Hideyoshi Toyokawa's research while affiliated with Kansai Medical University and other places

Publications (71)

Article
Objective:. No ideal training system exists for pancreaticoduodenectomy (PD). We developed an educational system that uses an objective structured assessment of technical skills. Methods:. This retrospective observational study was conducted using the data of consecutive trainees and patients who underwent PD from 2007 to 2013 in Kansai Medical Uni...
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Objective: The present study aimed to identify the clinical significance of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) imaging in patients with occupational cholangiocarcinoma. Methods: This study included 10 men with occupational cholangiocarcinoma who were former or current workers at a printing company in Osaka, Japan....
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Purpose: To determine the recommended dose (RD) of gemcitabine (GEM) plus S-1 (GS) in curatively resected biliary tract cancer (BTC) patients without major hepatectomy. Methods: A standard 3 + 3 dose-escalation design was used with planned dose levels (mg/m2) of GEM (administered intravenously on days 1 and 8) and S-1 (administered orally twice...
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The aim of current study is to verify usefulness of staging laparoscopy (stag-lap) for patient’s selection and to find prognostic factors in patients with radiographically defined locally advanced (RD-LA) pancreatic ductal adenocarcinoma (PDAC). The LA disease was defined as an unresectable disease without distant organ metastasis based on resectab...
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A 74-year-old man was diagnosed with small cell carcinoma arising from the extrahepatic bile duct according to a histological examination of the biopsy specimen obtained during endoscopic retrograde cholangiopancreatography. Additionally, bulky hilar lymphadenopathy was observed, and the patient was treated with the combination of radiation and che...
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We report a case of pancreaticoduodenectomy for intraductal papillary mucinous carcinoma (IPMC) with severe hypoalbuminemia. A 57-year-old man with a cystic tumor of the pancreas was referred to our hospital. His serum albumin was 1.6g/dl. A CT and MRI identified a cystic lesion in the head of the pancreas and main pancreatic duct dilation. Endosco...
Article
A woman in her fifties with a history of upper abdominal pain and elevation of both hepatobiliary and pancreatic enzymes was admitted to our hospital. Magnetic resonance cholangiopancreatography showed a notch-like constriction of the lower bile duct without bile duct dilatation. Endoscopic retrograde cholangiopancreatography from the papilla of Va...
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Background: Recent meta-analyses concluded that antibiotic prophylaxis is not warranted in low-risk laparoscopic cholecystectomy. However, most trials in the meta-analyses had a relatively small sample size and were statistically underpowered. In addition, many of the trials mentioned potential cost savings owing to the elimination of prophylactic...
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Background The purpose of the present study was to analyze the survival benefit and safety of adjuvant surgery in patients with initially unresectable pancreatic cancer following chemo(radio)therapy.Methods The 130 patients with unresectable pancreatic cancer treated during 2006 to 2013 were divided into a study group (15 patients) with planned adj...
Article
Background: Standardized adjuvant therapy is not performed after major hepatectomy for biliary tract cancer (BTC) because of frequent adverse events, which may be caused by insufficient liver function. Therefore, the aim of this multicenter study (KHBO1003) was to determine the safety protocol for adjuvant chemotherapy after major hepatectomy. Me...
Article
An outbreak of cholangiocarcinoma occurred among workers in the offset color proof-printing department at a printing company in Japan. The aim of this study was to clarify the characteristics of the patients with cholangiocarcinoma. This was a retrospective study conducted in 13 Japanese hospitals between 1996 to 2013. The clinicopathological findi...
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The most common postoperative complication after distal pancreatectomy (DP) is still postoperative pancreatic fistula (POPF), which is closely associated with other major complications and remains an unsolved problem. This retrospective study included 47 consecutive patients who underwent a distal pancreatectomy with (DP-PG group, n = 21) or withou...
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The aim of this study was to investigate the synergistic inhibitory effects of gemcitabine and losartan, angiotensin II type 1 (AT1) receptor blockers, on an orthotopic rat pancreatic cancer model. The rat orthotopic pancreatic cancer model was prepared using DSL-6A/C cells, a rat ductal pancreatic adenocarcinoma cell line. The rats were treated wi...
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We conducted a phase I study to determine the maximum tolerated dose and recommended dose (RD) of this gemcitabine plus cisplatin (GC) combination in the adjuvant setting for biliary tract cancer (BTC). GC has become a standard chemotherapy regimen for patients with locally advanced or metastatic BTC; however, the benefit of adjuvant therapy for BT...
