Publications (26)16.62 Total impact
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Article: A Phase III Study of Laparoscopy-Assisted Versus Open Distal Gastrectomy with Nodal Dissection for Clinical Stage IA/IB Gastric Cancer (JCOG0912).
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ABSTRACT: A Phase III study was started in Japan to evaluate the non-inferiority of overall survival of laparoscopy-assisted distal gastrectomy with open distal gastrectomy in patients with clinical IA (T1N0) or IB [T1N1 or T2(MP)N0] gastric cancer. This study followed the previous Phase II study to confirm the safety of laparoscopy-assisted distal gastrectomy (JCOG0703) and began in March 2010. A total of 920 patients will be accrued from 33 institutions within 5 years. The primary endpoint is overall survival. The secondary endpoints are relapse-free survival, proportion of laparoscopy-assisted distal gastrectomy completion, proportion of conversion to open surgery, adverse events, short-term clinical outcomes, postoperative quality of life. Only a credentialed surgeon can be responsible for both open distal gastrectomy and laparoscopy-assisted distal gastrectomy.Japanese Journal of Clinical Oncology 12/2012; · 1.78 Impact Factor -
Article: [A case report of multiple adenocarcinoma in small intestine after total gastrectomy by Roux-en-Y re-construction].
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ABSTRACT: This is a very rare case report of multiple small intestine cancer in jejunal loop of Roux-en-Y re-construction, duodenum and jejunum. A 51-year-old man had undergone total gastrectomy by Roux-en-Y re-construction for Stage III B gastric cancer in 1997. In 2008, he underwent partial jejunectomy and partial ilectomy for ileus due to small intestine adenocarcinoma, located at the jejunum 50 cm distal from Roux-en-Y anastomotic region and at the ileum 20 cm proximal from the ileocecal region. PET/CT suspected a recurrence and peritoneal dissemination, so he had undergone S-1/docetaxel treatment since 2009. In 2010, he was diagnosed as obstructive jaundice due to duodenal tumor revealed by CT. Furthermore, enteroscopy revealed duodenal advanced cancer, type 2 advanced cancer and five polyps in jejunal loop, type 2 advanced cancer and type II a early cancer in jejunum. He could not undergo both pancreatoduodenectomy and choledochojejunostomy because of the invasion to hepatoduodenal ligament. He underwent partial jejunectomy for the advanced cancer in jejunal loop 10 cm proximal form Roux-en-Y anastomotic region and in jejunum 50 cm distal from Roux-en-Y anastomotic region for prevention of ileus.Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2042-4. -
Article: [A long-term survival case of recurrent pancreatic vipoma with liver metastases treated by a combination of surgical resection and loco-regional therapies].
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ABSTRACT: We report a case of recurrent pancreatic VIPoma with liver and peritoneal metastases who has been surviving over 7 years by a successful treatment with a combination of surgical resection and loco-regional therapies. A 59-year-old female underwent distal pancreatectomy for pancreatic endocrine tumor. Five years after pancreatectomy, she had a recurrence of liver and peritoneal metastases with the symptoms by hypersecretion of VIP, and she underwent hepatectomy and peritoneal tumor resection. Seven months later, multiple liver metastases appeared and were treated with transcatheter arterial chemoembolization (TACE). Additionally radiofrequency ablation( RFA) for remnant viable lesion was performed. Seven years and eight months after primary panceatectomy and two years and six months after resection of the liver and peritoneal recurrences, she is now disease-free with good quality of life. The progression of well-differentiated pancreatic neuroendocrine carcinoma is usually slow. It is potentially useful in controlling of liver metastases to combine the loco-regional therapy like TACE and RFA with surgical resection.Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2158-60. -
Article: [Investigation of gastric cancer chemotherapy in hiroshima prefecture].
