Shuhei Komatsu

Publications (86)137.79 Total impact

• Article: The expression and role of Aquaporin 5 in esophageal squamous cell carcinoma.

  Hiroki Shimizu, Atsushi Shiozaki, Daisuke Ichikawa, Hitoshi Fujiwara, Hirotaka Konishi, Hiromichi Ishii, Shuhei Komatsu, Takeshi Kubota, Kazuma Okamoto, Mitsuo Kishimoto, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: BACKGROUND: Aquaporins (AQPs) are water channel proteins that facilitate transcellular water movements. Recent studies have shown that AQP5 is expressed in various cancers, and plays a role in tumor progression. However, its expression and role in esophageal squamous cell carcinoma (ESCC) have not been investigated. We examined the pathophysiologic role of AQP5 in cell proliferation and survival, and also investigated its expression and effects on the prognosis of ESCC patients. METHODS: AQP5 expression in human ESCC cell lines was analyzed by Western blot testing. Knockdown experiments with AQP5 siRNA were conducted, and the effects on cell proliferation, cell cycle progression, and cell survival were analyzed. The cells' gene expression profiles were analyzed by microarray analysis. Immunohistochemistry of AQP5 for 68 primary tumor samples obtained from ESCC patients undergoing esophagectomy was performed. RESULTS: AQP5 expression was high in TE2 and TE5 cells. In these cells, the knockdown of AQP5 using siRNA inhibited cell proliferation and G1-S phase progression, and induced apoptosis. The AQP5 siRNA transfected TE5 cells showed significant increase in p21 and decrease in CCND1 mRNA expression, respectively. The expression pattern of AQP5 and p21 protein was sharply contrasted, but AQP5 and CCND1 protein expression showed a similar pattern in ESCC tissue. These findings agree with the microarray results. Immunohistochemical staining of 68 ESCC patients showed the AQP5 expression is associated with tumor size, histological type, and tumor recurrence. CONCLUSION: The AQP5 expression in ESCC cells may affect cell proliferation and survival, and impact on the prognosis of ESCC patients.
  Journal of Gastroenterology 05/2013; · 4.16 Impact Factor
• Article: Long-term outcomes of patients who underwent limited proximal gastrectomy.

  Daisuke Ichikawa, Shuhei Komatsu, Takeshi Kubota, Kazuma Okamoto, Atsushi Shiozaki, Hitoshi Fujiwara, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: BACKGROUND: Because the incidence of early gastric cancers has been increasing in Asian countries, postoperative quality of life has received considerable attention in addition to oncological outcomes. METHODS: Eighty-four patients with clinically early gastric cancers were enrolled in this retrospective study. Among them, 35 patients underwent total gastrectomy (TG) and 49 patients underwent limited proximal gastrectomy (PG). Blood chemistry, changes in body weight, and oncological outcomes were compared between the two groups. RESULTS: Postoperative hemoglobin levels and body weights were significantly lower in the TG group than in the PG group, and there were no significant differences in the levels of other nutritional indicators such as serum total protein and total cholesterol. However, the overall survival rates of patients in the PG group were similar to those of patients in the TG group (5-year survival rates, 95 versus 97 %, respectively; p = 0.86). CONCLUSIONS: Limited proximal gastrectomy with regional lymph node dissection has possible positive effects on maintaining body weight and preventing postgastrectomy anemia with similar oncological outcomes to total gastrectomy in patients with early gastric cancers.
  Gastric Cancer 04/2013; · 2.42 Impact Factor
• Article: Overexpression of IL-6 by Gene Transfer Stimulates IL-8-mediated Invasiveness of KYSE170 Esophageal Carcinoma Cells.

