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Article ; Online: Predictors of 1-year mortality after gastrectomy for gastric cancer.

Sekimoto, Akihiro / Miyake, Hideo / Nagai, Hidemasa / Yoshioka, Yuichiro / Yuasa, Norihiro

2023 Volume 48, Issue 1, Page(s) 138–150

Abstract: Purpose: One-year mortality is important for referrals to specialist palliative care or advance care planning (ACP). This helps optimize comfort for those who cannot be cured or have a lower life expectancy. Few studies have investigated the risk ... ...

Abstract	Purpose: One-year mortality is important for referrals to specialist palliative care or advance care planning (ACP). This helps optimize comfort for those who cannot be cured or have a lower life expectancy. Few studies have investigated the risk factors for 1-year mortality after gastrectomy for gastric cancer (GC). Methods: A total of 1415 patients with gastric cancer (stages I-IV) who underwent gastrectomy between 2005 and 2020 were included. The patients were randomly assigned to the investigation group (n = 850) and validation group (n = 565) in a 3:2 ratio. In the investigation group, significant independent prognostic factors for predicting 1-year survival were identified. A scoring system for predicting 1-year mortality was developed which was validated in the validation group. Results: Multivariate analysis revealed that the following seven variables were significant independent factors for 1-year survival: age ≧78, preoperative comorbidity, total gastrectomy, postoperative complication (Clavien-Dindo classification CD ≧ 3a), stage III and IV, and R2 resection. While developing a 1-year mortality score (OMS), an age ≧78 was scored 2, preoperative comorbidity, total gastrectomy, and postoperative complication (CD ≧ 3a) were scored 1, and stage III, IV, and R2-resection were scored 2, 3, and 3, respectively. OMS 3 had a sensitivity of 91% and a specificity of 66% for predicting death within 1 year. In the validation group, OMS 5 had a sensitivity of 55% and a specificity of 93% for predicting death within 1 year. Conclusions: OMS may provide important information and help surgeons select the timing of ACP in patients with GC.
MeSH term(s)	Humans ; Stomach Neoplasms/surgery ; Stomach Neoplasms/mortality ; Gastrectomy/mortality ; Gastrectomy/methods ; Gastrectomy/adverse effects ; Male ; Female ; Aged ; Middle Aged ; Risk Factors ; Prognosis ; Aged, 80 and over ; Postoperative Complications/epidemiology ; Postoperative Complications/mortality ; Neoplasm Staging ; Survival Rate ; Retrospective Studies ; Adult ; Time Factors
Language	English
Publishing date	2023-12-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1002/wjs.12005
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Zs.A 1336: Show issues

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Article ; Online: Significance of Preoperative Pulmonary Function on Short- and Long-Term Outcomes Following Gastrectomy for Gastric Cancer.

Sekimoto, Akihiro / Miyake, Hideo / Nagai, Hidemasa / Yoshioka, Yuichiro / Yuasa, Norihiro

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2023 Volume 27, Issue 5, Page(s) 866–877

Abstract: Background: Preoperative pulmonary function assessment is useful for selecting surgical candidates and operative methods and assessing the risk of postoperative pulmonary complications. However, few studies have investigated the relationship between ... ...

Abstract	Background: Preoperative pulmonary function assessment is useful for selecting surgical candidates and operative methods and assessing the risk of postoperative pulmonary complications. However, few studies have investigated the relationship between preoperative pulmonary function and short- and long-term outcomes in patients who underwent gastrectomy for gastric cancer. Methods: Of the 1040 patients with gastric cancer (stages I-III) who had undergone R0 gastrectomy between 2009 and 2020, 750 who underwent preoperative spirometry were included. Restrictive ventilatory impairment was defined as a vital capacity of the predicted value (%VC) < 80%, while obstructive ventilatory impairment was defined as forced expiratory volume in one second (FEV1%) < 70%. Postoperative complications were assessed using the Clavien-Dindo (CD) classification. The relationship between clinical factors, including %VC, FEV1%, severe postoperative complications (CD ≥ 3b), overall survival (OS), and relapse-free survival, were assessed. Results: The mean age of the 750 patients was 68 ± 10.5 years. Severe postoperative complications were observed in 25 (3.3%) patients and were significantly associated with FEV1% < 70% in the univariate analysis. The 5-year OS was 72.5%. Multivariate analysis showed that the cancer stage, age > 75 years, preoperative comorbidities, %VC < 80%, total gastrectomy, severe postoperative complications, and postoperative adjuvant chemotherapy were the significant independent factors affecting OS. Pneumonia was significantly associated with %VC < 80%. Conclusions: FEV1% < 70%was associated with the development of severe postoperative complications, while %VC < 80% was associated with poor OS independent of the cancer stage because of death from pneumonia. Spirometry helps surgeons and patients discuss the risks and benefits of surgery.
MeSH term(s)	Humans ; Middle Aged ; Aged ; Stomach Neoplasms ; Retrospective Studies ; Neoplasm Recurrence, Local/etiology ; Gastrectomy/methods ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Risk Factors
Language	English
Publishing date	2023-01-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-023-05582-3
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Zs.A 5207: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Clinical features and risk factors for appendiceal diverticulitis: a comparative study with acute appendicitis.

