International journal of clinical oncology, Jan 30, 2017
Although S-1 based chemotherapy for patients with advanced gastric cancer has generally been acce... more Although S-1 based chemotherapy for patients with advanced gastric cancer has generally been accepted in Japan, discontinuations of treatment have been reported due to grade 3 or more adverse events. The present randomized phase II study was conducted to test whether alternate-day administration of S-1 would be comparably efficient and reduce adverse events compared with conventional daily administration in the first-line chemotherapy for advanced gastric cancer. 132 patients with advanced gastric cancer were randomly assigned to 1:2 ratios to receive treatment with daily at a standard dose of 80 mg/m(2)/day or alternate-day administration group received S-1 on 4 days a week. The primary end point was progression-free survival (PFS), and the secondary end points were safety, overall survival, time to treatment failure (TTF), disease control rate, and response rate. The 6-month PFS rate of the alternate-day administration group was 20.9% and failed to show significant difference from...
Two cases with periadrenal paraganglioma are herein reported. Patient 1: A 26-year-old woman who ... more Two cases with periadrenal paraganglioma are herein reported. Patient 1: A 26-year-old woman who presented with headache and hyperhidrosis was noted to have hypertension. Abdominal ultrasonography, computed tomography, magnetic resonance imaging, and I-tagged metaiodobenzylguanidine nuclear scintigraphy revealed a mass measuring 30 x 30 mm in size between the upper pole of the left kidney and the aorta. The value of urinary noradrenaline and normetanephrine were high. Patient 2: A 38-year-old woman who presented with headache and hyperhidrosis was noted to have hypertension. A preoperative imaging study revealed a mass measuring 20 x 20 mm in size between the upper pole of the left kidney and the aorta. The value of blood noradrenaline and urinary normetanephrine were high. In both cases, the paragangliomas were successfully removed laparoscopically without either any intraoperative or postoperative complications. Patient 1 is alive and doing well with no recurrence for 9 years, whe...
Journal of Experimental & Clinical Cancer Research, 2010
Background: MUC5AC is a secretory mucin normally expressed in the surface muconous cells of stoma... more Background: MUC5AC is a secretory mucin normally expressed in the surface muconous cells of stomach and bronchial tract. It has been known that MUC5AC de novo expression occurred in the invasive ductal carcinoma and pancreatic intraepithelial neoplasm with no detectable expression in normal pancreas, however, its function remains uncertain. Here, we report the impact of MUC5AC on the adhesive and invasive ability of pancreatic cancer cells.
of gastric cancer. Sox2 and Oct3/4 might be independent prognostic factors for patients with gast... more of gastric cancer. Sox2 and Oct3/4 might be independent prognostic factors for patients with gastric cancer. Ó 2012 Elsevier Inc. All rights reserved.
a b s t r a c t Background: Tumor-infiltrating antigen-presenting cells (APCs), involving tumor-a... more a b s t r a c t Background: Tumor-infiltrating antigen-presenting cells (APCs), involving tumor-associated macrophages and tumor-infiltrating dendritic cells, play an important role in tumor immunity and immune escape. The aim of this study was to determine whether tumor infiltrating CD11b þ APCs may affect tumor progression and clinical outcome. Methods: The immunohistochemical analysis was used to evaluate the expression of CD11b, FOXP3, and CD8 in 214 gastric cancer tissues. Concentrations of immunosuppressive cytokines in medium conditioned by gastric cancer cells were measured by enzymelinked immunosorbent assay. Effects of addition of tumor-conditioned media on CD11c þ cells were examined by flow cytometry.
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
A gastric tumor was pointed out in 43-year-old woman as a result of a medical check-up. We perfor... more A gastric tumor was pointed out in 43-year-old woman as a result of a medical check-up. We performed partial gastrectomy based on a preoperative diagnosis of a gastrointestinal stromal tumor (GIST). However, as intraoperative frozen section histological examination showed lymph node metastasis, we performed a total gastrectomy simlilar to cases of gastric cancer with lymph node dissection. Postoperative histological examination showed that the tumor was positive for c-kit immunohistochemically, and consisted of spindle cells. We made a diagnosis of GIST of the stomach with lymph node metastasis. Lymph node metastasis in a case of GIST is rare, and has a poor prognosis. We report a case of a rare gastrointestinal stromal tumor with lymph node metastasis, followed up for 7 years with no evidence of recurrence after radical surgery with lymph node dissection.