  Shinichi Okamura, Hitoshi Fujiwara, Masayuki Yoneda, Akinobu Furutani, Momoko Todo, Atsushi Ikai, Hiroyuki Tada, Hiroko Okamura, Seiji Umehara, Atsushi Shiozaki, Takeshi Kubota, Shuhei Komatsu, Daisuke Ichikawa, Kazuma Okamoto, Toshiya Ochiai, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: Interleukin-6 (IL-6) has been associated with disease progression and poor prognosis in esophageal carcinoma. The aim of this study was to investigate the possible influence of IL-6 on the biological activities of esophageal carcinoma cells in terms of invasiveness. The human esophageal carcinoma cell line, KYSE170, was transfected with a plasmid vector expressing IL-6, and a stable transfectant overexpressing IL-6 was established. Invasiveness was evaluated by an invasion assay and compared between IL-6 and control transfectants. The invasiveness of the IL-6 transfectant was significantly higher than that of the control transfectant, and was significantly reduced by IL-6-specific siRNA. In reverse transcriptase-polymerase chain reaction (RT-PCR) analysis, IL-8 expression was significantly higher in the IL-6 transfectant than in the control transfectant, whereas the expression of Hepatocyte growth factor (HGF) and Vascular endothelial growth factor (VEGF) was not different. IL-8 expression in the IL-6 transfectant was significantly inhibited by IL-8-specific siRNA, whereas IL-6 expression was not. In addition, the invasiveness of the IL-6 transfectant was significantly reduced by IL-8-specific siRNA. These results indicate that the overexpression of IL-6 increases the invasiveness of KYSE170 esophageal carcinoma cells and IL-6-induced IL-8 plays a predominant role in increasing invasiveness.
  Anticancer research 04/2013; 33(4):1483-9. · 1.73 Impact Factor
• Article: Anatomical hepatectomy for hepatocellular carcinoma in patients with preserved liver function.

  Toshiya Ochiai, Hisashi Ikoma, Yusuke Yamamoto, Hirotaka Konishi, Yasutoshi Murayama, Atsushi Shiozaki, Shuhei Komatsu, Yoshiaki Kuriu, Takeshi Kubota, Masayoshi Nakanishi, Daisuke Ichikawa, Hitoshi Fujiwara, Kazuma Okamoto, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: Background/Aim: This study aimed to clarify the efficacy of anatomical hepatectomy in patients with preserved liver function. We compared the clinicopathology of the anatomical hepatectomy (AH) group (n=264) with that of the non-anatomical hepatectomy (NAH) group (n=85) and evaluated favorable conditions of anatomical hepatectomy for patients with HCC with an indocyanine green 15-minute retention rate of less than 30%. There was no significant difference between the two groups in five-year disease-free survival. However, disease-free survival of the AH group was significantly better than that of the NAH group when patients had T1 tumors, tumors without intrahepatic metastasis, tumors located within one subsegment, or serum alpha feto-protein less than 100 ng/dl (p=0.015, p=0.009, p=0.046 and p=0.036, respectively). Anatomical hepatectomy was an independent favorable prognostic factor by multivariate analysis taking into consideration clinical factors, which could be clarified pre- or intraoperatively (p=0.003). Anatomical hepatectomy should be performed for HCC patients with HCC with preserved liver function.
  Anticancer research 04/2013; 33(4):1689-95. · 1.73 Impact Factor
• Article: Better outcomes by monitoring tumour dynamics using sensitive tumour markers in patients with recurrent gastric cancer.

  Shuhei Komatsu, Daisuke Ichikawa, Yukihisa Nishimura, Takeshi Kubota, Kazuma Okamoto, Atsushi Shiozaki, Hitoshi Fujiwara, Hirotaka Konishi, Yasutoshi Murayama, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: Little is known about the prognostic value and clinical significance of monitoring tumour status using tumour markers in patients with recurrent gastric cancer. Between 2002 and 2009, 91 consecutive patients exhibited recurrence after curative gastrectomy for gastric cancer. They were followed intensively using tumour markers such as CA19-9 and CEA and their records were retrospectively analyzed. At the time of recurrence, patients were divided into three groups. Each tumour marker was re-elevated in 45 patients (51%) (re-elevation group: REG), was continuously-elevated since initial surgery in 23 patients (25%) (continuous elevation group: CEG) and was not elevated in 22 patients (24%) (non-elevation group: NEG). Survival after recurrence in REG was significantly better than in the other groups. In particular, those in REG had significantly better outcomes than those in NEG, in both survival after recurrence (p=0.0109) and total postoperative survival (p=0.0197), although there were no significant differences in recurrence-free survival between the two groups (p=0.8818). REG patients were able to receive more chemotherapy regimens than NEG patients (p=0.0730, REG vs. NEG, first-line 43% vs. 68%, second-line 33% vs. 32%, third-line or more 24% vs. 0%). Multivariate analysis revealed that re-elevations in tumour markers were found to be an independent prognostic factor for survival after recurrence [p=0.0014, hazard ratio=2.55 (95% CI: 1.45-4.65)]. Particularly for peritoneal recurrence, those in REG had significantly better outcomes than those in NEG (p<0.0005). Monitoring tumour dynamics using tumour markers may facilitate clinical decision-making, according to changes in tumour markers and contribute to survival prolongation in patients with recurrent gastric cancer.
  Anticancer research 04/2013; 33(4):1621-7. · 1.73 Impact Factor
• Article: Anti-phosphohistone H3 as an Independent Prognostic Factor in Human Esophageal Squamous Cell Carcinoma.

