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3. Can Physician Judgment Enhance Model Trustworthiness? A Case Study on Predicting Pathological Lymph Nodes in Rectal Cancer

Author

Kobayashi, Kazuma, Takamizawa, Yasuyuki, Miyake, Mototaka, Ito, Sono, Gu, Lin, Nakatsuka, Tatsuya, Akagi, Yu, Harada, Tatsuya, Kanemitsu, Yukihide, and Hamamoto, Ryuji

Subjects
Electrical Engineering and Systems Science - Image and Video Processing, Computer Science - Computer Vision and Pattern Recognition
Abstract

Explainability is key to enhancing artificial intelligence's trustworthiness in medicine. However, several issues remain concerning the actual benefit of explainable models for clinical decision-making. Firstly, there is a lack of consensus on an evaluation framework for quantitatively assessing the practical benefits that effective explainability should provide to practitioners. Secondly, physician-centered evaluations of explainability are limited. Thirdly, the utility of built-in attention mechanisms in transformer-based models as an explainability technique is unclear. We hypothesize that superior attention maps should align with the information that physicians focus on, potentially reducing prediction uncertainty and increasing model reliability. We employed a multimodal transformer to predict lymph node metastasis in rectal cancer using clinical data and magnetic resonance imaging, exploring how well attention maps, visualized through a state-of-the-art technique, can achieve agreement with physician understanding. We estimated the model's uncertainty using meta-level information like prediction probability variance and quantified agreement. Our assessment of whether this agreement reduces uncertainty found no significant effect. In conclusion, this case study did not confirm the anticipated benefit of attention maps in enhancing model reliability. Superficial explanations could do more harm than good by misleading physicians into relying on uncertain predictions, suggesting that the current state of attention mechanisms in explainability should not be overestimated. Identifying explainability mechanisms truly beneficial for clinical decision-making remains essential.

Published
2023

5. Clinicopathological features and prognosis of primary small bowel adenocarcinoma: a large multicenter analysis of the JSCCR database in Japan

Author

Yamashita, Ken, Oka, Shiro, Yamada, Takeshi, Mitsui, Keigo, Yamamoto, Hironori, Takahashi, Keiichi, Shiomi, Akio, Hotta, Kinichi, Takeuchi, Yoji, Kuwai, Toshio, Ishida, Fumio, Kudo, Shin-Ei, Saito, Shoichi, Ueno, Masashi, Sunami, Eiji, Yamano, Tomoki, Itabashi, Michio, Ohtsuka, Kazuo, Kinugasa, Yusuke, Matsumoto, Takayuki, Sugai, Tamotsu, Uraoka, Toshio, Kurahara, Koichi, Yamaguchi, Shigeki, Kato, Tomohiro, Okajima, Masazumi, Kashida, Hiroshi, Akagi, Yoshito, Ikematsu, Hiroaki, Ito, Masaaki, Esaki, Motohiro, Kawai, Masaya, Yao, Takashi, Hamada, Madoka, Horimatsu, Takahiro, Koda, Keiji, Fukai, Yasumori, Komori, Koji, Saitoh, Yusuke, Kanemitsu, Yukihide, Takamaru, Hiroyuki, Yamada, Kazutaka, Nozawa, Hiroaki, Takayama, Tetsuji, Togashi, Kazutomo, Shinto, Eiji, Torisu, Takehiro, Toyoshima, Akira, Ohmiya, Naoki, Kato, Takeshi, Otsuji, Eigo, Nagata, Shinji, Hashiguchi, Yojiro, Sugihara, Kenichi, Ajioka, Yoichi, and Tanaka, Shinji

Published
2024
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8. Protocol amendment for ENSEMBLE study: A multicenter, randomized, phase III trial to test the superiority of consolidation irinotecan, capecitabine and oxaliplatin vs capecitabine and oxaliplatin following short course radiotherapy as total neoadjuvant therapy in patients with locally advanced rectal cancer—Changing the irinotecan dosage.

Author

Ando, Koji, Watanabe, Jun, Kagawa, Yoshinori, Bando, Hideaki, Kotani, Daisuke, Suwa, Yusuke, Nishizawa, Yujiro, Takahashi, Yusuke, Matsuhashi, Nobuhisa, Suwa, Hirokazu, Sugiyama, Masahiko, Kanemitsu, Yukihide, Oki, Eiji, Uemura, Mamoru, Yokota, Mitsuru, Tsuboyama, Takahiro, Oba, Koji, Kato, Takeshi, and Yoshino, Takayuki

Published
2024
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9. Impact of microsatellite status in early-onset colonic cancer.

Author

Zaborowski, Alexandra M, Adamina, Ahmed Abdile Michel, Aigner, Felix, d'Allens, Laura, Allmer, Caterina, Álvarez, Andrea, Anula, Rocio, Andric, Mihailo, Bach, Sam Atallah Simon, Bala, Miklosh, Barussaud, Marie, Bausys, Augustinas, Beggs, Andrew, Bellolio, Felipe, Bennett, Melissa-Rose, Berdinskikh, Anton, Bevan, Vicki, Biondo, Sebastiano, Bislenghi, Gabriele, Bludau, Marc, Brouwer, Nelleke, Brown, Carl, Bruns, Christiane, Buchanan, Daniel D, Buchwald, Pamela, Burger, Jacobus WA, Burlov, Nikita, Campanelli, Michela, Capdepont, Maylis, Carvello, Michele, Chew, Hwee-Hoon, Christoforidis, Dimitri, Clark, David, Climent, Marta, Collinson, Rowan, Cologne, Kyle G, Contreras, Tomas, Croner, Roland, Daniels, Ian R, Dapri, Giovanni, Davies, Justin, Delrio, Paolo, Denost, Quentin, Deutsch, Michael, Dias, Andre, D’Hoore, André, Drozdov, Evgeniy, Duek, Daniel, Dunlop, Malcolm, Dziki, Adam, Edmundson, Aleksandra, Efetov, Sergey, El-Hussuna, Alaa, Elliot, Brodie, Emile, Sameh, Espin, Eloy, Evans, Martyn, Faes, Seraina, Faiz, Omar, Figueiredo, Nuno, Fleming, Fergal, Foppa, Caterina, Fowler, George, Frasson, Matteo, Forgan, Tim, Frizelle, Frank, Gadaev, Shamil, Gellona, Jose, Glyn, Tamara, Goran, Barisic, Greenwood, Emma, Guren, Marianne G, Guillon, Stephanie, Gutlic, Ida, Hahnloser, Dieter, Hampel, Heather, Hanly, Ann, Hasegawa, Hirotoshi, Iversen, Lene Hjerrild, Hill, Andrew, Hill, James, Hoch, Jiri, Hompes, Roel, Hurtado, Luis, Iaquinandi, Fabiano, Imbrasaite, Ugne, Islam, Rumana, Jafari, Mehrenah D, Salido, Andrea Jiménez, Jiménez-Toscano, Marta, Kanemitsu, Yukihide, Karachun, Aleksei, Karimuddin, Ahmer A, Keller, Deborah S, Kelly, Justin, Kennelly, Rory, Khrykov, Gleb, Kocian, Peter, Koh, Cherry, and Kok, Neils

