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Validation of user-friendly models predicting extracapsular extension in prostate cancer patients

Asian Journal of Urology 2023年第1期10卷 81-88页

作者： Leandro Blas Masaki Shiota Shohei Nagakawa Shigehiro Tsukahara Takashi Matsumoto Ken Lee Keisuke Monji Eiji Kashiwagi Junichi Inokuchi Masatoshi Eto Department of Urology Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

Objective:There are many models to predict extracapsular extension(ECE)in patients with prostate cancer.We aimed to externally validate several models in a Japanese cohort.Methods:We included patients treated with robotic-assisted radical prostatectomy for prostate cancer.The risk of ECE was calculated for each patient in several models(prostate side-specific and non-side-specific).Model performance was assessed by calculating the receiver operating curve and the area under the curve(AUC),calibration plots,and decision curve analyses.Results:We identified ECE in 117(32.9%)of the 356 prostate lobes included.Patients with ECE had a statistically significant higher prostate-specific antigen level,percentage of positive digital rectal examination,percentage of hypoechoic nodes,percentage of magnetic resonance imaging nodes or ECE suggestion,percentage of biopsy positive cores,International Society of Urological Pathology grade group,and percentage of core involvement.Among the sidespecific models,the Soeterik,Patel,Sayyid,Martini,and Steuber models presented AUC of 0.81,0.78,0.77,0.75,and 0.73,respectively.Among the non-side-specific models,the memorial Sloan Kettering Cancer Center web calculator,the Roach formula,the Partin tables of 2016,2013,and 2007 presented AUC of 0.74,0.72,0.64,0.61,and 0.60,respectively.However,the 95%confidence interval for most of these models overlapped.The side-specific models presented adequate calibration.In the decision curve analyses,most models showed net benefit,but it overlapped among them.Conclusion:Models predicting ECE were externally validated in Japanese men.The side-specific models predicted better than the non-side-specific models.The Soeterik and Patel models were the most accurate performing models.

关键词： Prognosis Prostate cancer Nomogram Extracapsular extension

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Safety and feasibility of laparoscopic pancreatoduodenectomy

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Hepatobiliary Surgery and Nutrition 2022年第2期11卷 330-332页

作者： Nobuhiko Nakagawa Yuichi nagakawa Shingo Kozono Department of Gastrointestinal and Pediatric Surgery Tokyo Medical UniversityTokyoJapan

Laparoscopic pancreaticoduodenectomy(LPD)has been safely performed by experts with favorable surgical outcomes.However,the feasibility of LPD remains controversial.LPD is generally considered a challenging operation that requires advanced laparoscopic techniques.In particular,pancreatic reconstruction can be safely performed by only laparoscopic experts.Thus,guidelines created by LPD experts are valuable in indicating the future direction of LPD.Qin et al.developed practical guidelines regarding the safety and feasibility of LPD with 28 international experts from eight countries(1).To create these guidelines,the first summit on minimally invasive pancreatico-biliary surgery was held in Wuhan,China,to promote the development of LPD.Based on a systematic literature review and expert opinions,16 statements were created by the experts.These statements provide useful guidelines not only for surgical trainees who will attempt LPD but also for specialized surgeons.This expert consensus will contribute to the safe implementation of LPDs in the future.

关键词： laparoscopic specialized safely

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Computed tomography virtual endoscopy with angiographic imaging for the treatment of type Ⅳ-A choledochal cyst

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World Journal of Gastroenterology 2012年第28期18卷 3761-3764页

作者： Akihiko Tsuchida Yuichi nagakawa Kazuhiko Kasuya Bunso Kyo Takahisa Ikeda Yoshiaki Suzuki Tatsuya Aoki Takao Itoi Third Department of Surgery Tokyo Medical University Tokyo 160-0023 Japan Fourth Department of Internal Medicine Tokyo Medical University Tokyo 160-0023 Japan

