Article: SPan-1 Is a Useful Prognostic Marker for Patients with Stage IV Gastric Cancer Who Underwent Palliative Gastrectomy: A Retrospective Multivariate Study.Naoshi Kubo, Masaichi Ohira, Katsunobu Sakurai, Takahiro Toyokawa, Hiroaki Tanaka, Kazuya Muguruma, Hisashi Nagahara, Kenjiro Kimura, Eiji Noda, Ryosuke Amano, Nobuya Yamada, Masakazu Yashiro, Kiyoshi Maeda, Tetsuji Sawada, Kosei Hirakawa[show abstract] [hide abstract]
ABSTRACT: BACKGROUND: We retrospectively investigated prognostic factors to be used in selecting the patients with stage IV gastric cancer (GC) who have an unfavorable prognosis after palliative gastrectomy. METHODS: A total of 146 GC patients at stage IV who had undergone palliative gastrectomy were enrolled. Various clinicopathological parameters were evaluated for prognosis. RESULTS: Surgical morbidity and hospital mortality occurred in 35 (23.9 %) and 4 (2.7 %) patients, respectively. The overall 5-year survival rate and the median survival time were 11.2 % and 13.2 months, respectively. Of the 146 patients, 64 had uncomfortable symptoms associated with GC and 76 had no such symptoms. Of the 64 patients with uncomfortable symptoms, 60 (93.7 %) experienced relief of these symptoms after palliative surgery. Multivariate analysis for patients without uncomfortable symptoms associated with GC revealed that the number of incurable factors and serum SPan-1 level were independent prognostic factors. CONCLUSIONS: Patients with stage IV GC who had multiple incurable factors and a high level of serum SPan-1 might not be candidates for palliative gastrectomy for the purpose of prognostic benefit.World Journal of Surgery 04/2013; · 2.36 Impact Factor
Article: Successful resection of esophageal cancer with right aortic arch by video-assisted thoracoscopic surgery: a case report.Naoshi Kubo, Masaichi Ohira, Tomohiro Lee, Katsunobu Sakurai, Takahiro Toyokawa, Hiroaki Tanaka, Kazuya Muguruma, Kenjiro Kimura, Hisashi Nagahara, Eiji Noda, Ryosuke Amano, Hiroshi Ohtani, Yoshito Yamashita, Masakazu Yashiro, Kiyoshi Maeda, Kosei Hirakawa[show abstract] [hide abstract]
ABSTRACT: The right aortic arch (RAA) forms a vascular ring, encircling both the esophagus and trachea. We herein report a case of thoracic esophageal cancer with RAA successfully resected using video-assited thoracoscopic surgery (VATS). A 64-year-old man who presented with a complaint of abdominal pain, was admitted to our hospital. Further examinations revealed gall stones and multiple superficial esophageal carcinomas. Three-dimensional computed tomographic images showed RAA and aortic diverticulum. The trachea and esophagus were completely encircled by the RAA, the aortic diverticulum and the pulmonary artery. We successfully and safely performed VATS esophagectomy for esophageal cancer accompanied with RAA. To the best of our knowledge, this report is the first case for which VATS esophagectomy for esophageal cancer, accompanied with RAA, was carried out. Marking of the left recurrent laryngeal nerve with colored tape at the cervical part of the surgery made it easy to identify it during the thoracoscopic part of the surgery.Anticancer research 04/2013; 33(4):1635-40. · 1.73 Impact Factor
Article: Expression of E-cadherin and KRAS mutation may serve as biomarkers of cetuximab-based therapy in metastatic colorectal cancer.Kentaro Nakamoto, Hisashi Nagahara, Kiyoshi Maeda, Eiji Noda, Toru Inoue, Masakazu Yashiro, Yukio Nishiguchi, Masaichi Ohira, Kosei Hirakawa[show abstract] [hide abstract]
