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  1. Article ; Online: Laparoscopic extended right anterior sectionectomy including the paracaval caudate portion using the Arantius' approach (with video).

    Yasuda, Jungo / Onda, Shinji / Yanagaki, Mitsuru / Ikegami, Toru

    Surgical oncology

    2021  Volume 39, Page(s) 101669

    MeSH term(s) Anatomic Landmarks ; Hepatectomy/methods ; Hepatic Veins/anatomy & histology ; Humans ; Laparoscopy/methods ; Liver Neoplasms/surgery
    Language English
    Publishing date 2021-10-08
    Publishing country Netherlands
    Document type Journal Article ; Video-Audio Media
    ZDB-ID 1107810-8
    ISSN 1879-3320 ; 0960-7404
    ISSN (online) 1879-3320
    ISSN 0960-7404
    DOI 10.1016/j.suronc.2021.101669
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  2. Article ; Online: Left Lobe Living Donor Graft Could Be a Good Choice for Liver Transplantation.

    Ikegami, Toru / Haruki, Koichiro / Furukawa, Kenei / Onda, Shinji

    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

    2021  Volume 27, Issue 8, Page(s) 1215–1216

    MeSH term(s) Hepatic Veins ; Humans ; Liver/surgery ; Liver Transplantation ; Living Donors
    Language English
    Publishing date 2021-07-14
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 2006866-9
    ISSN 1527-6473 ; 1527-6465
    ISSN (online) 1527-6473
    ISSN 1527-6465
    DOI 10.1002/lt.26064
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  3. Article ; Online: Analysis of Preoperative Risk Factors for Early Recurrence in Patients After Hepatic Resection for Intrahepatic Cholangiocarcinoma.

    Akaoka, Munetoshi / Haruki, Koichiro / Furukawa, Kenei / Tsunematsu, Masashi / Ishizaki, Shunta / Okui, Norimitsu / Shirai, Yoshihiro / Yanagaki, Mitsuru / Onda, Shinji / Ikegami, Toru

    The American surgeon

    2024  , Page(s) 31348241227173

    Abstract: Background: Intrahepatic cholangiocarcinoma (ICC) has a poor prognosis even after curative-intent hepatic resection due to a high recurrence rate. The aim of this study was to investigate preoperative risk factors for early recurrence after surgery for ... ...

    Abstract Background: Intrahepatic cholangiocarcinoma (ICC) has a poor prognosis even after curative-intent hepatic resection due to a high recurrence rate. The aim of this study was to investigate preoperative risk factors for early recurrence after surgery for ICC, which may help to identify patients who need preoperative chemotherapy.
    Methods: We retrospectively analyzed 51 patients who had undergone primary surgery for ICC. We investigated the association of preoperative clinical variables with recurrence within 1 year after resection for ICC. We then created a high-risk ICC score using the identified preoperative factors and investigated the association of the score with disease-free and overall survival.
    Results: Recurrence within 1 year after surgery for ICC was significantly associated with poor overall survival (
    Conclusions: Our high-risk ICC score, combining preoperative tumor size and CAR, can be an indicator of early recurrence and poor survival in patients after hepatic resection for ICC. Our findings may provide better preoperative risk stratification of patients with ICC, and the high-risk ICC patients may benefit from preoperative therapy.
    Language English
    Publishing date 2024-01-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
    DOI 10.1177/00031348241227173
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  4. Article ; Online: The prognosis-based classification model in resectable pancreatic cancer.

    Okui, Norimitsu / Tsunematsu, Masashi / Furukawa, Kenei / Shirai, Yoshihiiro / Haruki, Koichiro / Sakamoto, Taro / Uwagawa, Tadashi / Onda, Shinji / Gocho, Takeshi / Ikegami, Toru

    Surgical oncology

    2024  Volume 52, Page(s) 102035

    Abstract: Aim: Pancreatic ductal adenocarcinoma treatment is mainly based on the anatomical resectability classification. However, prognosis-based classification may be more reasonable. In this study, we stratified resectable pancreatic ductal adenocarcinoma ... ...