  Shingo Nakashima, Atsushi Shiozaki, Daisuke Ichikawa, Shuhei Komatsu, Hirotaka Konishi, Daisuke Iitaka, Takeshi Kubota, Hitoshi Fujiwara, Kazuma Okamoto, Mitsuo Kishimoto, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: The immunohistochemical staining of phospho-histone H3 (PHH3) has recently been reported to predict the prognosis of different tumors. However, it has not been evaluated in esophageal squamous cell carcinoma (ESCC). The aim of this study was to evaluate the prognostic impact of PHH3 in ESCC. The number of anti-phophohistone H3-positive nuclei [i.e. PHH3 mitotic index (MI)] was calculated by immunohistochemistry of 50 primary tumor samples obtained from patients with ESCC who underwent curative esophagectomy. The PHH3 MI per 10 high-power fields ranged from 1 to 72 (median=15.5). When the patients were divided into two groups using a cut-off value of 10, the 5-year survival rate of the patients with PHH3 MI ≤10 was significantly higher than that of patients with PHH3 MI >10. Multivariate analysis indicated PHH3 MI to be an independent prognostic factor. The expression of PHH3 impacts the prognosis of patients with ESCC.
  Anticancer research 02/2013; 33(2):461-7. · 1.73 Impact Factor
• Article: COX-2 Overexpression Induced by Gene Transfer Reduces Sensitivity of TE13 Esophageal Carcinoma Cells to 5-Fluorouracil and Cisplatin.

  Hiroko Okamura, Hitoshi Fujiwara, Seiji Umehara, Shinichi Okamura, Momoko Todo, Akinobu Furutani, Masayuki Yoneda, Atsushi Shiozaki, Shuhei Komatsu, Takeshi Kubota, Daisuke Ichikawa, Kazuma Okamoto, Toshiya Ochiai, Chouhei Sakakura, Yoshitaka Takahashi, Tanihiro Yoshimoto, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: Previous clinicopathological studies demonstrated that overexpression of cyclooxygenase-2 (COX-2) is associated with a poor treatment response of esophageal carcinoma. The aim of this study was to elucidate the role of COX-2 overexpression in the chemosensitivity of esophageal carcinoma cells. TE13 human esophageal squamous cell carcinoma cells were transfected with a COX-2 constitutive expression vector, and stable transfectants overexpressing COX-2 were established. COX-2 overexpression in COX-2 transfectants was confirmed with western blotting and prostaglandin-E(2) (PGE(2)) assay. Chemosensitivity testing revealed that sensitivity of COX-2 transfectants to 5-fluorouracil and cisplatin was significantly lower than in control vector-only transfectants, and that sensitivity of COX-2 transfectants was restored by the transfection of COX-2-specific siRNA. In addition, expression of antiapoptotic B-cell lymphoma-extra large (BCL-xL) and myeloid cell leukaemia-1 (MCL-1) was increased in COX-2 transfectants. These results indicate that COX-2 overexpression may reduce the chemosensitivity of esophageal carcinoma cells through up-regulation of the expression of antiapoptotic BCL-2 family proteins.
  Anticancer research 02/2013; 33(2):537-42. · 1.73 Impact Factor
• Article: Efficacy of 5-aminolevulinic acid-mediated photodynamic therapy using light-emitting diodes in human colon cancer cells.

