17 results on '"Kitami, C."'
Search Results
2. Surgery for Recurrent Biliary Tract Cancer: A Multicenter Analysis
- Author
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Sakata, J., primary, Nomura, T., additional, Aono, T., additional, Kitami, C., additional, Yokoyama, N., additional, Minagawa, M., additional, Takizawa, K., additional, Miura, K., additional, Ishikawa, H., additional, Hirose, Y., additional, Mito, M., additional, Saito, S., additional, Abe, S., additional, Ichikawa, H., additional, Shimada, Y., additional, Kobayashi, T., additional, and Wakai, T., additional
- Published
- 2022
- Full Text
- View/download PDF
3. Surgical Outcomes of Primary Cystic Duct Carcinoma: A Multi-Institutional Analysis
- Author
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Abe, S., primary, Sakata, J., additional, Kitami, C., additional, Minagawa, M., additional, Nomura, T., additional, Yokoyama, N., additional, Aono, T., additional, Takizawa, K., additional, Miura, K., additional, Ishikawa, H., additional, Hirose, Y., additional, Mito, M., additional, Saito, S., additional, Ichikawa, H., additional, Shimada, Y., additional, Kobayashi, T., additional, and Wakai, T., additional
- Published
- 2022
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4. Extent of regional lymphadenectomy and number-based nodal classification for non-ampullary duodenal adenocarcinoma.
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Abe S, Sakata J, Hirose Y, Nomura T, Takano K, Kitami C, Yokoyama N, Aono T, Minagawa M, Tsukahara A, Ohashi T, Takizawa K, Miura K, Ichikawa H, Shimada Y, Kobayashi T, and Wakai T
- Subjects
- Humans, Neoplasm Staging, Lymph Node Excision, Prognosis, Lymph Nodes surgery, Lymph Nodes pathology, Adenocarcinoma surgery, Adenocarcinoma pathology, Duodenal Neoplasms surgery, Duodenal Neoplasms pathology
- Abstract
Background: This study aimed to evaluate the adequate extent of regional lymphadenectomy according to tumor location and the impact of number-based nodal classification on survival in patients with non-ampullary duodenal adenocarcinoma (NADAC)., Methods: A total of 85 patients with NADAC who underwent surgery were enrolled. The frequency of metastasis was calculated for each node group in the respective tumor locations for 63 patients who underwent lymphadenectomy for pT2-pT4 tumor., Results: The frequency of metastasis in the pancreaticoduodenal (nos. 13 and 17) and superior mesenteric artery (no. 14) nodes was high (16.7 %-52.3 %) regardless of tumor location. Metastasis in the perigastric (nos. 3 and 4d) and right celiac artery (no. 9) nodes was not uncommon (14.3 %-22.2 %) for tumors in the first portion. The frequency of metastasis in the pyloric (nos. 5 and 6) and the other peripancreaticoduodenal (nos. 8 and 12) nodes varied depending on tumor location but could not be ignored for staging. When these nodes were classified as regional nodes, the 5-year survival in patients with pN0, pN1 (1-2 positive nodes), and pN2 (≥3 positive nodes) were 82.9 %, 51.7 %, and 19.2 %, respectively (p < 0.001). pN classification independently predicted survival (pN1, p = 0.022; pN2, p < 0.001)., Conclusions: Nos. 5, 6, 8, 12, 13, 14, and 17 nodes in all advanced NADAC and nos. 3, 4d, and 9 nodes in advanced NADAC in the first portion should be considered as regional nodes for accurate staging. The number-based nodal classification allows good patients' prognostic stratification., (© 2023 Published by Elsevier Ltd.)
- Published
- 2023
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5. Outcomes of lung metastasis from pancreatic cancer: A nationwide multicenter analysis.
