Yuichiro Doki

Osaka City University, Ōsaka, Ōsaka, Japan

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Publications (593)1672.7 Total impact

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    ABSTRACT: Esophageal squamous cell carcinoma (ESCC) has a poor prognosis because invasion and metastasis are prevalent. To improve diagnosis, it is important to identify and characterize tumor-specific molecular markers in ESCC. FOXM1 is overexpressed and correlates with pathogenesis in a variety of human malignancies. We aimed to investigate the clinical significance of FOXM1 overexpression in ESCC. FOXM1 expression was assessed in ESCC specimens from 174 curatively-resected cases. The relationships between FOXM1 expression, clinicopathological parameters, and prognoses were examined. Immunohistochemical analysis showed that 94 (54.0%) tumors were positive for FOXM1 expression. FOXM1 positivity did not correlate with any clinicopathological parameter. However, FOXM1-positive cases had poorer prognoses than FOXM1-negative ones (p=0.0037, log-rank test). In multivariate analysis, the following were independent prognostic factors: pT, pN, neoadjuvant chemotherapy, and FOXM1 expression (hazard ratio=1.69, 95% confidence interval=1.06-2.75, p=0.027). FOXM1 may be a novel prognostic factor in patients with ESCC who undergo curative resection.
    Anticancer research 05/2014; 34(5):2427-32. · 1.71 Impact Factor
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    ABSTRACT: Background and study aims: Steady pressure automatically controlled endoscopy (SPACE) is a new insufflation system that provides constant carbon dioxide (CO2) insufflation pressure during prolonged procedures. The system consists of an overtube, a surgical insufflator, and a newly developed leak-proof valve. The aims of this study were to validate the feasibility and safety of SPACE for esophageal endoscopic submucosal dissection (ESD). Patients and methods: This was a clinical phase I trial, involving 10 patients who underwent esophageal ESD. The primary end point was the rate of adverse events within 30 days (grade 0 to 4). Secondary end points were changes in partial pressure of carbon dioxide (PaCO2) and vital signs during ESD, completion rate of ESD, and degree of abdominal distension by patient assessment and radiographic grading. Results: All adverse events were Grade 2 or less. Mild PaCO2 elevation after ESD was noted; however, no associated symptoms were reported. The procedure was completed under SPACE alone in 8 of 10 patients. Minimal post-procedural bowel distension was observed. Conclusions: In this small pilot study, SPACE was feasible and appeared to be safe. Further study with larger case numbers is required to demonstrate efficacy and safety. Clinical trial registration: UMIN000005434.
    Endoscopy 04/2014; · 5.74 Impact Factor
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    ABSTRACT: The efficacy and feasibility of laparoscopic surgery (LAP) for gastric GISTs >5 cm has not been adequately assessed. Here we investigated the clinical outcomes of these patients. Twenty-seven consecutive patients who underwent resection for gastric GISTs >5 cm were enrolled in this retrospective study. We assessed the tumor characteristics, surgical outcomes, tumor recurrence, and patient survival in the open surgery (OPEN) group and in the LAP group. The tumor size in the OPEN group was larger than that in the LAP group, but there were no differences in the mitotic count. There were no differences in operative complications. Finally, there were no differences in the disease-free and no patients in the LAP group died. In patients with gastric GISTs >5 cm, LAP can be performed with outcomes equivalent to those of OPEN if patient selection and intraoperative judgment are appropriate.