  Tomoya Hatakeyama, Yasutoshi Murayama, Shuhei Komatsu, Atsushi Shiozaki, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Daisuke Ichikawa, Hitoshi Fujiwara, Kazuma Okamoto, Toshiya Ochiai, Yukihito Kokuba, Katsushi Inoue, Motowo Nakajima, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: 5-Aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) (ALA-PDT) is a highly selective treatment for malignant cells. ALA-PDT has the potential to develop into a novel therapeutic strategy for various types of cancer. Recently, light-emitting diodes (LEDs), which are inexpensive, stable and easier to handle compared to lasers, have been used in PDT as a light source. However, in colorectal cancer (CRC), the efficacy of ALA-PDT in combination with LEDs has not been fully assessed. Therefore, in this study, we evaluated the antitumor effect of ALA-PDT using various LEDs in colon cancer cells. The HT-29 human colon cancer cell line was used both in vitro and in vivo. HT-29 cells were seeded in 96-well plates. Following 5-ALA administration, cells were irradiated using LEDs at different wavelengths. Three types of LEDs, blue (peak wavelength, 456 nm), white (broad-band) and red (635 nm) were used. Twenty-four hours after irradiation, the cytotoxic effects of ALA-PDT were measured using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. In order to evaluate the antitumor effect of ALA-PDT in vivo, nude mice were inoculated with HT-29 cells. Xenograft mice were injected intraperitoneally with 5-ALA and irradiated with 3 types of LEDs at a measured fluence rate of 96 mW/cm2 and fluence of 32 J/cm2. Each group comprised 6 mice. ALA-PDT was repeated 3 times at weekly intervals. Tumor weights were measured. Compared to the controls, ALA-PDT using LEDs showed significant antitumor effects in vitro and in vivo. The blue and white LEDs demonstrated greater antitumor effects compared to the red LEDs in vitro and in vivo. In particular, tumor inhibition rates in the blue and white LED groups were approximately 88% to those of the control group in the mouse models. In conclusion, ALA-PDT using LEDs is effective and useful in the treatment of CRC cells. This method could be a novel treatment modality for CRC.
  Oncology Reports 01/2013; · 1.84 Impact Factor
• Article: Prognostic Impact of Circulating miR-21 in the Plasma of Patients with Gastric Carcinoma.

  Shuhei Komatsu, Daisuke Ichikawa, Masahiro Tsujiura, Hirotaka Konishi, Hiroki Takeshita, Hiroaki Nagata, Tsutomu Kawaguchi, Shoji Hirajima, Tomohiro Arita, Atsushi Shiozaki, Takeshi Kubota, Hitoshi Fujiwara, Kazuma Okamoto, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: MicroRNAs (miRNAs) such as miR-17-5p, miR-21, miR-106a and miR-106b are reported to be highly expressed in gastric carcinoma (GC) tissues. Recently, we reported that these miRNAs were consistently detectable in plasma and reflected tumor dynamics of GC. We hypothesized that these plasma miRNA concentrations could be used as prognostic markers in patients with GC. Between 2008 and 2009, preoperative plasma samples were collected from 69 consecutive patients with GC at our hospital. We retrospectively examined the association between plasma miRNA concentrations and prognosis. The postoperative cause-specific survival rate of patients with high plasma miR-21 concentration was significantly poorer than those with a low concentration (p=0.0451), as was that of those with high plasma concentration of miR-106a (p=0.1132). There were no prognostic differences according to the plasma concentration of miR-17-5p and miR-106b. Those with high miR-21 concentration had also a slightly higher incidence of vascular invasion (p=0.0311). Multivariate analysis revealed that the presence of a high miR-21 concentration in plasma was an independent prognostic factor (p=0.0133, hazard ratio: 13.4 (95% CI: 1.72-104.4)). The level of circulating miR-21 could be a reliable prognostic marker in the plasma of patients with GC. These findings contribute to the stratification of patients in order to identify those who need meticulous follow-up for early detection of recurrence and additional or alternative treatments of GC.
  Anticancer research 01/2013; 33(1):271-6. · 1.73 Impact Factor
• Article: Evaluation of lymph node metastasis in patients with gastric cancer: a comparison of the directionality of lymph node metastasis and the total number of metastatic lymph nodes.

