Publications (14)20.06 Total impact
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Article: [A case report of multiple adenocarcinoma in small intestine after total gastrectomy by Roux-en-Y re-construction].
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ABSTRACT: This is a very rare case report of multiple small intestine cancer in jejunal loop of Roux-en-Y re-construction, duodenum and jejunum. A 51-year-old man had undergone total gastrectomy by Roux-en-Y re-construction for Stage III B gastric cancer in 1997. In 2008, he underwent partial jejunectomy and partial ilectomy for ileus due to small intestine adenocarcinoma, located at the jejunum 50 cm distal from Roux-en-Y anastomotic region and at the ileum 20 cm proximal from the ileocecal region. PET/CT suspected a recurrence and peritoneal dissemination, so he had undergone S-1/docetaxel treatment since 2009. In 2010, he was diagnosed as obstructive jaundice due to duodenal tumor revealed by CT. Furthermore, enteroscopy revealed duodenal advanced cancer, type 2 advanced cancer and five polyps in jejunal loop, type 2 advanced cancer and type II a early cancer in jejunum. He could not undergo both pancreatoduodenectomy and choledochojejunostomy because of the invasion to hepatoduodenal ligament. He underwent partial jejunectomy for the advanced cancer in jejunal loop 10 cm proximal form Roux-en-Y anastomotic region and in jejunum 50 cm distal from Roux-en-Y anastomotic region for prevention of ileus.Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2042-4. -
Article: [A long-term survival case of recurrent pancreatic vipoma with liver metastases treated by a combination of surgical resection and loco-regional therapies].
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ABSTRACT: We report a case of recurrent pancreatic VIPoma with liver and peritoneal metastases who has been surviving over 7 years by a successful treatment with a combination of surgical resection and loco-regional therapies. A 59-year-old female underwent distal pancreatectomy for pancreatic endocrine tumor. Five years after pancreatectomy, she had a recurrence of liver and peritoneal metastases with the symptoms by hypersecretion of VIP, and she underwent hepatectomy and peritoneal tumor resection. Seven months later, multiple liver metastases appeared and were treated with transcatheter arterial chemoembolization (TACE). Additionally radiofrequency ablation( RFA) for remnant viable lesion was performed. Seven years and eight months after primary panceatectomy and two years and six months after resection of the liver and peritoneal recurrences, she is now disease-free with good quality of life. The progression of well-differentiated pancreatic neuroendocrine carcinoma is usually slow. It is potentially useful in controlling of liver metastases to combine the loco-regional therapy like TACE and RFA with surgical resection.Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2158-60. -
Article: [A 6-year survival case of locally advanced unresectable pancreatic tail cancer treated with chemo-radiation therapy].
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ABSTRACT: We report a case of locally advanced unresectable pancreatic tail cancer patient who survived over 6 years by chemo-radiation therapy (CRT). A 61-year-old male was pointed out by CT to have pancreatic tail cancer of 5.6 cm in diameter that invaded to the stomach, left kidney and adrenal gland, nerve plexus of celiac and superior mesenteric artery, was diagnosed as locally advanced unresectable pancreatic tail cancer. CRT of gemcitabine (GEM) with RT to a primary lesion was successful. After two years and 11 months, Schnitzler's metastasis appeared and RT was effective to recover from rectal stricture. At three years and 3 months, GEM was converted to S-1. After 4 years and 5 months, paraaortic lymph node metastasis was enlarged, so chemotherapy was changed to combination of GEM + S-1. After 4 years and 10 months, upper mediastinal lymph node metastasis appeared. At 6 years and 1 month, RT to upper mediastinum for pain control was performed. Finally, 6 years and 6 months after the first diagnosis, he died of pancreatic cancer. A long-term survival of locally advanced unresectable pancreatic cancer is very rare. In the case of pancreatic cancer that CRT is effective to the remission of primary lesion, CRT is potentially useful to perform for the control of metastatic lesion or palliative therapy.Gan to kagaku ryoho. Cancer & chemotherapy 11/2010; 37(12):2355-7. -
Article: Well-differentiated endocrine cell carcinoma of ileum treated by laparoscopy-assisted surgery--a case report.
