Publications (119)246.5 Total impact
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Article: Surgical Outcome and Proposed Strategy for Biliary Stricture after Living Donor Liver Transplantation: A Single Center Analysis.
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ABSTRACT: Background/Aims: To clarify the surgical outcome and propose an appropriate strategy for biliary stricture (BS) treatment after living donor liver transplantation (LDLT). Methodology: Among 53 patients who underwent LDLT at our institute, 45 patients had duct-to-duct anastomosis. Of these, 33 who survived for at least 12 months after LDLT comprised the study group. Clinical parameters, BS treatment outcomes, and predictive factors for long-term patency were investigated. Results: Eleven patients developed BS. Biliary leakage occurred significantly more frequently, and the number of external biliary tubes was significantly lower than the number of graft bile-duct openings, in the BS group compared with the non-BS group (p=0.001 and 0.004). Multivariate analysis showed that the number of external biliary tubes was the only risk factor. Long-term patency was achieved in two patients in whom stents were retained for more than 20 months, which was significantly longer than in other patients (p=0.01). Identical stent-retention for more than 6 months was a risk factor for cholangitis. Conclusions: The number of external biliary tubes should match the number of graft bile-duct openings. When BS occurs, the duration of stent retention should be more than 20 months, and stents should be exchanged at least every 6 months.Hepato-gastroenterology 01/2013; 60(125). · 0.66 Impact Factor -
Article: Intrahepatic cholangiocarcinoma arising 28 years after excision of a type IV-A congenital choledochal cyst: report of a case.
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ABSTRACT: This report presents a rare case of intrahepatic cholangiocarcinoma (IHCC) arising 28 years after excision of a type IV-A congenital choledochal cyst. The patient underwent excision of a congenital choledochal cyst (Todani's type IV-A) at 12 years of age, with Roux-en-Y hepaticojejunostomy reconstruction. She received a pancreaticoduodenectomy (PD) using the modified Child method for an infection of a residual congenital choledochal cyst in the pancreatic head at the age of 18. She was referred to this department with a liver tumor 22 years later. Left hemihepatectomy with left-side caudate lobectomy was performed and the tumor was pathologically diagnosed to be IHCC. The cause of the current carcinogenesis was presumed to be reflux of pancreatic juice into the residual intrahepatic bile duct during surgery. This case suggests that a careful long-term follow-up is important for patients with congenital choledochal cysts, even if a separation-operation was performed at a young age, and especially after PD.Surgery Today 10/2012; · 1.22 Impact Factor -
Article: [Clinical features of hepatic metastasis from breast cancer].
Nippon rinsho. Japanese journal of clinical medicine 09/2012; 70 Suppl 7:124-30. -
Article: Two-stage hepatectomy with effective perioperative chemotherapy does not induce tumor growth or growth factor expression in liver metastases from colorectal cancer.
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ABSTRACT: BACKGROUND: Although short- and long-term results have been described in previous reports of 2-stage hepatectomy, growth activity in metastases resected at the first versus second hepatectomy has not been compared. METHODS: We analyzed growth activity of liver metastases from colorectal cancers resected at first and second hepatectomy by real-time reverse-transcription polymerase chain reaction and immunohistochemistry in 21 patients undergoing 2-stage hepatectomy to justify the 2-stage approach. RESULTS: Of 24 patients planned to undergo 2-stage hepatectomy for colorectal liver metastases, 21 had completion of both stages. Although maximum tumor size and serum carcinoembryonic antigen before and after the first procedure did not differ, volume of the future liver remnant increased after the first procedure. Ki67 and proliferating cell nuclear antigen positivity rates were comparable between initially and subsequently resected tumors (P = .09 and P = .83, respectively). Expression of mRNA (relative to glyceraldehyde-3-phosphate dehydrogenase mRNA) in initially versus subsequently resected tumors for cyclin D1 (4.27 ± 1.29 vs 6.52 ± 2.23; P = .90), cyclin E1 (24.18 ± 16.81 vs 10.53 ± 2.28; P = .60), hepatocyte growth factor (3.16 ± 1.42 vs 0.58 ± 0.15; P = .11), basic fibroblast growth factor (5.42 ± 1.54 vs 5.92 ± 3.33; P = .13), epidermal growth factor (19.56 ± 14.76 vs 9.07 ± 4.54; P = .74), and transforming growth factor-α (2.63 ± 1.02 vs 2.07 ± 1.15; P = .29) showed no differences between the 2 time points. CONCLUSION: Two-stage hepatectomy did not seem to induce tumor growth activity or growth factor expression. The 2-stage strategy in combination with effective preoperative chemotherapy is a valuable strategy for colorectal metastases.Surgery 08/2012; · 3.10 Impact Factor -
Article: Collapsin Response Mediator Protein 4 Expression is Associated with Liver Metastasis and Poor Survival in Pancreatic Cancer.