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Cancer, Genetic Testing, Digestive Diseases, Genetics, Clinical Research, Colo-Rectal Cancer, Aetiology, 2.1 Biological and endogenous factors, Colonic Neoplasms, Colorectal Neoplasms, Humans, Microsatellite Instability, Microsatellite Repeats, Mutation, Prognosis, Proto-Oncogene Proteins B-raf, Proto-Oncogene Proteins p21(ras), REACCT Collaborative, Medical and Health Sciences, Surgery, Clinical sciences
Abstract

BackgroundThe molecular profile of early-onset colonic cancer is undefined. This study evaluated clinicopathological features and oncological outcomes of young patients with colonic cancer according to microsatellite status.MethodsAnonymized data from an international collaboration were analysed. Criteria for inclusion were patients younger than 50 years diagnosed with stage I-III colonic cancer that was surgically resected. Clinicopathological features, microsatellite status, and disease-specific outcomes were evaluated.ResultsA total of 650 patients fulfilled the criteria for inclusion. Microsatellite instability (MSI) was identified in 170 (26.2 per cent), whereas 480 had microsatellite-stable (MSS) tumours (relative risk of MSI 2.5 compared with older patients). MSI was associated with a family history of colorectal cancer and lesions in the proximal colon. The proportions with pathological node-positive disease (45.9 versus 45.6 per cent; P = 1.000) and tumour budding (20.3 versus 20.5 per cent; P = 1.000) were similar in the two groups. Patients with MSI tumours were more likely to have BRAF (22.5 versus 6.9 per cent; P < 0.001) and KRAS (40.0 versus 24.2 per cent; P = 0.006) mutations, and a hereditary cancer syndrome (30.0 versus 5.0 per cent; P < 0.001; relative risk 6). Five-year disease-free survival rates in the MSI group were 95.0, 92.0, and 80.0 per cent for patients with stage I, II, and III tumours, compared with 88.0, 88.0, and 65.0 per cent in the MSS group (P = 0.753, P = 0.487, and P = 0.105 respectively).ConclusionPatients with early-onset colonic cancer have a high risk of MSI and defined genetic conditions. Those with MSI tumours have more adverse pathology (budding, KRAS/BRAF mutations, and nodal metastases) than older patients with MSI cancers.

Published
2022

10. Defining Benchmarks for Pelvic Exenteration Surgery: A Multicentre Analysis of Patients with Locally Advanced and Recurrent Rectal Cancer

Author

Brown, Kilian G. M., Solomon, Michael J., Koh, Cherry E., Sutton, Paul A., Aguiar, Samuel, Jr, Bezerra, Tiago S., Clouston, Hamish W., Desouza, Ashwin, Dozois, Eric J., Ersryd, Amanda L., Frizelle, Frank, Funder, Jonas A., Garcia-Aguilar, Julio, Garfinkle, Richard, Glyn, Tamara, Heriot, Alexander, Kanemitsu, Yukihide, Kong, Chia Y., Kristensen, Helle Ø, Malakorn, Songphol, Mens, David M., Nilsson, Per J., Palmer, Gabriella J., Pappou, Emmanouil, Quinn, Martha, Quyn, Aaron J., Sahakitrungruang, Chucheep, Saklani, Avanish, Solbakken, Arne M., Tiernan, Jim P., Verhoef, Cornelis, and Steffens, Daniel

Published
2024
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14. Definitive S-1/mitomycin-C chemoradiotherapy for stage II/III anal canal squamous cell carcinoma: a phase I/II dose-finding and single-arm confirmatory study (JCOG0903)

Author

Ito, Yoshinori, Hamaguchi, Tetsuya, Takashima, Atsuo, Mizusawa, Junki, Shimada, Yasuhiro, Shiozawa, Manabu, Mizoguchi, Nobutaka, Kodaira, Takeshi, Komori, Koji, Ohue, Masayuki, Konishi, Koji, Teraishi, Fuminori, Kinouchi, Makoto, Murata, Kohei, Fujita, Fumihiko, Watanabe, Masahiko, Iinuma, Gen, Ishida, Fumio, Saida, Yoshihisa, Matsuda, Takahisa, Katayama, Hiroshi, Fukuda, Haruhiko, and Kanemitsu, Yukihide

Published
2023
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16. Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer