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ABSTRACT: The Hiroshima Oncology Group of Gastric Cancer(HOG-GC)distributed a multiple-answer questionnaire to investigate the realities of chemotherapy for gastric cancer. Seventy-six hospitals in Hiroshima were surveyed. The Japanese classification was used for the staging criteria. Forty-one hospitals, including 10 centers for cancer treatment, completed and returned the questionnaires. For stage II & III cases requiring adjuvant chemotherapy, S-1 was the most commonly used(84%)regimen. A standard starting dose was used in 79% of these cases, and S-1 was administered for one year continuously in 84% of the cases. For stage I B & II (T1), S-1 and UFT were used in 45%and 20%of the cases, respectively. In cases with non-resectable gastric cancer, S-1 plus CDDP and S-1 alone were used as a first-line therapy in 62% and 26% of the patients under 75 years age, respectively, and in 33% and 46% of the patients older than 75 years of age, respectively. In patients with ascites and peritoneal dissemination, S-1 plus CDDP, S-1, S-1 plus DTX, S-1 plus PTX, and PTX were used in 26%, 15%, 21%, 17%, and 17% of cases, respectively. Some of the patients with peritoneal dissemination underwent gastrectomy. S-1 was widely used for gastric cancer chemotherapy in Hiroshima Prefecture. Taxane-containing regimens or palliative gastrectomy were commonly used in cases with peritoneal dissemination.Gan to kagaku ryoho. Cancer & chemotherapy 06/2011; 38(6):941-4. -
Article: [A 6-year survival case of locally advanced unresectable pancreatic tail cancer treated with chemo-radiation therapy].
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ABSTRACT: We report a case of locally advanced unresectable pancreatic tail cancer patient who survived over 6 years by chemo-radiation therapy (CRT). A 61-year-old male was pointed out by CT to have pancreatic tail cancer of 5.6 cm in diameter that invaded to the stomach, left kidney and adrenal gland, nerve plexus of celiac and superior mesenteric artery, was diagnosed as locally advanced unresectable pancreatic tail cancer. CRT of gemcitabine (GEM) with RT to a primary lesion was successful. After two years and 11 months, Schnitzler's metastasis appeared and RT was effective to recover from rectal stricture. At three years and 3 months, GEM was converted to S-1. After 4 years and 5 months, paraaortic lymph node metastasis was enlarged, so chemotherapy was changed to combination of GEM + S-1. After 4 years and 10 months, upper mediastinal lymph node metastasis appeared. At 6 years and 1 month, RT to upper mediastinum for pain control was performed. Finally, 6 years and 6 months after the first diagnosis, he died of pancreatic cancer. A long-term survival of locally advanced unresectable pancreatic cancer is very rare. In the case of pancreatic cancer that CRT is effective to the remission of primary lesion, CRT is potentially useful to perform for the control of metastatic lesion or palliative therapy.Gan to kagaku ryoho. Cancer & chemotherapy 11/2010; 37(12):2355-7. -
Article: Well-differentiated endocrine cell carcinoma of ileum treated by laparoscopy-assisted surgery--a case report.
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ABSTRACT: A 72-year-old woman presented at our hospital with a 1-year history of intermittent right lower abdominal pain. Colonoscopic examination revealed a submucosal tumor with a pitted surface in the terminal ileum. Histopathological diagnosis of the carcinoid tumor was made following biopsy. Blood serotonin and urine 5-hydroxy-indoleacetic acid levels were normal, and carcinoid syndrome was not detected. Enhanced abdominal computed tomography scan and 18F-fluorodeoxyglucose positron emission tomography failed to detect multiple lesions, lymph node swelling or distant metastasis. Laparoscopy-assisted ileocecal resection with lymph node dissection was performed. The resected specimen showed a submucosal tumor with a pitted surface 11 x 11 mm in size, located at the terminal ileum. Histopathological examination revealed a well-differentiated endocrine cell carcinoma with an invasion depth to the muscularis propria. Immunohistochemical analysis showed the tumor cells to be chromogranin A and CD56-positive. The patient had no sign of recurrence for 16 months.Hiroshima journal of medical sciences 06/2010; 59(2):35-8. -
Article: Survival of patients treated by an autonomic nerve-preserving gastrectomy for early gastric cancer.
