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Publications (11)0 Total impact

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    ABSTRACT: A 60-year-old man presented with anal pain. He was diagnosed as having perianal abscess and carcinoma associated with anal fistula. We performed chemoradiotherapy (radiation, total 50.4 Gy; capecitabine 2,000 mg/m2) followed by chemotherapy( XELOX, 2 courses: capecitabine 2,000 mg/m2, oxaliplatin 130 mg/m2). After chemoradiotherapy, the tumor significantly reduced in size. Laparoscopic abdominoperineal resection of the rectum, extended resection of the perianal region, and reconstruction of the perianal skin defect using a rectus abdominis musculocutaneous flap were performed. Histopathologically, the tumor was classified as tub2, pMP, ly0, v0, pN0 (0/3), pStage I, and the therapeutic efficacy was classified as Grade 2. Chemoradiation appears to be effective for the treatment of carcinomas associated with anal fistula.
    Gan to kagaku ryoho. Cancer & chemotherapy 11/2013; 40(12):1990-2.
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    ABSTRACT: Purpose: To evaluate the effectiveness and safety of radiofrequency ablation(RFA)for liver metastases from colorectal cancer after chemotherapy. Patients: From January 2006 to June 2012, 27 tumors in 17 patients with liver metastases from colorectal cancer were treated using RFA after systemic chemotherapy. Results: The median tumor diameter after chemotherapy was 12(range: 3-35)mm, and the mean number of tumors was 1.6(range: 1-4).The median time without local recurrence was 21.3(range: 2.2-61.9)months, and the median overall survival time was 38.0(range: 5.9-66.3)months. One patient had a complication(liver abscess).Of the 27 tumors, 9 were larger than 20 mm in diameter, and 4 of these 9 tumors showed local recurrence after RFA. In tumors smaller than 20 mm in diameter, only 1 showed local recurrence. The local recurrence rate was significantly higher for tumors larger than 20 mm than for tumors smaller than 20 mm(44.4% vs 5.6%,p=0.030).Conclusion: RFA was an effective and safe method for treating liver metastases from colorectal cancer, especially for tumors smaller than 20 mm and in cases of less than 3 tumors after systemic chemotherapy.
    Gan to kagaku ryoho. Cancer & chemotherapy 11/2013; 40(12):1984-6.
  • Yoshihito Ide, Koji Mikami, Kohei Murata
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    ABSTRACT: Background: Central venous access port(CV port)is used for long-term treatment of patients with advanced colorectal cancer. To confirm a standard procedure of CV port implant, we analyzed long-term outcomes and complications of upper arm CV ports. Methods: Ninety patients implanted with CV ports in the upper arm between November 2006 and November 2009 were studied retrospectively. Results: There were no complications from the implanting procedure. Twenty patients (22. 2%)had complications, including infection(n=10), occlusion(n=7), thrombosis(n=4)and persistent pain(n=1) (there is some overlapping). Eighteen patients(20%)received surgery for removal of the ports. The median follow-up period was 160 days(range, 30-1,167days). Univariate and multivariate analysis indicated that patients with a catheter tip above the tracheal bifurcation had a significantly higher risk for complications than patients with a tip below bifurcation. Conclusion: Upper arm CV ports were implanted safely. For long-term use, it is important to place the catheter tip below the tracheal bifurcation.
    Gan to kagaku ryoho. Cancer & chemotherapy 03/2013; 40(3):331-335.
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    ABSTRACT: Hepatic resection is a first choice for resectable liver metastatic tumor from colorectal carcinoma. In the case of unresectable tumor or a refusal to operation, laparoscopic radiofrequency ablation (RFA) becomes an option to treat. We report a case of laparoscopic RFA for liver metastatic tumor from colorectal carcinoma. A 74-year-old woman had a laparoscopic transverse colectomy for transverse colon cancer with multiple liver metastases in February 2009. She received UFT/LV and liver metastases were reduced. After the second course, the patient desired to stop chemotherapy. But the liver metastases had grown again. We recommended a hepatic resection. Since she didn't want to have the operation, we performed RFA. After the RFA, a liver metastasis was detected twice. After tumors were located near other organs, we performed a laparoscopic RFA. At 9 months after undergoing last RFA, she had no recurrence in the liver. We thought laparoscopic RFA was safe and effective for the lesion, which was difficult to treat with percutaneous approach RFA.
    Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2289-90.
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    ABSTRACT: A 75-year-old man underwent distal gastrectomy for gastric cancer (CY+, Stage IV) in June 2009. About 4 months after surgery, he had a strong pain in a right shoulder, and became writing difficulty. Some imaging examinations revealed multiple bone metastases, and it was diagnosed that the pain was caused by the tumor of cervical spine. Systemic chemotherapy was started using a regimen of S-1/CDDP, and radiotherapy (30 Gy) was performed for the cervical tumor at the same time. After two-course of the chemotherapy, the shoulder pain disappeared. About 12 months after surgery, he had a strong pain in a left leg, and became walking difficulty. Some imaging examinations revealed a progression of the tumor of lumbar spine. Radiotherapy (30 Gy) was demonstrated for the tumor. After the treatment, the leg pain disappeared. We experienced a case of multiple bone metastases successfully treated with chemo-radiotherapy.
    Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2149-51.
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    ABSTRACT: Neoadjuavnt chemotherapy for liver metastasis of colorectal cancer implies issues about timing for resection and management for adverse events due to chemotherapy. CASE: A 50-year-old male patient with synchronous liver metastasis from rectal cancer had a surgery for primary lesion followed by neo-adjuvant chemotherapy for liver resection. Chemotherapy of bevacizumab + mFOLFOX6 achieved a partial response for liver metastasis. When we planned a liver resection, platelet count decreased to 1.4 × 10(4)/µL. The patient was diagnosed as idiopathic thrombocytopenic purpura (ITP) by several examinations but medical control including steroids failed. Partial splenic artery embolization could recover platelet count successfully. However, during the period of therapy for ITP, liver metastasis became unresectable. The patient is currently treated by FOLFIRI and with stable disease for three months. CONCLUSION: NeoPyloriadjuvant chemotherapy for respectable liver metastasis should be considered carefully in terms of timing for resection and prompt management for adverse events.
    Gan to kagaku ryoho. Cancer & chemotherapy 11/2010; 37(12):2605-7.
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    ABSTRACT: The patient was a 75-year-old female. In 2005, abdominal computer tomography (CT) revealed a 18 mm-in-diameter early enhanced lesion (tumor A) in S8, which was diagnosed as hemangioma of liver with abdominal simple MRI examination. However, abdominal computer tomography (CT) revealed a 16 mm-in-diameter early enhanced lesion (tumor B) near the tumor A to at S8 in April 2008. Both tumor A and tumor B led to a diagnosis of hepatocellular carcinoma (HCC) with Gd-EOB-DTPA enhanced magnetic resonance imaging (MRI) (tumor A was suspected to HCC with adipose components, and tumor B was suspected to HCC with bile excretion disorder). In July 2008, he received S8 partial hepatectomy at these hepatic tumors. In this resected specimen, a new lesion was detected as a 7 mm-in-diameter HCC, sandwiched in previous two tumors. Previous two tumors were diagnosed as well differentiated HCCs and a new lesion was diagnosed as moderately differentiated HCC. This patient is still alive with no recurrence after 14 months from hepatectomy. In conclusion, Gd-EOB-DTPA enhanced MRI might be useful in diagnosis of hepatic tumor characteristics.
    Gan to kagaku ryoho. Cancer & chemotherapy 11/2009; 36(12):2386-8.