Author

Collaborative, REACCT, O’Connell, Lauren V, Zaborowski, Alexandra M, Abdile, Ahmed, Adamina, Michel, Aigner, Felix, d’Allens, Laura, Allmer, Caterina, Álvarez, Andrea, Anula, Rocio, Andric, Mihailo, Bach, Sam Atallah Simon, Bala, Miklosh, Barussaud, Marie, Bausys, Augustinas, Beggs, Andrew, Bellolio, Felipe, Bennett, Melissa-Rose, Bevan, Vicki, Biondo, Sebastiano, Bislenghi, Gabriele, Bludau, Marc, Brown, Carl, Bruns, Christiane, Buchanan, Daniel D, Buchwald, Pamela, Burger, Jacobus WA, Burlov, Nikita, Campanelli, Michela, Capdepont, Maylis, Carvello, Michele, Chew, Hwee-Hoon, Christoforidis, Dimitri, Clark, David, Climent, Marta, Collinson, Rowan, Cologne, Kyle G, Contreras, Tomas, Croner, Roland, Daniels, Ian R, Dapri, Giovanni, Davies, Justin, Delrio, Paolo, Denost, Quentin, Deutsch, Michael, Dias, Andre, D’Hoore, André, Drozdov, Evgeniy, Duek, Daniel, Dunlop, Malcolm, Dziki, Adam, Edmundson, Aleksandra, Efetov, Sergey, El-Hussuna, Alaa, Elliott, Brodie, Emile, Sameh, Espin-Basany, Eloy, Evans, Martyn, Faes, Seraina, Faiz, Omar, Figueiredo, Nuno, Fleming, Fergal, Foppa, Caterina, Fowler, George, Frasson, Matteo, Forgan, Tim, Frizelle, Frank, Gadaev, Shamil, Gellona, Jose, Glyn, Tamara, Goran, Barisic, Greenwood, Emma, Guren, Marianne G, Guillon, Stephanie, Gutlic, Ida, Hahnloser, Dieter, Hampel, Heather, Hanly, Ann, Hasegawa, Hirotoshi, Iversen, Lene Hjerrild, Hill, Andrew, Hill, James, Hoch, Jiri, Hompes, Roel, Hurtado, Luis, Iaquinandi, Fabiano, Imbrasaite, Ugne, Islam, Rumana, Jafari, Mehrenah D, Salido, Andrea Jiménez, Jiménez-Toscano, Marta, Kanemitsu, Yukihide, Karachun, Aleksei, Karimuddin, Ahmer A, Keller, Deborah S, Kelly, Justin, Kennelly, Rory, Khrykov, Gleb, Kocian, Petr, and Koh, Cherry

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Rehabilitation, Cancer, Clinical Research, Digestive Diseases, Good Health and Well Being, REACCT Collaborative, early onset rectal cancer, functional outcome, patient reported outcome, rectal cancer, young rectal cancer, Clinical sciences, Oncology and carcinogenesis
Abstract

BackgroundImpairment of bowel, urogenital and fertility-related function in patients treated for rectal cancer is common. While the rate of rectal cancer in the young (

Published
2022

17. Characteristics of Early-Onset vs Late-Onset Colorectal Cancer

Author

Collaborative, REACCT, Zaborowski, Alexandra M, Abdile, Ahmed, Adamina, Michel, Aigner, Felix, d’Allens, Laura, Allmer, Caterina, Álvarez, Andrea, Anula, Rocio, Andric, Mihailo, Atallah, Sam, Bach, Simon, Bala, Miklosh, Barussaud, Marie, Bausys, Augustinas, Bebington, Brendan, Beggs, Andrew, Bellolio, Felipe, Bennett, Melissa-Rose, Berdinskikh, Anton, Bevan, Vicki, Biondo, Sebastiano, Bislenghi, Gabriele, Bludau, Marc, Boutall, Adam, Brouwer, Nelleke, Brown, Carl, Bruns, Christiane, Buchanan, Daniel D, Buchwald, Pamela, Burger, Jacobus WA, Burlov, Nikita, Campanelli, Michela, Capdepont, Maylis, Carvello, Michele, Chew, Hwee-Hoon, Christoforidis, Dimitri, Clark, David, Climent, Marta, Cologne, Kyle G, Contreras, Tomas, Croner, Roland, Daniels, Ian R, Dapri, Giovanni, Davies, Justin, Delrio, Paolo, Denost, Quentin, Deutsch, Michael, Dias, Andre, D’Hoore, André, Drozdov, Evgeniy, Duek, Daniel, Dunlop, Malcolm, Dziki, Adam, Edmundson, Aleksandra, Efetov, Sergey, El-Hussuna, Alaa, Elliot, Brodie, Emile, Sameh, Espin, Eloy, Evans, Martyn, Faes, Seraina, Faiz, Omar, Fleming, Fergal, Foppa, Caterina, Fowler, George, Frasson, Matteo, Figueiredo, Nuno, Forgan, Tim, Frizelle, Frank, Gadaev, Shamil, Gellona, Jose, Glyn, Tamara, Gong, Jianping, Goran, Barisic, Greenwood, Emma, Guren, Marianne G, Guillon, Stephanie, Gutlic, Ida, Hahnloser, Dieter, Hampel, Heather, Hanly, Ann, Hasegawa, Hirotoshi, Iversen, Lene Hjerrild, Hill, Andrew, Hill, James, Hoch, Jiri, Hoffmeister, Michael, Hompes, Roel, Hurtado, Luis, Iaquinandi, Fabiano, Imbrasaite, Ugne, Islam, Rumana, Jafari, Mehrenah Dorna, Kanemitsu, Yukihide, Karachun, Aleksei, Karimuddin, Ahmer A, Keller, Deborah S, Kelly, Justin, and Kennelly, Rory

Subjects
Aging, Nutrition, Digestive Diseases, Cancer, Colo-Rectal Cancer, Genetics, Clinical Research, Prevention, 2.1 Biological and endogenous factors, Aetiology, Good Health and Well Being, Adult, Age of Onset, Colorectal Neoplasms, Humans, Incidence, Middle Aged, Risk Factors, REACCT Collaborative
Abstract

ImportanceThe incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer.ObservationsWithin the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts.Conclusions and relevanceThe clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.