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ABSTRACT: Autonomic nerve preservation in a gastrectomy for gastric cancer improves the postoperative quality of life. We retrospectively examined the survival of patients treated by an autonomic nerve-preserving gastrectomy in comparison to the survival of the patients treated by a conventional gastrectomy. The survival of 385 patients treated by an autonomic nerve-preserving gastrectomy for clinical early gastric cancer (the ANP group) was compared with that of 285 patients treated by a conventional gastrectomy (non-ANP group). Among the ANP group, the numbers of patients with tumor invasion to the mucosa, submucosa, and muscularis propria were 210, 166, and 9, respectively, whereas the numbers of patients with lymph node metastasis grades of N0, N1, and N2 were 360, 21, and 4, respectively. The overall 5-year survival rate of the ANP group was 94.7%, which was superior to that of the non-ANP group (90.4%; P = 0.003). The 5-year survival rates of patients with lymph node metastasis were 94.9% and 91.8% in the ANP and non-ANP groups, respectively (P = 0.733). Only 3 patients in the ANP group died from gastric cancer. The survival of patients treated by an autonomic nerve-preserving gastrectomy was equivalent to that of patients treated by a conventional gastrectomy, thus suggesting that an autonomic nervepreserving gastrectomy could be a useful procedure for the treatment of early gastric cancer.Surgery Today 05/2010; 40(5):444-50. · 1.22 Impact Factor -
Article: [A case of long-term survival in P1CY1 gastric cancer responding to combined chemotherapy with low-dose CDDP intraperitoneal administration].
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ABSTRACT: We reported a case of P1CY1 gastric cancer with intraperitoneal chemotherapy after surgery for more than four years. The patient was a 69-year-old male who had suffered from Type I+Type 0 IIc, T3 gastric cancer. He underwent total gastrectomy with D2 dissection. Operative findings revealed P1CY1, and it resulted in non-curative resection. After surgery, combined chemotherapy with low-dose CDDP intraperitoneal administration and UFT, and then combined chemotherapy with paclitaxel and 5-FU were performed. He also underwent palliative surgery for intestinal obstruction resulting from carcinomatous peritonitis. He achieved long-term survival by multidisciplinary therapy of chemotherapy and surgery.Gan to kagaku ryoho. Cancer & chemotherapy 11/2009; 36(12):2061-3. -
Article: Frequency of lymph node metastasis to the splenic hilus and effect of splenectomy in proximal gastric cancer.
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ABSTRACT: The purpose of this study was to investigate the clinicopathological characteristics and frequency of lymph node metastasis to the splenic hilus in proximal gastric cancer and the effect of splenectomy. Three hundred and forty-nine patients undergoing total gastrectomy for primary proximal gastric cancer were included. Among these patients, lymph node metastasis to the splenic hilus was histologically assessed in 201 cases. The incidence of lymph node metastasis to the splenic hilus was 31 cases (15.4%). No lymph node metastasis to the splenic hilus was detected in any T1 and T2 tumors located at the lesser curvature and anterior wall. No significant difference was observed between the survival rates of patients with and without splenectomy in each stage. Our findings indicated that gastrectomy with spleen preservation may be recommended at least in patients with T1 or T2 tumors located at the lesser curvature and anterior wall.Anticancer research 09/2009; 29(8):3347-51. · 1.73 Impact Factor -
Article: Phase II trial of S-1 for neoadjuvant chemotherapy against scirrhous gastric cancer (JCOG 0002).
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ABSTRACT: The prognosis of scirrhous gastric cancer remains poor despite extended surgery or adjuvant or neoadjuvant chemotherapy. A pilot study of S-1 (TS-1; Taiho Pharmaceutical, Tokyo, Japan), an oral 5-fluorouracil derivative, for neoadjuvant chemotherapy unexpectedly showed good response and a promising effect on survival. Therefore, the Japan Clinical Oncology Group conducted a phase II trial to confirm the efficacy of S-1 for neoadjuvant chemotherapy against resectable scirrhous gastric cancer. Patients were eligible if they had typical scirrhous gastric cancer invading more than half of the stomach, and resectable disease confirmed by laparoscopic staging. The treatment schedule consisted of two courses (each, 4-week administration and 2-week withdrawal) of S-1 (100-120 mg/body per day), followed by radical surgery. Fifty-five eligible patients were registered. Three completed only one course of the neoadjuvant chemotherapy, whereas 52 completed two courses. Toxicity was acceptable, with a few grade 3 (5.5%) events, but no grade 4 adverse events. The response rate was 32.6% in 43 evaluable patients. Of the 55 patients, 2 refused operation, 1 developed lung metastasis, and 52 underwent laparotomy. The curative resection rate was 80.8%, with acceptable morbidity and no mortality. The survival curve at 2 years' follow up showed a better survival rate than that of the historical controls, but did not reach the expected survival rate. S-1 neoadjuvant chemotherapy appeared feasible and showed positive effects against scirrhous gastric cancer; however, the survival rate with S-1 did not reach the expected rate required when selecting an agent for a phase III trial to confirm the effectiveness of neoadjuvant chemotherapy against scirrhous gastric cancer.Gastric Cancer 02/2009; 12(1):37-42. · 2.42 Impact Factor -
Article: [A case of long survival in Stage IV gastric carcinoma responding to combination treatment with paclitaxel and 5- fluorouracil followed by surgical resection].