Sugiura, Kota / Miyake, Hideo / Nagai, Hidemasa / Yoshioka, Yuichiro / Shibata, Koji / Yuasa, Norihiro / Fujino, Masahiko

Surgery today

2023 Volume 54, Issue 6, Page(s) 551–564

Abstract: Purpose: Despite their similar clinical characteristics, appendiceal diverticulitis (AD) and acute appendicitis (AA) are pathologically distinct. This study compared the clinical features of AD and AA and identified relevant risk factors.: Methods: ... ...

Abstract	Purpose: Despite their similar clinical characteristics, appendiceal diverticulitis (AD) and acute appendicitis (AA) are pathologically distinct. This study compared the clinical features of AD and AA and identified relevant risk factors. Methods: Patients who underwent appendectomy with a preoperative diagnosis of either AD or AA were categorized based on histopathological findings. The two groups were compared in terms of various clinical factors. Results: Among the 854 patients included in the study, a histopathological evaluation revealed 49 and 805 cases of AD and AA, respectively. A univariate analysis demonstrated that AD was more prevalent than AA among older, taller, and heavier males. A multivariate analysis revealed that male sex, a white blood cell (WBC) count < 13.5 × 10 Conclusions: AD was associated with an older age, robust physique, and significant risk of abscess and/or perforation despite a low WBC count. In addition to imaging modalities, the preoperative factors of male sex, a WBC count < 13.5 × 10
MeSH term(s)	Humans ; Risk Factors ; Male ; Appendicitis/surgery ; Appendicitis/pathology ; Appendicitis/diagnosis ; Female ; Diverticulitis/surgery ; Middle Aged ; Leukocyte Count ; Acute Disease ; Appendectomy ; Adult ; Sex Factors ; Age Factors ; Aged ; Diagnosis, Differential ; Eosinophils/pathology ; Young Adult
Language	English
Publishing date	2023-11-21
Publishing country	Japan
Document type	Journal Article ; Comparative Study
ZDB-ID	1115435-4
ISSN	1436-2813 ; 0941-1291
ISSN (online)	1436-2813
ISSN	0941-1291
DOI	10.1007/s00595-023-02766-x
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Zs.B 1077: Show issues

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Article ; Online: Blood pressure in Japanese junior and senior high school students.

Tanaka, Atsushi / Yajima, Ayumu / Kitaoka, Kaori / Natsuaki, Masahiro / Yoshioka, Goro / Kaneko, Hidehiro / Yano, Yuichiro / Nishiyama, Akira / Node, Koichi

Hypertension research : official journal of the Japanese Society of Hypertension

2023 Volume 47, Issue 1, Page(s) 195–196

MeSH term(s)	Humans ; Blood Pressure ; Japan/epidemiology ; Surveys and Questionnaires ; Alcohol Drinking ; Students
Language	English
Publishing date	2023-11-08
Publishing country	England
Document type	Letter
ZDB-ID	1175297-x
ISSN	1348-4214 ; 0916-9636
ISSN (online)	1348-4214
ISSN	0916-9636
DOI	10.1038/s41440-023-01498-2
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Zs.A 3898: Show issues

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Article: Diverticular perforation of terminal ileum associated with chemotherapy for non-small cell lung carcinoma: a case report.

Kasuga, So / Abe, Shinya / Nozawa, Hiroaki / Sasaki, Kazuhito / Murono, Koji / Emoto, Shigenobu / Matsuzaki, Hiroyuki / Yokoyama, Yuichiro / Nagai, Yuzo / Yoshioka, Yuichiro / Shinagawa, Takahide / Sonoda, Hirofumi / Ushiku, Tetsuo / Ishihara, Soichiro

Journal of surgical case reports

2023 Volume 2023, Issue 4, Page(s) rjad179

Abstract: A 71-year-old man was diagnosed with advanced non-small cell lung carcinoma and treated with chemotherapy developed ileocecal diverticulitis three times over the last 2 months of receiving second-line treatment. During the fourth diverticulitis event, ... ...