  Maki Kitagawa, Daisuke Ichikawa, Shuhei Komatsu, Kazuma Okamoto, Atsushi Shiozaki, Hitoshi Fujiwara, Yasutoshi Murayama, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Toshiya Ochiai, Yukihito Kokuba, Teruhisa Sonoyama, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: PURPOSE: The clinical impact of the directionality of lymph node (LN) metastasis was assessed in comparison with the staging by the Japanese Classification of Gastric Carcinoma (JCGC), a numerical LN staging system. METHODS: Two hundred forty-one gastric cancer patients who were diagnosed pathologically to have LN metastasis, and 54 patients who underwent preoperative multidetector-row computed tomography (MDCT) with an image thickness of 1 mm were classified into three groups (unidirectional [Uni-], bidirectional [Bi-], and tridirectional [Tri-] groups) depending on the directionality of their LN metastasis. RESULTS: The prognosis of the Uni-group was better than that of the Bi- or the Tri-group when assessed on the basis of the pathological findings of metastatic LN and also the preoperative MDCT findings. The exact preoperative evaluation was 70.2 % for the directionality system and 61.7 % for the JCGC system, respectively. The stages were less frequently underestimated by the directionality system than the JCGC system (P < 0.02, 19.1 vs. 34.0 %), and the staging could be more precisely performed by both systems in combination. CONCLUSIONS: More precise preoperative evaluation of disease stage could be obtained by the directionality system and the JCGC system in combination.
  Surgery Today 12/2012; · 1.22 Impact Factor
• Article: HGF regulates VEGF expression via the c-Met receptor downstream pathways, PI3K/Akt, MAPK and STAT3, in CT26 murine cells.

  Atsushi Matsumura, Takeshi Kubota, Hiroaki Taiyoh, Hitoshi Fujiwara, Kazuma Okamoto, Daisuke Ichikawa, Atsushi Shiozaki, Shuhei Komatsu, Masayoshi Nakanishi, Yoshiaki Kuriu, Yasutoshi Murayama, Hisashi Ikoma, Toshiya Ochiai, Yukihito Kokuba, Takahiro Nakamura, Kunio Matsumoto, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: In the present study, we assessed the involvement of hepatocyte growth factor (HGF)/c-Met signalling with vascular endothelial cell growth factor (VEGF) and hypoxia inducible factor (HIF)-1α expression in the downstream pathways phosphatidylinositol 3-kinase (PI3K)/Akt, mitogen-activated protein kinase (MAPK) and signal transducer and activator of transcription 3 (STAT3) in CT26 cells, to determine the mechanisms of the potent anti-angiogenic effect of NK4. We established genetically modified CT26 cells to produce NK4 (CT26-NK4). VEGF expression in subcutaneous CT26 tumours in vivo and in culture supernatants in vitro was determined by ELISA. HIF-1α expression in nuclear extracts was evaluated by western blot analysis. VEGF and HIF-1α mRNA levels were examined by real-time reverse transcription-polymerase chain reaction (RT-PCR). The DNA binding activity of HIF-1α was evaluated using an HIF-1α transcription factor assay kit. Our results demonstrated that VEGF expression was reduced in homografts of CT26-NK4 cells, compared to those of the control cells. In vitro, VEGF expression, which was induced by HGF, was inhibited by anti-HGF antibody, NK4 and by kinase inhibitors (PI3K, LY294002; MAPK, PD98059; and STAT3, Stattic). HGF‑induced HIF‑1α transcriptional activity was also inhibited by the kinase inhibitors. Real-time RT-PCR demonstrated that HGF‑induced HIF‑1α mRNA expression was not inhibited by LY294002 and PD98059, but was inhibited by Stattic. These data suggest that the PI3K̸Akt, MAPK and STAT3 pathways, downstream of HGF̸c‑Met signalling, are involved in the regulation of VEGF expression in CT26 cells. HGF̸c‑Met signalling may be a promising target for anti-angiogenic strategies.
  International Journal of Oncology 12/2012; · 2.40 Impact Factor
• Article: Staging fluorescence laparoscopy for gastric cancer by using 5-aminolevulinic Acid.