Studies of tumor-infiltrating immune cells have revealed that immune escape plays an important ro... more Studies of tumor-infiltrating immune cells have revealed that immune escape plays an important role in tumor growth. The aim of the present study was to investigate the impact of metastasis affecting CD4+ T cell subsets in human clinical samples. Single-cell suspensions derived from tumor-draining lymph node (TDLN) and primary cancer specimens were assessed by flow cytometry, qRT-PCR and immunohistochemistry. In the CD4+ T cell subsets detected in TDLN, effector T cells (TE) in metastatic TDLN (mTDLN) was significantly lower than that in metastatic-free TDLN (mfTDLN). TE in mfTDLN were increased compared with normal controls. Similarly, effector memory T cells (TEM) in mTDLN was significantly lower than in control and mfTDLN. There was a significantly positive correlation between the proportion of TEM in TDLN and number of tumor-infiltrating CD4+ and CD8+ T cells. Th1 to Th2 ratio was lower in mTDLN, and Treg in mTDLN was significantly higher than in mfTDLN. CD4+ T cell and TE subse...
The present study aimed to examine the survival benefit of adjuvant chemotherapy for the patients... more The present study aimed to examine the survival benefit of adjuvant chemotherapy for the patients with stage IB gastric cancer according to the second English edition of the Japanese Classification of Gastric Carcinoma (2nd JCGC). In total, 201 consecutive patients who underwent curative surgery for stage IB gastric cancer according to the 2nd JCGC were retrospectively analyzed. Seventy-four (36.8%) received adjuvant chemotherapy, and 72 (35.8%) had stage II diseases as defined by the 3rd JCGC. The 5-year overall survival (OS) was 86.9%. Multivariate analysis showed that adjuvant chemotherapy was an independent prognostic factor. In the sub-group analysis by stage according to the 3rd JCGC, those with stage II disease had better OS in the adjuvant-chemotherapy group than in the group treated with surgery alone (5-year OS 94.5% vs. 73.9%, p=0.002). Among patients with stage IB gastric cancer by 2nd JCGC, and especially patients with stage II defined by the 3rd JCGC, should be conside...
Recently, the preoperative immune-nutritional status has been reported to correlate with the surv... more Recently, the preoperative immune-nutritional status has been reported to correlate with the survival rate in patients with colorectal cancer (CRC). However, there have been no reports on the relationship between the controlling nutritional status (CONUT) score and the clinical outcome after curative surgery for CRC. We herein evaluated the prognostic significance of the CONUT score in patients with CRC, and then compared the accuracy of the CONUT score and the prognostic nutritional index (PNI) as a predictor of survival. We retrospectively reviewed a database of 204 patients who underwent curative surgery for Stage II/III CRC. Patients were divided into two groups according to the CONUT score and the PNI. The five-year cancer-specific survival (CSS) rate was significantly higher at 92.7% in the low CONUT group, compared to a rate of 81.0% in the high CONUT group (p=0.0016). The five-year CSS was 71.2% in the low PNI group and 92.3% in the high PNI group, which showed a significant...
To present a series of seven cases of gastric small cell carcinoma (GSCC) treated surgically and ... more To present a series of seven cases of gastric small cell carcinoma (GSCC) treated surgically and to illustrate the clinicopathological features and clinical course. Among 1,832 patients with gastric cancer who underwent gastric resection between 1997 and 2012, we reviewed the clinical records of 7 patients with histopathological diagnoses of GSCC. No patients had preoperative confirmation of GSCC from endoscopic biopsy. Curative resection (R0) was achieved in 5 patients (71.4%). Two out of the 5 patients with curative resection survived more than four years. Two out of 3 patients who received weekly paclitaxel had progression-free survival of more than 10 months. The median survival time for the whole patient group was 14 months and the 3-year survival rate was 25.0%. Curative surgery with adjuvant chemotherapy may be essential to improve the prognosis of GSCC, and weekly paclitaxel chemotherapy may represent a promising chemotherapy for GSCC.
The need for palliative resection of asymptomatic primary tumor in patients with unresectable met... more The need for palliative resection of asymptomatic primary tumor in patients with unresectable metastatic colorectal cancer (CRC) is still controversial. In order to identify predictors of survival after palliative resection, we investigated the correlations between clinicopathological factors, preoperative Glasgow prognostic score (GPS) and neutrophil-to-lymphocyte ratio (NLR), and survival. A total of 94 patients were enrolled in the present study. The prognostic value of the clinicopathological factors, GPS and NLR were analyzed retrospectively. A multivariate analysis revealed that both the GPS and NLR were independent predictors of survival along with the preoperative Eastern Cooperative Oncology Group performance status (PS) and extent of distant metastasis. We classified the patients using a combination of these factors, and categorized them into three risk groups. The median survival time was five months in the high-risk group, compared to 21.5 months in the intermediate-risk...