Article
Postoperative nonalcoholic fatty liver disease (NAFLD) after pancreaticoduodenectomy (PD) has recently become recognized. However, the pathoetiology of postoperative NAFLD is largely unknown. Furthermore, the optimal treatment has not been established. The aim of this prospective study was to clarify whether pancrelipase, which contains digestive p...
Article
Prognostic factors for patients with advanced biliary tract cancer (BTC) who received palliative chemotherapy have not been fully established. Especially, the status of unresectable/recurrent disease has not been well studied because of a small number of patients with recurrent BTC in previous studies. tj;4This multicenter retrospective study was c...
Article
347 Background: GC has become a standard chemotherapy for patients with locally advanced or metastatic BTC. The benefit of adjuvant therapy for BTC is unclear, however, it is used worldwide due to BTC’s dismal prognosis. We conducted a phase I study for adjuvant chemotherapy with GC in patients with BTC in order to determine the maximum-tolerated d...
Article
The objective of this study was to examine whether the development of cholangitis after preoperative biliary drainage (PBD) can increase the incidence of postoperative pancreatic fistula (POPF). The study population included 185 consecutive patients who underwent pancreaticoduodenectomy from April 2006 to March 2011. All patients were divided into...
Article
The aim of this study was to retrospectively compare morbidity and mortality before and after introduction of a new departmental policy for patients who undergo distal pancreatectomy. We have introduced the use of an ultrasonically-activated device in distal pancreatectomy, an "early removal of drains" policy and perioperative management using a cl...
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Lymphoepithelial cysts of the pancreas are a rare disease of true pancreatic cysts, the cause of which is unknown. The differential diagnosis is broad and includes many benign and malignant cystic lesions of the pancreas and surrounding organs. A combination of imaging modalities and fine needle aspiration might narrow the differential diagnosis. H...
Article
Few studies have reported the efficacy and safety of palliative chemotherapy in elderly patients with advanced biliary tract cancer. We aimed to investigate the clinical outcomes of palliative chemotherapy for advanced biliary tract cancer in elderly patients. We retrospectively evaluated 403 consecutive patients who received palliative chemotherap...
Article
Background/aim: There is a report suggesting that epidural anaesthesia and analgesia (EAA) after pancreatic resection is associated with hemodynamic instability and complications. The objective of this study is to retrospectively analyze the effect of EAA for the postoperative course and complications after pancreaticoduodenectomy (PD). Methods: 16...
Article
Background: To investigate the behavior of activated pancreatic stellate cells (PSCs), which express alpha-smooth muscle actin (α-SMA), and pancreatic cancer cells in vivo, we examined the expression of α-SMA-positive myofibroblast-like cells in pancreatic cancer tissue after treatment with gemcitabine (GEM) using a Lewis orthotopic rat pancreatic...
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Cystic duct leakage with metal clips persists after laparoscopic cholecystectomy (LC). The aim of the study is to evaluate the preventive effect of locking clips on leaks from the cystic duct stump after LC as an alternative to metal clips. Locking clips were routinely used to close the cystic duct in LC. A total of 1101 patients who underwent LC w...
Article
The aim of the study was to evaluate the potential advantages of the ultrasonic scalpel compared with the conventional technique in gastric cancer surgery. Patients with resectable adenocarcinoma of the stomach were randomly assigned to ultrasonic scalpel or conventional technique. We used the HARMONIC FOCUS® (Ethicon Endo-Surgery, Inc.) as ultraso...
Article
e14518 Background: The difference of prognosis between patients (pts) with unresectable and recurrent biliary tract cancer (BTC) receiving chemotherapy has not been clarified although some studies reported prognostic factors of BTC. In this study, we aimed to compare the prognosis of unresectable BTC with that of recurrent BTC. We also evaluated ot...
Article
Background/purpose: In June 2004, a critical pathway for patients undergoing pancreaticoduodenectomy (PD) was introduced. The objective of this study was to determine the clinical value of critical pathway implementation. Methods: 256 consecutive patients who underwent PD between 2000 and 2010 were divided into 4 groups by date of operation as f...
Article
The aim of this study was to compare short-term surgical results in pancreatic cancer patients who underwent surgical resection after neo-adjuvant chemoradiation therapy (NACRT) using S-1. The study population comprised 77 patients with pancreatic cancer between 2006 and 2010. Out of 34 patients who underwent staging laparoscopy between 2008 and 20...
