Yo Mikayama

Kanagawa Cancer Center, Yokohama, Kanagawa, Japan

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Publications (12)7.65 Total impact

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    ABSTRACT: To assess the outcomes of preoperative colonic stent placement for obstructive colorectal cancer. A total of 30 patients with colorectal cancer were treated after preoperative colonic metallic stent placement between July 2012 and March 2014. We reviewed their medical records to assess the usefulness of stent placement and the clinical course. The effects of various clinicopathological variables on post-operative complications were analyzed statistically. Stent insertion was effective in 93%of the 30 patients with obstructive colorectal cancer. Preoperative colonoscopy or enema for proximal colonic survey was possible in 70% of the patients after stent placement; colonic lesions requiring simultaneous resection were noted in 5 patients(24%). The mean interval between stent insertion and operation was 19 days, and 23%of the patients underwent laparoscopic surgery. Statistical analysis revealed that the occurrence of complications was associated with laparoscopic surgery and the amount of operative blood loss. Preoperative stent placement in patients with obstructive colorectal cancer is feasible and laparoscopic surgery can be selected after stent placement.
    No preview · Article · Nov 2014 · Gan to kagaku ryoho. Cancer & chemotherapy
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    ABSTRACT: Adjuvant chemotherapy is aimed at eradicating residual micro-metastatic tumor cells existing at the distant site outside of the surgical field. From evidence gathered from around the world, several courses of intensive neoadjuvant chemotherapy are promising even in Japan, where D2 surgery is the standard for local control. The Japan Clinical Oncology Group (JCOG) plays a central role in the development of neoadjuvant chemotherapy in Japan. Two JCOG Phase II trials clarified that neoadjuvant chemotherapy was effective for bulky nodal disease. A JCOG Phase III is now on-going to confirm the efficacy of neoadjuvant chemotherapy of S-1+CDDP for cancer of the schirrhous type. In another group, two randomized Phase II trials are also ongoing to compare different regimens and courses of neoadjuvant chemotherapy. These studies will set the direction of neoadjuvant chemotherapy development in the future.
    No preview · Article · Jun 2012 · Gan to kagaku ryoho. Cancer & chemotherapy
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    ABSTRACT: Background The factors that affect the 6-month continuation of adjuvant chemotherapy with S-1 have not been fully evaluated. The objective of this retrospective study was to clarify the risk factors for 6-month continuation of S-1 adjuvant chemotherapy. Methods The study selected patients who underwent curative D2 surgery for gastric cancer, were diagnosed with stage 2 or 3 disease, had a serum creatinine level of ≤1.2 mg/dl, and received adjuvant S-1 between June 2002 and March 2011. Results One hundred of these patients were eligible for the present study. A comparison of 6-month continuation of S-1 stratified by various clinical factors, using the log-rank test, revealed a marginally significant difference in creatinine clearance (CCr) between those patients who continued for 6 months and those who did not. A CCr of 60 ml/min was regarded as the critical point. Uni- and multivariate Cox’s proportional hazard analyses demonstrated that CCr was the only significant independent factor for the prediction of 6-month continuation. The 6-month continuation rate was 72.9 % in the patients with CCr ≥60 ml/min, and 40.0 % in patients with CCr <60 ml/min (P = 0.015). Adverse events occurred more frequently and earlier in the patients with CCr <60 ml/min than in those with CCr ≥60 ml/min. Conclusions CCr <60 ml/min was a significant risk factor for 6-month continuation of S-1 adjuvant chemotherapy, even though the renal function was judged as normal by the serum creatinine level. Careful attention is therefore required for S-1 continuation in patients with CCr <60 ml/min.