ABSTRACT: Cetuximab (Cmab), a chimeric monoclonal antibody for targeting the epidermal growth factor receptor, has become one of the standard treatments for metastatic colorectal cancer (mCRC). However, only a small proportion of patients respond to Cmab, and it has been reported that KRAS mutation is a negative biomarker of response to Cmab therapy. The aim of this study was to detect additional biomarkers of response to Cmab therapy in patients with mCRC. We evaluated the effects of Cmab therapy in 36 patients with mCRC according to the Response Evaluation Criteria in Solid Tumors, and classified patients who achieved complete response, partial response or stable disease as responders, and patients who achieved progressive disease as non-responders. We retrospectively examined the difference between the two groups using KRAS analysis and immunohistochemistry to determine the expression of E-cadherin, p53 and Ki67. Nineteen patients were responders, while 17 patients were non-responders. KRAS status and expression of E-cadherin were significantly correlated with the effect of Cmab therapy. Moreover, the expression of E-cadherin was significantly correlated with the effect of Cmab therapy in KRAS wild-type patients. In KRAS mutant-type patients, the expression of E-cadherin did not significantly correlate with the effect of Cmab therapy, but all responders with KRAS mutant-type tumors expressed E-cadherin. Our results indicate that the expression of E-cadherin detected by immunohistochemistry may be a positive predictor of Cmab-based therapy in mCRC, and that a combination of E-cadherin immunohistochemistry and KRAS analysis may be a more sensitive biomarker than KRAS analysis alone.Oncology letters 04/2013; 5(4):1295-1300. · 0.11 Impact Factor
Article: [Locally recurrent case of gastric cancer with serosal invasion after four months of endoscopic submucosal dissection].Mamiko Takii, Hiroaki Tanaka, Kenji Kuroda, Yuka Asano, Katsunobu Sakurai, Kazuya Muguruma, Naoshi Kubo, Hisashi Nagahara, Kenjiro Kimura, Ryosuke Amano, Eiji Noda, Nobuya Yamada, Kiyoshi Maeda, Masaichi Ohira, Kosei Hirakawa[show abstract] [hide abstract]
ABSTRACT: A 52-year-old woman underwent endoscopic submucosal dissection (ESD) for early gastric cancer at the lesser curvature. Microscopic examination revealed tub1, pSM1, ly0, v0, pHM0, and pVM0, which were considered to be relative resection. Four months later, upper gastrointestinal endoscopy showed local recurrence with suspected SM massive tumor infiltration. We performed a laparoscopic distal gastrectomy with lymph node dissection. Postoperative pathology showed tub2, pT4a (SE), pN2, ly0, v0, and fStage IIIb. This indicated that a few remnant cancer cells were stimulated by the local inflammation associated with ESD. ESD is less invasive than open surgery, but strict observation following curative resection is essential to rule out inflammation-mediated recurrence.Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2342-4.
Article: [A case of early gastric cancer with cervical lymph nodes recurrence 5 years after a curative resection].Kazuya Muguruma, Hiroaki Tanaka, Katsunobu Sakurai, Kenjirou Kimura, Hisashi Nagahara, Ryosuke Amano, Eiji Noda, Naoshi Kubo, Kiyoshi Maeda, Tetsuji Sawada, Masaichi Ohira, Kosei Hirakawa[show abstract] [hide abstract]
ABSTRACT: A 61-year-old man exhibiting epigastric malaise on hunger was diagnosed with early gastric cancer by upper gastrointestinal endoscopy. Since no obvious metastasis was recognized by abdominal computed tomography(CT), he underwent distal gastrectomy with D1+ lymphadenectomy. Histopathological examination revealed a pStage IA lesion[pT1a (m), pN0]. He received no adjuvant chemotherapy, and he remained alive and in good health without recurrence for more than 5 years. At 5 years and 7 months after gastrectomy, he noticed cervical lymph node swelling and underwent further examination. He was diagnosed with recurrent gastric cancer in cervical lymph nodes, and treatment with S-1 (120 mg/ day) was initiated. He remained alive and free of progression for approximately 1 year on S-1 therapy, but he suddenly died from disseminated intravascular coagulation without an obvious cause. We report a rare case of late recurrence after curative resection in a patient treated for early gastric cancer.Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2345-7.