    Abstract Aim: Pancreatic ductal adenocarcinoma treatment is mainly based on the anatomical resectability classification. However, prognosis-based classification may be more reasonable. In this study, we stratified resectable pancreatic ductal adenocarcinoma according to preoperative factors and reconsidered treatment strategies.
    Methods: We retrospectively evaluated 131 patients who underwent upfront surgery for resectable pancreatic ductal adenocarcinoma between 2007 and 2019. Recurrence within 1 year after surgery was defined as early recurrence, and the risk factors for early recurrence were identified using preoperative factors. Subsequently, we calculated the scores and stratified the participant groups.
    Results: Fifty-five (42 %) patients who relapsed within 1 year showed significantly poorer survival than those without recurrence (median overall survival, 14.0 vs. 80.6 months; p < 0.01). Multivariate analysis revealed that a tumor diameter of ≥24 mm (p < 0.01) and preoperative serum carbohydrate antigen 19-9 level of ≥380 U/mL (p = 0.04) were the independent risk factors for early recurrence. Early recurrence score was created using these factors, stratifying the participant group into three groups of 0-2 points, and the prognosis was significantly different (median overall survival, 49.3 vs. 31.2 vs. 16.0 months; p < 0.01).
    Conclusion: We stratified the upfront surgical cases of resectable pancreatic ductal adenocarcinoma. The group with a score of 0 had a good prognosis, and upfront surgery was possibly not futile on patients in poor general condition. The group with a score of 2 had a poor prognosis and may require stronger preoperative treatment.
    MeSH term(s) Humans ; Retrospective Studies ; Pancreatic Neoplasms/pathology ; Carcinoma, Pancreatic Ductal/pathology ; Prognosis ; Risk Factors ; Neoadjuvant Therapy
    Language English
    Publishing date 2024-01-05
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1107810-8
    ISSN 1879-3320 ; 0960-7404
    ISSN (online) 1879-3320
    ISSN 0960-7404
    DOI 10.1016/j.suronc.2024.102035
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  5. Article ; Online: Osteosarcopenia impacts treatment outcomes for Barcelona Cancer Liver Classification stage A hepatocellular carcinoma.

    Abe, Kyohei / Furukawa, Kenei / Matsumoto, Michinori / Futagawa, Yasuro / Shiozaki, Hironori / Onda, Shinji / Haruki, Koichiro / Shirai, Yoshihiro / Okamoto, Tomoyoshi / Ikegami, Toru

    Surgical oncology

    2024  Volume 53, Page(s) 102043

    Abstract: Aim: To study the effect of preoperative osteosarcopenia (OSP) on the prognosis of treatment (surgery or radiofrequency ablation (RFA)) in patients with Barcelona Cancer Liver Classification stage A hepatocellular carcinoma (BCLC A HCC).: Methods: ... ...

    Abstract Aim: To study the effect of preoperative osteosarcopenia (OSP) on the prognosis of treatment (surgery or radiofrequency ablation (RFA)) in patients with Barcelona Cancer Liver Classification stage A hepatocellular carcinoma (BCLC A HCC).
    Methods: This study enrolled 102 patients with BCLC A HCC who underwent surgical resection (n = 45) and RFA (n = 57); the patients were divided into two groups: OSP (n = 33) and non-OSP (n = 69). Overall survival (OS) and disease-free survival (DFS) curves for both the groups and treatment methods (surgery and RFA) were generated using the Kaplan-Meier method and compared using the log-rank test. Univariate analyses for OS and DFS were performed using log-rank test. Multivariate analyses were performed for factors that were significant at univariate analysis by Cox proportional hazard model.
    Results: Multivariate analysis showed that OSP (HR 2.44; 95 % CI 1.30-4.55; p < 0.01) and treatment (HR 0.57; 95 % CI 0.31-0.99; p = 0.05) were significant independent predictors of DFS; and treatment (HR, 0.30; 95 % CI 0.10-0.85; p = 0.03) was a significant independent predictor of OS in the non-OSP group, in which the OS rate was significantly lower in patients treated with RFA than in those treated by resection (p = 0.01).
    Conclusions: OSP is a prognostic factor for BCLC A HCC treatment. Surgical approach was associated with a significantly better prognosis in patients without OSP compared to those who underwent RFA.
    MeSH term(s) Humans ; Carcinoma, Hepatocellular/surgery ; Carcinoma, Hepatocellular/pathology ; Liver Neoplasms/surgery ; Liver Neoplasms/pathology ; Hepatectomy ; Retrospective Studies ; Catheter Ablation/adverse effects ; Treatment Outcome
    Language English
    Publishing date 2024-02-02
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1107810-8
    ISSN 1879-3320 ; 0960-7404
    ISSN (online) 1879-3320
    ISSN 0960-7404
    DOI 10.1016/j.suronc.2024.102043
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  6. Article ; Online: Prognostic significance of occult vertebral fracture in patients undergoing pancreatic resection for pancreatic cancer.

    Ishizaki, Shunta / Furukawa, Kenei / Haruki, Koichiro / Tsunematsu, Masashi / Shirai, Yoshihiro / Matsumoto, Michinori / Okui, Norimitsu / Onda, Shinji / Taniai, Tomohiko / Ikegami, Toru

    Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.