Abstract	A 71-year-old man was diagnosed with advanced non-small cell lung carcinoma and treated with chemotherapy developed ileocecal diverticulitis three times over the last 2 months of receiving second-line treatment. During the fourth diverticulitis event, the patient presented with fever and abdominal pain, worsening after 5 days. Abdominal computed tomography showed ascites and intra-abdominal free air, suggesting bowel perforation with acute diffuse peritonitis. We performed emergency surgery; the surgical findings showed diverticulosis with perforated diverticula in the ileocecal region. We performed ileocecal resection, an ileostomy and a mucous fistula of the ascending colon. Histopathological examinations revealed pseudodiverticula at the perforation, where the mucosa was depressed through the muscularis propria. Hence, we diagnosed perforated ileal diverticulitis. Repeated diverticulitis triggered by chemotherapy might have resulted in perforation. Small bowel diverticula are rare, but diverticulitis can occur in patients receiving chemotherapy and with cases of unexplained fever and abdominal pain.
Language	English
Publishing date	2023-04-12
Publishing country	England
Document type	Case Reports
ZDB-ID	2580919-2
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjad179
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Article ; Online: Local excision versus radical surgery for anal squamous cell carcinoma: a multicenter study in Japan.

Murai, Shin / Nozawa, Hiroaki / Yamada, Kazutaka / Saiki, Yasumitsu / Sasaki, Kazuhito / Murono, Koji / Emoto, Shigenobu / Matsuzaki, Hiroyuki / Yokoyama, Yuichiro / Abe, Shinya / Nagai, Yuzo / Yoshioka, Yuichiro / Shinagawa, Takahide / Sonoda, Hirofumi / Sugihara, Kenichi / Ajioka, Yoichi / Ishihara, Soichiro

International journal of clinical oncology

2024

Abstract: Background: The standard treatment for anal squamous cell carcinoma is chemoradiation therapy (CRT), but there is a possibility of over-treatment for early-stage disease. cTisN0 and cT1N0 disease is currently indicated for local excision, but it is ... ...

Abstract	Background: The standard treatment for anal squamous cell carcinoma is chemoradiation therapy (CRT), but there is a possibility of over-treatment for early-stage disease. cTisN0 and cT1N0 disease is currently indicated for local excision, but it is unclear whether the indication of local excision can be expanded to cT2N0 disease. Methods: 126 patients with cTis-T2N0 anal cancer treated at 47 centers in Japan between 1991 and 2015 were included. Patients were first classified into the CRT group and surgical therapy group according to the initial therapy, and the latter was further divided into local excision (LE) and radical surgery (RS) groups. We compared prognoses among the groups, and analyzed risk factors for recurrence after local excision. Results: The CRT group (n = 87) and surgical therapy group (n = 39) showed no difference in relapse-free survival (p = 0.29) and overall survival (p = 0.94). Relapse-free survival curves in the LE (n = 23) and RS groups (n = 16) overlapped for the initial 3 years, but the curve for the LE group went lower beyond (p = 0.33). By contrast, there was no difference in overall survival between the two groups (p = 0.98). In the LE group, the majority of recurrences distributed in locoregional areas, which could be managed by salvage treatments. Muscular invasion was associated with recurrence after local excision (hazard ratio: 22.91, p = 0.011). Conclusion: LE may be applied to selected patients with anal cancer of cTis-T2N0 stage. Given the high risk of recurrence in cases with muscular invasion, it may be important to consider close surveillance and additional treatment in such patients.
Language	English
Publishing date	2024-03-25
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1400227-9
ISSN	1437-7772 ; 1341-9625
ISSN (online)	1437-7772
ISSN	1341-9625
DOI	10.1007/s10147-024-02498-z
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Zs.A 4828: Show issues

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Article: Essential anatomy for lateral lymph node dissection.

Yokoyama, Yuichiro / Nozawa, Hiroaki / Sasaki, Kazuhito / Murono, Koji / Emoto, Shigenobu / Matsuzaki, Hiroyuki / Abe, Shinya / Nagai, Yuzo / Yoshioka, Yuichiro / Shinagawa, Takahide / Sonoda, Hirofumi / Hojo, Daisuke / Ishihara, Soichiro

Annals of coloproctology

2023 Volume 39, Issue 6, Page(s) 457–466

Abstract: In Western countries, the gold-standard therapeutic strategy for rectal cancer is preoperative chemoradiotherapy (CRT) following total mesorectal excision (TME), without lateral lymph node dissection (LLND). However, preoperative CRT has recently been ... ...

