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ABSTRACT: BACKGROUND: The negative impact of postoperative complications (POCs) on long-term outcomes is well documented for several cancer surgeries, but conclusive evidence has yet to be provided on the influence of POCs on long-term oncological outcomes after hepatic resection for colorectal liver metastasis (CRLM). METHODS: Studies published through February 2012 evaluating the oncological impact of POCs after hepatectomy for CRLM were identified by an electronic literature search. Finally, 4 studies were identified and included in the meta-analysis. The main outcome measures were 5-year disease-free survival (DFS) and overall survival (OS). A meta-analysis was performed using the DerSimonian-Laird random-effects models to compute odds ratio (OR) along with 95 % confidence intervals (95 % CI). RESULTS: The outcomes of 2,280 patients were studied. Meta-analysis of 5-year DFS data extracted from three studies demonstrated a significant reduction in 5-year DFS after POCs, with an OR of 1.98 (95 % CI = 1.33-2.96; P = .0008). Meta-analysis of 5-year OS data extracted from four studies demonstrated a significant reduction in 5-year OS after POCs, with an OR of 1.68 (95 % CI = 1.25-2.27; P = .0006). No differences between study heterogeneity were observed in either the DFS or the OS analyses. CONCLUSIONS: This study provides persuasive evidence that POCs following hepatic resection for CRLM have significant adverse oncological outcomes. These findings emphasize the need for meticulous surgical technique and careful perioperative management to minimize POCs.
Annals of Surgical Oncology 04/2013; · 4.17 Impact Factor
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ABSTRACT: We report a choledochal cyst that was successfully treated with laparoscopic surgery. A 32-year-old Japanese woman was referred to our hospital with a suspected choledochal cyst. Magnetic resonance cholangiopancreatography and computed tomography showed the common bile duct to be grossly dilated to the hepatic confluence. A diagnosis of type-Ia choledochal cyst in the Todani classification was made, and laparoscopic resection was performed. The patient was placed in the lithotomy position under general anesthesia, and 4 ports were inserted. After the cystic duct was dissected, the hepatoduodenal ligament was incised and a choledochal cyst was identified. Next, the common bile duct was mobilized and dissected away from the surrounding vessels and tissues. Taping of the common bile duct allowed better exposure and dissection of the surrounding tissues. Mobilization of the bile duct and dissection of the surrounding tissue was performed to the bifurcation of the common hepatic duct. Then the common hepatic duct was transected just distal to the choledochal cyst. The inferior common bile duct was dissected from the pancreas to identify the distal end of the choledochal cyst and the pancreaticobiliary junction behind the duodenum. The narrow segment of the choledochal cyst was identified and divided after distal closure with clips. After the gall bladder was dissected from the liver bed, the choledochal cyst and gallbladder were removed. A Roux limb was created extracorporeally via the umbilical incision. The jejunum 30 cm distal to the ligament of Treitz was removed through the transumbilical incision and transected. To create the Roux limb, the mesentery of the jejunum was also extracorporeally separated. A 50-cm Roux limb was made by means of side-to-side anastomosis with an endostapler. After a jejunostomy for hepaticojejunostomy anastomosis was created, the Roux limb was returned to the abdominal cavity. Then, pneumoperitoneum was started again, and the Roux limb was brought up laparoscopically in a retrocolic fashion. An end-to-side hepaticojejunostomy was intracorporeally established with a continuous, single-layer full-thickness 4-0 vicryl suture. Total operation time was 715 minutes. Intraoperative body fluid loss was 250 mL, and the postoperative course was uneventful with no major complications. The patient was discharged from hospital on the 12th postoperative day. She remains asymptomatic with normal liver function after 24 months of follow-up.
Journal of Nippon Medical School 01/2013; 80(2):160-4.