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Homma Y, Endo I, Matsuyama R, Sho M, Mizuno S, Seyama Y, Hirano S, Aono T, Kitami C, Morita Y, Takeda Y, Yoshida K, Tani M, Kaiho T, Yamamoto Y, Aoki H, Ogawa M, Niguma T, Mataki Y, Kawasaki H, Baba H, Yokomizo H, Rikiyama T, Yamaue H, and Yamamoto M
- Subjects
- Humans, Neoplasm Recurrence, Local surgery, Pancreatectomy, Prognosis, Retrospective Studies, Survival Rate, Pancreatic Neoplasms, Carcinoma, Pancreatic Ductal drug therapy, Carcinoma, Pancreatic Ductal surgery, Liver Neoplasms surgery, Lung Neoplasms secondary, Lung Neoplasms surgery, Pancreatic Neoplasms pathology
- Abstract
Background: Although distant metastasis from pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis, some single center studies reported that lung metastasis has a favorable prognosis. The aim of this study is to evaluate the prognostic value of site-specific metastasis after pancreatectomy for PDAC, with a focus on lung metastasis., Methods: Data from 117 cases of lung metastasis after pancreatectomy were collected retrospectively from 23 institutions in Japan. To compare the sites of metastasis we also collected the data of 134 patients with liver only metastasis, 67 patients with peritoneal only metastasis and 121 patients with locoregional recurrence alone., Results: In patients with lung only metastasis, the median time from recurrence to death (RTD) was 23.1 months, which was better in comparison to other sites of recurrence. In lung metastasis group, the patients who underwent pulmonary resection had better long-term outcomes in comparison to those who did not. (RTD: 29.2 vs 15.2, P < .001). In the multivariate analysis, solitary metastasis (HR 5.03; 95% CI 1.195-21.144, P = .022) and postoperative chemotherapy (HR 14.089; 95% CI 1.729-114.77, P = .023) were identified as significant prognostic factors after lung resection., Conclusions: Surgical resection is a favorable option for selected patients with a solitary lung metastasis and for whom adjuvant chemotherapy can be administrated., (© 2022 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)
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- 2022
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6. Oncological outcomes of surgery for recurrent biliary tract cancer: who are the best candidates?
- Author
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Sakata J, Nomura T, Aono T, Kitami C, Yokoyama N, Minagawa M, Takizawa K, Miura K, Hirose Y, Ichikawa H, Nagahashi M, Shimada Y, Kobayashi T, and Wakai T
- Subjects
- Bile Ducts, Intrahepatic, Humans, Neoplasm Recurrence, Local, Prognosis, Retrospective Studies, Bile Duct Neoplasms surgery, Biliary Tract Neoplasms surgery, Cholangiocarcinoma
- Abstract
Background: This study aimed to investigate the impact of surgery on outcomes in patients with recurrent biliary tract cancer (BTC) and elucidate factors affecting survival after surgery for this disease., Methods: A single-center study was undertaken in 178 patients with recurrent BTC, of whom 24 underwent surgery for recurrence, 85 received chemotherapy, and 69 received best supportive care. Then, we carried out a multicenter study in 52 patients undergoing surgery for recurrent BTC (gallbladder cancer, 39%; distal cholangiocarcinoma, 27%; perihilar cholangiocarcinoma, 21%; intrahepatic cholangiocarcinoma, 13%)., Results: In the single-center study, 3-year survival after recurrence was 53% in patients who underwent surgery, 4% in those who received chemotherapy, and 0% in those who received best supportive care (p < 0.001). Surgery was an independently prognostic factor (p < 0.001). In the multicenter series, the respective 3-year and 5-year survival after surgery for recurrence was 50% and 29% in the 52 patients. Initial site of recurrence was the only independent prognostic factor (p = 0.019). Five-year survival after surgery for recurrence in patients with single distant, multifocal distant, and locoregional recurrence was 51%, 0%, and 0%, respectively (p = 0.002). Sites of single distant recurrence included the liver (n = 13, 54%), distant lymph nodes (all from gallbladder cancer, n = 7, 29%), lung (n = 2, 9%), peritoneum (n = 1, 4%), and abdominal wall (n = 1, 4%)., Conclusion: Surgery may be an effective option for patients with less aggressive tumor biology characterized by single distant recurrence in recurrent BTC., (Copyright © 2021 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2021
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7. Clinicopathological Characteristics and Surgical Outcomes of Primary Cystic Duct Carcinoma: A Multi-institutional Study.