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    ABSTRACT: The patient was a 55-year-old female. In 1997, she was diagnosed as type-I glycogen storage disease (von Gierke disease). In March 2002, abdominal ultrasound tomography revealed an early enhanced lesion at liver S2, which suspected to a well differentiated hepatocellular carcinoma (HCC) with super-paramagnetic iron oxide (SPIO) enhanced magnetic resonance imaging (MRI). From 2002 to 2006, she received three times trans-arterial chemo-embolization (TACE) at enhanced lesions. But abdominal computer tomography (CT) revealed a 3.6 cm-in diameter early enhanced lesion near this tumor at S2, which was suspected to a diagnosis of recurrent HCC in December 2008. Therefore, she received a partial hepatectomy at S2. This resected specimen was diagnosed as poorly differentiated HCC. This patient is still alive with no recurrence after 6 months from operation. In conclusion, it might be effective for an early detection of recurrent HCC to see the doctor for a long regular checkup, because the growth of HCC with glycogen storage disease would be very slow.
    Gan to kagaku ryoho. Cancer & chemotherapy 11/2009; 36(12):2362-4.
  • Yoshihito Ide, Koji Mikami, Kohei Murata
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    ABSTRACT: We report 5 cases of metastatic colorectal cancer with intermittent hepatic arterial infusion (HAI) and systemic chemotherapy (CPT-11, biweekly) in 2006-2008. Two patients with poor performance status were for systemic chemotherapy, and 3 patients were initiated as third-line treatment or more. Among the 5 patients, 2 patients were recorded as PR, 2 patients were as SD, and 1 patient was as NE. Three patients are alive with a mean follow-up of 19 months. HAI is intended to have few side effects compared with the systemic chemotherapy, and the treatment methods for these cases were not indicated for any of standard chemotherapies. But HAI alone is considered as insufficient treatment for unresectable liver metastasis, because HAI cannot be proved to have an apparent survival benefit. It is possible that a combination of regional and systemic drug treatments will be more effective than systemic treatment alone for unresectable colorectal cancer.
    Gan to kagaku ryoho. Cancer & chemotherapy 11/2009; 36(12):2172-4.
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    ABSTRACT: We report a case of complete remission of relapsed rectal cancer liver metastasis after systemic chemotherapy successfully treated by radiofrequency ablation (RFA). A 60-year-old man was diagnosed as having rectal cancer with colonoscopy and as solitary liver metastasis with enhanced CT. After primary tumor was resected, modified FOLFOX6 chemotherapy was performed. A complete response (CR) was observed after the eighth course, and the chemotherapy was finished at the twelfth course. Recurrence of liver metastasis was showed after the chemotherapy for six months, so RFA was performed without any complications. He is living without relapsing for eight months. We basically performed first was systemic chemotherapy to liver metastasis of colorectal cancer, and performed a local treatment including resection, if necessary. We suppose that RFA after systemic chemotherapy is one of the useful treatment strategies for liver metastasis of colorectal cancer, because RFA is less invasive than resection and a discontinuation of the drug is not required for RFA.
    Gan to kagaku ryoho. Cancer & chemotherapy 12/2008; 35(12):2180-2.
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    ABSTRACT: A patient is a 78-year-old male. Abdominal ultrasound tomography revealed hepatic tumors. Abdominal computer tomography (CT) revealed a 5.5 cm-in-diameter low enhanced lesion and a 4.0 cm-in-diameter enhanced lesion at S8, and a 1.8 cm-in-diameter enhanced lesion at S5, a 1.4 cm-in-diameter enhanced lesion at S6, which led to a diagnosis of combined hepatocellular carcinoma with intra-hepatic metastasis (IM2) in July 2007. From August to October 2006, he received a hepatic combination therapy with trans-arterial chemotherapy at a low enhanced lesion and trans-arterial embolization (TAE), and radiofrequency ablation therapy (RFA) at enhanced lesions. As of June 2008, this patient is still alive with no recurrence after 8 months from the beginning of this treatment. In conclusion, it might have been effective and suitable to combine multiple therapies to each of the tumor characteristics for mixed hepatocellular carcinoma.
    Gan to kagaku ryoho. Cancer & chemotherapy 12/2008; 35(12):2103-5.