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ABSTRACT: A 72-year-old woman presented at our hospital with a 1-year history of intermittent right lower abdominal pain. Colonoscopic examination revealed a submucosal tumor with a pitted surface in the terminal ileum. Histopathological diagnosis of the carcinoid tumor was made following biopsy. Blood serotonin and urine 5-hydroxy-indoleacetic acid levels were normal, and carcinoid syndrome was not detected. Enhanced abdominal computed tomography scan and 18F-fluorodeoxyglucose positron emission tomography failed to detect multiple lesions, lymph node swelling or distant metastasis. Laparoscopy-assisted ileocecal resection with lymph node dissection was performed. The resected specimen showed a submucosal tumor with a pitted surface 11 x 11 mm in size, located at the terminal ileum. Histopathological examination revealed a well-differentiated endocrine cell carcinoma with an invasion depth to the muscularis propria. Immunohistochemical analysis showed the tumor cells to be chromogranin A and CD56-positive. The patient had no sign of recurrence for 16 months.Hiroshima journal of medical sciences 06/2010; 59(2):35-8. -
Article: Survival of patients treated by an autonomic nerve-preserving gastrectomy for early gastric cancer.
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ABSTRACT: Autonomic nerve preservation in a gastrectomy for gastric cancer improves the postoperative quality of life. We retrospectively examined the survival of patients treated by an autonomic nerve-preserving gastrectomy in comparison to the survival of the patients treated by a conventional gastrectomy. The survival of 385 patients treated by an autonomic nerve-preserving gastrectomy for clinical early gastric cancer (the ANP group) was compared with that of 285 patients treated by a conventional gastrectomy (non-ANP group). Among the ANP group, the numbers of patients with tumor invasion to the mucosa, submucosa, and muscularis propria were 210, 166, and 9, respectively, whereas the numbers of patients with lymph node metastasis grades of N0, N1, and N2 were 360, 21, and 4, respectively. The overall 5-year survival rate of the ANP group was 94.7%, which was superior to that of the non-ANP group (90.4%; P = 0.003). The 5-year survival rates of patients with lymph node metastasis were 94.9% and 91.8% in the ANP and non-ANP groups, respectively (P = 0.733). Only 3 patients in the ANP group died from gastric cancer. The survival of patients treated by an autonomic nerve-preserving gastrectomy was equivalent to that of patients treated by a conventional gastrectomy, thus suggesting that an autonomic nervepreserving gastrectomy could be a useful procedure for the treatment of early gastric cancer.Surgery Today 05/2010; 40(5):444-50. · 1.22 Impact Factor -
Article: [A case of long-term survival in P1CY1 gastric cancer responding to combined chemotherapy with low-dose CDDP intraperitoneal administration].
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ABSTRACT: We reported a case of P1CY1 gastric cancer with intraperitoneal chemotherapy after surgery for more than four years. The patient was a 69-year-old male who had suffered from Type I+Type 0 IIc, T3 gastric cancer. He underwent total gastrectomy with D2 dissection. Operative findings revealed P1CY1, and it resulted in non-curative resection. After surgery, combined chemotherapy with low-dose CDDP intraperitoneal administration and UFT, and then combined chemotherapy with paclitaxel and 5-FU were performed. He also underwent palliative surgery for intestinal obstruction resulting from carcinomatous peritonitis. He achieved long-term survival by multidisciplinary therapy of chemotherapy and surgery.Gan to kagaku ryoho. Cancer & chemotherapy 11/2009; 36(12):2061-3. -
Article: Frequency of lymph node metastasis to the splenic hilus and effect of splenectomy in proximal gastric cancer.
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ABSTRACT: The purpose of this study was to investigate the clinicopathological characteristics and frequency of lymph node metastasis to the splenic hilus in proximal gastric cancer and the effect of splenectomy. Three hundred and forty-nine patients undergoing total gastrectomy for primary proximal gastric cancer were included. Among these patients, lymph node metastasis to the splenic hilus was histologically assessed in 201 cases. The incidence of lymph node metastasis to the splenic hilus was 31 cases (15.4%). No lymph node metastasis to the splenic hilus was detected in any T1 and T2 tumors located at the lesser curvature and anterior wall. No significant difference was observed between the survival rates of patients with and without splenectomy in each stage. Our findings indicated that gastrectomy with spleen preservation may be recommended at least in patients with T1 or T2 tumors located at the lesser curvature and anterior wall.Anticancer research 09/2009; 29(8):3347-51. · 1.73 Impact Factor -
Article: [Efficacy of tegafur/uracil plus oral leucovorin therapy for advanced or recurrent colorectal cancer].