- Author
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Sakata J, Hirose Y, Prasoon P, Kitami C, Minagawa M, Nomura T, Yokoyama N, Aono T, Yuza K, Miura K, Katada T, Takizawa K, Nagahashi M, Kobayashi T, and Wakai T
- Subjects
- Cystic Duct diagnostic imaging, Cystic Duct surgery, Humans, Treatment Outcome, Bile Duct Neoplasms surgery, Carcinoma
- Published
- 2021
- Full Text
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8. Clinicopathological Characteristics and Surgical Outcomes of Primary Cystic Duct Carcinoma: A Multi-institutional Study.
- Author
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Sakata J, Hirose Y, Prasoon P, Kitami C, Minagawa M, Nomura T, Yokoyama N, Aono T, Yuza K, Miura K, Katada T, Takizawa K, Nagahashi M, Kobayashi T, and Wakai T
- Subjects
- Cystic Duct surgery, Hepatectomy, Humans, Retrospective Studies, Treatment Outcome, Carcinoma surgery, Gallbladder Neoplasms surgery
- Abstract
Background: The role of surgery in the management of primary cystic duct carcinoma (CDC) remains unclear especially in advanced disease. This study aimed to evaluate long-term outcomes in patients undergoing surgery for primary CDC., Methods: From a multi-institutional database, we identified 41 patients who underwent surgery for primary CDC, defined as a part of gallbladder carcinoma with the tumor centre located in the cystic duct., Results: Of the 41 patients, 31 (75.6%) underwent preoperative biliary drainage for jaundice. Twenty-eight (68.3%) patients underwent extensive resection including major hepatectomy (n = 21), pancreaticoduodenectomy (n = 4), or both procedures (n = 3). Thirty-four (82.9%) patients had ≥ pT3 tumor, while 31 (75.6%) patients had involvement of contiguous organs/structures. Nodal and distant metastasis was found in 26 (63.4%) and 7 (17.1%) patients, respectively. Most patients (90.2%) had perineural invasion. Median overall survival was 23.7 months in all 41 patients. Factors independently associated with both overall and disease-specific survival were pN (P = 0.003 and P = 0.007, respectively) and pM (P = 0.003 and P = 0.013, respectively) classification. Median survival was 75.3, 17.7, and 5.2 months for patients with pN0M0 (n = 14), pN1/2pM0 or pN0pM1 (n = 21), and pN1/2pM1 (n = 6) disease, respectively (P < 0.001)., Conclusions: Primary CDC is characterized by locally advanced disease with aggressive histopathological characteristics at surgery, leading to extensive resection during treatment. Surgery provides potential benefits for patients with pN0pM0 disease, whereas pN1/2 and/or pM1 status appear to have strong adverse effects on survival.
- Published
- 2020
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9. Risk factors for pancreatic fistula grade C after pancreatoduodenectomy: A large prospective, multicenter Japan-Taiwan collaboration study.