Previous studies have reported that elevated preoperative serum C-reactive protein (CRP) levels a... more Previous studies have reported that elevated preoperative serum C-reactive protein (CRP) levels are associated with a poor prognosis in patients with various types of cancer. The aim of this study was to evaluate the prognostic significance of the preoperative serum CRP levels in patients with colorectal cancer and determine an appropriate cutoff value of the serum CRP level. We enrolled 855 patients who underwent surgery for stage I-IV colorectal cancer. The median serum CRP level was 0.13 (range: 0.01-22.8). We set 0.6 as the cutoff value of the serum CRP level based on the receiver operating characteristic curve. The patients were classified into two groups according to the serum CRP level. The prognostic significance of an elevated serum CRP level was evaluated using a multivariate analysis. The cancer-specific survival was significantly worse in the patients with a high serum CRP level. In particular, more significant differences were observed in the patients with stage IV dise...
The aim of the present study was to investigate the efficacy of intracorporeal reinforcing suture... more The aim of the present study was to investigate the efficacy of intracorporeal reinforcing sutures for preventing anastomotic leakage (AL) after laparoscopic surgery for rectal cancer. This was a retrospective single-institution study consisting of 201 consecutive patients who underwent laparoscopic proctectomy with double-stapling anastomosis for primary rectal cancer between August 2007 and December 2013. The data for patients who received intracorporeal reinforcing sutures were compared with those of patients who did not receive reinforcing sutures. Patient-, tumor- and surgery-related variables were collected and examined using univariate and multivariate analyses. The overall incidence of AL was 9.0 % (18/201). No significant correlations were observed between the various clinicopathological factors and the use of reinforcing sutures. The multivariate analyses revealed the distance of the tumor from the anal verge, tumor size and presence of reinforcing sutures to be independen...
BACKGROND/AIM: Recent evidence indicates that inflammation is a hallmark of cancer. Tumor-associa... more BACKGROND/AIM: Recent evidence indicates that inflammation is a hallmark of cancer. Tumor-associated neutrophils (TANs) contribute to tumor invasion. However, whether TANs and lymph node metastasis are related is unknown. Intranodal lymphatic vessel density (LVD) is significantly correlated with tumor progression, lymph node metastasis in gastric cancer. Herein, we investigated the effects of TANs in regional lymph nodes. We investigated the association of the density of TANs in regional lymph nodes with clinicopathological features by immunohistochemistry. Furthermore, we examined the prognostic value of TANs in lymph nodes. The number of TANs in regional lymph nodes was positively correlated with intranodal LVD and micrometastases. Patients with higher cluster of differentiation 15(+) TAN counts had significantly poorer prognosis than those with lower counts. Our results suggest that TANs in regional lymph nodes promote the invasion of lymph nodes by cancer cells via augmentation ...
The neutrophil to lymphocyte ratio (NLR) may be related to progression in several cancers. The ai... more The neutrophil to lymphocyte ratio (NLR) may be related to progression in several cancers. The aim of this study was to investigate the impact of pretreatment NLR in advanced gastric cancer on the prognosis of the patients stratified by metastatic pattern. We retrospectively investigated clinical data from 191 patients with stage IV gastric cancer who had undergone surgery for primary gastric cancer between 1997 and 2010 at the Department of Surgical Oncology of Osaka City University. All patients had unresectable metastatic factors including peritoneal metastasis (P) and liver metastasis (H). Sixty-one (32%) patients had more than two unresectable factors. We determined a cutoff value of 2.5 for the NLR to be optimal to discriminate the patient's characteristics and divided patients into low (<2.5) and high (>2.5) NLR group for subsequent analysis. In the low NLR group, long survival was found in patients with H, P, or multiple site metastases. Our results suggest that NL...
