Hideo Shigematsu

Publications (10)17.67 Total impact

• Article: Role of FDG-PET/CT in evaluating surgical outcomes of operable breast cancer - Usefulness for malignant grade of triple-negative breast cancer.

  Masahiro Ohara, Hideo Shigematsu, Yasuhiro Tsutani, Akiko Emi, Norio Masumoto, Shinji Ozaki, Takayuki Kadoya, Morihito Okada
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  ABSTRACT: BACKGROUND: The aim of this study was to evaluate the significance of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for speculating the malignant level and prognostic value of operable breast cancers. METHODS: Of 578 consecutive patients with primary invasive breast cancer who underwent curative surgery between 2005 and 2010, 311 patients (53.8%) who received FDG-PET/CT before initial therapy were examined. RESULTS: Receiver operating characteristics (ROC) curve analysis showed the cutoff value of the maximum standardized uptake value (SUVmax) to predict cancer recurrence was 3.8 in all patients and 8.6 in patients with the triple-negative subtype, respectively. In all patients, 3-year DFS rates were 98.8% for patients with a tumor of SUVmax ≤ 3.8 and 91.6% for patients with a tumor of SUVmax > 3.8 (p < 0.001). High value of SUVmax was significantly associated with large tumor size (p < 0.001), lymph node metastasis (p = 0.040), high nuclear grade (p < 0.001), lymphovascular invasion (p = 0.032), negative hormone receptor status (p < 0.001), and positive HER2 status (p = 0.014). Based on the results of multivariate Cox analysis in all patients, high SUVmax (p = 0.001) and negative hormone receptor status (p = 0.005) were significantly associated with poor prognosis. In patients with triple-negative subtype, 3-year DFS rates were 90.9% for patients with a tumor of SUVmax ≤ 8.6 and 42.9% for patients with a tumor of SUVmax > 8.6 (p = 0.002), and high SUVmax was the only significant independent prognostic factor (p = 0.047). CONCLUSION: FDG-PET/CT is useful for predicting malignant behavior and prognosis in patients with operable breast cancer, especially the triple-negative subtype.
  Breast (Edinburgh, Scotland) 06/2013; · 2.09 Impact Factor
• Article: Three models for predicting the risk of non-sentinel lymph node metastasis in Japanese breast cancer patients.

  Tatsunari Sasada, Tsuyoshi Kataoka, Hideo Shigematsu, Norio Masumoto, Takayuki Kadoya, Morihito Okada, Hideki Ohdan
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  ABSTRACT: BACKGROUND: Axillary lymph node dissection (ALND) is the standard procedure for breast cancer with sentinel lymph node (SLN) metastasis. However, additional nodal metastasis is occasionally detected (<40 % cases) during complete ALND in patients with SLN metastasis. Several models have been developed to predict the non-SLN status of patients with SLN involvement. We evaluated 3 of these mathematical models independently. PATIENTS AND METHODS: A retrospective review was performed for 102 consecutive breast cancer patients with positive SLN biopsy who underwent ALND. We evaluated the area under the receiver operating characteristic curve (AUC) to determine the predicted risk of non-SLN metastases by using 3 mathematical models (from Memorial Sloan-Kettering Cancer Center (MSKCC), Stanford University, and Cambridge University). RESULTS: Of the 102 patients who underwent SLN biopsy, 47 (46.0 %) had a positive non-sentinel axillary lymph node metastasis. The AUC values were 0.71, 0.65, and 0.62 for the MSKCC, Stanford, and Cambridge nomograms, respectively. CONCLUSIONS: None of the 3 nomograms had reasonable predictive power for the Japanese population. However, these nomograms can help individualize the surgical treatment of patients with positive SLN when the likelihood of further axillary metastasis is low. Each nomogram has its own characteristics for prediction of the risk of non-SLN metastasis.
  Breast Cancer 01/2013; · 1.36 Impact Factor
• Source

  Available from: Shinji Ozaki

  Article: Technical Feasibility and Cosmetic Advantage of Hybrid Endoscopy-Assisted Breast-Conserving Surgery for Breast Cancer Patients.