Published
2021

18. Characteristics of Early-Onset vs Late-Onset Colorectal Cancer: A Review.

Author

REACCT Collaborative, Zaborowski, Alexandra M, Abdile, Ahmed, Adamina, Michel, Aigner, Felix, d'Allens, Laura, Allmer, Caterina, Álvarez, Andrea, Anula, Rocio, Andric, Mihailo, Atallah, Sam, Bach, Simon, Bala, Miklosh, Barussaud, Marie, Bausys, Augustinas, Bebington, Brendan, Beggs, Andrew, Bellolio, Felipe, Bennett, Melissa-Rose, Berdinskikh, Anton, Bevan, Vicki, Biondo, Sebastiano, Bislenghi, Gabriele, Bludau, Marc, Boutall, Adam, Brouwer, Nelleke, Brown, Carl, Bruns, Christiane, Buchanan, Daniel D, Buchwald, Pamela, Burger, Jacobus WA, Burlov, Nikita, Campanelli, Michela, Capdepont, Maylis, Carvello, Michele, Chew, Hwee-Hoon, Christoforidis, Dimitri, Clark, David, Climent, Marta, Cologne, Kyle G, Contreras, Tomas, Croner, Roland, Daniels, Ian R, Dapri, Giovanni, Davies, Justin, Delrio, Paolo, Denost, Quentin, Deutsch, Michael, Dias, Andre, D'Hoore, André, Drozdov, Evgeniy, Duek, Daniel, Dunlop, Malcolm, Dziki, Adam, Edmundson, Aleksandra, Efetov, Sergey, El-Hussuna, Alaa, Elliot, Brodie, Emile, Sameh, Espin, Eloy, Evans, Martyn, Faes, Seraina, Faiz, Omar, Fleming, Fergal, Foppa, Caterina, Fowler, George, Frasson, Matteo, Figueiredo, Nuno, Forgan, Tim, Frizelle, Frank, Gadaev, Shamil, Gellona, Jose, Glyn, Tamara, Gong, Jianping, Goran, Barisic, Greenwood, Emma, Guren, Marianne G, Guillon, Stephanie, Gutlic, Ida, Hahnloser, Dieter, Hampel, Heather, Hanly, Ann, Hasegawa, Hirotoshi, Iversen, Lene Hjerrild, Hill, Andrew, Hill, James, Hoch, Jiri, Hoffmeister, Michael, Hompes, Roel, Hurtado, Luis, Iaquinandi, Fabiano, Imbrasaite, Ugne, Islam, Rumana, Jafari, Mehrenah Dorna, Kanemitsu, Yukihide, Karachun, Aleksei, Karimuddin, Ahmer A, Keller, Deborah S, Kelly, Justin, and Kennelly, Rory

Subjects
REACCT Collaborative
Abstract

ImportanceThe incidence of early-onset colorectal cancer (younger than 50 years) is rising globally, the reasons for which are unclear. It appears to represent a unique disease process with different clinical, pathological, and molecular characteristics compared with late-onset colorectal cancer. Data on oncological outcomes are limited, and sensitivity to conventional neoadjuvant and adjuvant therapy regimens appear to be unknown. The purpose of this review is to summarize the available literature on early-onset colorectal cancer.ObservationsWithin the next decade, it is estimated that 1 in 10 colon cancers and 1 in 4 rectal cancers will be diagnosed in adults younger than 50 years. Potential risk factors include a Westernized diet, obesity, antibiotic usage, and alterations in the gut microbiome. Although genetic predisposition plays a role, most cases are sporadic. The full spectrum of germline and somatic sequence variations implicated remains unknown. Younger patients typically present with descending colonic or rectal cancer, advanced disease stage, and unfavorable histopathological features. Despite being more likely to receive neoadjuvant and adjuvant therapy, patients with early-onset disease demonstrate comparable oncological outcomes with their older counterparts.Conclusions and relevanceThe clinicopathological features, underlying molecular profiles, and drivers of early-onset colorectal cancer differ from those of late-onset disease. Standardized, age-specific preventive, screening, diagnostic, and therapeutic strategies are required to optimize outcomes.

Published
2021

19. Impact of Lesion Location on Recurrence After Resection of T1 Colorectal Cancer: Post Hoc Analysis of a Nationwide Multicenter Cohort Study

Author

Sugihara, Kenichi, Saito, Shoichi, Fukunaga, Yusuke, Kawachi, Hiroshi, Takamatsu, Manabu, Kojima, Motohiro, Hotta, Kinichi, Yamada, Masayoshi, Kanemitsu, Yukihide, Saito, Yutaka, Sekine, Shigeki, Tanaka, Shinji, Nagata, Shinji, Nakamura, Takahiro, Yamada, Kazutaka, Konno, Maki, Ishihara, Soichiro, Saitoh, Yusuke, Matsuda, Kenji, Togashi, Kazutomo, Komori, Koji, Ishiguro, Megumi, Kuwai, Toshio, Okuyama, Takashi, Ohuchi, Akihiro, Ohnuma, Shinobu, Sakamoto, Kazuhiro, Sugai, Tamotsu, Katsumata, Kenji, Matsushita, Hiro-o, Yamano, Hiro-o, Nakai, Keisuke, Uraoka, Toshio, Akimoto, Naohiko, Kobayashi, Hirotoshi, Minamide, Tatsunori, Ikematsu, Hiroaki, Kajiwara, Yoshiki, Oka, Shiro, Ajioka, Yoichi, and Ueno, Hideki

Published
2024
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20. Prognostic Relevance of Primary Tumor Sidedness in Early-stage Colorectal Cancer: An Integrated Analysis of 4 Randomized Controlled Trials (JCOG2003A)

Author

Ouchi, Akira, Sadachi, Ryo, Hamaguchi, Tetsuya, Tsukamoto, Shunsuke, Shimada, Yasuhiro, Inomata, Masafumi, Takii, Yasumasa, Komori, Koji, Shiomi, Akio, Shiozawa, Manabu, Ohue, Masayuki, Watanabe, Jun, Ito, Masaaki, Kawashima, Yoshiyuki, Kobatake, Takaya, Souda, Hiroaki, Saida, Yoshihisa, Hashimoto, Tadayoshi, Sano, Yusuke, and Kanemitsu, Yukihide