- Author
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Hirono S, Shimokawa T, Nagakawa Y, Shyr YM, Kawai M, Matsumoto I, Satoi S, Yoshitomi H, Okabayashi T, Motoi F, Amano R, Murakami Y, Hirano S, Kawamoto K, Nakamori S, Shan YS, Kobayashi S, Nitta H, Matsukawa H, Uchiyama K, Hsu CP, Kitami C, Yamamoto M, Hwang TL, and Yamaue H
- Subjects
- Humans, Japan epidemiology, Postoperative Complications epidemiology, Postoperative Complications surgery, Prospective Studies, Risk Factors, Taiwan, Pancreatic Fistula epidemiology, Pancreatic Fistula etiology, Pancreatic Fistula surgery, Pancreaticoduodenectomy adverse effects
- Abstract
Background/purpose: Grade C postoperative pancreatic fistula (POPF), as defined by International Study Group of Pancreatic Fistula (ISGPF), is the most life-threatening complication after pancreatoduodenectomy (PD). This study aims to evaluate risk factors for Grade C POPF after PD., Methods: This is a prospective, multicenter study based in Japan and Taiwan. Between December 2014 and May 2017, 3022 patients were enrolled in this study and 2762 patients were analyzed. We analyzed risk factors of Grade C POPF based on the updated 2016 ISGPF scheme (organ failure, reoperation, and/or death)., Results: Among 2762 patients, 46 patients (1.7%) developed Grade C POPF after PD. The mortality rate of the 46 patients with Grade C POPF was 37.0%. On the multivariate analysis, six independent risk factors for Grade C POPF were found; BMI ≥ 25.0 kg/m
2 , chronic steroid use, preoperative serum albumin <3.0 mg/dL, soft pancreas, operative time ≥480 minutes, and intraoperative transfusion. The c-statistic of our risk scoring model for Grade C POPF using these risk factors was 0.77. The score was significantly higher in Grade C POPF than in Grade B POPF (P < .001) or none/biochemical leak (P < .001)., Conclusions: This prospective study showed risk factors for Grade C POPF after PD., (© 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)- Published
- 2020
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10. [A Case of Radical Resection after CapeOX Therapy for Locally Advanced Sigmoid Colon Cancer with Anemia and Abscess Formation in a Jehovah's Witness].
- Author
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Motegi S, Kawahara M, Tonoike Y, Kitami C, Makino S, Nishimura A, Kawachi Y, Nikkuni K, Watanabe S, Lkarashi T, and Tomidokoro T
- Subjects
- Capecitabine administration & dosage, Female, Humans, Organoplatinum Compounds administration & dosage, Oxaliplatin, Sigmoid Neoplasms complications, Sigmoid Neoplasms surgery, Abscess etiology, Anemia etiology, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Jehovah's Witnesses, Sigmoid Diseases etiology, Sigmoid Neoplasms drug therapy
- Abstract
The patient-a Jehovah's Witness-was a woman in her 60s, with locally advanced sigmoid colon cancer. She had severe anemia, and a computed tomography scan of her abdomen showed a tumor with abscess formation and perforation that had invaded into the left urinary duct and the left ovary, without distant metastasis. It was difficult to perform curative resections without transfusion; therefore, CapeOX therapy was plannedas the neoadjuvant treatment. After 3 courses of CapeOX therapy, the patient's anemia improved, and the tumor and abscess had shrunk. Subsequently, a sigmoidectomy with D3 lymph node dissection, partial resection of the small intestine, and the left adnexectomy, as a radical surgery, were performed without blood transfusion. In cases of concomitant colon cancer with anemia that are treated with highly invasive surgery, it might be necessary to conduct systematic treatment in order to complete non-transfusion therapy.
- Published
- 2018
11. Right-sided Bochdalek hernia in an elderly adult: a case report with a review of surgical management.
- Author
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Moro K, Kawahara M, Muneoka Y, Sato Y, Kitami C, Makino S, Nishimura A, Kawachi Y, Gabriel E, and Nikkuni K
- Abstract
Background: Bochdalek hernias are one of the most common types of diaphragmatic hernia, with most cases diagnosed during the neonatal period. In contrast, diagnosis of a Bochdalek hernia in an adult is rare and is typically observed on the left side of the diaphragm. Even more rare is the diagnosis of a right-sided Bochdalek hernia in an adult, where there is concurrent visceral malformation in most cases., Case Presentation: We describe a case of an 89-year-old female who presented with abdominal pain. An abdominal computed tomography (CT) scan showed decreased intravenous contrast uptake and thickening of the wall of herniated small intestine through the right side of the diaphragm, which led to the diagnosis of a strangulated diaphragmatic hernia. The patient underwent emergent laparotomy and required a partial resection of the necrotic ileum and a hernia repair with direct closure. Interestingly, in this case, organ malformation was not observed. The patient was discharged approximately 2 weeks after surgery without complication., Conclusions: Adult right-sided Bochdalek hernia with strangulation in the absence of hepatic atrophy is a rare entity. Considering the severity of this condition, accurate diagnosis and proper treatment are needed. A tailored operative approach is required on an individual case basis.