    Surgical laparoscopy, endoscopy & percutaneous techniques 04/2014; · 0.88 Impact Factor
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    ABSTRACT: Although studies have shown that Oct4, Sox2, Klf4, and c-Myc (OKSM)-mediated induced pluripotent stem cell (iPSC) technology sensitizes cancer cells to drugs, the potential risk of inserting c-Myc and random insertions of exogenous sequences into the genome persists. Several authors, including us, have presented microRNA (miRNA)-mediated reprogramming as an alternative approach. Herein, we evaluated the efficacy of miRNA-mediated reprogramming on hepatocellular carcinoma (HCC) cells. Among three miRNAs (miR-200c, miR-302s, and miR-369s) that were previously presented for miRNA-mediated reprogramming, miR-302 was expressed at low levels in HCC cells. After transfecting three times with miR-302, the cells were incubated in ES medium for 3 weeks and then characterized. iPSC-like spheres were obtained after the 3-week incubation. Spheres presented high NANOG and OCT4 expression, low proliferation, high apoptosis, low epithelial-mesenchymal transition marker expression (N-cadherin, TGFBR2), and sensitization to drugs. Several miRNAs were changed (e.g., low oncomiR miR-21, high miR-29b). cMyc was decreased, and methylation was elevated on histone 3 at lysine 4 (H3K4). Differentiated cells expressed markers of each germ layer (GFAP, FABP4, and ALB). AOF2 (also known as LSD1 or KDM1), one of the targets for miR-302, was repressed in iPSC-like-spheres. Silencing of AOF2 resulted in similar features of iPSC-like-spheres, including cMyc down-regulation and H3K4 methylation. In drug-resistant cells, sensitization was achieved through miR-302-mediated reprogramming. miR-302-mediated iPSC technology reprogrammed HCC cells and improved drug sensitivity through AOF2 down-regulation, which caused H3K4 methylation and c-Myc repression.
    Annals of Surgical Oncology 04/2014; · 4.12 Impact Factor
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    ABSTRACT: Various kinds of molecular targeted drugs to inhibit receptor tyrosine kinases (RTKs) have been recently developed. The relationship between the expression status of major RTKs and prognosis in gastric cancer remains unclear. We conducted a multicenter study to evaluate the prognostic impact of the expression of epidermal growth factor receptor (EGFR), c-Met, platelet-derived growth factor receptor (PDGFR), and c-Kit in gastric cancer. This study included 153 gastric cancer patients who underwent gastrectomy at 9 institutions between 2000 and 2006. Expression status of EGFR, c-Met, PDGFR, and c-Kit were evaluated with immunohistochemistry (IHC) centrally. Overall survival based on RTK expression status was statistically compared. Cox multivariate analysis was conducted to adjust for potentially confounding factors. The positive rates for EGFR, c-Met, PDGFR, and c-Kit were 14.4, 24.8, 41.2, and 11.1 %, respectively. Significant interactions with expression status were observed for pathological N stage with EGFR; HER2-status with c-Met; tumor location, histology, and pathological N stage with PDGFR; and no examined variables with c-Kit. Concomitant HER2 positivity was observed for 0.7 % of tumors positive for EGFR, 3.9 % for c-Met, 4.6 % for PDGFR, and 1.3 % for c-Kit. There were some differences in overall survival between patients with or without RTK expression, but only c-Kit expression showed a significant survival difference in Cox multivariate analysis (P = 0.046). Our multicenter study indicated that IHC expression of 4 RTKs had some prognostic impact and that c-Kit-positive status may be a significant indicator of good prognosis in gastric cancer patients.
    Annals of Surgical Oncology 04/2014; · 4.12 Impact Factor
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    ABSTRACT: The 7th edition of the Union for International Cancer Control-TNM (UICC-TNM) classification for esophageal carcinoma made considerable modifications to the definition of N-staging by the number of involved lymph nodes and the regional node boundary. There were few validations of the regional boundary. We evaluated the nodal status of this classification for esophageal squamous cell carcinoma (ESCC). There were 665 patients reviewed who had ESCC and underwent esophagectomy between 1997 and 2012. We evaluated the impact of the location of lymph node metastasis on overall survival. There were 414 patients (61.7 %) who had lymph node metastases. The overall 5-year survival rate was 54.7 %. There were no significant differences in survival among N2, N3, and M1 patients. Cox regression analysis revealed that common hepatic or splenic node involvements (P = 0.001), pT stage (P = 0.0002), and pN stage (P < 0.0001) were independent predictors of survival, but supraclavicular node involvement (P = 0.29) was not. We propose a modified nodal status that designates supraclavicular node as regional: m-N0 (5-year survival = 79 %; n = 251); m-N1 (5-year = 56 %; n = 212); m-N2 (5-year = 30 %; n = 114); m-N3 (5-year = 18 %; n = 52); m-M1 (5-year = 6.2 %; n = 36). This modified nodal staging predicts survival better than the current staging system. The modification of supraclavicular lymph node from nonregional to regional in the 7th UICC classification of ESCC may allow for better stratification of overall survival.
