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Efficacy of neoadjuvant chemotherapy for initially resectable colorectal liver metastases:A retrospective cohort study

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World Journal of Gastrointestinal Oncology 2022年第7期14卷 1281-1294页

作者： Kazuhisa Takeda Yu Sawada Yasuhiro Yabushita Yuki Honma Takafumi Kumamoto Jun Watanabe Ryusei Matsuyama chikara kunisaki Toshihiro Misumi Itaru Endo Gastroenterological Center Yokohama City University Medical CenterYokohama 232-0024Japan Department of Gastroenterological Surgery Yokohama City University Graduate School of MedicineYokohama 236-0004Jordan Department of Biostatistics Yokohama City University Graduate School of MedicineYokohama 236-0004Japan

BACKGROUND The liver is the most common metastatic site of colorectal cancer.Hepatectomy is the mainstay of treatment for patients with colorectal liver metastases(CRLMs).However,there are cases of early recurrence after upfront hepatectomy alone.In selected high-risk patients,neoadjuvant chemotherapy(NAC)may improve longterm survival.AIM To determine the efficacy of NAC for initially resectable CRLMs.METHODS Among 644 patients who underwent their first hepatectomy for CRLMs at our institution,297 resectable cases were stratified into an upfront hepatectomy group(238 patients)and a NAC group(59 patients).Poor prognostic factors for upfront hepatectomy were identified using multivariate logistic regression analysis.Propensity score matching was used to compare clinical outcomes between the upfront hepatectomy and NAC groups,according to the number of poor prognostic factors.Survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test.RESULTS Preoperative carcinoembryonic antigen levels(≥10 ng/mL)(P=0.003),primary histological type(other than well/moderately differentiated)(P=0.04),and primary lymph node metastases(≥1)(P=0.04)were identified as independent poor prognostic factors for overall survival(OS)in the upfront hepatectomy group.High-risk status was defined as the presence of two or more risk factors.After propensity score matching,50 patients were matched in each group.Among high-risk patients,the 5-year OS rate was significantly higher in the NAC group(13 patients)than in the upfront hepatectomy group(18 patients)(100%vs 34%;P=0.02).CONCLUSION NAC may improve the prognosis of high-risk patients with resectable CRLMs who have two or more risk factors.

关键词： Colorectal neoplasms Neoadjuvant therapy Neoplasm metastasis Prognosis Risk factors Survival

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Bile duct hamartomas(von Mayenburg complexes) mimicking liver metastases from bile duct cancer:MRC findings

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World Journal of Gastroenterology 2006年第8期12卷 1321-1323页

作者： Yasuhiko Nagano Kenichi Matsuo Katsuya Gorai Kazuya Sugimori chikara kunisaki Hideyuki Ike Katsuaki Tanaka Toshio Imada Hiroshi Shimada Yokohama City University Medical Center Gastroenterological CenterYokohamaJapan Department of Gastroenterological Surgery Yokohama City UniversityGraduate School of MedicineYokohamaJapan

我们在场是的有胆总管癌症的一个 72 岁的人的一个盒子开始相信了吃多重肝转移基于计算断层摄影术调查结果，并且在磁性的回声胆管造影术(MRC ) 在谁揭示胆汁管 hamartomas 的诊断。在为 pancreaticoduodenectomy 的探索，肝触诊在肝的... 详细信息

我们在场是的有胆总管癌症的一个 72 岁的人的一个盒子开始相信了吃多重肝转移基于计算断层摄影术调查结果，并且在磁性的回声胆管造影术(MRC ) 在谁揭示胆汁管 hamartomas 的诊断。在为 pancreaticoduodenectomy 的探索，肝触诊在肝的表面揭示了传播小瘤。这些小瘤在在两片肝脑叶的表面上散布的直径显示出大约 0.5 厘米的灰色白人的榴状的损害，它被看起来像从胆汁管癌的多重肝转移。肝活体检视的冰冻切片揭示了多重胆汁管，稍微扩大的腔在多重胆汁管 hamartomas (BDH ) 的成胶的基质特征嵌入。仅仅二份报告描述了胆汁管 hamartomas 的 MRC 特征。所有成像过程， MRC 为胆汁管 hamartomas 的成像诊断提供最相关的特征。

关键词：胆管错构瘤肝脏疾病磁共振成像胆管造影术

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Long-term outcomes and prognostic factors of patients with obstructive colorectal cancer: A multicenter retrospective cohort study

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World Journal of Gastroenterology 2016年第22期22卷 5237-5245页

作者： Ishibe Atsushi Ota Mitsuyoshi Yamaguchi Kazuya Kaida Syuhei Kamiya Noriyuki Momiyama Masashi Watanabe Akira Sekizawa Kentaro Kamimukai Nobuyuki Sugimasa Natsuko Watanabe Jun Ichikawa Yasushi kunisaki chikara Endo Itaru Department of Gastroenterological Surgery Graduate School of Medicine Yokohama City University Fukuura Kanazawa-ku Yokohama 236-0004 Japan Department of Surgery Gastroenterological Center Yokohama City University Urafune Minami-ku Yokohama 232-0024 Japan Department of Surgery Yokohama City Hospital Okazawa Hodogaya-ku Yokohama 240-8555 Japan Department of Surgery Yokosuka Kyosai Hospital Maigahamadori Yokosuka 238-8558 Japan Department of Surgery Ito Municipal Hospital Ito 414-0055 Japan Department of Surgery Fujisawa City Hospital Fujisawa 251-8550 Japan Department of Surgery Yokosuka City Hospital Nagasaka Yokosuka 240-0195 Japan Department of Surgery Yokohama Hodogaya Central Hospital Kamadai Hodogaya-ku Yokohama 240-8585 Japan Department of Surgery Saiseikai Yokohamashi Nanbu Hospital Kounandai Kounan-ku Yokohama 234-0054 Japan Department of Oncology Graduate School of Medicine Yokohama City University Yokohama 236-0004 Japan