Abstract	In Western countries, the gold-standard therapeutic strategy for rectal cancer is preoperative chemoradiotherapy (CRT) following total mesorectal excision (TME), without lateral lymph node dissection (LLND). However, preoperative CRT has recently been reported to be insufficient to control lateral lymph node recurrence in cases of enlarged lateral lymph nodes before CRT, and LLND is considered necessary in such cases. We performed a literature review on aspects of pelvic anatomy associated with rectal surgery and LLND, and then combined this information with our experience and knowledge of pelvic anatomy. In this review, drawing upon research using a 3-dimensional anatomical model and actual operative views, we aimed to clarify the essential anatomy for LLND. The LLND procedure was developed in Asian countries and can now be safely performed in terms of functional preservation. Nonetheless, the longer operative time, hemorrhage, and higher complication rates with TME accompanied by LLND than with TME alone indicate that LLND is still a challenging procedure. Laparoscopic or robotic LLND has been shown to be useful and is widely performed; however, without a sufficient understanding of anatomical landmarks, misrecognition of vessels and nerves often occurs. To perform safe and accurate LLND, understanding the landmarks of LLND is essential.
Language	English
Publishing date	2023-12-08
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	2711906-3
ISSN	2287-9722 ; 2287-9714
ISSN (online)	2287-9722
ISSN	2287-9714
DOI	10.3393/ac.2023.00164.0023
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Article ; Online: Three-dimensional visualization of the total mesorectal excision plane for dissection in rectal cancer surgery and its ability to predict surgical difficulty.

Nagai, Yuzo / Kawai, Kazushige / Nozawa, Hiroaki / Sasaki, Kazuhito / Murono, Koji / Emoto, Shigenobu / Yokoyama, Yuichiro / Matsuzaki, Hiroyuki / Abe, Shinya / Sonoda, Hirofumi / Yoshioka, Yuichiro / Shinagawa, Takahide / Ishihara, Soichiro

Scientific reports

2023 Volume 13, Issue 1, Page(s) 2130

Abstract: Total mesorectal excision (TME) for rectal cancer is often technically challenging. We aimed to develop a method for three-dimensional (3D) visualization of the TME dissection plane and to evaluate its ability to predict surgical difficulty. Sixty-six ... ...

Abstract	Total mesorectal excision (TME) for rectal cancer is often technically challenging. We aimed to develop a method for three-dimensional (3D) visualization of the TME dissection plane and to evaluate its ability to predict surgical difficulty. Sixty-six patients with lower rectal cancer who underwent robot-assisted surgery were retrospectively analyzed. A 3D TME dissection plane image for each case was reconstructed using Ziostation2. Subsequently, a novel index that reflects accessibility to the deep pelvis during TME, namely, the TME difficulty index, was defined and measured. Representative bony pelvimetry parameters and clinicopathological factors were also analyzed. The operative time for TME was used as an indicator of surgical difficulty. Univariate regression analysis revealed that sex, body mass index, mesorectal fat area, and TME difficulty index were associated with the operative time for TME, whereas bony pelvimetry parameters were not. Multivariate regression analysis found that TME difficulty index (β = - 0.398, P = 0.0025) and mesorectal fat area (β = 0.223, P = 0.045) had significant predictability for the operative time for TME. Compared with conventional bony pelvimetry parameters, the TME difficulty index and mesorectal fat area might be more useful in predicting the difficulty of rectal cancer surgery.
MeSH term(s)	Humans ; Retrospective Studies ; Imaging, Three-Dimensional ; Rectum/diagnostic imaging ; Rectum/surgery ; Rectum/pathology ; Rectal Neoplasms/diagnostic imaging ; Rectal Neoplasms/surgery ; Rectal Neoplasms/pathology ; Pelvis/pathology ; Laparoscopy/methods ; Treatment Outcome
Language	English
Publishing date	2023-02-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-29426-x
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Article ; Online: Preoperative chemoradiotherapy using tegafur/uracil, oral leucovorin, and irinotecan (TEGAFIRI) followed by oxaliplatin-based chemotherapy as total neoadjuvant therapy for locally advanced rectal cancer: the study protocol for a phase II trial.