Article
Regulatory T cells (Treg) can inhibit immune responses mediated by T cells. The aim of this study was to evaluate the prevalence of Treg in peripheral blood mononuclear cells from patients with pancreatic cancers in relation to their clinical outcomes. Among a total of 100 patients with ductal adenocarcinoma of the pancreas, 40 underwent pancreatec...
Article
Pancreatic cancer is a malignant neoplasm with a poor prognosis that might be associated with defective immune function. In this study, we aimed to clarify the role of circulating myeloid dendritic cells (cmDCs) and lymphoid (cl) DCs in patients with unresectable pancreatic cancer. This study covered the period from January 2001 to December 2009, a...
Article
To examine whether the use of the new ultrasonically curved shear (UCS) can reduce the number of surgical stitches, extent of blood loss, and operation time in (pylorus-preserving) pancreaticoduodenectomy (PD) for periampullary cancer. The study population comprised 26 consecutive patients who underwent PD for periampullary cancer. Intraoperative d...
Article
The aims of this study were to verify whether the selective use of staging laparoscopy can prevent unnecessary laparotomy and to find a surrogate marker for surgical unresectability in patients with potentially or borderline resectable pancreatic cancer. Group A consisted of consecutive 33 patients evaluated between 2005 and 2006 and who directly u...
Article
Primary splenic mucinous cystadenocarcinoma (MCCa) is extremely rare, and only six cases appear to have been reported previously. We present herein a case of primary splenic MCCa resulting in pseudomyxoma peritonei (PMP). A 66-year-old Japanese woman presented to a hospital with a chief complaint of upper abdominal pain and a 7-year history of sple...
Article
We explored the outcome of the multi-disciplinary management for obtaining long-term survivors in patients with pancreatic cancer that extended beyond the pancreas. This single-institution experience indicates that surgical resection following the neoadjuvant chemoradiation (NACRT) therapy is able to increase the resectability rate with clear margi...
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To examine whether pressure-tight reinforcement of pancreaticojejunostomy (PJ) using polyglycolic acid (PGA) mesh and fibrin glue sealant can reduce the incidence of postoperative pancreatic fistula (POPF). The study population included 128 consecutive patients who underwent pancreaticoduodenectomy between September 2006 and January 2010. Postopera...
Article
Pancreatic cancer is a malignant neoplasm with poor prognosis that might be associated with defective immune function. We aimed to determine the influence on survival of circulating myeloid dendritic cells (c-m-DCs), circulating lymphoid DCs (c-l-DCs), and DCs within the tumor tissue in patients with pancreatic cancer. Between December 2001 and Jun...
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We evaluated the safety of, and clinical and immune responses to personalized peptide vaccination with gemcitabine (GEM) as the first line therapy in patients with non-resectable pancreatic cancer. Pre-vaccination peripheral blood mononuclear cells (PBMCs) and plasma were prepared to examine cellular and humoral responses to 14 and 16 peptides in h...
Article
Identification of tumor-associated antigens has enabled clinical development of a peptide-based cancer vaccine, which could induce cytotoxic T lymphocytes (CTLs) and lyse tumor cells in an HLA class I-restricted fashion. Until now, multiple clinical trials using tumor-associated antigen peptides have been performed. However, the clinical benefit ha...
Article
Xanthgranulomatous cholecystitis (XGC) is an usual disease and considered as uncommon variant of chronic cholecystitis resulting in the development of a granulomatous inflammation, mainly consisting of xanthoma cells containing bile pigments. Laparoscopic cholecystectomy is frequently unsuccessful with a relatively high conversion rate to open chol...
Article
After standardization of the perioperative management of pancreaticoduodenectomy, we retrospectively compared results in nonstented pancreaticojejunostomy with external-stented pancreaticojejunostomy. The study population included 129 consecutive patients who underwent pancreaticoduodenectomy between 2004 and 2008. The postoperative mortality and m...
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The results of surgical therapy alone for pancreatic cancer are disappointing. We explored surgical results after neoadjuvant chemoradiation therapy (NACRT) for patients with pancreatic cancer that extended beyond the pancreas. Sixty-eight consecutive patients with pancreatic cancer who underwent pancreatic resection were included. Twenty-seven pat...
Article
Accurate pre-operative staging in patients with pancreatic cancer is crucial for avoiding unnecessary laparotomy and for selecting patients accurately for curative resection. In this study, tumor resectability and residual tumor grading in patients evaluated by MD-CT (Multi-detector row CT) or by SD-CT (single-detector CT) were compared to determin...
