Takaho Okada

Publications (6)2.15 Total impact

• Article: [A 5-year survival case of locally advanced cancer of the pancreatic body treated by distal pancreatectomy with en bloc celiac axis resection after neoadjuvant chemoradiation therapy].

  Masahiro Iseki, Fuyuhiko Motoi, Masamichi Mizuma, Hiroki Hayashi, Kei Nakagawa, Takaho Okada, Hideo Otsuka, Shigeru Ottomo, Naoaki Sakata, Koji Fukase, Hiroshi Yoshida, Tohru Onogawa, Takeshi Naito, Yu Katayose, Shinichi Egawa, Michiaki Unno
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  ABSTRACT: A 59-year-old man was diagnosed with locally advanced cancer of the pancreatic body, involving the nerve plexus around the celiac axis, the common hepatic artery, and the splenic artery. He was treated with a combination of irradiation (2 Gy/day, total 24 Gy) and 600 mg/m2 of gemcitabine(GEM)biweekly. The tumor size and the involved plexus area were not diminished, but CA19-9 was reduced by half. Distal pancreatectomy with en bloc celiac axis resection(DP-CAR)was performed. The histological findings indicated extensive invasion into the nerve plexus, including that adjacent to the stump of the pancreas, and thus the R classification was R1. After surgery, 1,000 mg/m2 of GEM was administered biweekly. The chemotherapy has been performed for 5 years to prevent local and systemic recurrence. No recurrence has been found 5 years after surgery. Multidisciplinary treatment, combined with neoadjuvant chemoradiation therapy, curative-intent resection, and postoperative chemotherapy is important for effective treatment of locally advanced pancreatic cancer.
  Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):1948-50.
• Article: Potential utility of eGFP-expressing NOG mice (NOG-EGFP) as a high purity cancer sampling system.

  Kentaro Shima, Masamichi Mizuma, Hiroki Hayashi, Kei Nakagawa, Takaho Okada, Naoaki Sakata, Noriyuki Omura, Yo Kitamura, Fuyuhiko Motoi, Toshiki Rikiyama, Yu Katayose, Shinichi Egawa, Naoto Ishii, Akira Horii, Michiaki Unno
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  ABSTRACT: It is still technically difficult to collect high purity cancer cells from tumor tissues, which contain noncancerous cells. We hypothesized that xenograft models of NOG mice expressing enhanced green fluorescent protein (eGFP), referred to as NOG-EGFP mice, may be useful for obtaining such high purity cancer cells for detailed molecular and cellular analyses. Pancreato-biliary cancer cell lines were implanted subcutaneously to compare the tumorigenicity between NOG-EGFP mice and nonobese diabetic/severe combined immunodeficiency (NOD/SCID) mice. To obtain high purity cancer cells, the subcutaneous tumors were harvested from the mice and enzymatically dissociated into single-cell suspensions. Then, the cells were sorted by fluorescence-activated cell sorting (FACS) for separation of the host cells and the cancer cells. Thereafter, the contamination rate of host cells in collected cancer cells was quantified by using FACS analysis. The viability of cancer cells after FACS sorting was evaluated by cell culture and subsequent subcutaneous reimplantation in NOG-EGFP mice. The tumorigenicity of NOG-EGFP mice was significantly better than that of NOD/SCID mice in all of the analyzed cell lines (p < 0.01). Sorting procedures enabled an almost pure collection of cancer cells with only slight contamination by host cells. Reimplantation of the sorted cancer cells formed tumors again, which demonstrated that cell viability after sorting was well maintained. This method provides a novel cancer sampling system for molecular and cellular analysis with high accuracy and should contribute to the development of personalized medicine.
  Journal of Experimental & Clinical Cancer Research 06/2012; 31:55. · 2.15 Impact Factor
• Article: [A case of curatively resected locally advanced cancer of the pancreatic body treated by distal pancreatectomy with en bloc celiac axis resection after neoadjuvant chemotherapy].

  Takaho Okada, Naoki Sakurai, Kuniharu Yamamoto, Fuyuhiko Motoi, Yasuaki Kakizaki, Gen Tamura, Michiaki Unno, Hajime Iizawa
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  ABSTRACT: A 68-year-old man with locally advanced pancreatic body cancer invading the celiac axis(CA, including common hepatic artery)and in contact with the superior mesenteric artery(SMA)underwent 2 courses of neoadjuvant chemotherapy(NAC); gemcitabine hydrochloride(GEM 1,000 mg/m / / 2, on day 1 and 15)and S-1(100mg/m2day, 2-weeks of continuous administration followed by 1-week rest). The tumor volume and the contact area to SMA were greatly diminished. All tumor markers were reduced. He underwent R0 resection by distal pancreatectomy with en bloc celiac axis resection(DP-CAR). After the surgery, he could continue adjuvant chemotherapy; (GEM 1,000 mg/m2)only twice because of malnutrition. Nine months later CT revealed local recurrence and multiple lung metastases. The patient died 371 days after surgery. Appropriate NAC can contribute to R0 resection in locally advanced pancreatic cancer.
  Gan to kagaku ryoho. Cancer & chemotherapy 01/2012; 39(1):135-7.
• Article: Distal pancreatectomy (with video).