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ABSTRACT: BACKGROUND: Pancreatic cancer is an aggressive malignancy with one of the worst mortality rates of all cancers. Recently, collapsin response mediator proteins (CRMPs) were reported to be associated with proliferation, apoptosis, differentiation, and invasion in several cancers. However, CRMP expression and their role in pancreatic cancer have not been investigated. This study aimed to clarify the clinical significance of CRMPs in pancreatic cancer. METHODS: Expression of crmp genes in 11 pairs of pancreatic cancer and corresponding noncancerous pancreas tissues were examined by real-time RT-PCR. Knockdown of CRMP4 expression using siRNA was examined in pancreatic cancer cell lines to determine whether CRMP4 regulates cell proliferation and invasion in vitro. Furthermore, CRMP4 protein levels in primary tumors of pancreatic cancer (n = 53) were examined by immunohistochemistry and compared with the clinicopathological features of the tumors. RESULTS: Of all the CRMPs, only CRMP4 was differentially expressed in pancreatic cancer tissues (p = 0.008). CRMP4 knockdown using siRNA reduced cellular invasion, but did not affect proliferation. The expression of CRMP4 was detected immunohistochemically in 34 (64.2 %) of the 53 pancreatic cancer samples, and CRMP4 expression was correlated with severe venous invasion (p = 0.044), stage (p = 0.019), and liver metastasis (p = 0.021). Multivariate analyses suggested that venous invasion and CRMP4 overexpression were prognostic factors for survival. CONCLUSIONS: Our results suggested that CRMP4 is significantly associated with poor prognosis by promoting liver metastasis and can serve as a novel therapeutic target for pancreatic cancer.Annals of Surgical Oncology 07/2012; · 4.17 Impact Factor -
Article: The effectiveness and appropriate management of abdominal drains in patients undergoing elective liver resection: a retrospective analysis and prospective case series.
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ABSTRACT: PURPOSE: Although many studies have concluded that prophylactic drain insertion during elective liver resection offers few advantages, we reassessed the clinical value and appropriate management of drain insertion. METHODS: We retrospectively studied the clinical value of abdominal drainage in 167 consecutive patients who underwent hepatectomy, focusing on drainage volumes, bilirubin concentrations, drainage fluid bacterial culture results and short-term postoperative outcomes. The results were then validated prospectively in the next 50 consecutive patients to undergo hepatectomy. RESULTS: Most of the patients with morbidities such as biliary fistulas, ascites, fluid collection or duodenal perforation (20/24 or 83 %) were treated using operative drainage tubes, avoiding the use of percutaneous drainage procedures. The values obtained with the formula (drainage fluid bilirubin concentration/serum bilirubin concentration) × drainage fluid volume, were greater on both postoperative days (POD) 2 and 3 (P = 0.03 and P < 0.01) in patients with biliary leakage compared with those observed in the patients without leakage. The bacteriologic cultures of drainage fluid were positive less frequently on POD 4 or earlier (7/203) than on POD 5 or later (24/74, P < 0.01). In the validation cohort, new drain removal criteria based on the retrospective results led to successful drain management without additional treatment in 96 % of patients. CONCLUSIONS: Abdominal drainage is effective for both postoperative monitoring and morbidity treatment.Surgery Today 07/2012; · 1.22 Impact Factor -
Article: Timing of two-stage liver resection during chemotherapy for otherwise unresectable colorectal metastases.