Article
Pancreaticoduodenectomy (PD) is still associated with high morbidity. To reduce the frequency of postoperative complications, we have made revisions in perioperative managements of pancreaticoduodenectomy. Subjects were 128 consecutive patients who underwent PD between January 2000 and August 2006. In June 2004, the following new departmental guide...
Article
Our policy for the surgical treatment of hepatocellular carcinoma (HCC) has been to minimize the extent of liver resection using a microwave tissue coagulator (MTC) and to not perform Pringle's maneuver for the prevention of ischemic injury to the liver routinely. We verify the safety of liver resection using MTC in HCC patients with poor liver fun...
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To retrospectively evaluate the efficacy and tolerability of 5-fluorouracil and low-dose cisplatin (FP)-based preoperative concurrent chemoradiotherapy (PCRT) and gemcitabine (GEM)-based PCRT in patients with potentially resectable pancreatic cancer. Between December 2000 and December 2004, 32 patients with potentially resectable pancreatic cancer...
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To investigate whether circulating dendritic cells in patients with pancreatic cancer is a risk factor for septic complications after pancreatectomy. Retrospective study. University hospital. Forty-one patients with pancreatic cancer who underwent pancreatectomy from May 2001 to July 2005. Patients were divided into 2 groups depending on whether or...
Article
This study was designed to compare multidetector row computed tomography (MDCT) and CT-assisted hepatic arteriography (CTHA)/CT during arterial portography (CTAP)/angiography/contrast-enhanced CT (CECT) findings prospectively for accuracy in the detection of liver metastasis and vascular involvement of the tumor. The study included 43 patients with...
Article
Pancreatic cancer is a cancer with a very poor prognosis. Patients with locally advanced or metastatic pancreatic cancer especially have a poor prognosis. Many clinical trials have investigated the combination chemotherapies, but none has offered a significant improvement for the prognosis of advanced pancreatic cancer. Different clinical studies o...
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The pancreaticoduodenectomy with extended resection has been frequently performed in patients with pancreatic cancer in Japan. One result of this additional surgical stress may be that postoperative complications in patients with pancreatic cancer are more frequent than in patients with periampullary cancer. The 198 patients with pancreatic and per...
Article
Dendritic cells (DCs) are important for an immune surveillance. Myeloid DCs (DC1) are important for an effective antitumor immune system. The function and count of circulating DC1 (cDC1) in hosts with a malignant tumor would be defective. This study focused on analyzing the immunological features of cDC1 in patients with pancreatic cancer during th...
Article
Dendritic cells (DCs) are important for immune surveillance and play a central role in protection against infection and malignancy. DCs comprise two subsets: DC1 (myeloid DC) and DC2 (lymphoid DC). The aim of this study is to determine whether the number and/or function of circulating DCs were decreased in patients with pancreatic cancer and to eva...
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The biological effects of far-infrared ray (FIR) on whole organisms remain poorly understood. The aim of our study was to investigate not only the hyperthermic effect of the FIR irradiation, but also the biological effects of FIR on wound healing. To evaluate the effect of FIR on a skin wound site, the speed of full-thickness skin wound healing was...
Article
Between April 1992 and December 2000, 167 patients with pancreatic carcinoma were evaluated and treated in our department. One hundred eight patients (64.7%) with pancreatic carcinoma underwent pancreatectomy. Of these patients, 94 had histologically proven ductal adenocarcinoma. The overall postoperative mortality rate was 3.2% (3 patients), and t...
Article
The effects of biological response modifiers (BRMs) on the functions of two types of dendritic cells (DCs) were examined in relation to anti-tumor therapy. The two BRMs studied in our assay system were OK432 (a streptococcal preparation) and KP-40 (Propionibacterium avidum: a heat-inactivated bacterial vaccine). Recently, techniques for isolating h...

Citations

... 18 F-FDG PET allows in vivo assessment of the metabolic activation underlying hepatic malignancy. In particular, it is acknowledged to be useful in the primary staging of different types of cholangiocarcinoma, as well as lymph node metastasis and distant metastasis [6]. However, 18 F-FDG presents less sensitivity in detecting primary HCC lesions compared with ICC due to relatively weak phosphorylated FDG accumulation [7]. ...