  Shinichi Egawa, Takaho Okada, Fuyuhiko Motoi, Toshiki Rikiyama, Yu Katayose, Michiaki Unno
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  ABSTRACT: Distal pancreatectomy is indicated for lesions in the pancreatic body and tail. Understanding of the anatomical structure of the pancreas and its surroundings is required in various situations in left upper abdominal surgery including the laparoscopic approach. Spleen-preserving distal pancreatectomy is indicated for lesions confined to the pancreas. Two major spleen-preserving procedures reported are the Warshaw procedure that conserves the spleen by blood flow from the short gastric vessels and the Kimura procedure that preserves the spleen with splenic vessels. Considering the laparoscopic approach, the surgeon may preserve splenic vessels from the median toward the splenic hilum without mobilization of the spleen. A standard distal pancreatectomy using the medial approach is presented on video. The intraoperative complications of distal pancreatectomy can be minimized by avoiding splenic capsule injury, by careful differentiation of the splenic artery from the common hepatic artery, and by secure closure of the splenic vein stump. The incidence of postoperative pancreatic fistula following distal pancreatectomy is reported to be 13% in a nationwide pancreatic cancer registry. Based on the results of an international randomized trial of hand-sewn and staple closure of the pancreatic stump, the closure method of the pancreatic stump can be the surgeon's choice.
  Journal of hepato-biliary-pancreatic sciences. 11/2011; 19(2):135-40.
• Article: [A case of distal cholangiocarcinoma with high sensitivity to neoadjuvant chemoradiation therapy].

  Yoichi Haji, Masamichi Mizuma, Hiroki Hayashi, Kei Nakagawa, Takaho Okada, Hideo Otsuka, Shigeru Ottomo, Naoaki Sakata, Koji Fukase, Hiroshi Yoshida, Tohru Onogawa, Fuyuhiko Motoi, Takeshi Naito, Toshiki Rikiyama, Yu Katayose, Shinichi Egawa, Michiaki Unno
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  ABSTRACT: We hypothesized that neoadjuvant chemoradiation therapy for cholangiocarcinoma (NACRAC) using gemcitabine would improve the prognosis of resected cases. Phase II trial of NACRAC is ongoing. We report a very effective case to NACRAC for distal cholangiocarcinoma, which markedly reduced the size and levels of the tumor markers. The patient was a 50- year-old man who presented jaundice. Serum tumor markers were clearly elevated, and abdominal CT scan revealed an enhanced mass in the lower bile duct, a dilatation of the intrahepatic to the middle bile duct and a swollen regional lymph node. After NACRAC, the tumor markers were decreased within a normal range. Also on CT scan, the main tumor was slightly detectable and the swollen node was reduced more than 30% in short diameter. Therefore, the effect of NACRAC was considered PR in RECIST guidelines (ver.1 .1). Pancreaticoduodenectomy was performed 2 weeks after NACRAC. No perioperative complications occurred. Pathological examination showed a good response, Grade 2b on Oboshi-Shimosato's classification. In this case, NACRAC had a good effect in imaging and pathological findings as well as in the tumor markers. Therefore, the neoadjuvant chemoradiation therapy has a potential to improve the prognosis for cholangiocarcinoma.
  Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2426-8.
• Article: [A case of recurrent cholangiocarcinoma responding to weekly paclitaxel].

  Naoki Sakurai, Takaho Okada, Hajime Iizawa
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  ABSTRACT: A 72-year-old male underwent right hepatic lobectomy and pancreatoduodenectomy due to extrahepatic bile duct cancer in October 2007, and multiple lung metastases were later detected by CT three months after surgery. We started treatment with administration of S-1 at 100 mg/body. The CT at the end of the five courses revealed the progression of the lung metastases. Therefore we tried GEM at 1, 600 mg/body. After six courses, CT revealed more progression of the recurrent tumors. We then changed the chemotherapy menu to weekly PTX at 130 mg/body. Three courses after the chemotherapy of PTX, CT showed remarkable regression of multiple lung metastases, and the serum levels of tumor marker CA19-9 were also reduced to within the normal range. This remarkable regression of metastases has been maintained for 6 months.
  Gan to kagaku ryoho. Cancer & chemotherapy 07/2010; 37(7):1333-5.