Type Ⅳ-A choledochal cysts (CCs) are a congenital biliary anomaly which involve dilatation of the extrahepatic and intrahepatic bile ducts. We present the case of a 30-year-old woman with type Ⅳ-A CC, on whom threedimensional computed tomography (3D CT) and virtual endoscopy were performed. 3D CT revealed partial dilatation in the posterior branch of the intrahepatic bile duct and a relative stricture between it and the extrahepatic bile duct. Virtual endoscopy showed that this stricture was membrane-like and separated from the surrounding blood vessels. Based on these image findings, complete cyst resection, bile duct plasty for the stricture, and hepaticojejunostomy were safely performed. To the best of our knowledge, there are no reports of imaging by virtual endoscopy of the biliary tract which show the surrounding blood vessels running along the bile duct.

关键词：虚拟内窥镜血管造影三维CT 仿真囊肿计算机断层扫描 Ⅱ型治疗

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Diffusion-weighted imaging might be useful for reactive lymphoid hyperplasia diagnosis of the liver: A case report

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World Journal of Clinical Cases 2020年第21期8卷 5313-5319页

作者： Taro Tanaka Kazuhiro Saito Daisuke Yunaiyama Jun Matsubayashi Yuichi nagakawa Maki Tanigawa Toshitaka Nagao Department of Radiology Tokyo Medical UniversityTokyo 1600023Japan Department of Anatomic Pathology Tokyo Medical UniversityTokyo 1600023Japan Department of Gastrointestinal and Pediatric Surgery Tokyo Medical UniversityTokyo 1600023Japan

BACKGROUND Reactive lymphoid hyperplasia(RLH)of the liver is a rare liver lesion.It is considered difficult to differentiate radiologically from hepatocellular carcinoma,metastatic liver tumor and other pathologies.CASE SUMMARY A 54-year-old woman presented to our hospital with RLH of the liver.The patient had a diagnosis of metastatic carcinoma of the liver from an unknown origin and subsequently underwent partial hepatectomy.However,histopathological analysis revealed RLH.The lesion showed perinodular enhancement in the arterial phase on contrast-enhanced computed tomography and magnetic resonance imaging.On diffusion-weighted imaging(DWI),we encountered linear hyperintensity along the portal tract consecutive to the liver lesion,which is a new characteristic radiologic finding.This finding corresponded to the lymphoid cell infiltration of the portal tract.Furthermore,there was strongly restricted diffusion on the apparent diffusion coefficient map.We used these characteristic radiologic findings to diagnose the lesion as a lymphoproliferative disease.CONCLUSION The linear hyperintensity consecutive to the liver lesion on DWI provided additional valuable diagnostic information.

关键词： Reactive lymphoid hyperplasia Pseudolymphoma Magnetic resonance imaging Diffusion-weighted imaging Perinodular enhancement Portal tract infiltration Case report

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A nomogram to preoperatively predict 1-year disease-specific survival in resected pancreatic cancer following neoadjuvant chemoradiation therapy

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Chinese Journal of Cancer Research 2020年第1期32卷 105-114页

作者： Ho Kyoung Hwang Keita Wada Ha Yan Kim Yuichi nagakawa Yosuke Hijikata Yota Kawasaki Yoshiharu Nakamura Lip Seng Lee Dong Sup Yoon Woo Jung Lee Chang Moo Kang Division of HBP Surgery Department of SurgeryYonsei University College of MedicineSeoul 03722Korea Pancreatobiliary Cancer Clinic Yonsei Cancer CenterSeverance HospitalSeoul 03722Korea Department of Surgery Teikyo University School of MedicineTokyo 173-8605Japan Biostatistician Biostatistics Collaboration UnitDepartment of Biomedical Systems InformaticsYonsei University College of MedicineSeoul 03722Korea Department of Gastrointestinal and Pediatric Surgery Tokyo Medical UniversityTokyo 160-8402Japan Department of Digestive Surgery Breastand Thyroid SurgeryGraduate School of Medical SciencesKagoshima UniversityKagoshima 890-0065Japan Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Nippon Medical SchoolTokyo 890-0065Japan Department of General Surgery Changi General HospitalSingapore 529889Singapore