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- 2017
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12. Totally laparoscopic anterior resection with transvaginal assistance and transvaginal specimen extraction: a technique for natural orifice surgery combined with reduced-port surgery.
- Author
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Nishimura A, Kawahara M, Honda K, Ootani T, Kakuta T, Kitami C, Makino S, Kawachi Y, and Nikkuni K
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- Aged, 80 and over, Equipment Design, Female, Follow-Up Studies, Humans, Middle Aged, Pregnancy, Retrospective Studies, Treatment Outcome, Vagina, Colorectal Neoplasms surgery, Laparoscopes, Laparoscopy instrumentation, Natural Orifice Endoscopic Surgery instrumentation
- Abstract
Background: Natural orifice specimen extraction (NOSE) has been developed as a means of decreasing the incidence of surgical wound complications. However, NOSE performed using a conventional multiport technique has been reported previously. The current authors performed totally laparoscopic anterior resection with transvaginal specimen extraction (TVSE) using the reduced-port surgery (RPS) technique. The Alexis wound retractor (Applied Medical, Rancho Santa Margarita, CA, USA) and Free Access (Top Corporation, Tokyo, Japan) were attached to the transvaginal route for transvaginal assistance and smooth specimen extraction. The authors documented this simple and safe technique and its short-term results., Methods: Data were prospectively collected for five patients who underwent totally laparoscopic anterior resection with TVSE for colorectal cancer between June 2012 and December 2012. A multiport access device (GelPOINT advanced-access platform; Applied Medical) was inserted into the navel, and a 5-mm port was inserted into the right lower quadrant to be used as a drain site. Transverse transvaginal posterior colpotomy then was performed. One ring of an Alexis ring pair was inserted into the peritoneal cavity through the vagina. The other white ring was placed outside of the vagina and then covered with a Free Access to maintain the pneumoperitoneum for insertion of a 12-mm port. Lymph node dissection and transection of the distal colon were performed with transvaginal assistance. The specimen then was extracted transvaginally. After the Alexis had been removed, the vaginal incision was closed transvaginally. End-to-end colorectal anastomosis was performed using the double-stapling technique., Results: Transvaginal extraction was completed in all five cases. The median operation time was 235 min. One case was complicated by chyloperitoneum. The median hospital stay was 6 days. Only one patient required intravenous analgesics once on postoperative day 1. All the patients remained disease free., Conclusion: Totally laparoscopic anterior resection using TVSE with RPS appears to be feasible, safe, and oncologically acceptable for selected cases.
- Published
- 2013
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13. [A case of hyperammonemic encephalopathy related to 5-FU in an aged patient with recurrent colon cancer treated with FOLFIRI therapy].
- Author
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Okamura T, Kawachi Y, Nikkuni K, Nishimura A, Makino S, Kawahara M, Kitami C, and Hashimoto Y
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- Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Appendiceal Neoplasms pathology, Appendiceal Neoplasms surgery, Camptothecin administration & dosage, Camptothecin analogs & derivatives, Combined Modality Therapy, Fluorouracil administration & dosage, Humans, Hyperammonemia drug therapy, Leucovorin administration & dosage, Male, Recurrence, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Appendiceal Neoplasms drug therapy, Brain Diseases, Metabolic etiology, Fluorouracil adverse effects, Hyperammonemia chemically induced
- Abstract
We report a case of hyperammonemic encephalopathy related to 5-FU in an aged patient with recurrent colon cancer treated with FOLFIRI therapy. An 80-year-old man underwent right hemicolectomy for cecal cancer. After 10 months, surgical resection was performed for its local recurrence. He was then treated with FOLFIRI therapy, and during the fifth course, he presented with a sudden onset of congestive disturbances. Through radiographic examination and laboratory data, only hyperammonemia was found; he was therefore diagnosed with hyperammonemic encephalopathy. By starting branchedamino acid solutions for its treatment, his consciousness and serum ammonia were promptly improved. Hyperammonemic encephalopathy related 5-FU is caused by increasing ammonia production and its metabolic inhibition, and is worsened by renal dysfunction, dehydration, constipation, infections, or body weight loss. On account of the potential decrease of metabolic function of liver and kidney, an aged person tends to have hyperammonnemia more than a youth. Clinicians should be aware of the adverse events associated with hyperammonemia when then administer a large amount of 5-FU to elderly patients.