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ABSTRACT: Introduction. Leiomyosarcomas of vascular origin are particularly rare tumors occurring mainly in the inferior vena cava (IVC). They are malignant, slow-growing tumors with a poor prognosis. This paper reports on a rare case of surgical resection of an IVC leiomyosarcoma mimicking a hepatic tumor. Case Presentation. A 65-year-old Japanese male was admitted for evaluation of an abdominal tumor. Enhanced computed tomography of the abdomen revealed a slightly enhanced heterogeneous tumor, 18 mm in diameter, between the Spiegel lobe of the liver and the IVC in early-phase images, with no enhancement or washout in late-phase images. We diagnosed this tumor as either a hepatic tumor in the Spiegel lobe or a retroperitoneal tumor such as leiomyosarcoma or liposarcoma and performed a laparotomy. On the basis of surgical findings, we extirpated the tumor by performing a wedge resection of the wall of the IVC and suturing the primary IVC wall. Pathological findings led to a further diagnosis of the tumor as a leiomyosarcoma originating in the IVC. Thirty-seven months after the operation, multiple liver and lung metastases were detected, and the patient died from multiple organic failures. Conclusion. We experienced a rare case of a leiomyosarcoma of IVC mimicking hepatic tumor.
Case Reports in Medicine 01/2013; 2013:235698.
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ABSTRACT: We report a rare case of adenocarcinoma of the minor papilla of the duodenum treated with transduodenal minor papillectomy. A 64-year-old woman was treated for an asymptomatic duodenal tumor detected on gastroduodenoscopy. Endoscopy showed a 15-mm sessile mass in the descending duodenum proximal to the major papilla. The major papilla was a villous 24-mm-diameter polypoid tumor. Histopathologic examination of the biopsy specimen showed tubular adenoma with moderate epithelial atypia. Transduodenal major and minor papillectomies were performed. The orifice of the duct of Santorini and the pancreatic duct were re-approximated to the duodenal wall to prevent acute pancreatitis caused by scarring and stenosis of the duct orifice. Histological findings were consistent with well-differentiated adenocarcinoma limited to the minor duodenal papilla, without infiltration of the duodenal wall submucosa, and confirmed complete resection. The patient had an uneventful postoperative course and has remained asymptomatic, without evidence of tumor recurrence or stenosis of the pancreatic duct orifice, for 4 years.
Journal of Nippon Medical School 01/2013; 80(2):165-70.
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ABSTRACT: Background: Frey's procedure might be a good alternative to pylorus-preserving pancreaticoduodenectomy (PPPD) for patients with an inflammatory mass of the head of the pancreas, because it is technically easy and associated with low morbidity and good pain relief. Purpose: To analyze the short-term and long-term outcomes of Frey's procedure in comparison with PPPD and to evaluate the efficacy of Frey's procedure against preoperative locoregional complications. Patients and Methods: From August 1997 through December 2007, 6 patients underwent Frey's procedure (as described by Frey and Smith), and 10 patients underwent PPPD. The mean follow-up times were 70.8 months (Frey's procedure) and 119.8 months (PPPD). Preoperative biliary stricture and duodenal stenosis were observed in 4 and 3 patients, respectively, of patients undergoing Frey's procedure. Pain intensity was assessed with a pain scoring system. Quality of life (QOL) was assessed with the European Organization for Research and Treatment of Cancer Quality of-Life Questionnaire-Core 30. Exocrine and endocrine pancreatic function was measured during follow-up. Results: Significant reductions in total pain scores and all QOL scale scores were observed immediately after surgery in all patients (P<0.05). Frey's procedure was superior to PPPD with regard to physical status 7 years after surgery (P<0.05). One patient in the Frey group had a grade B pancreatic fistula, and 2 patients in the PPPD group had intra-abdominal bleeding and delayed gastric emptying. There were no re-operations or surgery-related deaths in either group. Diabetes developed postoperatively in 2 patients in the PPPD group. No patients with preoperative duodenal or biliary stricture or both had a relapse. Three patients in the PPPD group died during follow-up of diseases unrelated to chronic pancreatitis. Conclusion: Frey's procedure is safe and effective with regard to pain relief, preservation of pancreatic function, and improvement of QOL over the long term. Moreover, this procedure can also be used to treat preoperative biliary stricture and duodenal stenosis associated with an inflammatory mass of the pancreatic head.