It has been suggested that acute exercise improves cognitive function. However, little is known a... more It has been suggested that acute exercise improves cognitive function. However, little is known about how exercise under hypoxia affects cognitive function. The purpose of this study was to determine if hypoxia alters working memory and executive function during prolonged exercise. Sixteen participants performed cognitive tasks at rest and during exercise under normoxia and hypoxia [fraction of inspired oxygen (FIO2)=0.15, corresponding to an altitude of approximately 2600 m]. The level of hypoxia was moderate. We used a combination of Spatial Delayed Response (Spatial DR) task and Go/No-Go (GNG) task, where spatial working memory and executive function are required. Working memory was assessed by the accuracy of the Spatial DR task, and executive function was assessed by the accuracy and reaction time in the GNG task. The participants cycled an ergometer for 30 min under normoxia and moderate hypoxia while keeping their heart rate (HR) at 140 beats/min. They performed the cognitive...
Lymph node metastasis is one of the most important prognostic factors in patients with esophageal... more Lymph node metastasis is one of the most important prognostic factors in patients with esophageal squamous cell carcinoma (ESCC). Neoadjuvant treatment can reduce micrometastasis in lymph nodes to enable curative resection by down staging. The aim of this study was to evaluate the histological effect of neoadjuvant therapy on lymph node metastasis of ESCC by performing immunohistochemistry for cytokeratin staining. A total of 3061 lymph nodes were examined from 62 patients who received neoadjuvant treatment followed by esophagectomy with lymphadenectomy. We observed positive staining for cytokeratin in 276 (9.0%) lymph nodes, which included overt metastasis, micrometastasis and hyalinized cytokeratin particles (HCP). Patients with HCPs in lymph nodes had better outcomes than patients without HCPs in lymph node. A significant prognostic difference between the patients with HCPs and without HCPs was observed in a subgroup of patients with nodal metastasis. Our findings suggest that HC...
Brain metastasis from gastric cancer is fairly uncommon and prognosis is dismal. We report a case... more Brain metastasis from gastric cancer is fairly uncommon and prognosis is dismal. We report a case of early gastric cancer with brain metastasis arising 8 years after gastrectomy. A 78-year-old Japanese female presented to our hospital complaining of dizziness, 8 years after undergoing gastrectomy for gastric cancer. Histopathological type of the tumor was well-differentiated adenocarcinoma. Final TNM classification was T1b(sm1)N0M0, and pathological stage was IA. Further examination revealed a metastatic tumor in the cerebellum and multiple liver metastases. The brain metastasis was treated using radiotherapy and steroid. Systemic treatment for liver metastases was performed using the oral fluoropyrimidine drug S-1. Neurological symptoms decreased, enabling the patient to be discharged from hospital. However, chemotherapy was discontinued due to loss of appetite and general fatigue. She died 5 months after the diagnosis of brain metastasis due to progressive disease. Cases of brain ...
The purpose of this study was to evaluate the significance of the combination of the carcinoembry... more The purpose of this study was to evaluate the significance of the combination of the carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels as a prognostic indicator and for monitoring for recurrence and metastasis after potentially curative surgery for patients with stage II colorectal cancer. A total of 238 patients with stage II colorectal cancer who underwent potentially curative surgery were enrolled in the study. A high CEA level was defined as a level exceeding 5 ng/ml and a high CA19-9 level was defined as a level exceeding 37 U/ml. Out of these 238 patients, 92 (38.7%) patients had high CEA levels, 23 (9.7%) patients had high CA19-9 levels and 15 (6.3%) patients had both high CEA and CA19-9 levels. The disease-free and overall survival rates were significantly worse in patients with both a high CEA level and high CA19-9 level. Tumor marker(s) elevated before the operation tended to be elevated again at the time of relapse. The combination of preoperati...
Prostaglandin D2 (PGD2) has been demonstrated to have antitumor effects on cancer cells. PGD2 act... more Prostaglandin D2 (PGD2) has been demonstrated to have antitumor effects on cancer cells. PGD2 acts through two major receptors of DP1 and DP2, as well as through the peroxisome proliferator-activated receptor γ (PPARγ) via the PGD2 metabolite, 15-deoxy-Δ12-14-PGJ2. The expression levels of DP1, DP2, and PPARγ were analyzed by immunohistochemistry on 277 primary gastric carcinomas. Either DP1- or DP2-positive cases were regarded as DP-positive. DP-Positive tumour was significantly associated with lymph mode metastasis, lymphatic invasion, and venous invasion. PPARγ positivity was not associated with any clinicopathological factors of gastric cancer. DP-Negative and PPARγ-positive cases were significantly associated with T category, lymph metastasis, and lymphatic invasion. The prognosis of DP-negative and PPARγ-positive cases was better than that of the other cases. These findings suggest that DP and PPARγ signaling influence the invasiveness of cancer cells. DP and PPARγ can be used...