Objective: This study aimed to develop a nomogram to predict the 1-year survival of patients with pancreatic cancer who underwent pancreatectomy following neoadjuvant treatment with preoperatively detectable clinical parameters. Extended pancreatectomy is necessary to achieve complete tumor removal in borderline resectable and locally advanced pancreatic cancer. However, it increases postoperative morbidity and mortality rates, and should be balanced with potential benefit of long-term survival.Methods: The medical records of patients who underwent pancreatectomy following neoadjuvant treatment from January 2005 to December 2016 at Severance Hospital were retrospectively reviewed. Medical records were collected from five international institutions from Japan and Singapore for external validation.Results: A total of 113 patients were enrolled. The nomogram for predicting 1-year disease-specific survival was created based on 5 clinically detectable preoperative parameters as follows: age(year), symptom(no/yes), tumor size at initial diagnostic stage(cm), preoperative serum carbohydrate antigen(CA) 19-9 level after neoadjuvant treatment(<34/≥34 U/m L), and planned surgery [pancreaticoduodenectomy(PD)(pylorus-preserving PD)/distal pancreatectomy(DP)/total pancreatectomy]. Model performance was assessed for discrimination and calibration.The calibration plot showed good agreement between actual and predicted survival probabilities;the the Greenwood-Nam-D’Agostino(GND) goodness-of-fit test showed that the model was well calibrated(χ~2=8.24,P=0.5099). A total of 84 patients were used for external validation. When correlating actual disease-specific survival and calculated 1-year disease-specific survival, there were significance differences according to the calculated probability of 1-year survival among the three groups(P=0.044).Conclusions: The developed nomogram had quite acceptable accuracy and clinical feasibility in the decision-making process for the management of pancreatic cancer.

关键词： Pancreatic cancer neoadjuvant treatment pancreatectomy survival nomogram

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Evaluation of novel slim biopsy forceps for diagnosis of biliary strictures: Single-institutional study of consecutive 360 cases(with video)

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World Journal of Gastroenterology 2017年第35期23卷 6429-6436页

作者： Kenjiro Yamamoto Takayoshi Tsuchiya Takao Itoi Shujiro Tsuji Reina Tanaka Ryosuke Tonozuka Mitsuyoshi Honjo Shuntaro Mukai Kentaro Kamada Mitsuru Fujita Yasutsugu Asai Yukitoshi Matsunami Yuichi nagakawa Hiroshi Yamaguchi Atsushi Sofuni Department of Gastroenterology and Hepatology Tokyo Medical University Third Department of Surgery Tokyo Medical University Department of Pathology Tokyo Medical University

AIM To evaluate the feasibility and reliability of endoscopic transpapillary bile duct biopsy for the diagnosis of biliary strictures.METHODS A total of 360 patients(241 men) who underwent endoscopic retrograde cholangiopancreatography for biliary strictures with biopsy from April 2012 to March 2016 at Tokyo Medical University Hospital were retrospectively reviewed. This study was approved by our Institutional Review Board(No. 3516). Informed consent was obtained from all individual participants included in this study. The biopsy specimens were obtained using a novel slim biopsy forceps(Radial Jaw 4P, Boston Scientific, Boston, MA, United States).RESULTS The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 69.6%, 100%, 100%, 59.1%, and 78.8%, respectively. The sensitivity was 75.6% in bile duct cancer, 64% in pancreatic cancer, 61.1% in gallbladder cancer, and 57.1% in metastasis. In bile duct cancer, a lower sensitivity was observed for perihilar bile duct stricture(68.7%) than for distal bile duct stricture(83.1%). In terms of the stricture lengths of pancreatic cancer, gallbladder cancer, and metastasis, a longer stenosis resulted in a better sensitivity. In particular, there was a significant difference between pancreatic cancer and gallbladder cancer(P < 0.05). One major complication was perforation of the extrahepatic bile duct with bile leakage. CONCLUSION Endoscopic transpapillary biopsy alone using novel slim biopsy forceps is feasible and reliable, but restrictive. Biopsy should be performed in consideration of the stricture level, stricture length, and cancer type.