    Annals of Surgical Oncology 04/2014; · 4.12 Impact Factor
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    ABSTRACT: Laparoscopic surgery (Lap) is a feasible therapy in advanced colorectal cancer (CRC) without distant metastasis. Resection of primary lesion in stage IV CRC is now recognized as part of multimodal therapy. However, technical safety and invasiveness of Lap in stage IV CRC remain controversial. The feasibility of Lap in stage IV CRC was determined. Clinical outcomes were compared in primary colorectal resection using Lap, open surgery (Opn), and radical Lap for stages I to III CRC. No difference was observed regarding estimated blood loss and operative time between procedures. Postoperative recovery time and time to subsequent secondary therapy in the stage IV Lap group were significantly shorter than those in the Opn group. Similar results were observed for the 3-year overall survival rate. Lap for stage IV CRC is feasible and preferable in terms of technical safety and invasiveness. It may be useful in multimodal therapy for stage IV CRC.
    Surgical laparoscopy, endoscopy & percutaneous techniques 04/2014; 24(2):153-7. · 0.88 Impact Factor
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    ABSTRACT: In Japan, absolute shortage of donors still continues even after the law allowing organ transplantation from deceased donors came into force in 1997. With the passage of the waiting period after registration for pancreas transplantation (PTx), both deaths and serious cases of diabetic complications necessitating withdrawal of the registration have undoubtedly increased. Therefore, so-called "marginal donor" (MD) has been considered as a potential solution for shortage of donors in Japan. The aim of the present study is to evaluate feasibility of MD in terms of post-PTx outcomes using data from Japan Organ Transplantation Network. A total of 148 PTx were performed from deceased donors in Japan from 2000 to 2012. MD was defined as follows: (1) >45 years old; (2) hemodynamically unstable at harvest using a high-dose dopamine or more than 2 vasopressors; or (3) non-heart-beating status. Postoperative outcomes after PTx were compared between the MD group and the non-MD group. Among the 148 PTx donors, 108 donors (73.0%) satisfied the criteria of MD. Early graft loss of pancreas graft during 3 months post-transplant was observed in 15 patients (10.1%), and the marginality (MD vs non-MD) was not significantly correlated with the early loss of pancreas graft. The overall patient survival of the MD group (1, 3, 5 years: 94.7%, 94.7%, 94.7%) was not significantly different from that of the non-MD group (1, 3, 5 years: 95.0%, 95.0%, 95.0%). Pancreas graft survival in the MD group (1, 3, 5 years: 80.9%, 73.2%, 66.0%) seemed to be slightly lower than that in the non-MD group (1, 3, 5 years: 92.5%, 85.2%, 77.4%), but no statistically significant differences were found between the 2 groups. These results suggest the feasibility of the use of MD for PTx.
    Transplantation Proceedings 04/2014; 46(3):954-7. · 0.95 Impact Factor
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    ABSTRACT: This study evaluated the venous variations of the right colon using preoperative three-dimensional computed tomography (3D-CT), and to investigate its usefulness in laparoscopic complete mesocolic excision (CME) for right colon cancer. 3D-CT was performed prior to surgery in 81 consecutive patients with right colon cancer. Laparoscopic right hemicolectomy was performed without conversion to open surgery in all cases (100 %). All 81 patients had a single ileocolic vein (ICV). The ICV flowed into the superior mesenteric vein (SMV) in 98 % of patients and the gastrocolic trunk (GCT) in 2 % of patients. The right colic vein (RCV) was absent in 6 % of patients. One RCV was present in 88 % of patients and two were present in 6 % of patients. The main RCV flowed into the GCT in 84 % of patients and the SMV in 10 % of patients. The superior RCV was present in 21 % of patients, and all cases flowed into the GCT. One middle colic vein (MCV) was present in 49 % of patients, two in 46 %, and three in 5 % of patients. The main MCV flowed into the SMV in 68 % of patients, GCT in 20 %, jejunal vein in 6 %, inferior mesenteric vein in 5 %, and the splenic vein in 1 % of patients. The GCT was present in 88 % of patients. Although the venous tributaries of the right colon are variable, preoperative 3D-CT is informative and helpful for surgeons performing laparoscopic CME for right colon cancer.