International journal of clinical oncology, Jan 30, 2017
Although S-1 based chemotherapy for patients with advanced gastric cancer has generally been acce... more Although S-1 based chemotherapy for patients with advanced gastric cancer has generally been accepted in Japan, discontinuations of treatment have been reported due to grade 3 or more adverse events. The present randomized phase II study was conducted to test whether alternate-day administration of S-1 would be comparably efficient and reduce adverse events compared with conventional daily administration in the first-line chemotherapy for advanced gastric cancer. 132 patients with advanced gastric cancer were randomly assigned to 1:2 ratios to receive treatment with daily at a standard dose of 80 mg/m(2)/day or alternate-day administration group received S-1 on 4 days a week. The primary end point was progression-free survival (PFS), and the secondary end points were safety, overall survival, time to treatment failure (TTF), disease control rate, and response rate. The 6-month PFS rate of the alternate-day administration group was 20.9% and failed to show significant difference from...
Two cases with periadrenal paraganglioma are herein reported. Patient 1: A 26-year-old woman who ... more Two cases with periadrenal paraganglioma are herein reported. Patient 1: A 26-year-old woman who presented with headache and hyperhidrosis was noted to have hypertension. Abdominal ultrasonography, computed tomography, magnetic resonance imaging, and I-tagged metaiodobenzylguanidine nuclear scintigraphy revealed a mass measuring 30 x 30 mm in size between the upper pole of the left kidney and the aorta. The value of urinary noradrenaline and normetanephrine were high. Patient 2: A 38-year-old woman who presented with headache and hyperhidrosis was noted to have hypertension. A preoperative imaging study revealed a mass measuring 20 x 20 mm in size between the upper pole of the left kidney and the aorta. The value of blood noradrenaline and urinary normetanephrine were high. In both cases, the paragangliomas were successfully removed laparoscopically without either any intraoperative or postoperative complications. Patient 1 is alive and doing well with no recurrence for 9 years, whe...
Journal of Experimental & Clinical Cancer Research, 2010
Background: MUC5AC is a secretory mucin normally expressed in the surface muconous cells of stoma... more Background: MUC5AC is a secretory mucin normally expressed in the surface muconous cells of stomach and bronchial tract. It has been known that MUC5AC de novo expression occurred in the invasive ductal carcinoma and pancreatic intraepithelial neoplasm with no detectable expression in normal pancreas, however, its function remains uncertain. Here, we report the impact of MUC5AC on the adhesive and invasive ability of pancreatic cancer cells.
of gastric cancer. Sox2 and Oct3/4 might be independent prognostic factors for patients with gast... more of gastric cancer. Sox2 and Oct3/4 might be independent prognostic factors for patients with gastric cancer. Ó 2012 Elsevier Inc. All rights reserved.
a b s t r a c t Background: Tumor-infiltrating antigen-presenting cells (APCs), involving tumor-a... more a b s t r a c t Background: Tumor-infiltrating antigen-presenting cells (APCs), involving tumor-associated macrophages and tumor-infiltrating dendritic cells, play an important role in tumor immunity and immune escape. The aim of this study was to determine whether tumor infiltrating CD11b þ APCs may affect tumor progression and clinical outcome. Methods: The immunohistochemical analysis was used to evaluate the expression of CD11b, FOXP3, and CD8 in 214 gastric cancer tissues. Concentrations of immunosuppressive cytokines in medium conditioned by gastric cancer cells were measured by enzymelinked immunosorbent assay. Effects of addition of tumor-conditioned media on CD11c þ cells were examined by flow cytometry.
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
A gastric tumor was pointed out in 43-year-old woman as a result of a medical check-up. We perfor... more A gastric tumor was pointed out in 43-year-old woman as a result of a medical check-up. We performed partial gastrectomy based on a preoperative diagnosis of a gastrointestinal stromal tumor (GIST). However, as intraoperative frozen section histological examination showed lymph node metastasis, we performed a total gastrectomy simlilar to cases of gastric cancer with lymph node dissection. Postoperative histological examination showed that the tumor was positive for c-kit immunohistochemically, and consisted of spindle cells. We made a diagnosis of GIST of the stomach with lymph node metastasis. Lymph node metastasis in a case of GIST is rare, and has a poor prognosis. We report a case of a rare gastrointestinal stromal tumor with lymph node metastasis, followed up for 7 years with no evidence of recurrence after radical surgery with lymph node dissection.