Published
2024
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21. Outcomes of Metastatic and Unresectable Small Bowel Adenocarcinoma in Japan According to the Treatment Strategy: A Nationwide Observational Study

Author

Nishikawa, Yoshitaka, Horimatsu, Takahiro, Oka, Shiro, Yamada, Takeshi, Mitsui, Keigo, Yamamoto, Hironori, Takahashi, Keiichi, Shiomi, Akio, Hotta, Kinichi, Takeuchi, Yoji, Kuwai, Toshio, Ishida, Fumio, Kudo, Shin-Ei, Saito, Shoichi, Ueno, Masashi, Sunami, Eiji, Yamano, Tomoki, Itabashi, Michio, Ohtsuka, Kazuo, Kinugasa, Yusuke, Matsumoto, Takayuki, Sugai, Tamotsu, Uraoka, Toshio, Kurahara, Koichi, Yamaguchi, Shigeki, Kato, Tomohiro, Okajima, Masazumi, Kashida, Hiroshi, Fujita, Fumihiko, Ikematsu, Hiroaki, Ito, Masaaki, Esaki, Motohiro, Kawai, Masaya, Yao, Takashi, Hamada, Madoka, Koda, Keiji, Fukai, Yasumori, Komori, Koji, Saitoh, Yusuke, Kanemitsu, Yukihide, Takamaru, Hiroyuki, Yamada, Kazutaka, Nozawa, Hiroaki, Takayama, Tetsuji, Togashi, Kazutomo, Shinto, Eiji, Torisu, Takehiro, Toyoshima, Akira, Ohmiya, Naoki, Kato, Takeshi, Otsuji, Eigo, Nagata, Shinji, Hashiguchi, Yojiro, Sugihara, Kenichi, Ajioka, Yoichi, and Tanaka, Shinji

Published
2024
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23. Nomogram as a novel predictive tool for lymph node metastasis in T1 colorectal cancer treated with endoscopic resection: a nationwide, multicenter study

Author

Kajiwara, Yoshiki, Oka, Shiro, Tanaka, Shinji, Nakamura, Takahiro, Saito, Shoichi, Fukunaga, Yosuke, Takamatsu, Manabu, Kawachi, Hiroshi, Hotta, Kinichi, Ikematsu, Hiroaki, Kojima, Motohiro, Saito, Yutaka, Yamada, Masayoshi, Kanemitsu, Yukihide, Sekine, Shigeki, Nagata, Shinji, Yamada, Kazutaka, Kobayashi, Nozomu, Ishihara, Soichiro, Saitoh, Yusuke, Matsuda, Kenji, Togashi, Kazutomo, Komori, Koji, Ishiguro, Megumi, Kuwai, Toshio, Okuyama, Takashi, Ohuchi, Akihiro, Ohnuma, Shinobu, Sakamoto, Kazuhiro, Sugai, Tamotsu, Katsumata, Kenji, Matsushita, Hiro-o, Yamano, Hiro-o, Eda, Hirotsugu, Uraoka, Toshio, Akimoto, Naohiko, Kobayashi, Hirotoshi, Ajioka, Yoichi, Sugihara, Kenichi, and Ueno, Hideki

Published
2023
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24. Optimal bowel resection margin in colon cancer surgery: prospective multicentre cohort study with lymph node and feeding artery mapping

Author

Ueno, Hideki, Hase, Kazuo, Shiomi, Akio, Shiozawa, Manabu, Ito, Masaaki, Sato, Toshihiko, Hashiguchi, Yojiro, Kusumi, Takaya, Kinugasa, Yusuke, Ike, Hideyuki, Matsuda, Kenji, Yamada, Kazutaka, Komori, Koji, Takahashi, Keiichi, Kanemitsu, Yukihide, Ozawa, Heita, Ohue, Masayuki, Masaki, Tadahiko, Takii, Yasumasa, Ishibe, Atsushi, Watanabe, Jun, Toiyama, Yuji, Sonoda, Hiromichi, Koda, Keiji, Akagi, Yoshito, Itabashi, Michio, Nakamura, Takahiro, and Sugihara, Kenichi

Published
2023
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27. Assessment of Elastic Laminal Invasion Contributes to an Objective pT3 Subclassification in Colon Cancer

Author

Kojima, Motohiro, Yokota, Mitsuru, Yanagisawa, Naotake, Kitamura, Sakiko, Amemiya, Kota, Kawano, Shingo, Tsukada, Yuichiro, Sakuyama, Naoki, Nagayasu, Kiichi, Hashimoto, Taiki, Nakashima, Kota, Jiang, Kun, Kanemitsu, Yukihide, Fujita, Fumihiro, Akiba, Jun, Notohara, Kenji, Itakura, Junya, Sekine, Shigeki, Sakashita, Shingo, Sakamoto, Naoya, Ishikawa, Shumpei, Nakanishi, Yukihiro, Yao, Takashi, Liang, Wen-Yih, Lauwers, Gregory Y., Ito, Masaaki, Sakamoto, Kazuhiro, Ishii, Genichiro, and Ochiai, Atsushi

Published
2023
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30. Adverse effects of cell-free and concentrated ascites reinfusion therapy for malignant ascites: a single-institute experience

Author

Tsubokura, Misato, Adegawa, Yuko, Kojima, Minoru, Tanosaki, Ryuji, Ohtake, Ryuzaburo, Kase, Yuki, Iwashita, Nao, Kasane, Moemi, Nakabayashi, Saori, Takeuchi, Sayaka, Kato, Ken, Boku, Narikazu, Kanemitsu, Yukihide, Okusaka, Takuji, Fujimoto, Hiroyuki, Yonemori, Kan, Ishiki, Hiroto, Kawamura, Kimihiko, Satomi, Eriko, and Matsushita, Hiromichi

Published
2022
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31. Oxaliplatin Added to Fluoropyrimidine/Bevacizumab as Initial Therapy for Unresectable Metastatic Colorectal Cancer in Older Patients: A Multicenter, Randomized, Open-Label Phase III Trial (JCOG1018).