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ABSTRACT: Tumor downsizing by effective chemotherapy while increasing remnant liver volume by two-stage hepatectomy can expand eligibility for resection of otherwise unresectable liver metastases. However, optimal timing of two-stage hepatectomy with respect to chemotherapy is undetermined. We retrospectively analyzed the effect of timing of two-stage hepatectomy and chemotherapy using data from 95 patients whose colorectal liver metastases initially were considered unresectable. In 21 of 22 (95 %) patients whose first liver resection preceded chemotherapy (Hx-CTx group) and in 39 of 73 (53 %) patients whose chemotherapy preceded surgery (CTx-Hx group), macroscopic complete resection ultimately was achieved (P < 0.01). Overall and disease-free survivals were comparable between groups. However, overall survival of patients not achieving complete resection in the CTx-Hx group was significantly poorer than that for patients achieving complete resection (P < 0.01). When the 21 patients with complete resection in the Hx-CTx group were compared to the 39 patients with complete resection in the CTx-Hx group, no difference in overall or disease-free survival was observed (P = 0.12 and P = 0.24, respectively), although poor response to chemotherapy was more frequent in the Hx-CTx group. Optimal timing of hepatectomy and chemotherapy is difficult to specify, but performing the initial resection in a two-stage hepatectomy before chemotherapy may increase likelihood of macroscopic complete resection, even in patients with a poor response to chemotherapy or with limited courses of chemotherapy.World Journal of Surgery 04/2012; 36(8):1832-41. · 2.36 Impact Factor -
Article: Major liver resection stimulates stromal recruitment and metastasis compared with repeated minor resection.
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ABSTRACT: The present study examined the effects of types of liver resection on the growth of liver and lung metastases. Experimental liver metastases were established by spleen injection of the Colon 26 murine adenocarcinoma cell line expressing green fluorescent protein (GFP) into transgenic nude mice expressing red fluorescent protein. Experimental lung metastases were established by tail-vein injection with Colon 26-GFP. Three days after cell injection, groups of mice underwent (35% + 35% repeated minor resection versus 70% major resection versus 35% minor resection). Metastatic tumor growth was measured by color-coded fluorescence imaging of the GFP-expressing cancer cells and red fluorescent protein-expressing stroma. Although major and repeated minor resection removed the same total volume of liver parenchyma, the 2 procedures had very different effects on metastatic tumor growth. Major resection stimulated liver and lung metastatic growth and recruitment of host-derived stroma compared with repeated minor resection. Repeated minor resection did not stimulate metastasis or stromal recruitment. No significant difference was found in liver regeneration between the 2 groups. Host-derived stroma density, which was stimulated by major resection compared with repeated minor resection, might stimulate growth in the liver-metastatic tumor. Transforming growth factor-β is also preferentially stimulated by major resection and might play a role in stromal and metastasis stimulation. The results of the present study indicate that when liver resection is necessary, repeated minor liver resection will be superior to major liver resection, because major resection, unlike repeated minor resection, stimulates metastasis. This should be taken into consideration in clinical situations that require liver resection.Journal of Surgical Research 03/2012; 178(1):280-7. · 2.25 Impact Factor -
Article: Predictive Factors for Prolonged Intubation Following Liver Transplantation.