Journal of Nippon Medical School 01/2013; 80(2):148-54.
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Eriko Shinozuka,
Masao Miyashita,
Yoshiaki Mizuguchi,
Ichiro Akagi,
Kunio Kikuchi,
Hiroshi Makino,
Takeshi Matsutani,
Nobutoshi Hagiwara,
Tsutomu Nomura, Eiji Uchida,
Toshihiro Takizawa
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ABSTRACT: It is now evident that changes in microRNA are involved in cancer progression, but the mechanisms of transcriptional regulation of miRNAs remain unknown. Ski-related novel gene (SnoN/SKIL), a transcription co-factor, acts as a potential key regulator within a complex network of p53 transcriptional repressors. SnoN has pro- and anti-oncogenic functions in the regulation of cell proliferation, senescence, apoptosis, and differentiation. We characterized the roles of SnoN in miRNA transcriptional regulation and its effects on cell proliferation using esophageal squamous cell carcinoma (ESCC) cells. Silencing of SnoN altered a set of miRNA expression profiles in TE-1cells, and the expression levels of miR-720, miR-1274A, and miR-1274B were modulated by SnoN. The expression of these miRNAs resulted in changes to the target protein p63 and a disintegrin and metalloproteinase domain 9 (ADAM9). Furthermore, silencing of SnoN significantly upregulated cell proliferation in TE-1 cells, indicating a potential anti-oncogenic function. These results support our observation that cancer tissues have lower expression levels of SnoN, miR-720, and miR-1274A compared to adjacent normal tissues from ESCC patients. These data demonstrate a novel mechanism of miRNA regulation, leading to changes in cell proliferation.
Biochemical and Biophysical Research Communications 11/2012; · 2.48 Impact Factor
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ABSTRACT: Oxaliplatin(L-OHP)is an important chemotherapeutic drug for the treatment of colorectal cancer. Peripheral neuropathy was observed in 90% of patients who received L-OHP.Neuropathy often results in the discontinuation of treatment or a decrease the quality of life(QOL). The most effective method for reducing neuropathy is the discontinuation of L-OHP. To reduce neuropathy, we administered Keishikajutsubutou(TJ-18)with powdered processed aconite root(TJ-3023), and we report the effect of these compounds. The subjects comprised 11 patients with metastatic colorectal cancer. L-OHP(85mg/m2)was administered as part of the FOLFOX6(10 patients)or FOLFOX7(1 patient)regimen. All patients had experienced neuropathy. We administered TJ-18(7.5 g)and T-3023(1 g). After 2 weeks, the TJ-3023 dose was increased to 2 g for nonresponders. The response was evaluated according to the Neurotoxicity Criteria of DEBIOPHARM. Reduction in neuropathy was observed in 5 cases(45.5% ). Among 6 patients whose feet and hands felt warm, reduction in neuropathy was observed in 5(83.3% ).
Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(11):1687-1691.
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ABSTRACT: INTRODUCTION: We introduce a technique for pancreaticojejunostomy with closure of the pancreatic stump by endoscopic linear stapler as a reliable intervention with benefits for pancreatic resection in laparoscopic pancreaticoduodenectomy (Lap-PD). MATERIALS AND SURGICAL TECHNIQUE: Following laparoscopic resection, we perform pancreaticojejunostomy under direct visualization. We employ the same method as in open surgery and enter via a 4-5-cm incision, the minimum size feasible for easy removal of resected material from the body, positioned directly above the stump of the distal pancreas. In January 2011, we began using endoscopic linear stapler when cutting the pancreas during Lap-PD in order to reduce the leakage of pancreatic juice, which may contain tumor cells from the neoplastic lesion. Since then, we have used this procedure in 12 subjects undergoing Lap-PD and 5 subjects undergoing laparoscopic central pancreatectomy. We have observed postoperative complication in only one of the laparoscopic central pancreatectomy cases, involving grade B/C pancreatic fistula, and in none of the Lap-PD cases. DISCUSSION: Our pancreaticojejunostomy with closure of the pancreatic stump by endoscopic linear stapler is a feasible procedure in Lap-PD and has produced positive results over a short time frame.