  Shinji Ozaki, Masahiro Ohara, Hideo Shigematsu, Tatsunari Sasada, Akiko Emi, Norio Masumoto, Takayuki Kadoya, Shigeru Murakami, Tsuyoshi Kataoka, Masayoshi Fujii, Koji Arihiro, Morihito Okada
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  ABSTRACT: Abstract Background: We developed a new procedure called hybrid endoscopy-assisted breast-conserving surgery (EBCS), which consists of a combination of plastic surgery and endoscopic surgery techniques. The purpose of this study was retrospectively to analyze the clinical outcome of hybrid EBCS and compare the cosmetic outcomes between hybrid EBCS and conventional breast-conserving surgery (CBCS). Patients and Methods: We reviewed medical records of patients who had undergone hybrid EBCS (n=73) or CBCS (n=90) between May 2005 and April 2011 and had been followed up in our department until March 2012. The clinical outcomes and cosmetic outcomes of these two groups were compared. The safety of hybrid EBCS was also analyzed by confirming its complications and pathological surgical margin. Results: In the hybrid EBCS group, operation time was longer by 30-50 minutes. Blood loss was not significantly different between the two groups. The surgical margin of hybrid EBCS was as follows: 1 patient (1.4%) had a positive margin, 4 patients (5.5%) had a margin of <2 mm, in 9 patients (12.3%) the margin was ≥2 mm and <5 mm, and in 59 patients (80.8%) it was ≥5 mm. Seven cases (9.6%) of postoperative complications occurred in 6 hybrid EBCS patients. To date, no local recurrence has been observed in hybrid EBCS patients (postoperative observation period, 18.1±5.6 months). Compared with the CBCS group, the hybrid EBCS group had better cosmetic results, especially with a less noticeable operative scar (P<.01). Conclusions: Hybrid EBCS can provide sufficient free margin, and its surgical curability is acceptable. Additionally, this method is superior to CBCS in terms of cosmetic outcome.
  Journal of Laparoendoscopic & Advanced Surgical Techniques 12/2012; · 1.40 Impact Factor
• Article: [A resected case of complete response after treatment with S-1 for recurrent squamous cell carcinoma component of the breast].

  Yoshie Kobayashi, Takayuki Kadoya, Emiko Kanno, Tatsunari Sasada, Keiko Kajitani, Akiko Emi, Hideo Shigematsu, Norio Masumoto, Rumi Haruta, Tsuyoshi Kataoka, Koji Arihiro, Morihito Okada
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  ABSTRACT: A resected case of complete response after treatment with S-1 for recurrent squamous cell carcinoma component of the breast is presented.A 65-year-old woman was admitted to another hospital because of a left breast tumor. A tumor approximately 6 cm in diameter was palpable in the subareolar-lower (DBE) region of the left breast; the diagnosis was breast cancer. We performed mastectomy and axillary lymph node dissection. The pathological diagnosis revealed squamous cell carcinoma of the left breast(pT3N1M0, Stage III A). FEC chemotherapy, a standard chemotherapy regimen for general breast cancer, was performed as first-line adjuvant therapy, but was withdrawn after 1 course due to sepsis shock. Weekly PTX chemotherapy as second-line treatment was also withdrawn after six courses due to interstitial pneumonia. Few skin rashes were observed along the incision scar of the left breast, but biopsy revealed skin invasion by local recurrence of squamous cell carcinoma of the breast. Treatment with S-1 was performed for 8 months, and she underwent resection of left skin, fat tissue, and underlying muscle, including the recurrent region. No residual primary carcinoma foci was found in the resected specimen; therefore, the pathological diagnosis revealed complete response for the squamous cell carcinoma component.
  Gan to kagaku ryoho. Cancer & chemotherapy 09/2012; 39(9):1403-6.
• Article: [High incidence-rate of oral mucositis in breast cancer patients receiving anthracycline-based chemotherapy (FEC100)].

  Mami Fukazawa, Hidetoshi Kawaguchi, Hideo Shigematsu, Chinami Koga, Emiko Mori, Sumiko Nishimura, Yoshiaki Nakamura, Seishi Satou, Kuniko Sawamura, Kunihiro Kashiwaba, Shinji Ohno
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  ABSTRACT: Background: Oral mucositis is a frequent complication, but is poorly studied among patients with solid tumors. The purpose of this study is to clarify the incidence rate of oral mucositis in Japanese breast cancer patients receiving anthracycline-based chemotherapy(FEC100). Methods: From June 2007 to July 2008, 61 breast cancer patients eligible for this study received anthracycline-based chemotherapy(FEC100: 5-FU 500mg/m / / 2, epirubicin 100 mg/m2, cyclophosphamide 500 mg/m2)at National Kyushu Cancer Center and Iwate Medical University Hospital. The incidence rate and grade of oral mucositis were evaluated in these patients. Results: The cumulative incidence of oral mucositis was about 50%. Episodes of oral mucositis were more common during courses with febrile neutropenia than during courses without it(75. 0% vs 44. 9%, p=0. 12). The reduction of oral mucositis was only 13. 6% after administering the steroidal ointment and/or mouthwash, including sodium azulene sulfonate. Conclusions: New methods are needed to prevent and treat oral mucositis in patients receiving anthracycline- based chemotherapy(FEC100).
  Gan to kagaku ryoho. Cancer & chemotherapy 03/2012; 39(3):395-8.
• Source

  Available from: PubMed Central

  Article: A case of HER-2-positive recurrent breast cancer showing a clinically complete response to trastuzumab-containing chemotherapy after primary treatment of triple-negative breast cancer.