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ABSTRACT: Background/Aims: This study identified risk factors associated with prolonged intubation after living donor liver transplantation (LDLT). Methodology: Out of 50 patients who underwent LDLT, clinical data were compared between those extubated within 4 days of LDLT (early group; n=20) and those extubated 5 days post-LDLT (delayed group; n=30). Results: Univariate analysis associated the following factors with prolonged intubation: preoperative age >48 years (p=0.05), body mass index >22kg/m2 (p=0.01), creatinine clearance <90mL/min/1.73m2 (p=0.003), ratio between arterial oxygen tension and fractional inspired oxygen =375 (p=0.02) and postoperative changes of body-weight per body surface area ((BW - preoperative BW)/BSA)) on postoperative day (POD) 3 (>2.0kg/m2) (p=0.01). Multivariate analysis showed that creatinine clearance and (BW-preoperative BW)/BSA on POD 3 remained as independent predictive factors (p=0.04 and 0.04, respectively). Conclusions: We should aim for postoperative fluid management such that ((BW - preoperative BW)/BSA) =2.0kg/m2 on POD 3, especially in patients with low preoperative levels of creatinine clearance.Hepato-gastroenterology 03/2012; 59(119). · 0.66 Impact Factor -
Article: Assessment of Gastric Emptying Function after Gastrectomy using a Real-Time 13C Breath Test.
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ABSTRACT: Background/Aims: Effectiveness of gastric emptying after pylorus-preserving gastrectomy (PPG) remains unclear and a method for continuous assessment is needed. We assessed post-PPG gastric emptying with a continuous real-time 13C breath test (BreathID system, Oridion, Israel). Methodology: Gastric emptying function was assessed by 13C breath test in 12 post-PPG patients and 9 post-distal gastrectomy (DG) patients. Continuous 13C-acetic acid breath test was performed using the BreathID system. Endoscopic study was also completed. Results: Diarrhea was significantly less common in PPG than DG patients (p=0.021). No other questionnaire items and endoscopic findings showed a significant difference. In the 13C-acetic acid breath test, the gastric emptying coefficient (GEC) was significantly greater in PPG than DG patients (p=0.025). No other test parameters showed a significant difference. Conclusions: Emptying function in the remnant stomach was assessed successfully by the continuous 13C-acetic acid breath test. A greater GEC suggested better gastric emptying in PPG patients.Hepato-gastroenterology 01/2012; 59(119). · 0.66 Impact Factor -
Article: A nomogram predicting disease-free survival in patients with colorectal liver metastases treated with hepatic resection: multicenter data collection as a Project Study for Hepatic Surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery.
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ABSTRACT: The aim of this study was to create a nomogram to predict the disease-free survival of patients with colorectal liver metastases treated with hepatic resection. Perioperative factors were assessed in 727 hepatectomized patients with colorectal liver metastases between 2000 and 2004 at the 11 institutions of the "Project Committee of the Liver" in the Japanese Society of Hepato-Biliary-Pancreatic Surgery. A nomogram was developed as a graphical representation of a stepwise Cox proportional hazards regression model. Perioperative mortality was 0.55%. Disease-free and overall survival rates were 31.2 and 63.8% at 3 years, 27.2 and 47.7% at 5 years, and 24.7 and 38.5% at 10 years, respectively. Six preoperative factors were selected to create the nomogram for disease-free survival: synchronous metastases, 3 points; primary lymph node positive, 3 points; number of tumors 2-4, 4 points and ≥5, 9 points; largest tumor diameter >5 cm, 2 points; extrahepatic metastasis at hepatectomy, 4 points, and preoperative carbohydrate antigen 19-9 level >100, 4 points. The estimated median disease-free survival time was easily calculated by the nomogram: >8.4 years for patients with 0 points, 1.9 years for 5 points, 1.0 years for 10 points, and the rates were lower than 0.6 years for patients with more than 10 points. This nomogram can easily calculate the median and yearly disease-free survival rates from only 6 preoperative variables. This is a very useful tool to determine the likelihood of early recurrence and the necessity for perioperative chemotherapy in patients with colorectal liver metastases after hepatic resection.Journal of hepato-biliary-pancreatic sciences. 01/2012; 19(1):72-84. -
Article: Right hepatectomy with resection of caudate lobe and extrahepatic bile duct for hilar cholangiocarcinoma.