  Yasutoshi Murayama, Daisuke Ichikawa, Noriaki Koizumi, Shuhei Komatsu, Atsushi Shiozaki, Yoshiaki Kuriu, Hisashi Ikoma, Takeshi Kubota, Masayoshi Nakanishi, Yoshinori Harada, Hitoshi Fujiwara, Kazuma Okamoto, Toshiya Ochiai, Yukihito Kokuba, Tetsuro Takamatsu, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: Precise staging of gastric cancer is essential when selecting for the appropriate treatment approach. 5-Aminolevulinic acid (5-ALA) is metabolized and accumulated as protoporphyrin IX (PpIX), which is a photosensitizer. In this study, we evaluated the diagnostic usefulness of 5-ALA for demonstrating peritoneal dissemination in patients with gastric cancer. Fluorescence laparoscopy (FL) was performed in 13 patients with gastric cancer. All patients received preoperative oral administration of 5-ALA. Fluorescence-light laparoscopies were sequentially performed intraoperatively. In four out of the 13 patients, primary tumors were detected by FL and demonstrated serosal invasion on histological examination. Five out of the 13 patients demonstrated peritoneal metastases, and one patient demonstrated superficial liver micrometastases, by FL. All of these lesions were diagnosed as metastatic lesions by hematoxylin and eosin staining. These findings show that FL diagnosis with 5-ALA is accurate and suitable for the detection of peritoneal metastases and of superficial liver micrometastases in patients with gastric cancer.
  Anticancer research 12/2012; 32(12):5421-7. · 1.73 Impact Factor
• Article: [A case of pancreaticoduodenectomy after the placement of an expandable metallic stent].

  Hisashi Ikoma, Yusuke Yamamoto, Hiroki Konishi, Rei Morimura, Yasutoshi Murayama, Shuhei Komatsu, Atsushi Shiozaki, Yoshiaki Kuriu, Takeshi Kubota, Masayoshi Nakanishi, Daisuke Ichikawa, Hitoshi Fujiwara, Kazuma Okamoto, Toshiya Ochiai, Yukihito Kokuba, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: This is a case report of a 75-year-old man who underwent pancreaticoduodenectomy and received a placement of an expandable metallic stent (EMS) for palliation of the biliary stricture following diagnosis as middle bile duct carcinoma. At a local hospital, abdominal computed tomography revealed multiple low-density lesions with peripheral enhancement in the liver. After being diagnosed as metastatic liver tumor with cholangiocarcinoma, an EMS was inserted for palliation of the biliary stricture on the basis of the diagnosis as unresectable carcinoma due to the metastatic lesion. One month after stenting, because of relieving the biliary obstruction, no hepatic tumors were detected in either lobe by computed tomography. Based on this finding, the lesions were diagnosed as inflammatory pseudotumor of the liver rather than as metastatic liver tumor. A pancreaticoduodenectomy was performed without removal of the EMS, and fortunately, we were able to divide the bile duct upstream of the EMS. However, insertion of a stent may increase the difficulty of operation in many cases.
  Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2134-6.
• Article: [A case of advanced colon cancer resected successfully after neoadjuvant chemotherapy].

  Yosuke Kamada, Masayoshi Nakanishi, Yasutoshi Murayama, Shuhei Komatsu, Atsushi Shiozaki, Yoshiaki Kuriu, Hisashi Ikoma, Akio Kimura, Daisuke Ichikawa, Kazuma Okamoto, Hitoshi Fujiwara, Toshiya Ochiai, Yukihito Kokuba, Tsuyoshi Ishikawa, Satoshi Kokura, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: This case concerns a 54-year-old male patient who had been identified as having a type 2 tumor in the cecum, which subsequent pathologic examination revealed to be an adenocarcinoma. The results of a computed tomography (CT) scan suggested that the tumor had directly invaded the right iliopsoas. Neoadjuvant chemotherapy was performed to avoid a non-curative resection. CT and positron-emission tomography(PET) findings after the 6th course of chemotherapy revealed a significant reduction in tumor size, at which point a right hemicolectomy with D3 nodal dissection was performed. The changes from neoadjuvant chemotherapy were judged to be Grade 1a. The patient was recurrence-free at his 14- months follow-up examination. Neoadjuvant chemotherapy with a drug that targets a specific molecule is a useful treatment for patients with an unresectable primary cancer.
  Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2213-5.
• Article: [Diagnostic problems in gastric cancer patients with sarcoidosis-case report and literature review].