Author

Takashima, Atsuo, Hamaguchi, Tetsuya, Mizusawa, Junki, Nagashima, Fumio, Ando, Masahiko, Ojima, Hitoshi, Denda, Tadamichi, Watanabe, Jun, Shinozaki, Katsunori, Baba, Hideo, Asayama, Masako, Hasegawa, Seiji, Masuishi, Toshiki, Nakata, Ken, Tsukamoto, Shunsuke, Katayama, Hiroshi, Nakamura, Kenichi, Fukuda, Haruhiko, Kanemitsu, Yukihide, and Shimada, Yasuhiro

Published
2024
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32. A pedicled anterolateral thigh flap decreased the risk of empty pelvis syndrome following total pelvic exenteration.

Author

Hirata, Shintaro, Kanemitsu, Yukihide, Moritani, Konosuke, Arikawa, Masaki, Kudose, Yozo, Takamizawa, Yasuyuki, Inoue, Manabu, Tsukamoto, Shunsuke, Daiko, Hiroyuki, and Akazawa, Satoshi

Abstract

Aim Method Results Conclusions Total pelvic exenteration (TPE) can be complicated by empty pelvis syndrome (EPS), and none of the currently available procedures completely mitigate this problem. The aim of this study was to evaluate the feasibility and effectiveness of a pedicled anterolateral thigh (p‐ALT) flap for preventing EPS.All cases of TPE at the National Cancer Center Hospital in Tokyo between 2008 and 2022 were retrospectively reviewed. The main indication for TPE was colorectal cancer, with some other malignancies. Background factors, surgical outcomes and postoperative complications were compared between patients who underwent primary suture closure (the PC group) and those who underwent p‐ALT flap reconstruction (the flap group).A total of 114 patients underwent TPE during the study period. Twenty patients in whom a different procedure was performed or a different flap was used for reconstruction were excluded, leaving 94 for analysis (PC group, n = 54; flap group, n = 40). There was no significant between‐group difference in patient characteristics. Severe pelvic abscess developed in 12 patients (22.2%) in the PC group and 2 (5%) in the flap group. Multivariable analysis identified a significantly lower risk of severe pelvic abscess in the p‐ALT flap reconstruction (OR 0.07, 95% CI 0.01–0.58, p = 0.01). EPS‐related readmissions were more common in the PC group [37.0% (20/54) vs. 25% (10/40)].The risk of severe pelvic abscesses and readmission for EPS was significantly lower after perineal reconstruction with a p‐ALT flap. Perineal reconstruction with this flap is a feasible and effective method in TPE. [ABSTRACT FROM AUTHOR]

Published
2024
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33. RAS mutation associated with short surgically controllable period in colorectal liver metastases: a retrospective study.

Author

Ito, Sono, Takamoto, Takeshi, Nara, Satoshi, Ban, Daisuke, Mizui, Takahiro, Nagata, Hiroshi, Takamizawa, Yasuyuki, Moritani, Konosuke, Tsukamoto, Shunsuke, Kanemitsu, Yukihide, Kinugasa, Yusuke, and Esaki, Minoru

Subjects
COLORECTAL liver metastasis, NEOADJUVANT chemotherapy, PROGNOSIS, OVERALL survival, SURGICAL indications
Abstract

Background: The prognostic implications of the RAS status in colorectal cancer liver metastasis (CRLM) remain unclear. This study investigated the prognostic significance of RAS status after curative hepatectomy, focusing on surgical controllability. Methods: This retrospective study included liver-only CRLM patients who underwent the first hepatectomy between 2015 and 2022 at the National Cancer Center Hospital. Recurrence-free survival (RFS), surgically controllable period (SCP), and overall survival (OS) were compared between RAS wild-type (RAS-wt) and mutant (RAS-mt) patients. Multivariate analyses were conducted to identify independent prognostic factors for each outcome and independent risk factors for less than 1 year SCP. Results: A total of 150 patients were evaluated, comprising 63 patients with RAS-mt status. There was no significant difference in RFS between RAS-mt and RAS-wt (7.00 vs. 8.03 months, p = 0.48). RAS-mt patients exhibited worse SCP (11.80 vs.21.13 months, p < 0.001) and OS (44.03 vs. 70.03 months, p < 0.001) compared to RAS-wt. Multivariate analysis identified RAS-mt as an independent prognostic factor for both OS (hazard ratio [HR]: 3.37, p < 0.001) and SCP (HR: 2.20, p < 0.001), and as an independent risk factor for less than 1 year of SCP (odds ratio, 2.31; p = 0.03). Conclusions: CRLM with RAS mutations should be considered for strict surgical indications with preoperative chemotherapy and thorough examination, considering the possibility of short SCP. [ABSTRACT FROM AUTHOR]

Published
2024
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34. Clinical utility of sarcopenia dynamics assessed by psoas muscle volume in patients with colorectal cancer.

Author

Kumamoto, Tomotaka, Takamizawa, Yasuyuki, Miyake, Mototaka, Inoue, Manabu, Moritani, Konosuke, Tsukamoto, Shunsuke, Eto, Ken, and Kanemitsu, Yukihide