Abe, Shinya / Kawai, Kazushige / Nozawa, Hiroaki / Sasaki, Kazuhito / Murono, Koji / Emoto, Shigenobu / Yokoyama, Yuichiro / Matsuzaki, Hiroyuki / Nagai, Yuzo / Yoshioka, Yuichiro / Shinagawa, Takahide / Sonoda, Hirofumi / Yamamoto, Yoko / Oba, Koji / Ishihara, Soichiro

BMC cancer

2023 Volume 23, Issue 1, Page(s) 450

Abstract: Background: Total neoadjuvant therapy (TNT) is a novel treatment strategy that is an alternative to preoperative chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC). However, an optimal protocol for TNT has not yet been established. The ... ...

Abstract	Background: Total neoadjuvant therapy (TNT) is a novel treatment strategy that is an alternative to preoperative chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC). However, an optimal protocol for TNT has not yet been established. The present study will be an open-label, single-arm, single-center trial to develop a new protocol. Methods: Thirty LARC patients at high risk of distant metastasis will receive CRT consisting of long-course radiation, concurrent with tegafur/uracil, oral leucovorin, irinotecan (TEGAFIRI), followed by mFOLFOX-6 or CAPOX before undergoing surgery. Discussion: Since previous findings showed a high percentage of grade 3-4 adverse events with the TEGAFIRI regimen for CRT and TNT, the primary outcome of this study will be safety and feasibility. Our regimen for CRT consists of the biweekly administration of irinotecan for good patient compliance. The novel combination approach of this treatment may improve the long-term outcomes of LARC. Trial registration: Japan Registry of Clinical Trials jRCTs031210660.
MeSH term(s)	Humans ; Irinotecan/therapeutic use ; Tegafur ; Oxaliplatin ; Leucovorin ; Neoadjuvant Therapy/methods ; Rectal Neoplasms/drug therapy ; Rectal Neoplasms/pathology ; Treatment Outcome ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Chemoradiotherapy/methods ; Fluorouracil/therapeutic use ; Neoplasm Staging ; Clinical Trials, Phase II as Topic
Chemical Substances	Irinotecan (7673326042) ; Tegafur (1548R74NSZ) ; Oxaliplatin (04ZR38536J) ; Leucovorin (Q573I9DVLP) ; Fluorouracil (U3P01618RT)
Language	English
Publishing date	2023-05-17
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2041352-X
ISSN	1471-2407 ; 1471-2407
ISSN (online)	1471-2407
ISSN	1471-2407
DOI	10.1186/s12885-023-10941-z
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Article: Neuroendocrine carcinoma associated with chronic ulcerative colitis: a case report and review of the literature.

Yokota, Yumi / Anzai, Hiroyuki / Nagai, Yuzo / Sonoda, Hirofumi / Shinagawa, Takahide / Yoshioka, Yuichiro / Abe, Shinya / Yokoyama, Yuichiro / Matsuzaki, Hiroyuki / Emoto, Shigenobu / Murono, Koji / Sasaki, Kazuhito / Nozawa, Hiroaki / Ushiku, Tetsuo / Ishihara, Soichiro

Annals of coloproctology

2023

Abstract: Adenocarcinoma is a common histological type of ulcerative colitis-associated cancer (UCAC), whereas neuroendocrine carcinoma (NEC) is extremely rare. UCAC is generally diagnosed at an advanced stage, even with regular surveillance colonoscopy. A 41-year- ...

Abstract	Adenocarcinoma is a common histological type of ulcerative colitis-associated cancer (UCAC), whereas neuroendocrine carcinoma (NEC) is extremely rare. UCAC is generally diagnosed at an advanced stage, even with regular surveillance colonoscopy. A 41-year-old man with a 17-year history of UC began receiving surveillance colonoscopy at the age of 37 years; 2 years later, dysplasia was detected in the sigmoid colon, and he underwent colonoscopy every 3 to 6 months. Approximately 1.5 years thereafter, a flat adenocarcinoma lesion occurred in the rectum. Flat lesions with high-grade dysplasia were found in the sigmoid colon and surrounding area. The patient underwent laparoscopic total proctocolectomy and ileal pouch-anal anastomosis with ileostomy. Adenocarcinoma was diagnosed in the sigmoid colon and NEC in the rectum. One year postoperation, recurrence or metastasis was not evident. Regular surveillance colonoscopy is important in patients with long-term UC. A histological examination of UCAC might demonstrate NEC.
Language	English
Publishing date	2023-04-19
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2711906-3
ISSN	2287-9722 ; 2287-9714
ISSN (online)	2287-9722
ISSN	2287-9714
DOI	10.3393/ac.2022.00801.0114
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