Asian Journal of Endoscopic Surgery 11/2012; 5(4):191-4.
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ABSTRACT: Nausea and vomiting are common side effects due to opioid therapy, and may greatly impede the quality of life of cancer patients. A preventive method for nausea and vomiting has not yet been established. We developed a clinical pathway(CP) for cancer pain management in which prochlorperazine is used for the prevention of nausea and vomiting caused by opioids. We have shown that this CP is effective for relieving cancer pain. In this study, we investigated the efficacy prochlorperazine has for preventing nausea and vomiting caused by opioids in patients treated with the CP. The incidence of nausea and vomiting of those patients was 15. 8% which was lower than the results of other previous clinical trials. However, we could not show the effectiveness of prochlorperazine. Prochlorperazine, which is a dopamine D2 receptor antagonist, may show limited utility for the prevention of nausea and vomiting; however, in opioid therapy, histamine receptor(H1)prevention is also important.
Gan to kagaku ryoho. Cancer & chemotherapy 10/2012; 39(10):1517-21.
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ABSTRACT: BACKGROUND: Implantation of exfoliated cancer cells has been suggested as a possible mechanism of local recurrence at the site of colorectal anastomosis. Intraoperative rectal washout has been suggested to eliminate free cancer cells; however, there is no conclusive evidence of a beneficial effect of intraoperative rectal washout on local recurrence after anterior resection of rectal cancer. METHODS: Studies published through February 2012 evaluating the impact of intraoperative rectal washout for local recurrence or positive cytology from donuts wash were identified by an electronic literature search. A meta-analysis was performed using the DerSimonian-Laird random-effects models to compute risk ratio (RR) along with 95 % confidence intervals (CI). RESULTS: Nine studies met the inclusion criteria, yielding a total of 5,395 patients. Eight studies evaluated overall local recurrence, including anastomotic recurrence, and five of the eight studies evaluated anastomotic recurrence separately. Two studies evaluated positive cytology from donuts wash. Local recurrence rate was 5.79 % in the washout group and 10.05 % in the no washout group-a difference that was statistically significant (RR = 0.57; 95 % CI = 0.46-0.71; P < 0.00001). Rectal washout significantly reduced the risk of anastomotic recurrence (RR = 0.3; 95 % CI = 0.12-0.71; P = 0.007). No influence of rectal washout was observed on positive cytology from donuts wash. CONCLUSIONS: From the results of this meta-analysis, it may be justified to recommend intraoperative rectal washout to prevent local recurrence in rectal cancer surgery.
Annals of Surgical Oncology 09/2012; · 4.17 Impact Factor
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ABSTRACT: Evidence-based guidelines for the prevention of surgical site infection (SSI) have been published by the U.S. Centers for Disease Control and Prevention (CDC). According to these guidelines, a wound should usually be covered with a sterile dressing for 24 to 48 h when a surgical incision is closed primarily. However, it is not recommended that an incision be covered by a dressing beyond 48 h. In this study, patients were stratified into two groups for analysis: patients whose surgical wound was sterilized and whose gauze was changed once daily until postoperative day 7 (7POD; group A); and patients whose surgical wound was sterilized and whose gauze was changed once daily until 2POD (group B). We evaluated the incidence of SSI, nursing hours and cost implications. The results showed that there was no significant difference in SSI occurrence between the two groups (group A, 10% vs. group B, 7.3%). By contrast, the average nursing time differed by 2.8 min (group A, 3.8 min vs. group B, 0.9 min). The material costs per patient were also reduced by $14.70 (group A, $61.80 vs. group B, $47.10). In conclusion, we applied our knowledge of the evidence-based CDC guidelines to determine whether 48-h wound management can be made easier, more uniform and more cost-effective compared to conventional wound management. The results of the present study showed that surgical wound management methods can be more convenient and inexpensive.