    Annals of Surgical Oncology 03/2014; · 4.12 Impact Factor
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    ABSTRACT: Chemoradiotherapy followed by total mesorectal excision (TME) is the standard treatment for locally advanced rectal cancer. Although this approach decreases the risk of local recurrence, pelvic radiation is associated with long-term morbidity and delays systemic treatment. We conducted this study to evaluate the feasibility of neoadjuvant capecitabine and oxaliplatin (XELOX) plus bevacizumab as a treatment for high-risk localized rectal cancer. Patients with T4 or lymph node-positive rectal cancer were treated with three cycles of XELOX plus bevacizumab and one additional cycle of XELOX. This was followed by TME performed 3-8 weeks after the last chemotherapy session. Twenty-five patients were recruited between December 2009 and November 2011. In seven of the patients (28.0 %), grade 3-4 adverse events occurred. After preoperative chemotherapy, the frequency of tumor (T) downstaging was 69.6 %, and that of lymph node (N) downstaging was 78.9 %. Seven patients discontinued the treatment after 2-3 cycles of XELOX plus bevacizumab. The frequency of subsequent surgery was 92 %, and all patients underwent R0 resections. Postoperative complications occurred in six patients (26.1 %). One patient achieved a pathological complete response (pCR) for the primary tumor and lymph nodes, whereas an additional four patients achieved near-pCR. After a median follow-up of 31 months, five patients displayed metastatic progression, including one who suffered local recurrence. XELOX plus bevacizumab followed by TME is feasible for high-risk localized rectal cancer, as it achieves good tumor regression and causes manageable toxicity.
    Cancer Chemotherapy and Pharmacology 03/2014; · 2.80 Impact Factor
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    ABSTRACT: Gastroduodenal stents for gastric outlet obstruction due to unresectable advanced gastric cancer are increasingly used; however, their effects have not been fully evaluated. A multicenter prospective observational study was performed. Patients were eligible if they had stage IV gastric cancer with a gastric outlet obstruction scoring system (GOOSS) score of 0 (no oral intake) or 1 (liquids only). Self-expandable metallic stents were delivered endoscopically. The effects of stents were evaluated. Twenty patients were enrolled and 18 were eligible (15 men, three women; median age, 70 years). Stent placement was successfully performed in all patients, with no complications. After stenting, a GOOSS score of 2 (soft solids only) or 3 (low-residue or full diet) was achieved in 13 (72%) patients. An improvement in the GOOSS score by one or more points was obtained in 16 (94%) patients. The median duration of fasting and hospital stay was 3 (range, 0-9) days and 18 (6-168) days, respectively. Chemotherapy was performed after stenting in 13 (72%) patients. Gastroduodenal stents are thought to be feasible, safe, and effective for gastric outlet obstruction due to unresectable advanced gastric cancer, with rapid clinical relief and a short hospital stay. J. Surg. Oncol. 2014 109:208-212. © 2013 Wiley Periodicals, Inc.
    Journal of Surgical Oncology 03/2014; 109(3):208-12. · 2.64 Impact Factor
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    ABSTRACT: We recently showed that liver metastatic tissue from patients with colorectal cancer (CRC) was a useful model for identifying novel, hypoxia-inducible genes and prognostic markers. We showed that the expression of secretoglobin, family 2A, member 1 (SCGB2A1) was a potential prognostic factor for CRC. Here, we further evaluated the prognostic impact and function of SCGB2A1 in 222 patients with CRC. The impact of SCGB2A1 expression on disease-free survival (DFS) and overall survival (OS) was assessed with mRNA expression profiling. The function of SCGB2A1 was analyzed by evaluating mRNA expression profiles in cells derived from patients with CRC and by testing the effects of transfecting SCGB2A1 into different CRC-derived cell lines. We evaluated the effects of SCGB2A1 on proliferation, chemosensitivity, radiation sensitivity and sphere formation. Univariate and multivariate analyses indicated that the expression of SCGB2A1 was an independent prognostic factor for CRC (p<0.05), together with lymph node metastasis (p<0.05). Enforced expression of SCGB2A1 in CRC-derived cell lines promoted proliferation (DLD1, SW480 and LoVo cells; p<0.05), decreased chemosensitivity to 5-fluorouracil and oxaliplatin (DLD1 and SW480 cell lines; p<0.05), and significantly increased the viability of irradiated cells (DLD1, SW480 and LoVo cell lines; p<0.05). SCGB2A1 expression was also correlated to cancer stemness-related genes (Wnt, Zeb1 and Twist). Consistent with this correlation, SCGB2A1 expressing cells (SW480) showed increased sphere formation (p<0.05). These results indicated that SCGB2A1 represented a novel, prognostic factor for CRC, and that expression of SCGB2A1 correlated with chemoresistance, radioresistance and cancer cell stemness.