    No preview · Article · Apr 2012 · Gastric Cancer

  • No preview · Article · Jan 2012 · Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons)
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    ABSTRACT: The peritoneum is still the most frequent site of recurrence in stage II/III gastric cancer patients, although the survival rate was improved by the introduction of S-1 adjuvant chemotherapy. The objective of this retrospective study was to clarify the risk factors for peritoneal recurrence in patients who received S-1 adjuvant chemotherapy. Peritoneal recurrence-free survival was examined in 100 gastric cancer patients who underwent curative D2 surgery, which were diagnosed with stage II or III disease pathologically, and received adjuvant S-1 between June 2002 and March 2011. The univariate and multivariate analyses were performed to identify risk factors by a Cox proportional hazards analysis. The P-RFS was 64.3% at 3 years and 58.8% at 5 years. A total of 18 patients were diagnosed with peritoneal recurrence. The macroscopic tumor diameter, depth of tumor invasion, and lymph node metastasis were the significant factors identified by the univariate analysis, while the tumor diameter and lymph node metastasis were the only significant independent risk factors identified by the multivariate analysis. The macroscopic tumor diameter and presence of lymph node metastasis were the most important risk factors for peritoneal recurrence. When patients had these risk factors, S-1 was not sufficient to inhibit peritoneal recurrence. A novel adjuvant chemotherapeutic agent targeting peritoneal metastasis in these patients should be developed.
    No preview · Article · Dec 2011 · Annals of Surgical Oncology
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    ABSTRACT: S-1 mono-therapy for advanced gastric cancer is hard to continue in some patients due to adverse events. We retrospectively examined the patients who received S-1/Krestin( PSK) immunochemotherapy for advanced gastric cancer. During September 2006 to August 2008, 3 patients had received S-1/PSK. S-1 was given for 6-week schedule or 3-week schedule, and PSK was for everyday during the S-1 treatment. Cases 1 and 2 had lymph node metastases after surgery. Case 3 had peritoneal metastasis. The median treatment duration was 112 days. The median overall survival was 552 days. All patients stopped the treatment due to progression of disease. There were no patients who stopped the treatment due to adverse events. PSK may increase the compliance of S-1.
    No preview · Article · Nov 2011 · Gan to kagaku ryoho. Cancer & chemotherapy
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    ABSTRACT: We report 3 cases of resectable pancreatic metastasis. CASE 1: A 76-year-old woman was followed after nephrectomy for renal cell carcinoma for 13 years. CT examination demonstrated a high vascular lesion in the pancreatic body and tail. We conducted distal pancreatectomy and diagnosed with metastatic tumor from renal cell carcinoma. She died of liver metastasis 8 years after pancreatic resection. CASE 2: A 64-year-old man, who had undergone right lower lobectomy for lung cancer a year ago, was found to have a mass in the pancreatic tail. We performed distal pancreatectomy and diagnosed with metastatic tumor from lung cancer. He died of lung metastasis 12 months after pancreatic resection. CASE 3: A 62- year-old woman, who had undergone left nephrectomy for renal cell carcinoma 3 years ago, was found to have a mass in the pancreatic body. With a diagnosis of metastatic pancreatic tumor from renal cell carcinoma, distal pancreatectomy was done. She died of liver and lung metastases 15 months after pancreatic resection. Long-term survival can be achieved in patients undergoing a pancreatic standard resection including lymphadenectomy for isolated metastasis from nonpancreatic sites.
    No preview · Article · Nov 2011 · Gan to kagaku ryoho. Cancer & chemotherapy
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    ABSTRACT: The cost of laparoscopic gastrectomy (LG) has not been fully clarified yet. The actual cost for the instruments used for surgery was examined between LG and conventional open gastrectomy( OG) by separating distant (l D-) and total (l T-) gastrectomy in a total of 20 patients(5 for each)during Oct 2010 and Feb 2011. The profit was defined as the difference of the actual cost and the operation fee including the instruments determined by the insurance and compared. The fee for D-OG, T-OG, D-LG, and T-LG were 708, 700 yen, 856 , 400 yen, 783 , 600 yen and 922 , 300 yen, respectively. The mean profits of D-OG, T-OG, D-LG, and T-LG were 408 , 297 yen, 475 , 812 yen, 308, 681 yen and 269 , 478 yen, respectively. Appropriate surgical and instrumental fees should be determined considering the actual cost.