  Hirotaka Konishi, Shuhei Komatsu, Daisuke Ichikawa, Akira Sougawa, Kazuma Okamoto, Atsushi Shiozaki, Hitoshi Fujiwara, Yasutoshi Murayama, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Toshiya Ochiai, Yukihito Kokuba, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: Sarcoidosis is an idiopathic systemic disease with non-caseating granuloma that is reported to occur concomitantly with various malignant tumors. We report here a case of advanced gastric cancer with sarcoidosis, for which precise preoperative diagnosis was difficult. A 69-year-old woman was diagnosed with a far-advanced gastric cancer because multiple intra-abdominal and intra-thoracic lymph node swellings and a tumorous lesion in the spleen were detected by multidetector computed tomography and fluorodeoxyglucose positron emission tomography. However, these multiple changes might be derived from sarcoidosis, because the multiple lymph node swellings were nonspecific changes for gastric cancer. With appropriate informed consent, surgery was selected in order to accurately confirm the stage of progression. Consequently, these changes were shown to not be metastatic, and curative surgery was performed. In conclusion, careful examination and a reasonable treatment strategy are important for avoiding the risk of overdiagnosis in gastric cancer patients with sarcoidosis.
  Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2330-2.
• Article: [Operative Problems during Simultaneous Laparoscopic Surgery for Gastric and Colorectal Cancer].

  Masataka Kasuga, Shuhei Komatsu, Daisuke Ichikawa, Kazuma Okamoto, Atsushi Shiozaki, Hitoshi Fujiwara, Yasutoshi Murayama, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Toshiya Ochiai, Yukihito Kokuba, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: Recent technological advances in optical and surgical devices have resulted in laparoscopic surgery for gastric and colorectal cancer, gaining wider acceptance and becoming more common. Simultaneous laparoscopic surgery for gastric and colorectal cancer has many potential advantages, including a small incision, good cosmetic result, less postoperative pain, and less mobility. However, some problems have to be resolved. To clarify the anastomotic problem of combined abdominal minilaparotomy, we present here 2 typical cases of simultaneous laparoscopic surgery for gastric and colorectal cancer. Case 1: The anastomoses after laparoscopic right hemicolectomy and distal gastrectomy were easily performed by combined upper abdominal minilaparotomy. Case 2: The anastomosis after laparoscopic right hemicolectomy was easily performed by upper abdominal minilaparotomy. However, the ensuing esophago-jejuno anastomosis after laparoscopic total gastrectomy resulted in failure during combined upper abdominal minilaparotomy because the anastomotic angle was incomplete. In conclusion, the choice of abdominal mini-incision site is crucial during simultaneous laparoscopic surgery for gastric and colorectal cancer. Surgeons should not hesitate to perform an additional mini-incision or change other anastomotic procedures if the operation is difficult, requires a long time to complete, and is likely to cause intraoperative complications.
  Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2351-3.
• Article: [Diagnostic value of direct inspection and palpitation by surgeons in intra-operative nodal staging of gastric cancer].

  Hidefumi Ueda, Shuhei Komatsu, Daisuke Ichikawa, Kazuma Okamoto, Takeshi Kubota, Atsushi Shiozaki, Hitoshi Fujiwara, Yasutoshi Murayama, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Toshiya Ochiai, Yukihito Kokuba, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: Background and purpose: Recent imaging modalities such as multi-detector computed tomography, fluorodeoxyglucose positron emission tomography/computed tomography, and magnetic resonance imaging have emerged as promising diagnostic and staging methods in various cancers. However, these modalities lack the diagnostic ability to evaluate tissue elasticity, which could instead be easily estimated by a surgeon through palpitation. To add tissue elasticity to future diagnostic methods, this study was designed to evaluate the ability of surgeons to estimate elasticity by direct inspection and palpitation during intra-operative nodal staging of gastric cancer. Patients and Methods: Between 2008 and 2009, 57 consecutive patients with gastric cancer underwent curative gastrectomy and all their regional lymph nodes showing metastatic involvement were intra-operatively counted using direct inspection and palpitation by surgeons. Results: The overall sensitivity, specificity, and accuracy were 63.1%, 86.8%, and 82.8%, respectively. The sensitivity was higher in D1 lymph nodes such as No.6, No.5, No.7, and No.3. The specificity and accuracy were higher in D2 lymph nodes such as No.9, No.11p and No.8a. Conclusions: Nodal diagnosis through direct inspection and palpitation by surgeons could be a reliable and accurate method in gastric cancer, comparable to other recent modalities. These data imply that tissue elasticity could be applied as a new modality in the nodal diagnosis of gastric cancer.
  Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2295-7.
• Article: [The clinical influence of double or multiple primary cancers on the prognosis of patients with gastric cancer].