Oncology letters 07/2012; 4(1):97-100. · 0.11 Impact Factor
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ABSTRACT: The urinary trypsin inhibitor (UTI) is responsible for most of the antitryptic activity in urine and is excreted in increased amounts in urine under certain pathological conditions such as cancer and bacterial infections. Our aim in this study was to better understand the mechanisms responsible for the increase in UTI excretion on surgical stress and thus to better appreciate the information provided by inflammatory mediators. Thirty-one consecutive patients who underwent radical esophagectomy for esophageal cancer were investigated in this study. We determined serum UTI and polymorphonuclear cell elastase (PMNE), urine UTI and evaluated the effectiveness of preoperative administration of methylprednisolone on the postoperative clinical course and adverse inflammatory reactions. The results revealed that urine UTI and serum PMNE levels in the steroid group were significantly lower than those in the non-steroid group. In addition, UTI levels correlated positively with serum levels of aminotransferases. More importantly, the maximum level of urine UTI in patients without complications was lower than that in patients with complications. These results suggest that urine UTI provides useful information concerning postoperative clinical course, and that preoperative administration of methylprednisolone may contribute to decrease postoperative complications following esophagectomy.
Experimental and therapeutic medicine 07/2012; 4(1):84-88.
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Satoshi Mizutani,
Hideyuki Suzuki,
Takayuki Aimoto,
Satoshi Nomura,
Arichika Hoshino,
Naoto Chihara,
Osamu Komine,
Masanori Yoshino,
Masao Ogata,
Masanori Watanabe,
Hiroyuki Tajima, Eiji Uchida
Digestive Endoscopy 07/2012; 24(4):289. · 1.19 Impact Factor
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ABSTRACT: Late-onset and solitary recurrence of gastric signet ring cell (SRC) carcinoma is rare. We report a successful surgical resection of late solitary locoregional recurrence after curative gastrectomy for gastric SRC carcinoma.
The patient underwent total gastrectomy for advanced gastric carcinoma at age 52. Seven years after the primary operation, he visited us again with sudden onset of abdominal pain and vomiting. We finally decided to perform an operation, based on a diagnosis of colon obstruction due to the recurrence of gastric cancer by clinical findings and instrumental examinations. The laparotomic intra-abdominal findings showed that the recurrent tumor existed in the region surrounded by the left diaphragm, colon of splenic flexure, and pancreas tail. There was no evidence of peritoneal dissemination, and peritoneal lavage fluid cytology was negative. We performed complete resection of the recurrent tumor with partial colectomy, distal pancreatectomy, and partial diaphragmectomy. Histological examination of the resected specimen revealed SRC carcinoma, identical in appearance to the previously resected gastric cancer. We confirmed that the intra-abdominal tumor was a locoregional gastric cancer recurrence in the stomach bed. The patient showed a long-term survival of 27 months after the second operation.
In the absence of effective alternative treatment for recurrent gastric carcinoma, surgical options should be pursued, especially for late and solitary recurrence.