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ABSTRACT: A 62-year-old female with epigastric pain was diagnosed with Type 4 gastric cancer upon detailed examination. Abdominal computed tomography(CT)revealed metastasis to the paraaortic lymph node and ascites at pelvis, and aspiration cytology of the ascites through vagina was positive(CY1). The clinical stage was determined as T4(panc) N1H0P0CY1M1(LYM), cStageIV. Three courses of neoadjuvant chemotherapy combined with paclitaxel and 5-fluorouracil( FT therapy)were performed. FT therapy showed a substantial reduction of the size of metastatic lymph nodes by sequentialCT examination, which was evaluated as partial response. Surgical resection consisted of total gastrectomy, and D2 lymph node dissection was performed. Operative cytology of ascites proved negative. The pathologic effect on primary lesion and metastatic lymph nodes was diagnosed as Grade 2. Although the prognosis of gastric cancer with carcinomatous peritonitis is poor, we here reported a patient with StageIV gastric cancer who markedly responded to FT therapy, which made surgical resection possible with the anticipation of extended survival. FT therapy may be a useful method for a patient with StageIVgastric cancer.Gan to kagaku ryoho. Cancer & chemotherapy 11/2008; 35(10):1745-8. -
Article: [A case of long survival of a scirrhous gastric cancer patient with esophageal invasion and peritoneal dissemination through chemotherapy and palliative surgery].
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ABSTRACT: We report a case of advanced scirrhous gastric cancer treated by operation and chemotherapy for over four years. The patient was a 54-year-old female who had suffered from gastric cancer with esophageal invasion. She underwent total gastrectomy with D2 dissection. Operative findings revealed peritoneal dissemination, and it resulted in non-curative resection. After surgery, combination chemotherapy with low-dose CDDP administered intraperitoneally and S-1, combination chemotherapy with paclitaxel and 5-FU, and then combination chemotherapy with docetaxel and S-1 were sequentially performed. She also underwent palliative surgery for intestinal obstruction resulting from carcinomatous peritonitis. She achieved long survival with good quality of life (QOL) by multidisciplinary therapy of chemotherapy and surgical operation.Gan to kagaku ryoho. Cancer & chemotherapy 10/2008; 35(9):1551-4. -
Article: [A case report of highly advanced gastric cancer with ascites with long survival and improved QOL from combined chemotherapy of paclitaxel and 5-fluorouracil].
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ABSTRACT: The patient was a 63-year-old male who came to our hospital with the chief complaints of dyspepsia and abdominal fullness. Endoscopic findings showed Type 3 gastric cancer with pyloric stenosis. CT examination revealed a large amount of peritoneal fluid, invasion to the pancreas, peritoneal dissemination and paraaortic lymph node metastasis. Intraperitoneal administration of weekly CDDP 10 mg/body was in vain, and combined chemotherapy of paclitaxel and 5-fluorouracil was carried out. Ascites was significantly reduced and oral intake became possible two courses after this regimen. The tumor decreased in size after 3 courses, and the tumor markers returned to within normal limits. The patient was then discharged, and followed as an outpatient thereafter. Endoscopic examination showed improvement in narrowing of the antrum. However,tumor invasion to pancreas, peritoneal dissemination and lymph node metastasis relapsed. He died one year and one month after the onset.Gan to kagaku ryoho. Cancer & chemotherapy 07/2007; 34(6):911-4. -
Article: [A case report of advanced gastric cancer with carcinomatous ascites successfully treated by outpatient chemotherapy].