... In addition, the Kansai Hepatobiliary Oncology Group (KHBO1401-MIT-SUBA study; NCT02182778) conducted a phase III trial to evaluate Gemcitabine + Cisplatin + S-1 combination therapy (GCS) over GC therapy in terms of MST. Yanagimoto, H et al. proved that GCS therapy is better than GC [30]. Research on Capecitabine, with results from three phase III clinical trials (BCAT, PRODIGE-12/ACCORD-18, BILCAP) [31][32][33], of which the BILCAP trial showed the presence of adjuvant therapy BILCAP included 447 postoperative patients, randomized to the singleagent Capecitabine group (223 patients) and the observation group (224 patients), the purpose of the trial is to determine the OS difference of the intentionto-treat (ITT) population based on factors such as anatomical location, resection margin status, lymphatic status and many more. ...
... In patients with resectable tumors, accurate diagnoses of tumor extension, vessel involvement, and the presence or absence of liver metastasis are necessary before operation. 5 The latest multi-detector computed tomography (MDCT) technology provides three-dimensional multi-planar reconstruction techniques enabling determination of tumor involvement of the common bile duct (CBD), pancreatic duct, and peripancreatic vasculature, which is expected to improve the preoperative determination of surgical resectability, particularly in relation to vascular invasion. 6 ...
... Postoperative morbidity remains as high as 30-50% even in high volume centres different techniques are used in these cases. 11 Postoperative pancreatic fistula (POPF) is the major cause of postoperative morbidity and its incidence is 9% to 29%. 12 POPF significantly affects the patient's quality of life and also increases the treatment cost. Hospital stay is prolonged and postoperative mortality is also increased. ...
... For patients who received neoadjuvant therapy and underwent surgical resection, the median OS range was 15.6 to 35 months. Compared with the group without neoadjuvant radiotherapy, the difference in median OS was statistically significant [15,16]. In this study, patients with non-metastatic PDAC were divided into T1-3N0M0, T1-3N + M0, T4N0M0, T4N + M0 according to TNM stages, and the effects of different treatment regimens including neoadjuvant radiotherapy on the prognosis were analyzed. ...
... In the near future, advance in chemotherapy can have potential to expand surgical indication. 3,4 We believe the most important strategy for cholangiocarcinoma is to perform optimal extended procedures after careful consideration of background factors. 5 We will keep making efforts toward seeking for the surgical possibility of expanded indications and improved curability for cholangiocarcinoma. ...
... The presence of gross and microscopic peritoneal dissemination is important in the diagnosis and treatment of pancreatic cancer. The prognosis of pancreatic cancer with peritoneal dissemination is particularly poor, with the median survival time (MST) reported to be approximately 7 months (2). Based on an analysis of pancreatic cancer cases registered by the Japan Pancreatic Society, Tsuchida et al. reported that intraoperative cytology (CY)-positive cases had a poorer prognosis than negative cases (MST: 17.5 vs. 29.4 ...
... Los ensayos clínicos con evidencia para dar respuesta a esta pregunta mostraron que el uso prolongado de antimicrobianos posterior al procedimiento quirúrgico comparado con la dosis única, no tiene utilidad para la reducción del riesgo de infecciones nosocomiales ni de ISQ, esto en el escenario de diferentes procedimientos quirúrgicos, como: apendicectomía; cirugía colorrectal; cirugía del tracto gastrointestinal superior; colecistectomía; cirugía hepatobiliar; cirugía general mixta; cesárea; cirugía ginecológica; cirugía ortopédica y traumatológica; cirugía de columna; cirugía cardíaca; cirugía torácica; cirugía vascular; cirugía de trasplante; cirugía de cabeza y cuello; cirugía de oído, nariz y garganta; cirugía maxilofacial; y cirugía ortognática 42 aguda, vesícula biliar no funcional, episodio de cólico biliar en los 30 días previos al procedimiento, manipulación de prótesis en la vía biliar, procedimiento con duración > a 2 horas, ruptura intraoperatoria de la vesícula o paso de colecistectomía laparoscópica a colecistectomía abierta (79)(80)(81)(82)(83) b. Factores de riesgo de infección: edad ≥ 70 años, inmunosupresión, ASA clasificación ≥ 3 o procedimiento con duración > a 2 horas. ...
... Some prospective studies have evaluated the tolerability and pharmacokinetics of adjuvant chemotherapy [183][184][185][186][187][188]. The regimens evaluated were gemcitabine alone, S-1 alone, and GC. ...
... However, the survival benefit is still limited, and the median OS of patients who underwent these new regimens was reported to be within one year [3,4]. To improve pancreatic cancer prognosis, the concept of conversion surgery recently emerged and is surgery for pancreatic cancer, which is initially considered as unresectable advanced one, as a result of significant response to chemotherapy or CRT [5][6][7][8][9][10][11]. However, the efficacy and safety of conversion surgery have not been well studied yet. ...