- Published
- 2013
14. Hepatic resection for liver metastases from carcinomas of the distal bile duct and of the papilla of Vater.
- Author
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Kurosaki I, Minagawa M, Kitami C, Takano K, and Hatakeyama K
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- Aged, Ampulla of Vater pathology, Common Bile Duct Neoplasms mortality, Common Bile Duct Neoplasms pathology, Disease Progression, Disease-Free Survival, Female, Humans, Liver Neoplasms mortality, Liver Neoplasms pathology, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Neoplastic Cells, Circulating, Reoperation, Risk Factors, Ampulla of Vater surgery, Common Bile Duct Neoplasms surgery, Hepatectomy, Liver Neoplasms secondary, Liver Neoplasms surgery, Pancreaticoduodenectomy
- Abstract
Purpose: Hepatectomy for liver metastasis from carcinomas of the distal bile duct (BDC) and of the papilla of Vater (PVC) has not been studied in detail. The purpose of this study is to analyze risk factors of liver metastasis and to evaluate outcome of hepatectomy for liver metastasis., Methods: Risk factors of liver metastasis were analyzed in 122 patients who underwent pancreaticoduodenectomy for BDC or PVC. In addition, 13 patients who underwent hepatectomy were reviewed., Results: Liver metastasis after pancreaticoduodenectomy occurred in 33.8% of BDC and 26.3% of PVC patients. Multivariate analyses revealed that microvenous invasion was a significant risk factor common to BDC and PVC (p ≤ 0.05). However, 4 of the 13 resected cases survived more than 5 years (5-year survival rate, 44.9%). All four long-term survivors underwent margin-negative hepatectomy for a solitary metastasis and were given postoperative adjuvant chemotherapy. Margin-positive hepatectomy in four patients resulted in early re-recurrence of tumor. Limited hepatectomy (three cases) provided margin-positive surgery., Conclusions: Hepatectomy for a solitary metastasis is the treatment of choice even after pancreaticoduodenectomy, but indication of hepatectomy for multiple metastases is still limited. The combination of surgery and adjuvant chemotherapy should be studied further to improve survival rates.
- Published
- 2011
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15. Video-assisted living donor hemihepatectomy through a 12-cm incision for adult-to-adult liver transplantation.
- Author
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Kurosaki I, Yamamoto S, Kitami C, Yokoyama N, Nakatsuka H, Kobayashi T, Watanabe T, Oya H, Sato Y, and Hatakeyama K
- Subjects
- Adult, Blood Loss, Surgical, Female, Humans, Laparotomy methods, Male, Treatment Outcome, Hepatectomy methods, Living Donors, Tissue and Organ Harvesting methods, Video-Assisted Surgery methods
- Abstract
Objectives: There has been remarkable progress in recent technical innovations for laparoscopic hepatectomy. However, a laparoscopic procedure rarely has been indicated for donation of the liver in living-related liver transplantation (LRLT). Here, we described the technique and the outcome of video-assisted donor hepatectomy (VADH) for adult-to-adult LRLT., Methods: For 13 donors in adult-to-adult LRLT, 3 types of major hepatectomy--right hemihepatectomy (3), and left hemihepatectomy, with or without the caudate lobe (10)--were performed through video-assisted procedures; surgical manipulation via ports or via a 12-cm incision and viewing through a laparoscope or through incision were combined and used., Results: VADH was completed in 13 donors, with a median operation time of 363 +/- 33 minutes and a median blood loss of 302 +/- 191 mL. No complications specific to video-assisted procedures, postoperative bile leak, or bleeding were observed. The restoration of the liver function was smooth, and the use of an analgesic (median: 1.2 times) was reduced, compared with the historical control (median: 3.8 times) that underwent a standard donation of the liver. Currently, all donors are healthy and have returned to their previous activities. The grafts have been functioning well, excluding 3 recipients who succumbed to serious complications unrelated to the video-assisted procedure., Conclusion: We have shown a new method of VADH through a 12-cm laparotomy for adult-to-adult LRLT. This technique is as feasible as standard open donor hepatectomy, with less pain and with improved postoperative symptoms.