  Hideo Shigematsu, Takayuki Kadoya, Yoshie Kobayashi, Keiko Kajitani, Tatsunari Sasada, Akiko Emi, Norio Masumoto, Rumi Haruta, Tsuyoshi Kataoka, Miyo Oda, Kouji Arihiro, Morihito Okada
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  ABSTRACT: We report a case of HER-2-positive recurrent breast cancer showing a clinically complete response to trastuzumab-containing chemotherapy 6 years after primary treatment of triple-negative breast cancer. The primary tumor was negative for HER-2 as determined by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) (1+, and ratio, 1.1), but examination of the recurrent lymph node metastasis showed positivity for HER-2 by FISH (ratio, 5.2). No lesions were detected in either her left breast or in other organs, and the patient was diagnosed as having HER-2-positive recurrent disease. Combination chemotherapy using weekly paclitaxel and trastuzumab was initiated, and a clinically complete response was achieved. This report suggests the benefit of routine evaluation of HER-2 status in recurrent breast cancer with the introduction of HER-2-targeting agents.
  World Journal of Surgical Oncology 11/2011; 9:146. · 1.12 Impact Factor
• Source

  Available from: Kenichi Taguchi

  Article: Significant survival improvement of patients with recurrent breast cancer in the periods 2001-2008 vs. 1992-2000.

  Hideo Shigematsu, Hidetoshi Kawaguchi, Yoshiaki Nakamura, Kimihiro Tanaka, Satoko Shiotani, Chinami Koga, Sumiko Nishimura, Kenichi Taguchi, Kenichi Nishiyama, Shinji Ohno
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  ABSTRACT: It is unclear whether individualized treatments based on biological factors have improved the prognosis of recurrent breast cancer. The purpose of this study is to evaluate the survival improvement of patients with recurrent breast cancer after the introduction of third generation aromatase inhibitors (AIs) and trastuzumab. A total of 407 patients who received first diagnosis of recurrent breast cancer and treatment at National Kyushu Cancer Center between 1992 and 2008 were retrospectively evaluated. As AIs and trastuzumab were approved for clinical use in Japan in 2001, the patients were divided into two time cohorts depending on whether the cancer recurred before or after 2001. Cohort A: 170 patients who were diagnosed between 1992 and 2000. Cohort B: 237 patients who were diagnosed between 2001 and 2008. Tumor characteristics, treatments, and outcome were compared. Fourteen percent of cohort A and 76% of cohort B received AIs and/or trastuzumab (P < 0.001). The median overall survival (OS) times after breast cancer recurrence were 1.7 years and 4.2 years for these respective cohorts (P < 0.001). Both the time period and treatment of AIs and/or trastuzumab for recurrent disease were significant prognostic factors in multivariate analysis (cohort B vs. cohort A: HR = 0.70, P = 0.01; AIs and/or trastuzumab for recurrent disease: yes vs. no: HR = 0.46, P < 0.001). When patients were categorized into 4 subgroups by the expression of hormone receptor (HR) and HER-2 status, the median OS times of the HR-positive/HER-2-negative, HR-positive/HER-2-positive, HR-negative/HER-2-positive, and HR-negative/HER-2-negative subtypes were 2.2, 2.4, 1.6, and 1.0 years in cohort A and 4.5, 5.1, 5.0, and 1.4 years in cohort B. The prognosis of patients with recurrent breast cancer was improved over time following the introduction of AIs and trastuzumab and the survival improvement was apparent in HR- and/or HER-2-positive tumors.
  BMC Cancer 03/2011; 11:118. · 3.01 Impact Factor
• Article: A case of HER-2-positive advanced inflammatory breast cancer with invasive micropapillary component showing a clinically complete response to concurrent trastuzumab and paclitaxel treatment.

  Hideo Shigematsu, Yoshiaki Nakamura, Kimihiro Tanaka, Satoko Shiotani, Chinami Koga, Hidetoshi Kawaguchi, Sumiko Nishimura, Kenichi Taguchi, Kenichi Nishiyama, Shinji Ohno
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  ABSTRACT: We report a case of HER-2-positive advanced inflammatory breast cancer with invasive micropapillary component showing a complete response to trastuzumab and paclitaxel treatment. A 37-year-old woman was referred to our hospital for right breast swelling with broad skin redness and right axillary tumor. Ipsilateral infraclavicular and contralateral axillary lymph nodes swelling were also recognized. The histopathological findings of core-needle biopsy specimens from primary breast tumor and ipsilateral axillary lymph node were invasive ductal carcinoma with a micropapillary component. Immunohistochemical examination gave a negative result for estrogen receptor (ER)/progesterone receptor (PgR), and overexpression of HER-2 (Hercep Test 3+). Advanced inflammatory breast cancer with an invasive micropapillary component was diagnosed (T4d N3 M1 (LYM), stage IV). The patient was treated with combination chemotherapy using weekly paclitaxel and trastuzumab. After administration of three courses, the breast swelling, skin redness, and lymph node swelling disappeared completely. She maintained complete remission of disease for 12 months and was judged to have a clinically complete response by the RECIST criteria. Invasive micropapillary carcinoma is known to be an aggressive histological type associated with a high incidence of lymph node metastasis and poor prognosis. This is the first reported case of advanced inflammatory breast cancer with an invasive micropapillary component showing a clinically complete response to trastuzumab-containing treatment. This report suggests trastuzumab-containing chemotherapy is a promising therapy for HER-2-positive advanced invasive micropapillary carcinoma.
  International Journal of Clinical Oncology 12/2010; 15(6):615-20. · 1.41 Impact Factor
• Article: Rapamycin enhances chemotherapy-induced cytotoxicity by inhibiting the expressions of TS and ERK in gastric cancer cells.