Studies of tumor-infiltrating immune cells have revealed that immune escape plays an important ro... more Studies of tumor-infiltrating immune cells have revealed that immune escape plays an important role in tumor growth. The aim of the present study was to investigate the impact of metastasis affecting CD4+ T cell subsets in human clinical samples. Single-cell suspensions derived from tumor-draining lymph node (TDLN) and primary cancer specimens were assessed by flow cytometry, qRT-PCR and immunohistochemistry. In the CD4+ T cell subsets detected in TDLN, effector T cells (TE) in metastatic TDLN (mTDLN) was significantly lower than that in metastatic-free TDLN (mfTDLN). TE in mfTDLN were increased compared with normal controls. Similarly, effector memory T cells (TEM) in mTDLN was significantly lower than in control and mfTDLN. There was a significantly positive correlation between the proportion of TEM in TDLN and number of tumor-infiltrating CD4+ and CD8+ T cells. Th1 to Th2 ratio was lower in mTDLN, and Treg in mTDLN was significantly higher than in mfTDLN. CD4+ T cell and TE subse...
The present study aimed to examine the survival benefit of adjuvant chemotherapy for the patients... more The present study aimed to examine the survival benefit of adjuvant chemotherapy for the patients with stage IB gastric cancer according to the second English edition of the Japanese Classification of Gastric Carcinoma (2nd JCGC). In total, 201 consecutive patients who underwent curative surgery for stage IB gastric cancer according to the 2nd JCGC were retrospectively analyzed. Seventy-four (36.8%) received adjuvant chemotherapy, and 72 (35.8%) had stage II diseases as defined by the 3rd JCGC. The 5-year overall survival (OS) was 86.9%. Multivariate analysis showed that adjuvant chemotherapy was an independent prognostic factor. In the sub-group analysis by stage according to the 3rd JCGC, those with stage II disease had better OS in the adjuvant-chemotherapy group than in the group treated with surgery alone (5-year OS 94.5% vs. 73.9%, p=0.002). Among patients with stage IB gastric cancer by 2nd JCGC, and especially patients with stage II defined by the 3rd JCGC, should be conside...
Recently, the preoperative immune-nutritional status has been reported to correlate with the surv... more Recently, the preoperative immune-nutritional status has been reported to correlate with the survival rate in patients with colorectal cancer (CRC). However, there have been no reports on the relationship between the controlling nutritional status (CONUT) score and the clinical outcome after curative surgery for CRC. We herein evaluated the prognostic significance of the CONUT score in patients with CRC, and then compared the accuracy of the CONUT score and the prognostic nutritional index (PNI) as a predictor of survival. We retrospectively reviewed a database of 204 patients who underwent curative surgery for Stage II/III CRC. Patients were divided into two groups according to the CONUT score and the PNI. The five-year cancer-specific survival (CSS) rate was significantly higher at 92.7% in the low CONUT group, compared to a rate of 81.0% in the high CONUT group (p=0.0016). The five-year CSS was 71.2% in the low PNI group and 92.3% in the high PNI group, which showed a significant...
To present a series of seven cases of gastric small cell carcinoma (GSCC) treated surgically and ... more To present a series of seven cases of gastric small cell carcinoma (GSCC) treated surgically and to illustrate the clinicopathological features and clinical course. Among 1,832 patients with gastric cancer who underwent gastric resection between 1997 and 2012, we reviewed the clinical records of 7 patients with histopathological diagnoses of GSCC. No patients had preoperative confirmation of GSCC from endoscopic biopsy. Curative resection (R0) was achieved in 5 patients (71.4%). Two out of the 5 patients with curative resection survived more than four years. Two out of 3 patients who received weekly paclitaxel had progression-free survival of more than 10 months. The median survival time for the whole patient group was 14 months and the 3-year survival rate was 25.0%. Curative surgery with adjuvant chemotherapy may be essential to improve the prognosis of GSCC, and weekly paclitaxel chemotherapy may represent a promising chemotherapy for GSCC.
The need for palliative resection of asymptomatic primary tumor in patients with unresectable met... more The need for palliative resection of asymptomatic primary tumor in patients with unresectable metastatic colorectal cancer (CRC) is still controversial. In order to identify predictors of survival after palliative resection, we investigated the correlations between clinicopathological factors, preoperative Glasgow prognostic score (GPS) and neutrophil-to-lymphocyte ratio (NLR), and survival. A total of 94 patients were enrolled in the present study. The prognostic value of the clinicopathological factors, GPS and NLR were analyzed retrospectively. A multivariate analysis revealed that both the GPS and NLR were independent predictors of survival along with the preoperative Eastern Cooperative Oncology Group performance status (PS) and extent of distant metastasis. We classified the patients using a combination of these factors, and categorized them into three risk groups. The median survival time was five months in the high-risk group, compared to 21.5 months in the intermediate-risk...