Abstract

Background: Sarcopenia affects the postoperative prognosis of patients with colorectal cancer (CRC). Recently, it has become possible to measure psoas volume from computed tomography images, and an index called psoas volume index (PVI) has been reported. However, it is unclear whether the dynamics of PVI before and after surgery is associated with clinical outcomes after CRC surgery. This study aimed to evaluate the association between pre‐ and postoperative PVI dynamics and clinical outcomes after CRC surgery. Methods: This study analyzed 1115 patients diagnosed with primary CRC and operated on for treatment between January 2014 and December 2017. Sarcopenia was defined as PVI below the lowest tertile in the preoperative assessment for each sex. The overall population was divided into four groups according to the dynamics of sarcopenia from preoperative to postoperative: group 1 (pre‐to postoperative sarcopenia), group 2 (preoperative nonsarcopenia to postoperative sarcopenia), group 3 (pre‐to postoperative nonsarcopenia), and group 4 (pre‐to postoperative nonsarcopenia). Results: Based on pre‐ and postoperative sarcopenia dynamics, 343 patients (29.7%) were classified into group 1, 105 patients (9.1%) into group 2, 42 patients (3.6%) into group 3, and 665 patients (57.6%) into group 4. Comparison of overall survival (OS) by the Kaplan–Meier method showed that Group 2 tended to have the worst prognosis (p = 0.007). Multivariate analysis showed an increased OS risk in Group 2 in sarcopenia dynamics (Hazard ratio: 2.103, 95% CI: 1.202–3.681, p = 0.009). Conclusions: Sarcopenia dynamics using PVI is an independent prognostic predictor of OS in patients with CRC. [ABSTRACT FROM AUTHOR]

Published
2024
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35. Peritoneal lavage cytology in patients with curative resection for stage II and III colorectal cancer: A multi‐institutional prospective study.

Author

Kobayashi, Hirotoshi, Kotake, Kenjiro, Maeda, Kotaro, Suto, Takeshi, Kawasaki, Masayasu, Ueno, Hideki, Komori, Koji, Ozawa, Heita, Koda, Keiji, Ohue, Masayuki, Funahashi, Kimihiko, Takemasa, Ichiro, Ishida, Hideyuki, Kazama, Shinsuke, Shimada, Yoshifumi, Morohashi, Hajime, Kinugasa, Yusuke, Kanemitsu, Yukihide, Ochiai, Hiroki, and Ishihara, Soichiro

Subjects
PERITONEAL dialysis, COLORECTAL cancer, CYTOLOGY, LONGITUDINAL method, OVERALL survival, BRONCHOALVEOLAR lavage
Abstract

Aim: To clarify the usefulness of intraoperative lavage cytology in patients undergoing curative resection for pStage II‐III colorectal cancer in a prospective multicenter study. Methods: Patients preoperatively diagnosed with stage II‐III colorectal cancer between 2013 and 2017 from 20 hospitals were enrolled. Lavage cytology was performed twice during the surgery. The primary endpoint was the effect of lavage cytology on the 5‐year relapse‐free survival (RFS) in patients with pStage II‐III colorectal cancer. The secondary endpoint was the effect of lavage cytology on the 5‐year overall survival (OS) and peritoneal recurrence. Results: A total of 1378 patients were eligible for analysis. The number of patients with pStage II‐III colorectal cancer was 670 and 708, respectively. Fifty‐four patients (3.9%) had positive cytological results. In pStage II patients, the 5‐year RFS rates with positive and negative cytology were 61.1% and 81.6%, respectively (p = 0.023). The 5‐year OS rates were 67.1% and 91.7%, respectively (p = 0.0083). However, there was no difference in RFS or OS between pStage III patients with positive and negative cytology results. The peritoneal recurrence rates were 11.8% and 1.5% in pStage II patients with positive and negative cytology results, respectively (p = 0.032). These rates were 10.5% and 2.5% in patients with stage III disease, respectively (p = 0.022). Conclusion: Stage II colorectal cancer patients with negative cytology had better outcomes than those with positive cytology. Peritoneal lavage cytology is useful for predicting peritoneal recurrence after curative resection of stage II‐III colorectal cancer. [ABSTRACT FROM AUTHOR]

Published
2024
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41. List of contributors

Author

Akiyoshi, Takashi, primary, Beets-Tan, Regina, additional, Benson, Sean, additional, Bodalal, Zuhir, additional, Brouwer, Nelleke Pietronella Maria, additional, Burggraaf, Jacobus, additional, Cai, Lishan, additional, Ceelen, Wim P., additional, Chang, Daniel T., additional, De Clercq, Alexander, additional, Debbaut, Charlotte, additional, Delgado, Carlos Alejandro Silvera, additional, Elias, Alexandra, additional, Francke, Kai, additional, Frick, Melissa A., additional, Galema, Hidde A., additional, Hans, Dedecker, additional, Hans, Prenen, additional, Hardiman, Karin, additional, Hazen, Sanne-Marije J.A., additional, Hilling, Denise E., additional, Hoorens, Anne, additional, Hutteman, Merlijn, additional, Ikeda, Masataka, additional, Ito, Masaaki, additional, Jan, Albert, additional, Kanemitsu, Yukihide, additional, Kataoka, Kozo, additional, Keereweer, Stijn, additional, Koudehi, Ghazal Adeli, additional, Kusters, Miranda, additional, Laura, Wuyts, additional, Laure-Anne, Teuwen, additional, Lauwerends, Lorraine J., additional, Loo, Phoebe, additional, Maas, Monique, additional, Marc, Peeters, additional, Meijer, Ruben P.J., additional, Monson, John R.T., additional, Nagtegaal, Iris D., additional, Pollom, Erqi L., additional, Rey, Sergio, additional, Salavati, Hooman, additional, Schito, Luana, additional, Segers, Patrick, additional, Shiozawa, Manabu, additional, Sluckin, Tania C., additional, Smithson, Mary, additional, Struys, Mathieu J.R., additional, Tiernan, Jim P., additional, Tije, ten, additional, Timon, Vandamme, additional, Trebeschi, Stefano, additional, Tsukada, Yuichiro, additional, Vahrmeijer, Alexander L., additional, van Ramshorst, Gabrielle H., additional, Verhoef, Cornelis, additional, Vitzthum, Lucas K., additional, Waktola, Selam, additional, West, Nicholas P., additional, Westwood, Alice C., additional, Willaert, Wouter, additional, and Wright, Jesse P., additional

Published
2022
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42. Yokukansan for Treatment of Preoperative Anxiety and Prevention of Postoperative Delirium in Cancer Patients Undergoing Highly Invasive Surgery. J-SUPPORT 1605 (ProD Study): A Randomized, Double-Blind, Placebo-Controlled Trial

Author

Wada, Saho, Sadahiro, Ryoichi, Matsuoka, Yutaka J., Uchitomi, Yosuke, Yamaguchi, Takuhiro, Sato, Tetsufumi, Shimada, Kazuaki, Yoshimoto, Seiichi, Daiko, Hiroyuki, Kanemitsu, Yukihide, Kawai, Akira, Kato, Tomoyasu, Fujimoto, Hiroyuki, and Shimizu, Ken

Published
2021
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45. Short‐ and long‐term outcomes of surgical treatment for inguinal lymph node metastasis in rectal and anal canal adenocarcinoma.