  Hideo Shigematsu, Kazuhiro Yoshida, Yuichi Sanada, Shinnji Osada, Takao Takahashi, Yoshiyuki Wada, Kazuo Konishi, Morihito Okada, Masakazu Fukushima
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  ABSTRACT: We have previously reported the synergistic cytotoxic effects of Docetaxel (TXT) and S-1 in gastric cancer in vitro and in vivo, and the combination regimen is now under phase III clinical trail. In this study, to elucidate whether the rapamycin, the inhibitor of the mTOR (mammalian target of rapamaycin), can enhance the potentiation of TXT and 5-fluorouracil (5-Fu) in gastric carcinoma cells. Rapamycin inhibited the growth of TMK-1, MKN-28, MKN-45 and MKN-74 cell lines by MTT assay, and it demonstrated the cytostatic effects as G1 arrest shown by flowcytometry. However, the cytotoxic effects of 5-Fu, TXT and cisplatin were enhanced by 2 to 4 times with the concomitant administration of rapamycin. To clarify the mechanism of the potentiation, the expression changes of the enzymes relating DNA metabolism and cell growth signal transduction pathways were examined by western blot analysis. Interestingly, the expression of thymidilate synthase was markedly decreased by the administration of rapamycin in TMK-1 cells in a time- and dose-dependent manner. Moreover, rapamycin decreased the phosphorylation of 4E-BP1, the phosphorylation of ERK1/2 and enhanced the phosphorylation of c-Jun NH2-terminal kinase, and the activation of caspase of apoptotic pathways in combination with TXT. These results strongly indicate that the mTOR inhibitor can enhance the potentiation of TXT and 5-Fu or S-1 and can serve as a new therapeutic tool for advanced and recurrent gastric cancer patients.
  International Journal of Cancer 10/2009; 126(11):2716-25. · 5.44 Impact Factor
• Article: The expression profiles of orotate phosphoribosyltransferase and dihydropyrimidine dehydrogenase in gastric cancer and their clinical significance.

  Mamoru Oeda, Kazuhiro Yoshida, Yuichi Sanada, Yoshiyuki Wada, Takahisa Suzuki, Hirozumi Mizuiri, Kazuo Konishi, Hideo Shigematsu, Kazuaki Tanabe, Masakazu Fukushima
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  ABSTRACT: Orotate phosphoribosyltransferase (OPRT) is an enzyme that causes the activation of 5-fluorouracil (5-FU). Dihydropyrimidine dehydrogenase (DPD) is known to catabolize 5-FU, which is widely used in chemotherapeutic treatments for patients with a variety of malignant tumors including gastric and colorectal cancer. The expression and activities of these two enzymes therefore play important roles in the response of cancer patients to chemotherapy. However, little is known about the expression of these enzymes in gastric cancer. In the present study, we further elucidate the expression patterns of ORPT and DPD and their clinicopathological significance by immunohistochemical analysis in 221 and RT-PCR in 36 gastric cancer samples. The expression of OPRT by immunohistochemical analysis was detected in 117 (52.9%) cases, whereas DPD was detected in 66 (29.9%) cases. Moreover, the level of expression of OPRT was found to correlate with the depth of tumor invasion and a poorer prognosis. Although the mRNA and protein expression of OPRT and DPD levels did not correlate, an inverse correlation in the expression of OPRT and DPD was observed by RT-PCR. The survival benefit of post-operative adjuvant chemotherapy could not be confirmed in our present analysis. However, among the patients who had received such treatment with 5-FU or its derivatives, the prognosis in cases with low DPD levels was better than that in cases with high DPD expression by immunohistochemical analysis. These results indicate that the expression of OPRT and DPD are important predictors of both survival and the response to adjuvant chemotherapy in gastric cancer patients.
  Oncology Reports 01/2007; 16(6):1165-72. · 1.84 Impact Factor