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ABSTRACT: The patient was a 54-year-old male with peritoneal dissemination and carcinomatous ascites of advanced gastric cancer. Although 4 months of temporary partial responses were obtained by a combination chemotherapy with TS-1 and DOC, retention of ascites appeared. Second-line combination chemotherapy with 5-FU and PTX was not effective, and we attempted to use intraperitoneal chemotherapy of low-dose CDDP. After 100 mg of CDDP had been administered, ascites almost disappeared. Then,intraperitoneal injection of low-dose CDDP and intravenous injection of 5-FU were given. Tumor marker decreased remarkably, and CT revealed reduction of peritoneal dissemination. These regimens seem to be effective in ambulant patients with advanced gastric cancer with peritoneal dissemination and carcinomatous ascites.Gan to kagaku ryoho. Cancer & chemotherapy 02/2007; 34(1):85-7. -
Article: [A case of progressive gastric carcinoma accompanied by disseminated carcinomatosis of bone marrow due to bone metastasis with DIC recovery by joint administration of 5-FU and paclitaxel].
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ABSTRACT: A 54-year-old male visited our hospital with the chief complaint of anorexia. Based on various tests, a diagnosis of scirrhous gastric carcinoma accompanied by bone metastasis and liver metastasis was made. As DIC developed following hospital admission, 5-FU and PTX therapy (5-FU at 600 mg/m(2), 24-hour continuous infusion, day 1-5 and PTX at 80 mg/m(2), iv, day 8, 15, 22) were administered. Although primary foci, bone metastasis, and liver metastasis were observed by image diagnostic procedures, recovery from DIC was achieved. 5-FU+PTX therapy is considered to be effective for DIC due to bone metastasis of gastric carcinoma.Gan to kagaku ryoho. Cancer & chemotherapy 01/2007; 33(13):2079-81. -
Article: Phase II study of docetaxel and S-1 combination therapy for advanced or recurrent gastric cancer.
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ABSTRACT: To evaluate the efficacy and toxicity of docetaxel in combination with a novel oral 5-fluorouracil analogue S-1 for patients with advanced or recurrent gastric cancer. Patients with advanced or recurrent adenocarcinoma of the stomach and up to one previous chemotherapy regimen were treated with i.v. docetaxel 40 mg/m2 on day 1 and oral S-1 80 mg/m2/d on days 1 to 14 every 3 weeks. Forty-eight patients (median age, 65 years; range, 25-75 years) received a total of 272 treatment cycles (median, 4; range, 1-17). No complete responses and 27 partial responses were observed for an overall response rate of 56.3% [95% confidence interval (95% CI), 38-66%]. Eighteen patients (37.5%) had stable disease and three patients (6.3%) had progressive disease as best response. The tumor control rate (complete response + partial response + stable disease) was 93.8% (95% CI, 83-98%). Median overall survival was 14.3 months (95% CI, 10.7-20.3 months) and median time to tumor progression was 7.3 months (95% CI, 4.3-10.0 months). The most common grade 3 to 4 hematologic toxicities were neutropenia (58.3%), leukopenia (41.7%), febrile neutropenia (8.3%), and anemia (8.3%). The most common grade 3 nonhematologic toxicities included anorexia (14.6%), stomatitis (8.3%), and nausea (6.3%). No grade 4 nonhematologic toxicities were reported and all treatment-related toxicities were resolved. Docetaxel/S-1 combination is highly active and well tolerated in advanced or recurrent gastric cancer. Further investigation in randomized studies is warranted.Clinical Cancer Research 07/2006; 12(11 Pt 1):3402-7. · 7.74 Impact Factor -
Article: [A case of recurrent gastric cancer with improvement of obstructive symptoms caused by carcinomatous peritonitis and prolonged survival by chemotherapy with combined use of Paclitaxel and 5-FU].
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ABSTRACT: A 29-year-old male underwent Cur B surgery including total gastrectomy, pancreaticoduodenectomy, transverse colectomy, and D 2 dissection for scirrhous gastric carcinoma accompanied by duodenal and pancreatic infiltration. Thereafter, the patient suffered from recurrence with development of ileus caused by carcinomatous peritonitis. Ileus tube was inserted, followed by conservative therapy without ingestion. But, as the symptoms aggravated without any alleviation, an emergency surgical procedure was conducted. As disseminated changes were observed in the entire region of the abdominal cavity of the epigastric region, ileus by-pass procedure and ileostomy were performed. Though ileus symptoms were improved, peroral intake was difficult,and the ileus tube had to be left in place. Thereafter, chemotherapy with combined use of paclitaxel and 5-FU was initiated, and peroral intake become possible. The Ileus tube could be removed after improvement of obstructive symptoms. The patient was treated at the outpatient clinic with nutritional help of HPN, but died 14 months after the recurrence.Gan to kagaku ryoho. Cancer & chemotherapy 03/2006; 33(2):247-50. -
Article: [A clinical study of endoscopic local coagulation therapy for hepatocellular carcinoma (HCC)].