    2024  Volume 24, Issue 2, Page(s) 249–254

    Abstract: Objective: The prognostic impact of occult vertebral fracture (OVF) in patients with malignancies is a new cutting edge in cancer research. This study was performed to analyze the prognostic impact of OVF after surgery for pancreatic cancer.: Methods!# ...

    Abstract Objective: The prognostic impact of occult vertebral fracture (OVF) in patients with malignancies is a new cutting edge in cancer research. This study was performed to analyze the prognostic impact of OVF after surgery for pancreatic cancer.
    Methods: This study involved 200 patients who underwent surgical treatment of pancreatic ductal adenocarcinoma. OVF was diagnosed by quantitative measurement using preoperative sagittal computed tomography image reconstruction from the 11th thoracic vertebra to the 5th lumbar vertebra.
    Results: OVF was diagnosed in 65 (32.5 %) patients. The multivariate analyses showed that male sex (p = 0.01), osteopenia (p < 0.01), OVF (p < 0.01), a carbohydrate antigen 19-9 level of ≥400 U/mL (p < 0.01), advanced stage of cancer (p < 0.01), and non-adjuvant chemotherapy (p = 0.02) were independent risk factors for overall survival. An age of ≥74 years (p < 0.01) and obstructive jaundice (p = 0.03) were independent risk factors for OVF. Furthermore, the combination of OVF and osteopenia further worsened disease-free survival and overall survival compared with osteopenia or OVF alone (p < 0.01; respectively).
    Conclusion: Evaluation of preoperative OVF might be a useful prognostic indicator for patients with pancreatic ductal adenocarcinoma.
    MeSH term(s) Humans ; Male ; Aged ; Spinal Fractures/diagnostic imaging ; Spinal Fractures/surgery ; Prognosis ; Spine ; Pancreatic Neoplasms/surgery ; Carcinoma, Pancreatic Ductal/surgery ; Bone Diseases, Metabolic
    Language English
    Publishing date 2024-01-09
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2056680-3
    ISSN 1424-3911 ; 1424-3903
    ISSN (online) 1424-3911
    ISSN 1424-3903
    DOI 10.1016/j.pan.2024.01.003
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  7. Article ; Online: Prognostic Significance of Sarcopenia and Eicosapentaenoic Acid (EPA) Levels in Patients With Unresectable Pancreatic or Biliary Tract Cancer.

    Abe, Kyohei / Furukawa, Kenei / Shirai, Yoshihiro / Onda, Shinji / Tsunematsu, Masashi / Haruki, Koichiro / Akaoka, Munetoshi / Uwagawa, Tadashi / Matsumoto, Michinori / Ikegami, Toru

    Cancer diagnosis & prognosis

    2024  Volume 4, Issue 2, Page(s) 135–140

    Abstract: Background/aim: This study aimed to investigate the relationship between prechemotherapy blood eicosapentaenoic acid (EPA) levels, sarcopenia, and overall survival in patients with pancreatic and biliary tract cancer undergoing chemotherapy.: Patients ...

    Abstract Background/aim: This study aimed to investigate the relationship between prechemotherapy blood eicosapentaenoic acid (EPA) levels, sarcopenia, and overall survival in patients with pancreatic and biliary tract cancer undergoing chemotherapy.
    Patients and methods: Forty-five patients with recurrent, non-resected pancreatic or biliary tract cancer undergoing chemotherapy were retrospectively analyzed. The skeletal muscle mass was measured at the third lumbar vertebra. Sarcopenia cut-off values were based on the Japanese Society of Hepatology sarcopenia assessment criteria. Two months after starting chemotherapy, the patients received enteral nutrition containing omega-3 fatty acids.
    Results: Patients with pancreatic and biliary tract cancers with low pre-treatment blood EPA levels had significantly more intense sarcopenia than those with high EPA levels (p=0.023). Patients with sarcopenia before chemotherapy had significantly lower overall survival than those without sarcopenia. Multivariate analysis revealed blood EPA concentration as an independent prognostic factor (p<0.01). Lumbar muscle volume, a marker of sarcopenia, showed a clear positive correlation with prechemotherapy EPA concentration (p=0.008). In patients administered with enteral nutrition containing omega-3 fatty acids, both EPA concentration and lumbar muscle volume were significantly higher than those prior to intervention, indicating sarcopenia improvement due to the intervention.
    Conclusion: In patients with recurrent non-resected pancreatic and biliary tract cancer, low blood EPA levels before chemotherapy are associated with sarcopenia and poor prognosis.
    Language English
    Publishing date 2024-03-03
    Publishing country Greece
    Document type Journal Article
    ISSN 2732-7787
    ISSN (online) 2732-7787
    DOI 10.21873/cdp.10299
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  8. Article ; Online: The Signal Intensity Ratio of Pancreas to Spleen in Magnetic Resonance Imaging Can Predict Nonalcoholic Fatty Liver Disease After Pancreaticoduodenectomy.