    International Journal of Oncology 02/2014; · 2.66 Impact Factor
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    ABSTRACT: In gastrointestinal cancer surgery, particularly in early cancer, accurate tumor localization is important in order to determine the extent of resection. In laparoscopic surgery, because of the inability to palpate the lesion, the most prevalent method of localization is endoscopic tattooing. However, complicated maneuvering makes it difficult to control local dye spreading and dye leakage into the intraperitoneal cavity. A simpler, safe method is needed. In this study, we developed a novel method for applying fluorescence-coated endoscopic clips to visualize locations inside the colon during laparoscopic surgery. We tested the procedure in an in vivo porcine model and with ex vivo human colon tissues. Bovine serum albumin was conjugated to indocyanine green or the succinimidyl ester CF™ 790 to form a pasty mixture, which was used to coat the front ends of endoscopic clips. The fluorescence-coated clips were endoscopically placed on the mucosal surface of a porcine colon. Using an Olympus near-infrared laparoscopy system, we attempted to identify the fluorescent clips from the outer, serosal side of the porcine colon during laparoscopic surgery in vivo. The clips were also evaluated using ex vivo human colon tissues. After placing two clips on the inner, mucosal surface of the porcine colon, we used near-infrared laparoscopy to view them from the outer, serosal surface of the colon in real time during in vivo laparoscopic surgery. We also identified the fluorescence-coated clips through human colon tissues in an ex vivo study. We developed a novel, fluorescence-coated clip that can be placed endoscopically for rapid, exact localization of colonic lesions. The clips were successfully visualized with near-infrared fluorescence imaging during laparoscopic surgery in an in vivo porcine model and in ex vivo human colon tissues.
    Surgical Endoscopy 02/2014; · 3.43 Impact Factor
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    ABSTRACT: Wilms tumor gene (WT1) protein is an attractive target for cancer immunotherapy. We aimed to investigate the feasibility of a combination therapy consisting of gemcitabine and WT1 peptide-based vaccine for patients with advanced pancreatic cancer and to make initial assessments of its clinical efficacy and immunologic response. Thirty-two HLA-A*24:02 patients with advanced pancreatic cancer were enrolled. Patients received HLA-A*24:02-restricted, modified 9-mer WT1 peptide (3 mg/body) emulsified with Montanide ISA51 adjuvant (WT1 vaccine) intradermally biweekly and gemcitabine (1000 mg/m) on days 1, 8, and 15 of a 28-day cycle. This combination therapy was well tolerated. The frequencies of grade 3-4 adverse events for this combination therapy were similar to those for gemcitabine alone. Objective response rate was 20.0% (6/30 evaluable patients). Median survival time and 1-year survival rate were 8.1 months and 29%, respectively. The association between longer survival and positive delayed-type hypersensitivity to WT1 peptide was statistically significant, and longer survivors featured a higher frequency of memory-phenotype WT1-specific cytotoxic T lymphocytes both before and after treatment. WT1 vaccine in combination with gemcitabine was well tolerated for patients with advanced pancreatic cancer. Delayed-type hypersensitivity-positivity to WT1 peptide and a higher frequency of memory-phenotype WT1-specific cytotoxic T lymphocytes could be useful prognostic markers for survival in the combination therapy with gemcitabine and WT1 vaccine. Further clinical investigation is warranted to determine the effectiveness of this combination therapy.