Previous studies have reported that elevated preoperative serum C-reactive protein (CRP) levels a... more Previous studies have reported that elevated preoperative serum C-reactive protein (CRP) levels are associated with a poor prognosis in patients with various types of cancer. The aim of this study was to evaluate the prognostic significance of the preoperative serum CRP levels in patients with colorectal cancer and determine an appropriate cutoff value of the serum CRP level. We enrolled 855 patients who underwent surgery for stage I-IV colorectal cancer. The median serum CRP level was 0.13 (range: 0.01-22.8). We set 0.6 as the cutoff value of the serum CRP level based on the receiver operating characteristic curve. The patients were classified into two groups according to the serum CRP level. The prognostic significance of an elevated serum CRP level was evaluated using a multivariate analysis. The cancer-specific survival was significantly worse in the patients with a high serum CRP level. In particular, more significant differences were observed in the patients with stage IV dise...
The aim of the present study was to investigate the efficacy of intracorporeal reinforcing suture... more The aim of the present study was to investigate the efficacy of intracorporeal reinforcing sutures for preventing anastomotic leakage (AL) after laparoscopic surgery for rectal cancer. This was a retrospective single-institution study consisting of 201 consecutive patients who underwent laparoscopic proctectomy with double-stapling anastomosis for primary rectal cancer between August 2007 and December 2013. The data for patients who received intracorporeal reinforcing sutures were compared with those of patients who did not receive reinforcing sutures. Patient-, tumor- and surgery-related variables were collected and examined using univariate and multivariate analyses. The overall incidence of AL was 9.0 % (18/201). No significant correlations were observed between the various clinicopathological factors and the use of reinforcing sutures. The multivariate analyses revealed the distance of the tumor from the anal verge, tumor size and presence of reinforcing sutures to be independen...
BACKGROND/AIM: Recent evidence indicates that inflammation is a hallmark of cancer. Tumor-associa... more BACKGROND/AIM: Recent evidence indicates that inflammation is a hallmark of cancer. Tumor-associated neutrophils (TANs) contribute to tumor invasion. However, whether TANs and lymph node metastasis are related is unknown. Intranodal lymphatic vessel density (LVD) is significantly correlated with tumor progression, lymph node metastasis in gastric cancer. Herein, we investigated the effects of TANs in regional lymph nodes. We investigated the association of the density of TANs in regional lymph nodes with clinicopathological features by immunohistochemistry. Furthermore, we examined the prognostic value of TANs in lymph nodes. The number of TANs in regional lymph nodes was positively correlated with intranodal LVD and micrometastases. Patients with higher cluster of differentiation 15(+) TAN counts had significantly poorer prognosis than those with lower counts. Our results suggest that TANs in regional lymph nodes promote the invasion of lymph nodes by cancer cells via augmentation ...
The neutrophil to lymphocyte ratio (NLR) may be related to progression in several cancers. The ai... more The neutrophil to lymphocyte ratio (NLR) may be related to progression in several cancers. The aim of this study was to investigate the impact of pretreatment NLR in advanced gastric cancer on the prognosis of the patients stratified by metastatic pattern. We retrospectively investigated clinical data from 191 patients with stage IV gastric cancer who had undergone surgery for primary gastric cancer between 1997 and 2010 at the Department of Surgical Oncology of Osaka City University. All patients had unresectable metastatic factors including peritoneal metastasis (P) and liver metastasis (H). Sixty-one (32%) patients had more than two unresectable factors. We determined a cutoff value of 2.5 for the NLR to be optimal to discriminate the patient's characteristics and divided patients into low (<2.5) and high (>2.5) NLR group for subsequent analysis. In the low NLR group, long survival was found in patients with H, P, or multiple site metastases. Our results suggest that NL...