    Tsunematsu, Masashi / Haruki, Koichiro / Shirai, Yoshihiro / Onda, Shinji / Furukawa, Kenei / Okui, Norimitsu / Abe, Kyohei / Sakamoto, Taro / Gocho, Takeshi / Ikegami, Toru

    Pancreas

    2024  Volume 53, Issue 4, Page(s) e310–e316

    Abstract: Objectives: Signal intensity ratio of pancreas to spleen (SI ratio p/s ) on fat-suppressed T1-weighted images of magnetic resonance imaging has been associated with pancreatic exocrine function. We here investigated the predictive value of the SI ratio ... ...

    Abstract Objectives: Signal intensity ratio of pancreas to spleen (SI ratio p/s ) on fat-suppressed T1-weighted images of magnetic resonance imaging has been associated with pancreatic exocrine function. We here investigated the predictive value of the SI ratio p/s for the development of nonalcoholic fatty liver disease (NAFLD) after pancreaticoduodenectomy (PD).
    Materials and methods: This study comprised 208 patients who underwent PD. NAFLD was defined as a liver-to-spleen attenuation ratio of <0.9 calculated by a computed tomography 1 year after surgery. SI ratio p/s was calculated by dividing the average pancreas SI by the spleen SI. We retrospectively investigated the association of clinical variables including the SI ratio p/s and NAFLD by univariate and multivariate analyses.
    Results: NAFLD after 1 year was developed in 27 patients (13%). In multivariate analysis, the SI ratio p/s < 1 ( P < 0.001) was an independent predictor of incidence of NAFLD. The SI ratio p/s < 1 was associated with low amylase level of the pancreatic juice ( P < 0.001) and progressed pancreatic fibrosis ( P = 0.017). According to the receiver operating characteristics curve, the SI ratio p/s had better prognostic ability of NAFLD than the remnant pancreas volume.
    Conclusions: The SI ratio p/s is useful to predict NAFLD development after PD. Moreover, the SI ratio p/s can be a surrogate marker, which represents exocrine function of the pancreas.
    MeSH term(s) Humans ; Non-alcoholic Fatty Liver Disease/epidemiology ; Pancreaticoduodenectomy/adverse effects ; Spleen/diagnostic imaging ; Retrospective Studies ; Pancreas/diagnostic imaging ; Pancreas/surgery ; Pancreas/pathology ; Magnetic Resonance Imaging/methods ; Risk Factors
    Language English
    Publishing date 2024-02-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632831-3
    ISSN 1536-4828 ; 0885-3177
    ISSN (online) 1536-4828
    ISSN 0885-3177
    DOI 10.1097/MPA.0000000000002306
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  9. Article ; Online: Prognostic impact of osteosarcopenia in patients undergoing pancreatic resection for pancreatic ductal adenocarcinoma.

    Yanagaki, Mitsuru / Onda, Shinji / Gocho, Takeshi / Igarashi, Yosuke / Shirai, Yoshihiro / Okui, Norimitsu / Matsumoto, Michinori / Sakamoto, Taro / Haruki, Koichiro / Ikegami, Toru

    Langenbeck's archives of surgery

    2024  Volume 409, Issue 1, Page(s) 130

    Abstract: Background: We investigated the prognostic impact of osteosarcopenia, defined as the combination of osteopenia and sarcopenia, in patients undergoing pancreatic resection for pancreatic ductal adenocarcinoma (PDAC).: Methods: The relationship of ... ...