    Journal of immunotherapy (Hagerstown, Md.: 1997) 02/2014; · 3.20 Impact Factor
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    ABSTRACT: Single-port laparoscopic surgery is more difficult for sigmoid colon and rectal cancers than for right-sided colon cancer. We sought to analyze the feasibility of this procedure for sigmoid colon and rectal cancers and to estimate its difficulty. We analyzed prospectively collected data from 63 consecutive patients with sigmoid colon or rectal cancers who underwent single-port laparoscopic surgery at our institution from June 2009 to December 2011. Patient and tumor characteristics, including patients' pelvic anatomy which was assessed on CT scan imaging, were evaluated to elucidate what factors would affect the difficulty of the procedure and the necessity of using an additional trocar. Overall, the median operative duration was 190 min and blood loss was 20 ml, with no postoperative complications. The median number of lymph nodes harvested was 17 and the distal margin was 58 mm. The tumor was located significantly closer to the anus in cases in which an additional trocar was required in the right lower quadrant (9.5 vs 18 cm, p < 0.0001). Procedural difficulty was significantly increased in cases in which the sacral promontory protruded ventrally (odds ratio 0.779 [95 % confidence interval 0.613 to 0.945], p = 0.0236). Depending on tumor location and sacral promontory shape, the introduction of an additional trocar might render single-port laparoscopic surgery feasible for sigmoid colon and rectal cancer resection.
    Journal of Gastrointestinal Surgery 01/2014; · 2.36 Impact Factor
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    ABSTRACT: Background:S-1, an oral fluoropyrimidine, plus cisplatin (SP) is a standard regimen for advanced gastric cancer (AGC) in East Asia. To date, no studies have evaluated the efficacy and safety of trastuzumab combined with SP in patients with human epidermal growth factor receptor type 2 (HER2)-positive AGC.Methods:Patients with HER2-positive AGC received S-1 (80-120 mg per day) orally on days 1-14, cisplatin (60 mg m(-2)) intravenously on day 1, and trastuzumab (course 1, 8 mg kg(-1); course 2 onward, 6 mg kg(-1)) intravenously on day 1 of a 21-day cycle. The primary end point was response rate (RR); secondary end points included overall survival (OS), progression-free survival (PFS), time to treatment failure (TTF), and adverse events.Results:A total of 56 patients were enrolled. In the full analysis set of 53 patients, the confirmed RR was 68% (95% confidence interval (CI)=54-80%), and the disease control rate was 94% (95% CI=84-99%). Median OS, PFS, and TTF were estimated as 16.0, 7.8, and 5.7 months, respectively. Major grade 3 or 4 adverse events included neutropaenia (36%), anorexia (23%), and anaemia (15%).Conclusions:Trastuzumab in combination with SP showed promising antitumour activity and manageable toxic effects in patients with HER2-positive AGC.British Journal of Cancer advance online publication, 28 January 2014; doi:10.1038/bjc.2014.18 www.bjcancer.com.
    British Journal of Cancer 01/2014; · 5.08 Impact Factor
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    ABSTRACT: Studies have shown the prognostic significance of disseminated tumor cells (DTCs) in bone marrow (BM) of patients with colorectal cancer (CRC). However, the molecular characteristics of DTCs, including their miRNA expression profiles, remain mostly unknown. In this study, we analyzed the miRNA expression of DTCs in BM. EpCAM+ BM cells were collected using immunomagnetic beads after exclusion of CD14+ and CD45+ cells, then subjected to miRNA microarray analysis. Cluster analysis (7 CRC patients with liver metastasis and 12 CRC patients without liver metastasis) indicated that miR-340 and miR-542-3p expressions were significantly decreased in EpCAM+ BM cells of patients with liver metastasis (P = 0.019 and 0.037, respectively). We demonstrated that pre-miR-340 administration inhibited growth of colon cancer cells and suppressed c-Met expression in vitro. In clinical samples of CRC, miR-340 was expressed at significantly lower levels in tumor tissues compared to normal mucosa. Survival analysis in 136 CRC patients indicated that low miR-340 expression was correlated with shorter 5-year disease-free survival (P = 0.023) and poor 5-year overall survival (P = 0.046). It was of note that the CRC group with low miR-340 and high c-Met expression had the worst prognosis. We further demonstrated that systemic pre-miR-340 administration suppressed growth of pre-established HCT116 tumors in animal therapeutic models. These findings indicate that miR-340 may be useful as a novel prognostic factor and as a therapeutic tool against colorectal cancer. Our data suggest that miR-340 in bone marrow may play an important role in regulating the metastasis cascade of colorectal cancer.