Medical science monitor: international medical journal of experimental and clinical research 06/2012; 18(7):CS53-6. · 1.70 Impact Factor
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Junji Ueda,
Hiroshi Yoshida,
Yasuhiro Mamada,
Nobuhiko Taniai,
Sho Mineta,
Masato Yoshioka,
Youichi Kawano,
Tetsuya Shimizu,
Etsuko Hara,
Chiaki Kawamoto,
Keiko Kaneko, Eiji Uchida
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ABSTRACT: Lymph node (LN) metastases from hepatocellular carcinoma (HCC) are considered uncommon. We describe the surgical resection of a solitary para-aortic LN metastasis from HCC. A 65-year-old Japanese man with B-type liver cirrhosis was admitted for the evaluation of a liver tumor. He had already undergone radiofrequency ablation, transcatheter arterial chemoembolization, and percutaneous ethanol injection therapy for HCC. Despite treatment, viable regions remained in segments 4 and 8. We performed a right paramedian sectionectomy with partial resection of the left paramedian section of the liver. Six months later, serum concentrations of alpha-fetoprotein (189 ng/mL) and PIVKA-2 (507 mAU/mL) increased. Enhanced computed tomography of the abdomen revealed a tumor (20 mm in diameter) on the right side of the abdominal aorta. Fluorine-18 fluorodeoxyglucose positron emission tomography revealed an increased standard uptake value. There was no evidence of recurrence in other regions. Esophagogastroduodenoscopy and colonoscopy revealed no malignant tumor in the gastrointestinal tract. Para-aortic LN metastasis from HCC was thus diagnosed. We performed lymphadenectomy. Histopathological examination revealed that the tumor was largely necrotic, with poorly differentiated HCC on its surface, which confirmed the suspected diagnosis. After 6 mo tumor marker levels were normal, with no evidence of recurrence. Our experience suggests that a solitary para-aortic LN metastasis from HCC can be treated surgically.
World Journal of Gastroenterology 06/2012; 18(23):3027-31. · 2.47 Impact Factor
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ABSTRACT: The indications for endoscopic treatment have expanded in recent years, and relatively intestinal-type mucosal stomach carcinomas with a low potential for metastasis are now often resected en bloc by endoscopic submucosal dissection (ESD), even if they measure over 20 mm in size. However, ESD requires complex maneuvers, which entails a long operation time, and is often accompanied by complications such as bleeding and perforation. Many technical developments have been implemented to overcome these complications. The scope, cutting device, hemostasis device, and other supportive devices have been improved. However, even with these innovations, ESD remains a potentially complex procedure. One of the major difficulties is poor visualization of the submucosal layer resulting from the poor countertraction afforded during submucosal dissection. Recently, countertraction devices have been developed. In this paper, we introduce countertraction techniques and devices mainly for gastric cancer.
World journal of gastrointestinal endoscopy. 06/2012; 4(6):231-5.
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Seiichi Shinji,
Koho Akimaru,
Yoshikazu Tsuchiya,
Tetsuya Shimizu,
Masao Kawamoto,
Miki Iwamoto,
Noritaka Yamaguchi,
Hiroo Suzuki,
Takayuki Yamada,
Takashi Nikaido, Eiji Uchida
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ABSTRACT: We herein present a rare case of enterovesical fistula caused by ileal non-Hodgkin's lymphoma. A 75-year-old Japanese male presented with macrohematuria at Kosei General Hospital in December 2010. An egg-sized mass was palpable in his right lower abdominal region, and computed tomography (CT) revealed that the ileal tumor had invaded the right posterior wall of the urinary bladder (UB). A histopathological examination of a CT-guided needle biopsy specimen revealed diffuse large B-cell lymphoma involving the ileum and the UB. Thereafter, fecaluria appeared. A transurethral catheter was put in place, and there were no symptoms of cystitis. The patient received chemotherapy for the lymphoma, which produced a partial response. However, the fecaluria continued, and an examination of the small intestine with contrast revealed a thick and irregular wall of the ileum and a fistula between the ileum and UB. A partial resection of the ileum and a partial cystectomy were carried out in April 2011. The surgical specimen demonstrated two tumors 5 cm apart in the ileum, measuring 4.5 × 7 and 4 × 3 cm in size. The proximal tumor had directly invaded the UB and formed an ileovesical fistula. The patient made a good recovery and was doing well 5 months after the surgery without any evidence of recurrence.