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ABSTRACT: En-bloc liver resection with caudate lobectomy (segmentectomy 1) is the standard procedure for hilar cholangiocarcinoma. Although its surgical mortality has been reduced below 5%, it is still a potentially hazardous operation. Complete tumor resection with negative surgical margins and safe reconstruction of bilio-enteric continuity are two principles of the surgical treatment of hilar cholangiocarcinoma. Surgeons must pay attention to the variation of the hilar structures including portal veins, hepatic arteries, and bile ducts. Three-dimensional imaging is beneficial not only for understanding anatomical variations but also for preoperative simulations. Since the U-point can be identified by both preoperative imaging and intraoperative inspection, it can be used as the landmark for the hepatectomy and the dissection point of the hilar plate. The hanging maneuver might be useful for both hepatic parenchymal dissection and bile duct dissection just right of the U-point. For safe biliary reconstruction, stay sutures in the anterior wall and transanastomotic stents may be helpful.Journal of hepato-biliary-pancreatic sciences. 12/2011; 19(3):216-24. -
Article: Severe outflow block syndrome caused by compression by the swollen caudate lobe after living donor liver transplantation: report of a case.
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ABSTRACT: A 50-year-old man with primary biliary cirrhosis underwent living-donor liver transplantation (LDLT) using a graft of a left hemiliver with a left caudate lobe and duct-to-duct hepaticocholedochostomy. Postoperative bile leakage necessitated percutaneous drainage 22 days after LDLT. The patient presented to our hospital 205 days after the LDLT with abdominal distension and fever. Computed tomography showed ascites and a diffusely mottled pattern in the graft. The caudate lobe was swollen, and its bile ducts were dilated. The inferior vena cava was forced to the right by the swollen caudate lobe, and the root of the hepatic vein was stretched. The hepatic vein was not contrasted. Endoscopic retrograde cholangiography showed a biliary anastomotic stricture. Based on these findings, we diagnosed a severe outflow block of the hepatic vein and biliary anastomotic stricture. We performed balloon dilation of the biliary anastomosis and implanted a metallic stent in the hepatic vein. Thereafter, his clinical symptoms improved dramatically.Surgery Today 11/2011; 42(2):177-80. · 1.22 Impact Factor -
Article: Emergency versus elective living-donor liver transplantation: a comparison of a single center analysis.
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ABSTRACT: We studied the risk factors for postoperative mortality between patients who underwent emergency or elective living-donor liver transplantation (LDLT). Forty-seven patients underwent LDLT in our institute, 16 for emergencies and 31 as elective procedures. The emergency LDLT status was applied to cases in which the time period between referral to our institution and transplantation did not exceed 10 days, and in which liver failure was accompanied by the presence of any degree of hepatic encephalopathy. With regard to preoperative factors, age (P = 0.03), the model for end-stage liver disease score (P = 0.001), preoperative tracheal intubation (P = 0.001), ratio between arterial oxygen tension and fractional inspired oxygen (PaO2/FiO2 ratio) (P = 0.03), steroid therapy use (P = 0.001), lymphocyte count (P = 0.02), and cases requiring hemodiafiltration (P = 0.001) differed significantly between the two groups. Postoperative pneumonia occurred more frequently in emergency LDLT patients than in elective LDLT patients (P = 0.006). Invasive pulmonary aspergillosis (IPA) was the main cause of postoperative death in emergency LDLT patients, and, in a univariate analysis, a preoperative status of high serum (1 → 3)-β-D: -glucan (>20 pg/ml, P = 0.001), advanced age (>52 years, P = 0.02), and a low PaO2/FiO2 ratio (<320, P = 0.01) were identified as factors predictive of IPA. Careful perioperative management, including preoperative investigation of aspergillosis and empiric antibiotic therapy, should be considered for emergency LDLT patients who fulfill IPA risk factors.Surgery Today 11/2011; 42(5):453-9. · 1.22 Impact Factor -
Article: Postchemotherapy histological analysis of major intrahepatic vessels for reversal of attachment or invasion by colorectal liver metastases.