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ABSTRACT: Eighteen subjects with cases of HCC who underwent endoscopic local coagulation therapy at Hiroshima City Hospital between 1998 and 2004 were studied and compared with 6 cases of HCC patients who underwent laparoscopic partial hepatectomy during the same period. The subjects composed of 10 cases of laparoscopic microwave coagulation therapy (L-MCT), 5 cases of laparoscopic radio frequency ablation therapy (L-RFA), and 3 cases of thoracoscopic microwave coagulation therapy (T-MCT). The operation time was 114 minutes for L-MCT and 92 minutes for L-RFA, both of which were significantly shorter than 208 minutes for resection cases. No complications were developed in any of the cases and the postoperative hospitalization period of the cases was 13.1 days, 8.2 days, and 13.0 days, respectively. Although each case of local recurrence was observed both in L-MCT and L-RFA groups, one case displayed observation difficulty from the liver surface and the other required a daughter nodule. The three-year survival rate was 71.4%, while the five-year survival rate was 53.6%. Endoscopic local coagulation therapy is not too invasive and useful for hepatocellular carcinoma in which percutaneous RFA is difficult. However, it is well indicated when the scope is evident with observation being feasible from the liver surface.Gan to kagaku ryoho. Cancer & chemotherapy 11/2005; 32(11):1603-5. -
Article: [A case report of recurrent gastric cancer in which combination chemotherapy with paclitaxel and 5-fluorouracil made for successful biliary stenting and improvement in QOL].
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ABSTRACT: The patient was a 49-year-old female who had undergone a total gastrectomy for gastric cancer on March 9 2001. Pathological diagnosis revealed sig, T 3 (SE), N 2, H 0, P 1, CY 0, M 0, Stage IV, and the curability was C. 5' DFUR 800 mg/day was administered as adjuvant chemotherapy. CDDP 10 mg/body/week intraperitoneally and 5-FU 500 mg/body/week were added. Retention of ascites, peritoneal dissemination, obstructive jaundice and right hydronephrosis appeared in June, 2003, and we started combination chemotherapy with paclitaxel and 5-fluorouracil. 5-fluorouracil (600 mg/m2/day) was infused continuously for 120-hours (days 1-5), and paclitaxel (80 mg/m2) was infused on days 8, 15, and 22 on an outpatient basis. Ascites and peritoneal dissemination had disappeared, and swollen lymph nodes were reduced after 2 courses of the chemotherapy. Furthermore, billiary stenting was performed and a PTCD tube could be removed after 4 courses. No serious adverse effect was observed, and the patient maintained good QOL through this treatment.Gan to kagaku ryoho. Cancer & chemotherapy 02/2005; 32(1):81-4. -
Article: [Evaluation of multimodality therapy for synchronous liver metastases of gastric cancer].
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ABSTRACT: We evaluated the significance of multimodality therapy for cases of liver metastases of gastric cancer. Accumulated survival rate and median survival time were analyzed for twenty cases of such gastric cancer. Survival rates of H1+H2 group and hepatic resection (HR) group were higher than that of H3 group and non-HR group. MST of HR group and hepatic arterial infusion (HAI) group were longer than that of non-HR group and non-HAI group. Survival rate of HAI group was higher than that of non-HAI group among eleven cases of HR group. On the other hand, survival rate of HR group was higher than that of non-HR group among eleven cases of HAI group. These results suggested that HAI chemotherapy after hepatic resection for gastric cancer patients with synchronous liver metastasis would improve prognosis.Gan to kagaku ryoho. Cancer & chemotherapy 11/2004; 31(11):1924-6.
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2004–2011
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Hiroshima City Hospital
Hiroshima-shi, Hiroshima-ken, Japan
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