervasive clones, many of which are positively selected by acquiring mutations that commonly involve the NFKBIZ, TRAF3IP2, ZC3H12A, PIGR and HNRNPF genes and are implicated in the downregulation of IL-17 and other pro-inflammatory signals. Mutational profiles vary substantially between colitis-associated cancer and non-dysplastic tissues in ulcerative colitis, which indicates that there are distinct mechanisms of positive selection in both tissues. In particular, mutations in NFKBIZ are highly prevalent in the epithelium of patients with ulcerative colitis but rarely found in both sporadic and colitis-associated cancer, indicating that NFKBIZ-mutant cells are selected against during colorectal carcinogenesis. In further support of this negative selection, we found that tumour formation was significantly attenuated in Nfkbiz-mutant mice and cell competition was compromised by disruption of NFKBIZ in human colorectal cancer cells. Our results highlight common and discrete mechanisms of clonal selection in inflammatory tissues, which reveal unexpected cancer vulnerabilities that could potentially be exploited for therapeutics in colorectal cancer.

Published
2020

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