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ABSTRACT: Although tumor reduction via present-day prehepatectomy chemotherapy can render initially unresectable disease potentially resectable, little is known about the effects of such chemotherapy on liver metastases with known attachment to or invasion of major intrahepatic vessels. We histologically assessed the relationships of liver tumors to major intrahepatic vessels after chemotherapy. In 45 patients who underwent chemotherapy and hepatectomy with pretreatment images showing metastases attached to or invading major intrahepatic vessels, 77 metastases showed attachment to or invasion of 96 vessels. Using postchemotherapy imaging, 11 of 77 metastases (14.3%) appeared separated from 12 of 96 major hepatic vessels (12.5%). Among 83 vessels later examined pathologically, 29 showed direct invasion (35%) and 10 showed attachment (12%). Tumors involved another 9 vessels (11%) that were separated surgically from the tumor and preserved during hepatectomy. Tumor attachment that exceeded 25% of vessel circumferences via imaging after chemotherapy was a factor associated with pathological vascular invasion or attachment according to multivariate analysis (relative risk, 8.449; 95% confidence interval, 1.961-36.415; P = .0042). Liver metastasis attachment to or invasion of major intrahepatic vessels is difficult to eradicate even with otherwise effective chemotherapy.Cancer 09/2011; 118(9):2443-53. · 4.77 Impact Factor -
Article: Liver resection for advanced or aggressive colorectal cancer metastases in the era of effective chemotherapy: a review.
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ABSTRACT: Liver surgery has been known to cure metastatic colorectal cancer in a small proportion of patients. However, advances in procedural technique and chemotherapy now allow more patients to have safe, potentially curative surgery. Here we review surgery for unresectable colorectal liver metastases using an expert multidisciplinary approach. With multidisciplinary management of patients with effective chemotherapy that can downstage metastases, more patients with previously inoperable disease can benefit from surgery. Portal vein embolization results in hypertrophy of the future liver remnant; on occasions, combining embolization with staged liver resection permits potentially curative surgery for patients previously unable to survive resection. However, increasing use of chemotherapy has raised awareness of potential hepatotoxicity and other deleterious effects of cytotoxic agents. Prolonged prehepatectomy chemotherapy therefore can reduce resectability even using a 2-stage procedure. Suitable timing of surgery for unresectable liver metastases during chemotherapy is critical. Because of advances in chemotherapy, colorectal cancer, like ovarian cancer, can now show survival benefit from maximum surgical debulking. Benefit from such maximum hepatic debulking surgery for metastatic colorectal disease is uncertain, but likely. Surgery in isolation may be approaching technical limits, but is now likely to help more patients because of the success of complementary strategies, particularly newer chemotherapy and targeted therapy. Expert individualized multidisciplinary treatment planning and problem-solving is essential.International Journal of Clinical Oncology 07/2011; 16(5):452-63. · 1.41 Impact Factor -
Article: A giant adrenal pseudocyst presenting with right hypochondralgia and fever: a case report.
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ABSTRACT: Adrenal pseudocysts are rare cystic masses that arise from the adrenal gland and which are usually non-functional and asymptomatic. Adrenal pseudocysts consist of a fibrous wall without an epithelial or endothelial lining. We report the case of a patient with a giant adrenal pseudocyst presenting with right hypochondralgia and high fever. A 52-year-old Japanese man was admitted with right hypochondralgia and a chill. Abdominal computed tomography revealed a well-defined cystic mass measuring 19 cm which was located in the right adrenal region and the contents of which were not enhanced with contrast medium. Abdominal ultrasonography revealed a heterogeneously hypo-echoic lesion with a peripheral high-echoic rim. Serum hormonal levels were almost normal. Despite treatment with antibiotics, the high fever persisted. Based on these findings, we made a preoperative diagnosis of a right adrenal cyst with infection. However, the possibility of malignancy still remained. The patient underwent laparotomy and right adrenal cyst excision with partial hepatectomy in order to relieve the symptoms and to confirm an accurate diagnosis. Histological examination revealed an adrenal pseudocyst with infection. His condition improved soon after the operation. We report a case of a giant adrenal pseudocyst with infection. Surgery is required for symptomatic cases in order to relieve the symptoms and in cases of uncertain diagnosis.Journal of Medical Case Reports 04/2011; 5:135. -
Article: Efficacy of surgery for lung metastases from colorectal cancer synchronous to or following that for liver metastases.