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ABSTRACT: The aim of this study was to evaluate the efficacy of tegafur/uracil (UFT) and oral Leucovorin(UZEL) in patients with advanced or recurrent colorectal cancer. Eight patients were treated with UFT/UZEL therapy as a first-line chemotherapy. UFT(300 mg/m(2)/day) and UZEL (75 mg/body/day) were administered orally for 28 consecutive days followed by a 7-day rest period, and this schedule was repeated every 5 weeks. The mean of treatment courses given to the patients was 7.6. Tumor response was evaluated in 7 patients who had assessable lesions, and the response rate was 86% (6 PR and 1 NC). Adverse reactions of grade 3 were observed in 2 patients (25%), but toxicity did not cause a discontinuance of treatment in any case. The UFT/UZEL therapy was considered to be a promising regimen for advanced or recurrent colorectal cancer from a standpoint of effect, safety and QOL of patients.Gan to kagaku ryoho. Cancer & chemotherapy 12/2005; 32(12):1935-8. -
Article: Long-term outcome of S-1 and cisplatin combination therapy in patients with advanced or recurrent gastric cancer.
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ABSTRACT: Although combination therapy of S-1 and cisplatin (CDDP) has excellent efficacy against gastric cancer, the effect of the treatment on survival has been unclear. The aim of this study was to evaluate the long-term outcome of this combination therapy. Sixty-three patients with advanced or recurrent gastric cancer were treated with S-1, with or without CDDP, as first-line chemotherapy, and the clinical results were compared retrospectively. S-1 was administered orally at a standard dose of 80 mg/m(2). In the treatment of the S-1 group, S-1 was given for 28 consecutive days, followed by a 14-day rest. In the treatment of the S-1/CDDP group, S-1 was given for 21 consecutive days, followed by a 14-day rest, and CDDP, at 60 mg/m(2), was infused on day 8. The incidence of adverse reactions of more than grade 3 was 22.5% in the S-1 group and 43.5% in the S-1/CDDP group, and the treatment compliance was better in the S-1 group. The overall response rate was 25.9% in the S-1 group, and 36.8% in the S-1/CDDP group. The combination of S-1 with CDDP had better effects on the primary lesion and on differentiated-type carcinoma than S-1 alone. However, there was no difference in survival between the two patient groups. The median survival time after the initiation of treatment in the S-1 group was 322 days, and that in the S-1/CDDP group was 319 days. Our results suggest that the combination of CDDP with S-1 does not improve the long-term outcome of S-1 therapy.Gastric Cancer 02/2005; 8(2):111-6. · 2.42 Impact Factor -
Article: [A case of advanced esophageal cancer responding remarkably to chemotherapy of TS-1 and weekly CDDP combined with radiotherapy].
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ABSTRACT: A 66-year-old patient, who had advanced esophageal cancer with lymph node metastasis, was treated by neoadjuvant chemo-radiotherapy, followed by curative surgery. Chemotherapy of TS-1 (80 mg/m2) was administered orally for 21 days, and weekly intravenous administration of CDDP (20 mg/m2) was done 3 times. Radiotherapy at 2 Gy/day was combined 15 times (total 30 Gy). The tumor responded well to the treatment, and the size was remarkably reduced. Chemoradiotherapy using TS-1 and weekly CDDP revealed their efficacy for esophageal cancer.Gan to kagaku ryoho. Cancer & chemotherapy 01/2005; 31(13):2159-62. -
Article: Endoscopic Anatomy of Perforating Veins in Chronic Venous Insufficiency of the Legs: “Solitary” Incompetent Perforating Veins Are Often Actually Multiple Vessels
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ABSTRACT: We have already reported on the effectiveness of subfascial, endoscopic, perforating-veins surgery for chronic venous insufficiency of the legs. The incompetent perforating vein (IPV) often appears to be a single vessel, when it is actually two or more vessels. Accordingly we examined the anatomy and features of IPVS. The features of perforating veins were assessed in 173 limbs of 152 patients. In the recent 50 limbs, 128 IPVs were subjected to complete dissection of the adventitia to confirm the number of vessels. Ninety-seven out of 110 IPVs (88.2%) had a concomitant artery. On endoscopy 128 IPVs could be classified into seven types (type N, type O, type I, type II, type III, type IV, and type V) according to the combination of arteries and veins which were presented. Type N means a normal perforator consisting of a single artery with a pair of normal veins running alongside it. Type O has the same anatomy as type N but shows reverse flow. Type I has an incompetent vein with thick walls and reverse flow, which is not accompanied by an artery. Type II is an artery associated with an incompetent vein. Type III is composed of an artery, a normal vein, and an incompetent vein. Type IV is an artery with two incompetent veins and type V contains multiple incompetent veins. When the anatomy of 128 IPVs was confirmed, the number of each type was as follows: 7 type O (5%), 32 type I (25%), 1 type II (1%), 48 type III (38%), 39 type IV (30%), and 1 type V (1%). This is the first report on all the components of IPVs directly visualized in vivo. It has been almost impossible to predict the postoperative reversibility of IPVs after surgical ablation of superficial veins. By using our classification of IPVs, it will be possible to treat only the irreversible (true) incompetent veins and to avoid operating on arteries, normal veins, and reversibly incompetent veins. In the future, it will be necessary to devise the operative strategy according to the type of IPVs as assessed by endoscopic examination.International Journal of Angiology 01/2004; 13(1):31-36. -
Article: Immunohistochemical and mutational analyses of beta-catenin, Ki-ras, and p53 in two subtypes of colorectal mucinous carcinoma.