  Yukihisa Nishimura, Shuhei Komatsu, Daisuke Ichikawa, Kazuma Okamoto, Atsushi Shiozaki, Hitoshi Fujiwara, Yasutoshi Murayama, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Toshiya Ochiai, Yukihito Kokuba, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: Background: An aging population and advances in diagnostic technology have led to an increase in the incidence of double or multiple primary cancers(DMPC) in patients with gastric cancer(GC). This study was designed to evaluate the clinical influence of DMPC on the prognosis of patients with GC. Methods: Between 1997 and 2009, 1,086 patients underwent curative gastrectomy for GC in our hospital. Results: 1) 1,086 patients were analyzed, and of these 166 patients (15%) had DMPC and the remaining 920 patients had no DMPC. GC patients with DMPC had a significantly higher age (p <0.0001) and higher incidence of differentiated cancer(p=0.0045) than those without DMPC. 2) Multivariate analysis showed the presence of DMPC was an independent prognostic factor for overall survival. It was particularly noteworthy that the prognosis of GC patients with hematological cancer, hepato-biliary pancreatic cancer and esophageal cancer was extremely poor. In contrast, those with colorectal cancer and urological cancer had a comparatively better prognosis. The number of DMPC had little influence on the prognosis of GC patients. 3) In a survival associated with GC, the presence of DMPC had no influence on the prognosis of GC patients. Conclusions: The types of DMPC had more clinical influence on the prognosis of GC patients than the number of DMPC with respect to overall survival.
  Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2301-3.
• Article: [A Novel Treatment Strategy Using Trafermin, Containing Basic Fibroblast Growth Factor, for Intractable Duodenal Fistula following Curative Gastrectomy for Gastric Cancer-Case Report and Literature Review].

  Kenichi Takemoto, Shuhei Komatsu, Kazuma Okamoto, Daisuke Ichikawa, Atsushi Shiozaki, Hitoshi Fujiwara, Yasutoshi Murayama, Yoshiaki Kuriu, Hisashi Ikoma, Masayoshi Nakanishi, Toshiya Ochiai, Yukihito Kokuba, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: Despite recent perioperative technological advances in gastric cancer treatment, duodenal stump leakage and intractable duodenal fistula are still major critical complications following gastrectomy that should be specifically targeted in order to improve postoperative outcomes. Here, we provide a preliminary report of a case of intractable duodenal fistula successfully treated with Trafermin containing basic fibroblast growth factor. A 70-year-old man underwent distal gastrectomy with radical lymphadenectomy for early distal gastric cancer (pT1bN0M0). After surgery, duodenal fistula occurred and persisted for 1 year and 2 months despite surgery and several conservative treatments. After obtaining informed consent, we started injection of Trafermin at 50 μg/day through a drainage tube into the dehiscence of the duodenum. Consequently, the duodenal fistula was successfully closed within 4 weeks. Our novel treatment technique is simple, rapid, and cost effective. If informed consent is obtained from patients with a low risk of recurrence, this technique should be recommended as one of the treatment choices for intractable duodenal fistula following curative gastrectomy for gastric cancer.
  Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):1960-2.
• Article: [Neoadjuvant chemoradiotherapy for locally advanced rectal cancer].

  Yoshiaki Kuriu, Yukihito Kokuba, Yasutoshi Murayama, Shuhei Komatsu, Atsushi Shiozaki, Hisashi Ikoma, Masayoshi Nakanishi, Daisuke Ichikawa, Hitoshi Fujiwara, Kazuma Okamoto, Toshiya Ochiai, Eigo Otsuji
  [show abstract] [hide abstract]
  ABSTRACT: A total of 37 patients treated with chemoradiotherapy between 2008 and 2011 were analyzed. Radiotherapy was administered in fractions of 1.8 Gy/day for 25 days. S-1 was administered orally in a fixed daily dose of 80 mg/m2 on days 1-5, 8-12, 22-26, and 29-33. Irinotecan(CPT-11 80 mg/m2) was infused on days 1, 8, 22, and 29. Curative surgery was performed 6-8 weeks later. The clinical downstaging rate was 40%. During the median follow-up time of 664 days, 37 patients survived. Recurrence was found in 8 patients. Local recurrence (pelvic lymph node metastasis) was only observed in 1 patient. Grade 3-4 toxic effects, including interstitial pneumonia, occurred in 27% of the patients. Neoadjuvant chemoradiotherapy may result in excellent local control with acceptable morbidity. However, longer follow up is required to assess neoadjuvant chemoradiotherapy for locally advanced rectal cancers.
  Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):1951-3.