    No preview · Article · Nov 2011 · Gan to kagaku ryoho. Cancer & chemotherapy
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    ABSTRACT: Survival and clinical course were unknown in patients with recurrence of para-aortic lymph node after curative D2 gastrectomy and adjuvant S-1 chemotherapy. The study examined clinical characteristics and prognosis of 3 patients who had para-aortic nodal recurrence after curative D2 gastrectomy and S-1 adjuvant chemotherapy. Initial stage was III C in all of the patients. Median treatment interval of S-1 was 8 . 8 months. Para-aortic nodal metastasis was single in 2 and multiple in 1 patient. Median survival time was 14 .3 months. Other recurrent sites than para- aortic node were not seen in all of the patients. In the times of S-1 adjuvant chemotherapy, it is valuable to know whether para-aortic node should be resected prophylactically, or be treated after recurrence, or be treated by locally or systemically.
    No preview · Article · Nov 2011 · Gan to kagaku ryoho. Cancer & chemotherapy
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    ABSTRACT: Background and aim: Colorectal cancer is generally thought as a disease of older persons, but there exist young patients. The aim of this study was to clarify the differences in colorectal cancer between the young and elderly patients, and compare the results of surgical intervention in these two groups. Method: A total of 1189 colorectal cancer patients who underwent curative surgery at Kanagawa Cancer Center for the years between 1990 and 2008 were reviewed retrospectively. The patients were divided by age as follows: younger group (n = 29, under 40 years old); control group (n = 1160, 40 or more years old and less than 75 years old). Result: There were no significant differences between the two groups with regard to gender, double cancer, tumor markers, lesion distribution, tumor differentiation, depth of invasion, lymph node metastasis, lymphatic invasion, vessel invasion, number of resected lymph node and Stage. Large tumor was more frequent in the younger group than in the control group (p<0.05). Adjuvant chemotherapy was more frequently done in the younger group (p<0.05). The overall 5-year survival rate of the younger group was not significantly different from that of the control group (84. 3% and 86.0%, respectively p>0.05). The young group showed low 3-year relapse-free survival rate but there was no significant difference between the younger group and the control group (70.8% and 83.1%, respectively p = 0.083). Conclusion: Large tumor was more frequent in the younger group than in the control group. Curative resection can improve the overall survival rate of the younger patient as same as that of the control group. It is necessary to advance investigation for recurrence in young patients with colorectal cancer.
    No preview · Article · Jan 2011 · Yokohama Medical Journal
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    ABSTRACT: We report a case of an intraabdominal metastasis of extremity myxoid liposarcoma. The patient was diagnosed as having left lower extremity myxoid liposarcoma and underwent surgery at our hospital in 2007. After surgery, he was followed up at our hospital by chest and abdominal computed tomography (CT). In 2009, CT showed a mass, 80mm in diameter, in the right abdomen. He was diagnosed as having intraabdominal metastasis of myxoid liposarcoma and underwent chemotherapy [ifosfamide(lFM)+etoposide(VP-16)]. After chemotherapy, the size of the intraabdominal tumor was not change. CT failed to reveal other metastatic lesions, and he underwent intraabdominal tumor resection. The tumor was histologically diagnosed as myxoid liposarcoma. After resection he underwent chemotherapy (lFM+VP-16), but myxoid liposarcoma recurred as another intraabdominal lesion. At present tumor resection is planned. Soft tissue sarcoma is a rare disease and metastasizes to the lung. Myxoid liposarcoma has been known to frequently metastasize to extrapulmonary sites, even when the primary site is an extremity. Resection of the metastatic lesions can improve the clinical outcome, and selected patients with isolated intraabdominal metastasis of myxid liposarcoma may benefit from surgical resection.
    No preview · Article · Jan 2011 · Yokohama Medical Journal
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    ABSTRACT: A 77-year-old man had sigmoidectomy for sigmoid colon cancer. Two years later, a right hepatectomy for a liver metastasis was performed. Two years thereafter, abdominal computed tomography scanning and FDG-PET showed the right adrenal mass. Right adrenalectomy was performed with a diagnosis of solitary adrenal metastasis from sigmoid colon cancer. On pathology, adrenal metastasis was confirmed. The patient underwent adjuvant chemotherapy (IRIS). There have been no signs of recurrence for 6 months after the operation. We conclude that patients with solitary adrenal metastasis from colorectal cancer may benefit from surgical resection.
    No preview · Article · Nov 2010 · Gan to kagaku ryoho. Cancer & chemotherapy