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ABSTRACT: The adenoma-carcinoma sequence theory is accepted in carcinogenesis of colorectal carcinoma. To elucidate the nature and genetic alterations in colorectal mucinous carcinoma (MC), we analyzed clinical and pathological characteristics of colorectal MC and nonmucinous carcinoma (NMC), and, furthermore, we compared the prognoses and the statuses of the Wnt signaling pathway, Ki-ras, and p53 in these two subtypes. Samples of colorectal MC obtained by surgical resections from 41 patients during the period from 1980 to 1999 were classified into fixed (FIX) type and floating (FLO) type (22 and 19 cases, respectively). The statuses of the Wnt signaling pathway and p53 protein were estimated by immunohistochemistry of beta-catenin and p53 proteins, respectively. The mutations in the Ki-ras gene were examined by direct sequencing. The prognosis of colorectal MC was poorer than that of NMC at both stage II and stage III (P = 0.0037 and <0.0001, respectively). The survival rate of patients with the FLO type of MC was lower than that of patients with the FIX type (P = 0.021). Although the results of immunohistochemistry of beta-catenin and mutational analysis of the Ki-ras gene in the two subtypes were not significantly different; the rate of positive nuclear staining of p53 was lower in the FLO type than in the FIX type (P = 0.04). Colorectal MC, particularly the FLO type, has a more aggressive nature than does colorectal NMC. The FLO type of colorectal MC may develop through different mechanisms from those through which NMC and the FIX type develop.Clinical Cancer Research 11/2003; 9(15):5660-5. · 7.74 Impact Factor -
Article: A new method for laparoscopic percutaneous tube gastrostomy with a single 1-cm-long incision for patients with esophageal obstruction.
Journal of the American College of Surgeons 10/2002; 195(3):431-3. · 4.55 Impact Factor -
Article: Immunohistochemistry of cyclin D1 and beta-catenin, and mutational analysis of exon 3 of beta-catenin gene in parathyroid adenomas.
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ABSTRACT: Parathyroid adenomas are benign uniglandular tumors and are the most common cause of primary hyperparathyroidism. Several genetic changes in parathyroid tumors, including inactivation of tumor suppressor genes, activation of oncogenes and loss of heterozygosity at several chromosomal loci, have been reported. In this study, we analyzed the status of cyclin D1 and beta-catenin in 24 cases of parathyroid adenoma. Immunohistochemistry of cyclin D1 showed positive staining in 9 (37.5%) of the 24 parathyroid adenomas. The status of beta-catenin, which has recently been identified as a regulator of cyclin D1 transcription, was examined by direct sequencing of exon 3 of the beta-catenin gene and immunohistochemistry of beta-catenin protein, but neither mutation nor accumulation of beta-catenin was detected in any of the cases. These results indicate that cyclin D1 is frequently accumulated in parathyroid adenomas, independently of dysfunction in the Wnt signaling pathway.International Journal of Oncology 04/2002; 20(3):463-6. · 2.40 Impact Factor
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2002–2003
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Hiroshima University
- Department of Surgery
Hiroshima-shi, Hiroshima-ken, Japan
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