AIM: To investigate the long-term oncologic outcomes and prognostic factors in patients with obstructive colorectal cancer(CRC) at multiple Japanese institutions.METHODS: We identified 362 patients diagnosed with obstructive colorectal cancer from January 1, 2002 to December 31, 2012 in Yokohama Clinical Oncology Group's department of gastroenterological surgery. Among them, 234 patients with stage Ⅱ/Ⅲ disease who had undergone surgical resection of their primary lesions were analyzed, retrospectively. We report the long-term outcomes, the risk factors for recurrence, and the prognostic factors.RESULTS: The five-year disease free survival and cancer-specific survival were 50.6% and 80.3%, respectively. A multivariate analysis showed the ASAPS(HR = 2.23, P = 0.026), serum Albumin ≤ 4.0 g/d L(HR = 2.96, P = 0.007), T4 tumor(HR = 2.73, P = 0.002) and R1 resection(HR = 6.56, P = 0.02) to be independent risk factors for recurrence. Furthermore, poorly differentiated cancers(HR = 6.28, P = 0.009), a T4 tumor(HR = 3.46, P = 0.011) and R1 resection(HR = 6.16, P = 0.006) were independent prognostic factors in patients with obstructive CRC.CONCLUSION: The outcomes of patients with obstructive CRC was poor. T4 tumor and R1 resection were found to be independent prognostic factors for both recurrence and survival in patients with obstructive CRC.

关键词： Obstructive colorectal cancer Prognostic factor Survival

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Prospective study of differential diagnosis of hepatic tumors by pattern-based classification of contrast-enhanced sonography

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World Journal of Gastroenterology 2006年第39期12卷 6290-6298页

作者： Kazushi Numata Tetsuo Isozaki Manabu Morimoto Kazuya Sugimori Reiko kunisaki Toshio Morizane Katsuaki Tanaka Gastroenterological Center Yokohama City University Medical Center Yokohama 232-0024 Japan Department of Medicine Kanagawa Dental College Yokosuka 238-0003 Japan

AIM: To prospectively evaluate the usefulness of a pattern-based classification of contrast-enhanced sonographic findings for differential diagnosis of hepatic tumors. METHODS: We evaluated the enhancement pattern of the contrast-enhanced sonography images in 586 patients with 586 hepatic lesions, consisting of 383 hepatocellular carcinomas, 89 metastases, and 114 hemangiomas. After injecting a galactose-palmitic acid contrast agent, lesions were scanned by contrast- enhanced harmonic gray-scale sonography in three phases: arterial, portal, and late. The enhancement patterns of the initial 303 lesions were classified retrospectively, and multiple logistic regression analysis was used to identify enhancement patterns that allowed differentiation between hepatic tumors. We then used the pattern-based classification of enhancement we had retrospectively devised to prospectively diagnose 283 liver tumors. RESULTS: Seven enhancement patterns were found to be significant predictors of different hepatic tumors. The presence of homogeneous or heterogeneous enhancement both in the arterial and portal phase was the typical enhancement pattern for hepatocellular carcinoma, while the presence of peritumoral vessels in the arterial phase and ring enhancement or a perfusion defect in the portal phase was the typical enhancement pattern for metastases, and the presence of peripheral nodular enhancement both in the arterial and portal phase was the typical enhancement pattern forhemangioma. The sensitivity, specificity, and accuracy of prospective diagnosis based on the combinations of enhancement patterns, respectively, were 93.2%, 96.2%, and 94.0% for hepatocellular carcinoma, 87.9%, 99.6%, and 98.2% for metastasis, and 95.6%, 94.1%, and 94.3% for hemangioma. CONCLUSION: The pattern-based classification of the contrast-enhanced sonographic findings is useful for differentiating among hepatic tumors.

关键词：诊断方法肝肿瘤血管瘤超声技术

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HBV感染患者合并肝的黏膜相关淋巴组织淋巴瘤及肝细胞性肝癌

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世界核心医学期刊文摘（胃肠病学分册） 2005年第3期1卷 50-50页

作者： Takeshima F. kunisaki M. Aritomi T. 王志宇 Second Dept. of Internal Medicine Nagasaki Univ. School of Medicine 1-7-1 Sakamoto Nagasaki 852-8501 Japan Dr.

Primary hepatic mucosa associated lymphoid tissue (MALT) lymphoma is an extremely rare disease. A 65-year old female patient with chronic hepatitis B presented with multiple solid masses in segment (S) 4, S5, and S6 of the liver. The nodule in S5 was diagnosed preoperatively as hepatocellular carcinoma by computed tomography, magnetic resonance imaging, and angiography. The nodule in S4 was initially interpreted as lymphoid follicles by needle biopsy. Segmentectomy of S5 and partial resection of S6 were performed. Microscopic examination of the S5 nodule revealed moderately differentiated hepatocellular carcinoma. The nodule from S6 showed nodular proliferation of atypical intermediate to medium sized lymphoid cells in the portal area and lymph epithelial lesions of bile ducts. The atypical lymphoid cells were positive for LCA, L-26 and bcl-2 and negative for UCHL-1. These features were consistent with the diagnosis of MALT lymphoma. This is the first case report of synchronous hepatic MALT lymphoma and hepatocellular carcinoma associated with chronic hepatitis B.

关键词：肝细胞性肝癌 HBV感染乙型肝炎淋巴瘤小淋巴细胞显微镜检淋巴滤泡切除术血管造影诊断穿刺活检

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