Surgery Today 06/2012; 42(10):1005-9. · 1.22 Impact Factor
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ABSTRACT: A 64-year-old man visited our hospital complaining of abdominal discomfort. A 2-cm-long 0-IIc+IIa esophageal superficial
carcinoma was detected in the middle third of the thoracic esophagus with endoscopy and esophagography. Computed tomography
(CT) did not detect any metastasis. The patient underwent video-assisted thoracic surgery of the esophagus (VATS-E). Anastomotic
leakage and a thoracic abscess were detected 16days after the operation. Repeated thoracic drainages and conservative therapy
with enteral nutrition were continued for approximately 1month, but an esophago-mediastinal fistula and small mediastinal
cavity remained. Additional drainage using interventional radiology (IVR) reduced the size of the cavity, but could not cure
the esophago-mediastinal fistula, 68days after the operation. The occurrence of an esophago-respiratory fistula followed
by a thoracic abscess is a very serious and frequently fatal complication. We performed endoscopic clipping and filling with
fibrin glue and succeeded in closing the fistula. Oral intake was started after training in swallowing, and the patient was
discharged from hospital 172days after the operation. One year after the operation he has no sign of a recurrence of the
tumor or fistula. We demonstrated a case in which an esophago-mediastinal fistula was successfully repaired by endoscopic
clipping with fibrin glue after an operation.
KeywordsEsophago-mediastinal fistula–Clipping–Esophagectomy
Esophagus 04/2012; 8(2):113-117. · 0.66 Impact Factor
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ABSTRACT: Pancreatic cancer frequently causes extrahepatic cholestasis. To identify the direct effects of bile acids in jaundiced serum
on pancreatic cancer, the proliferation of PANC-1 and MIA PaCa-2 cells as well as the ultrastructural alteration of PANC-1
cells cultured in crude bile modified media were studied. The growth of these cells in the RPMI-1640 media with or without
1%, 2%, and 4% of the refined crude bile was assessed after 48 and 96 h of incubation. The ultrastructure of PANC-1 cells
was investigated by scanning and transmission electron microscopy after 24 and 48 h of incubation. The proliferation of both
cell lines in the bile-treated media was greatly inhibited. The inhibitory rates of bile on PANC-1 ranged from 24.1%±3.3%
to 66.9%±6.6% (P < 0.01) and those on MIA PaCa-2 ranged from 16.7%±3.8% to 50.7%±5.5%. (P < 0.01). When the bile-added media were replaced, the cells were able to restore their proliferating ability. The PANC-1
cells incubated in the bile-supplied media indicated that the mirovilli, mitochondria, and other organelles had thus been
injured. These results suggest that bile acids appear to inhibit the proliferation of PANC-1 and MIA PaCa-2 cells, and the
probable inhibitory mechanism is mainly considered to be due to the cytotoxicity of such bile acids.
Key wordsBile acid–Extrahepatic cholestasis–Cytotoxicity–Pancreatic cancer cell line
Surgery Today 04/2012; 30(10):903-909. · 1.22 Impact Factor
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ABSTRACT: A 66-year-old male with a chief complaint of dysphagia was admitted to our hospital. Upper gastrointestinal endoscopy revealed a type 3 tumor on the gastric upper body, and pathological examinations of the biopsy specimens revealed a poorly differentiated adenocarcinoma. Computed tomography (CT) of the abdomen showed significant wall thickness of the stomach, and regional and para-aortic lymph node metastases. The CA19-9 level was high: 978 U/mL on admission. He received neoadjuvant chemotherapy using S-1 (120 mg/body, days 1-21) and cisplatin (108 mg/body, days 8) for faradvanced gastric cancer. After neoadjuvant chemotherapy, upper gastrointestinal endoscopy revealed that the gastric carcinoma had significant reductions in the size of its tumors, and CT showed that the lymph node metastases had disappeared, leading to a partial response. He underwent total gastrectomy, distal pancreatectomy, splenectomy and Roux-en Y reconstruction. Pathological examination of the resected specimens showed a small number of cancer cells in the submucosal layer, suggesting a Grade 2 pathological response, and gave a positive reaction to CA19-9 staining. The postoperative CA19-9 level decreased to a normal level. This case is diagnosed as CA19-9-producing gastric cancer. He was treated on an outpatient basis with adjuvant therapy.
Gan to kagaku ryoho. Cancer & chemotherapy 04/2012; 39(4):653-6.