    Molecular Cancer Therapeutics 01/2014; · 5.60 Impact Factor
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    ABSTRACT: Patients with adventitia-invading (T3) tumors, which account for the majority of esophageal cancers, are indicated for surgery but still have a poor prognosis. Subclassifying T3 tumors based on clinical outcome would be useful for selecting adequate adjuvant therapies. Using 268 esophageal cancer specimens from patients without preoperative treatment, the length of the vertical and longitudinal tumor invasion, entire esophageal wall thickness, and interruption of the outer muscle layer were measured. These morphological parameters correlated with clinico-pathological factors and outcome.Patients were classified as T1 (38.4 %), T2 (11.9 %), T3 (38.4 %), and T4 (11.2 %) and T stage correlated well with the four morphological parameters (p p = 0.009). T3 tumors with p = 0.019).T3 esophageal cancer can be classified into subgroups according to the length of MLI. Additional local treatment would be indicated for T3 tumors with >20 mm MLI.
    Esophagus 01/2014; 11(2). · 0.83 Impact Factor
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    ABSTRACT: Intraoperative palpation around the target organs and an overview of the operative field are difficult to achieve in laparoscopic surgery for colorectal cancer. Understanding the three-dimensional anatomy of the target organs and the neighboring structures along with a precise preoperative diagnosis is essential in individual cases for completion of an appropriate laparoscopic procedure. A routine virtual three-dimensional multi-imaging integrating PET/MDCT, CT colonography and CT angiography is useful for a precise diagnosis. Local anatomy and patient's features directly affect surgical outcome, especially in the laparoscopic surgery for the rectal cancer. CT pelvimetry is useful for a preoperative prediction of the difficulties of the laparoscopic surgery. These data should be taken into account when planning this procedure.
    Nippon rinsho. Japanese journal of clinical medicine 01/2014; 72(1):77-81.

Publication Stats

6k Citations
1,672.70 Total Impact Points


  • 2000–2014
    • Osaka City University
      • • Department of Gastroenterological Surgery
      • • Graduate School of Medicine
      Ōsaka, Ōsaka, Japan
  • 1998–2014
    • Osaka University
      • • Division of Gastroenterological Surgery
      • • Department of Surgery
      • • Department of Integrated Medicine
      Suika, Ōsaka, Japan
  • 2013
    • Kaizuka Hospital
      Hukuoka, Fukuoka, Japan
    • Kansai Rosai Hospital
      Itan, Hyōgo, Japan
  • 2010–2013
    • Kyushu University
      • • Division of Surgery
      • • Medical Institute of Bioregulation - MIB Hospital
      Fukuoka-shi, Fukuoka-ken, Japan
    • National and Kapodistrian University of Athens
      • Department of Surgery
      Athens, Attiki, Greece
  • 2012
    • National Defense Medical College
      • Department of Surgery
      Tokorozawa, Saitama-ken, Japan
    • Osaka National Hospital
      Ōsaka, Ōsaka, Japan
  • 2000–2012
    • Osaka Medical Center for Cancer and Cardiovascular Diseases
      Ōsaka, Ōsaka, Japan
  • 2011
    • Toyonaka Municipal Hospital
      Toyonaka, Ōsaka, Japan
    • Tokyo Medical University
      Edo, Tōkyō, Japan
    • Sakai City Hospital
      Sakai, Ōsaka, Japan
  • 2008–2009
    • University of Toyama
      Тояма, Toyama, Japan
  • 1996–2003
    • Toyama Medical and Pharmaceutical University
      Тояма, Toyama, Japan
    • Weizmann Institute of Science
    • New York Presbyterian Hospital
      New York City, New York, United States
  • 1995–2000
    • Columbia University
      • College of Physicians and Surgeons
      New York City, NY, United States