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ABSTRACT: To evaluate the validity of surgical therapy for isolated hepatic and pulmonary colorectal metastases. Among 256 patients with liver resection for colorectal cancer metastases, 31 patients underwent resection for lung metastases synchronously or following liver resection. Twenty-nine patients (93.5%) underwent pulmonary resection for lung metastases after hepatectomy. Two patients (6.5%) with synchronously identified liver and lung metastases underwent staged liver and lung resection. The 5-, and 10-year overall survival rates were 77.5% and 39.5% after the initial liver resection and were 44.7% and 38.2% after the pulmonary resection, respectively. By multivariate analysis, the presence of three or more pulmonary metastases (risk ratio=3.692, 95% confidence interval C I=1.039-13.118, p=0.043) was an independent adverse prognostic factor. Surgical resection for both hepatic and pulmonary metastases from colorectal cancer appears feasible and efficacious in patients with <3 pulmonary metastases.Anticancer research 03/2011; 31(3):1049-54. · 1.73 Impact Factor -
Article: The influence of viral hepatitis status on long-term HCC outcome in patients with non-cirrhotic livers.
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ABSTRACT: To evaluate the influence of viral hepatitis status on the long-term outcome of patients with hepatocellular carcinoma (HCC) in non-cirrhotic livers. Two hundred and seventy-nine patients diagnosed with HCC underwent liver resection. Histologic examination of the resected liver confirmed the absence of cirrhosis in 145 patients. Clinical characteristics and surgical outcome were compared between patients with HCC derived from non-cirrhotic liver with (n=111) and without (n=34) viral hepatitis. One-, three- and five-year disease-specific survival rates in patients without viral markers (97.0%, 93.9% and 88.1%, respectively) were significantly higher than in patients with positive viral markers (97.2%, 81.0% and 62.3%, respectively) (p=0.0151). The five-year remnant liver recurrence-free survival rate in patients with negative viral markers (64.1%) was significantly higher than in patients with viral markers (44.9%) (p=0.0412). Hepatic resection is beneficial for HCC in non-cirrhotic livers patients without viral hepatitis.Anticancer research 03/2011; 31(3):1055-9. · 1.73 Impact Factor -
Article: [Prehepatectomy chemotherapy using hepatic artery infusion plus systemic chemotherapy for liver metastases from colorectal cancer].
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ABSTRACT: The purpose of this study was to determine the efficacy of hepatic artery infusion (HAI) plus systemic chemotherapy (SYS) as the prehepatectomy chemotherapy for liver metastases from colorectal cancer. Clinicopathologic data were available for 117 patients who were treated with chemotherapy before liver surgery. Response rate of chemotherapy and frequency of liver resection after chemotherapy of patients treated with HAI/SYS (n=26; 65% and 96%, respectively) were higher than those treated with HAI alone (n=63; 41% and 70%) or SYS alone (n=28; 25% and 42%). Histological examination of adjacent nonneoplastic liver confirmed that severe sinusoidal dilatation was less frequent in HAI/SYS group than in SYS group, and moderate to severe steatosis was also less frequent in HAI/SYS group as compared to HAI group. The combination of regional HAI and systemic chemotherapy is an effective prehepatectomy regimen for the treatment of patients with aggressive liver metastases from colorectal cancer.Gan to kagaku ryoho. Cancer & chemotherapy 11/2010; 37(12):2267-70.
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Institutions
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2002–2011
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Yokohama City University
- • Department of Gastroenterological Surgery
- • School of Medicine
Yokohama-shi, Kanagawa-ken, Japan
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