    Abstract Background: We investigated the prognostic impact of osteosarcopenia, defined as the combination of osteopenia and sarcopenia, in patients undergoing pancreatic resection for pancreatic ductal adenocarcinoma (PDAC).
    Methods: The relationship of osteosarcopenia with disease-free survival and overall survival was analyzed in 183 patients who underwent elective pancreatic resection for PDAC. Computed tomography was used to measure the pixel density in the midvertebral core of the 11th thoracic vertebra for evaluation of osteopenia and in the psoas muscle area of the 3rd lumbar vertebra for evaluation of sarcopenia. Osteosarcopenia was defined as the simultaneous presence of both osteopenia and sarcopenia. The study employed a retrospective design to examine the relationship between osteosarcopenia and survival outcomes.
    Results: Osteosarcopenia was identified in 61 (33%) patients. In the univariate analysis, disease-free survival was significantly worse in patients with male sex (p = 0.031), pathological stage ≥ III PDAC (p = 0.001), NLR, ≥ 2.71 (p = 0.041), sarcopenia (p = 0.027), osteopenia (p = 0.001), and osteosarcopenia (p < 0.001), and overall survival was significantly worse in patients with male sex (p = 0.001), pathological stage ≥ III PDAC (p = 0.001), distal pancreatectomy (p = 0.025), sarcopenia (p = 0.003), osteopenia (p < 0.001), and osteosarcopenia (p < 0.001). In the multivariate analysis, the independent predictors of disease-free survival were osteosarcopenia (p < 0.001) and pathological stage ≥ III PDAC (p = 0.002), and the independent predictors of overall survival were osteosarcopenia (p < 0.001), male sex (p = 0.006) and pathological stage ≥ III PDAC (p = 0.001).
    Conclusion: Osteosarcopenia has an adverse prognostic impact on long-term outcomes in patients undergoing pancreatic resection for PDAC.
    MeSH term(s) Humans ; Male ; Pancreatectomy ; Prognosis ; Retrospective Studies ; Sarcopenia ; Carcinoma, Pancreatic Ductal ; Pancreatic Neoplasms ; Bone Diseases, Metabolic
    Language English
    Publishing date 2024-04-18
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1423681-3
    ISSN 1435-2451 ; 1435-2443
    ISSN (online) 1435-2451
    ISSN 1435-2443
    DOI 10.1007/s00423-024-03315-x
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  10. Article ; Online: Strategies to Perform Emergency Laparoscopic Partial Liver Resection for Ruptured Hepatocellular Carcinoma.

    Tsunematsu, Masashi / Onda, Shinji / Shirai, Yoshihiro / Abe, Kyohei / Horiuchi, Takashi / Haruki, Koichiro / Furukawa, Kenei / Okui, Norimitsu / Taniai, Tomohiko / Ikegami, Toru

    Anticancer research

    2024  Volume 44, Issue 5, Page(s) 2171–2176

    Abstract: Background/aim: Laparoscopic hepatic resection is currently used for ruptured hepatocellular carcinoma (HCC); however, it is technically challenging. We developed and implemented surgical strategies for emergency laparoscopic partial liver resection in ... ...

    Abstract Background/aim: Laparoscopic hepatic resection is currently used for ruptured hepatocellular carcinoma (HCC); however, it is technically challenging. We developed and implemented surgical strategies for emergency laparoscopic partial liver resection in selected patients with peripheral lesions who were hemodynamically stable and without severe liver dysfunction.
    Patients and methods: The surgical techniques used were as follows. First, the Pringle maneuver was performed to control hepatic blood inflow (step 1). Next, strong hemostatic agents were applied at the rupture point of the tumor (step 2). The hanging tape was positioned along the dorsal side of the resection line to control the partial blood inflow and outflow of the tumor, as well as to expose the surgical plane (step 3). The liver parenchyma was dissected along the hanging tape (step 4). We performed emergency laparoscopic partial liver resection in three patients who were in a pre-shock status.
    Results: The tumors were located in segments 6 (cases 1 and 2) and 2 (case 3). The tumor diameters were 90, 62, and 80 mm. The Preoperative Child-Pugh scores were B7, B9, and B8. The hemostatic products performed well and controlled bleeding from the ruptured HCC. The hanging tape facilitated the dissection of the liver parenchyma. The operative time and intraoperative blood loss were 135 min and 400 ml, 266 min and 200 ml, and 191 min and 495 ml for cases 1, 2, and 3 respectively. There were no in-hospital deaths.
    Conclusion: Emergency laparoscopic partial liver resection could be an option for patients with ruptured HCC.
    MeSH term(s) Humans ; Carcinoma, Hepatocellular/surgery ; Carcinoma, Hepatocellular/pathology ; Liver Neoplasms/surgery ; Liver Neoplasms/pathology ; Laparoscopy/methods ; Hepatectomy/methods ; Male ; Aged ; Middle Aged ; Female ; Rupture, Spontaneous/surgery ; Blood Loss, Surgical ; Emergencies
    Language English
    Publishing date 2024-04-27
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 604549-2
    ISSN 1791-7530 ; 0250-7005
    ISSN (online) 1791-7530
    ISSN 0250-7005
    DOI 10.21873/anticanres.17023
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