It has been suggested that acute exercise improves cognitive function. However, little is known a... more It has been suggested that acute exercise improves cognitive function. However, little is known about how exercise under hypoxia affects cognitive function. The purpose of this study was to determine if hypoxia alters working memory and executive function during prolonged exercise. Sixteen participants performed cognitive tasks at rest and during exercise under normoxia and hypoxia [fraction of inspired oxygen (FIO2)=0.15, corresponding to an altitude of approximately 2600 m]. The level of hypoxia was moderate. We used a combination of Spatial Delayed Response (Spatial DR) task and Go/No-Go (GNG) task, where spatial working memory and executive function are required. Working memory was assessed by the accuracy of the Spatial DR task, and executive function was assessed by the accuracy and reaction time in the GNG task. The participants cycled an ergometer for 30 min under normoxia and moderate hypoxia while keeping their heart rate (HR) at 140 beats/min. They performed the cognitive...
Lymph node metastasis is one of the most important prognostic factors in patients with esophageal... more Lymph node metastasis is one of the most important prognostic factors in patients with esophageal squamous cell carcinoma (ESCC). Neoadjuvant treatment can reduce micrometastasis in lymph nodes to enable curative resection by down staging. The aim of this study was to evaluate the histological effect of neoadjuvant therapy on lymph node metastasis of ESCC by performing immunohistochemistry for cytokeratin staining. A total of 3061 lymph nodes were examined from 62 patients who received neoadjuvant treatment followed by esophagectomy with lymphadenectomy. We observed positive staining for cytokeratin in 276 (9.0%) lymph nodes, which included overt metastasis, micrometastasis and hyalinized cytokeratin particles (HCP). Patients with HCPs in lymph nodes had better outcomes than patients without HCPs in lymph node. A significant prognostic difference between the patients with HCPs and without HCPs was observed in a subgroup of patients with nodal metastasis. Our findings suggest that HC...
Brain metastasis from gastric cancer is fairly uncommon and prognosis is dismal. We report a case... more Brain metastasis from gastric cancer is fairly uncommon and prognosis is dismal. We report a case of early gastric cancer with brain metastasis arising 8 years after gastrectomy. A 78-year-old Japanese female presented to our hospital complaining of dizziness, 8 years after undergoing gastrectomy for gastric cancer. Histopathological type of the tumor was well-differentiated adenocarcinoma. Final TNM classification was T1b(sm1)N0M0, and pathological stage was IA. Further examination revealed a metastatic tumor in the cerebellum and multiple liver metastases. The brain metastasis was treated using radiotherapy and steroid. Systemic treatment for liver metastases was performed using the oral fluoropyrimidine drug S-1. Neurological symptoms decreased, enabling the patient to be discharged from hospital. However, chemotherapy was discontinued due to loss of appetite and general fatigue. She died 5 months after the diagnosis of brain metastasis due to progressive disease. Cases of brain ...
The purpose of this study was to evaluate the significance of the combination of the carcinoembry... more The purpose of this study was to evaluate the significance of the combination of the carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels as a prognostic indicator and for monitoring for recurrence and metastasis after potentially curative surgery for patients with stage II colorectal cancer. A total of 238 patients with stage II colorectal cancer who underwent potentially curative surgery were enrolled in the study. A high CEA level was defined as a level exceeding 5 ng/ml and a high CA19-9 level was defined as a level exceeding 37 U/ml. Out of these 238 patients, 92 (38.7%) patients had high CEA levels, 23 (9.7%) patients had high CA19-9 levels and 15 (6.3%) patients had both high CEA and CA19-9 levels. The disease-free and overall survival rates were significantly worse in patients with both a high CEA level and high CA19-9 level. Tumor marker(s) elevated before the operation tended to be elevated again at the time of relapse. The combination of preoperati...
Prostaglandin D2 (PGD2) has been demonstrated to have antitumor effects on cancer cells. PGD2 act... more Prostaglandin D2 (PGD2) has been demonstrated to have antitumor effects on cancer cells. PGD2 acts through two major receptors of DP1 and DP2, as well as through the peroxisome proliferator-activated receptor γ (PPARγ) via the PGD2 metabolite, 15-deoxy-Δ12-14-PGJ2. The expression levels of DP1, DP2, and PPARγ were analyzed by immunohistochemistry on 277 primary gastric carcinomas. Either DP1- or DP2-positive cases were regarded as DP-positive. DP-Positive tumour was significantly associated with lymph mode metastasis, lymphatic invasion, and venous invasion. PPARγ positivity was not associated with any clinicopathological factors of gastric cancer. DP-Negative and PPARγ-positive cases were significantly associated with T category, lymph metastasis, and lymphatic invasion. The prognosis of DP-negative and PPARγ-positive cases was better than that of the other cases. These findings suggest that DP and PPARγ signaling influence the invasiveness of cancer cells. DP and PPARγ can be used...
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Papers by Hiroaki Tanaka