- Published
- 2006
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16. [A case of multiple liver metastases of colon cancer with PyNPase-positive successfully treated with 5'-DFUR].
- Author
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Maruyama S, Tamiya Y, Nihei K, and Kitami C
- Subjects
- Adenocarcinoma enzymology, Adenocarcinoma secondary, Aged, Colectomy, Colonic Neoplasms pathology, Colonic Neoplasms surgery, Combined Modality Therapy, Humans, Liver Neoplasms enzymology, Male, Pyrimidine Phosphorylases, Remission Induction, Adenocarcinoma drug therapy, Antimetabolites, Antineoplastic therapeutic use, Colonic Neoplasms drug therapy, Colonic Neoplasms enzymology, Floxuridine therapeutic use, Liver Neoplasms drug therapy, Liver Neoplasms secondary, Pentosyltransferases metabolism
- Abstract
A 75-year-old man was diagnosed with transverse colon cancer. We therefore performed a transverse colectomy. Diagnosis of multiple liver metastases was made by intraoperative palpation, core needle biopsy and postoperative abdominal CT scan. 5'-deoxy-5-fluorouridine (5'-DFUR) 800 mg/day was administered orally after the surgery. After 2 months of administration, an abdominal CT scan showed the metastatic lesions of liver were reduced. After 8 months, an abdominal CT scan showed no evidence of liver metastases. Pyrimidine nucleoside phosphorylase (PyNPase), an enzyme that converts 5'-DFUR to 5-FU, has an important role in the expression of the anti-tumor activity of 5'-DFUR. Primary specimens of this case were regarded as PyNPase-positive. We think that administration of 5'-DFUR may be a useful treatment for advanced colon cancer that is PyNPase-positive.
- Published
- 2003
17. Malignant islet cell tumor projecting into the main pancreatic duct.
- Author
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Kitami CE, Shimizu T, Sato O, Kurosaki I, Mori S, Yanagisawa Y, Ajioka Y, and Hatakeyama K
- Subjects
- Acute Disease, Carcinoma, Islet Cell complications, Carcinoma, Islet Cell surgery, Humans, Male, Middle Aged, Neoplasm Invasiveness, Pancreatectomy, Pancreatic Neoplasms complications, Pancreatic Neoplasms surgery, Pancreatitis etiology, Carcinoma, Islet Cell pathology, Pancreatic Ducts pathology, Pancreatic Neoplasms pathology
- Abstract
We report herein a rare case of islet cell tumor showing a unique growth pattern in a patient who developed repeated acute pancreatitis as the tumor's initial symptom. Preoperative imaging examinations showed dilatation of the main pancreatic duct (MPD) and cysts around the pancreatic tail. A distal pancreatectomy with splenectomy was performed because the pancreatitis was localized in the distal pancreas and was not controlled by various drug therapies. Grossly, the tumor consisted of two component parts: a markedly infiltrative part in the pancreatic parenchyma, and a papillary elevated part in the MPD. The MPD was obstructed by the tumor spreading widely along the distal MPD. Microscopically, the tumor was composed entirely of islet cell tumors (nonfunctioning), with several foci of venous and lymphatic involvement. Based on its growth behavior, we assumed that the tumor may have arisen from the MPD or from islet cells closely adjacent to the MPD. The patient's postoperative course was uneventful and he is doing well 2 years after the operation. We discuss the growth pattern of the tumor and the cause of the pancreatitis.
- Published
- 2000
- Full Text
- View/download PDF
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