关键词： Endoscopic transpapillary biopsy Biopsy forceps Biliary stricture Bile duct cancer Endoscopic retrograde cholangiography

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International consensus statement on robotic pancreatic surgery

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Hepatobiliary Surgery and Nutrition 2019年第4期8卷 345-360页

作者： Rong Liu Go Wakabayashi Chinnusamy Palanivelu Allan Tsung Kehu Yang Brian KPGoh Charing Ching-Ning Chong Chang Moo Kang Chenghong Peng Eli Kakiashvili Ho-Seong Han Hong-Jin Kim Jin He Jae Hoon Lee Kyoichi Takaori Marco Vito Marino Shen-Nien Wang Tiankang Guo Thilo Hackert Ting-Shuo Huang Yiengpruksawan Anusak Yuman Fong Yuichi nagakawa Yi-Ming Shyr Yao-Ming Wu Yupei Zhao Department of Hepatopancreatobiliary Surgical Oncology Chinese People’s Liberation Army(PLA)General HospitalBeijing 100853China Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases Ageo Central General HospitalAgeoJapan Division of Gastrointestinal Surgery and Minimal Access Surgery GEM Hospital and Research CentreCoimbatoreIndia Division of Surgical Oncology Gastrointestinal Disease Specific Research GroupThe Ohio State University Wexner Medical Center Department of SurgeryColumbusOHUSA Evidence-Based Medicine Center School of Basic Medical SciencesLanzhou UniversityLanzhou 730000China Department of Hepatopancreatobiliary and Transplant Surgery Singapore General HospitalSingapore Department of Surgery Division of Hepatobiliary and Pancreatic SurgeryPrince of Wales Hospitalthe Chinese University of Hong KongHong KongChina Division of HBP Surgery Yonsei University College of MedicinePancreatobiliary Cancer CenterYonsei Cancer CenterSeverance HospitalSeoulKorea Pancreatic Disease Centre Ruijin HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200025China Department of General Surgery Galilee Medical CenterNahariyaIsrael Department of Surgery Seoul National University College of MedicineSeoul National University Bundang HospitalSeoulKorea Department of Surgery Yeungnam University HospitalDaeguKorea Department of Surgery The Johns Hopkins HospitalBaltimoreMDUSA Division of Hepatobiliary&Pancreas Surgery Department of SurgeryAsan Medical CenterSeoulKorea Department of Surgery Kyoto University HospitalShogoinSakyo-KuKyotoJapan Department of General Surgery Azienda OspedalieraOspedali Riuniti Villa Sofia-CervelloPalermoItaly Division of General and Digestive Surgery Department of SurgeryKaohsiung Medical University HospitalKaohsiung Department of General Surgery Gansu Provincial HospitalLanzhou 730030China Department of General Visceral and Transplantation SurgeryHeidelberg University HospitalHeidelbergGermany Division of General Surge

The robotic surgical system has been applied to various types of pancreatic surgery. However, controversies exist regarding a variety of factors including the safety, feasibility, efficacy, and cost-effectiveness of robotic surgery. This study aimed to evaluate the current status of robotic pancreatic surgery and put forth experts' consensus and recommendations to promote its development. Based on the WHO Handbook for Guideline Development, a Consensus Steering Group* and a Consensus Development Group were established to determine the topics, prepare evidence-based documents, and generate recommendations. The GRADE Grid method and Delphi vote were used to formulate the recommendations. A total of 19 topics were analyzed. The first 16 recommendations were generated by GRADE using an evidence-based method (EBM) and focused on the safety, feasibility, indication, techniques, certification of the robotic surgeon, and cost-effectiveness of robotic pancreatic surgery. The remaining three recommendations were based on literature review and expert panel opinion due to insufficient EBM results. Since the current amount of;evidence was low/meager as evaluated by the GRADE method, further randomized controlled trials (RCTs) are needed in the future to validate these recommendations.

关键词： Robotic surgery consensus statement pancreatectomy pancreaticoduodenectomy pancreatic enucleation

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