Author

Ito, Sono, Tsukamoto, Shunsuke, Kagawa, Hiroyasu, Kanemitsu, Yukihide, Hiro, Junichiro, Kawai, Kazushige, Nozawa, Hiroaki, Takii, Yasumasa, Yamaguchi, Tomohiro, Akagi, Yoshito, Suto, Takeshi, Hirano, Yasumitsu, Ozawa, Heita, Komori, Koji, Ohue, Masayuki, Toiyama, Yuji, Shinji, Seiichi, Minami, Kazuhito, Shimizu, Tomoharu, and Sakamoto, Kazuhiro

Subjects
LYMPHADENECTOMY, ANUS, LYMPHATIC metastasis, RECTAL cancer, PROGNOSIS, COLON cancer
Abstract

Aim: The significance of lymphadenectomy and its indications in patients with inguinal lymph node metastasis (ILNM) of anorectal adenocarcinoma is unclear. This study aimed to clarify the surgical outcomes and prognostic factors of inguinal lymphadenectomy for ILNM. Method: This study included patients who underwent surgical resection for ILNM of rectal or anal canal adenocarcinoma with pathologically positive metastases between 1997 and 2011 at 20 participating centres in the Study Group for Inguinal Lymph Node Metastasis from Colorectal Cancer organized by the Japanese Society for Cancer of the Colon and Rectum. Clinicopathological characteristics and short‐ and long‐term postoperative outcomes were retrospectively analysed. Results: In total, 107 patients were included. The primary tumour was in the rectum in 57 patients (53.3%) and in the anal canal in 50 (46.7%). The median number of ILNMs was 2.34. Postoperative complications of Clavien–Dindo Grade III or higher were observed in five patients. The 5‐year overall survival rate was 38.8%. Multivariate analysis identified undifferentiated histological type (P < 0.001), pathological venous invasion (P = 0.01) and pathological primary tumour depth T0–2 (P = 0.01) as independent prognostic factors for poor overall survival. Conclusion: The 5‐year overall survival after inguinal lymph node dissection was acceptable, and it warrants consideration in more patients. Further larger‐scale studies are needed in order to clarify the surgical indications. [ABSTRACT FROM AUTHOR]

Published
2024
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46. Lymphatic spread patterns in young versus elderly patients with stage III colon cancer.

Author

Song, Jihyung, Kataoka, Kozo, Inoue, Manabu, Yamada, Takeshi, Shiozawa, Manabu, Beppu, Naohito, Kuriyama, Sho, Suto, Takeshi, Matsuhashi, Nobuhisa, Sakura, Yusuke, Kanazawa, Akiyoshi, Kagawa, Hiroyasu, Kanemitsu, Yukihide, Ceelen, Wim, and Ikeda, Masataka

Subjects
OLDER patients, COLON cancer, LYMPH nodes, OVERALL survival, PROGNOSIS
Abstract

Background The anatomical pattern of lymph nodes spread differs between young (aged 45 years or younger) and elderly (aged 80 years or older) patients with stage III colon cancer and is poorly investigated. Methods Two groups of patients (young and elderly) with stage III colon cancer who underwent upfront extensive (D3) lymphadenectomy at eight Japanese centres between 1998 and 2018 were retrospectively analysed. The primary endpoint was the proportion of positive central lymph nodes. The lymph nodes spreading pattern and its prognostic impact on recurrence-free survival and overall survival in the two groups were also compared. Results Two hundred and ten young patients and 348 elderly patients were identified and compared. The total number of lymph nodes harvested and the total number of invaded lymph nodes were significantly higher in younger patients compared with elderly patients (median of 31.5 (3–151) versus 21 (3–116), P < 0.001 and median of 3 (1–21) versus 2 (1–25), P < 0.001 respectively). The proportion of positive central lymph nodes were higher in younger patients than in elderly patients (9.52% (95% c.i. 6.24 to 14.2%) versus 4.59% (95% c.i. 2.84 to 7.31%), P = 0.012). In multivariate models for recurrence-free survival, central lymph nodes invasion were identified as a poor prognostic factor in younger patients (HR 5.21 (95% c.i. 1.76 to 15.39)) but not in elderly patients (HR 1.73 (95% c.i. 0.80 to 3.76)). Conclusion Young patients with stage III colon cancer have a higher risk of central lymph nodes invasion, suggesting a more aggressive disease biology. The presence of central lymph nodes invasion are associated with a worse outcome in young patients. [ABSTRACT FROM AUTHOR]

Published
2024
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49. Study protocol for a multi-institutional randomized phase III study comparing combined everolimus plus lanreotide therapy and everolimus monotherapy in patients with unresectable or recurrent gastroenteropancreatic neuroendocrine tumors; Japan Clinical Oncology Group Study JCOG1901 (STARTER-NET study)

Author

Shimoyama, Ryo, Hijioka, Susumu, Mizuno, Nobumasa, Ogawa, Gakuto, Kataoka, Tomoko, Katayama, Hiroshi, Machida, Nozomu, Honma, Yoshitaka, Boku, Narikazu, Hamaguchi, Tetsuya, Fukuda, Haruhiko, Terashima, Masanori, Kanemitsu, Yukihide, and Furuse, Junji

Published
2020
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