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Perihilar cholangiocarcinoma:a surgeon's perspective

iLIVER 2022年第1期1卷 12-24页

作者： masato nagino Department of Gastroenterological Surgery Aichi Cancer Center1-1 KanokodenChikusa-kuNagoya464-8681Japan

Perihilar cholangiocarcinoma(PHC)is defined anatomically as tumors located in the extrahepatic biliary tree proximal to the origin of the cystic ***,as the boundary between the extrahepatic and intrahepatic bile ducts is not well defined,PHC potentially includes two types of tumors:one is the extrahepatic type,which arises from the large hilar bile duct,and the other is the intrahepatic type,which has an intrahepatic component with invasion of the hepatic *** new American Joint Commission on Cancer tumor-node-metastasis staging system for PHC was well revised;an important revision is that the Bismuth type IV was removed from T4 stage *** patients with PHC present with obstructive jaundice,and preoperative biliary drainage is ***,percutaneous transhepatic biliary drainage was used in many centers;however,it has been accepted that endoscopic nasobiliary drainage is the most suitable method for ***,inside-stents have also been adopted for biliary drainage,with favorable *** vein embolization is widely performed as presurgical treatment for patients undergoing extended hepatectomy to minimize postoperative liver *** resection of PHC is technically demanding and continues to be the most difficult challenge for hepatobiliary *** of advances in diagnostic and surgical techniques,surgical outcomes and survival rates after resection have steadily ***,survival rates,especially for patients with lymph node metastasis,are unsatisfactory,and establishing a protocol for effective adjuvant chemotherapy is an urgent *** synergy of endoscopists,radiologists,oncologists,and surgeons is required to conquer this intractable disease.

关键词： Perihilar cholangiocarcinoma Biliary drainage Portal vein embolization Extended surgery

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Modified docetaxel, cisplatin and capecitabine for stage Ⅳ gastric cancer in Japanese patients: A feasibility study

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World Journal of Gastroenterology 2017年第6期23卷 1090-1097页

作者： Osamu Maeda Ayumu Matsuoka Ryoji Miyahara Kohei Funasaka Yoshiki Hirooka Masahide Fukaya masato nagino Yasuhiro Kodera Hidemi Goto Yuichi Ando Department of Clinical Oncology and Chemotherapy Nagoya University Hospital Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine Department of Endoscopy Nagoya University Hospital Department of Surgery Nagoya University Graduate School of Medicine Department of Gastroenterological Surgery(Surgery II)Nagoya University Graduate School of Medicine

AIM To evaluate the feasibility of chemotherapy including fluoropyrimidine, platinum and taxane with modified dosages for unresectable gastric cancer in Japanese *** We performed a feasibility study of a modified docetaxel, cisplatin and capecitabine (DCX) regimen for stage Ⅳ gastric cancer. In particular, 30 or 40 mg/m^2 of docetaxel on day 1, 60 mg/m^2 of cisplatin on day 1, and 2000 mg/m^2 of capecitabine for 2 wk were administered every three *** Three patients were treated with modified DCX(m DCX) with 30 mg/m^2 docetaxel, and five patients were treated with this regimen with 40 mg/m^2 docetaxel. Grade 3 or 4 neutropenia was observed in six of the eight patients; no patients exhibited febrile neutropenia. Partial response was achieved in four of the eight patients. Three patients underwent gastrectomy, which achieved R0 resection without residual tumors in dissected lymph nodes. In one of these three patients, resected specimens revealed pathological complete response in the primary lesion and in lymph *** m DCX was well tolerated by Japanese patients with stage Ⅳ gastric cancer. This regimen might be useful for allowing gastric cancer patients with distant lymph node metastasis to undergo conversion surgery.

关键词： Docetaxel Cisplatin Capecitabine Gastric cancer

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Synchronous rectal and esophageal cancer treated with chemotherapy followed by two-stage resection

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World Journal of Clinical Cases 2013年第2期1卷 87-91页

作者： Setsuo Utsunomiya Keisuke Uehara Takuya Kurimoto Ken Hirose Masahide Fukaya Yu Takahashi Yoshiro Taguchi Keita Itatsu masato nagino Department of Gastrointestinal Oncology Nagoya Kyoritsu Hospital Division of Surgical Oncology Department of Surgery Nagoya University Graduate School of Medicine Department of Gastroenterology Nagoya Kyoritsu Hospital

We report a case of 61-year-old male who had synchronous advanced rectal cancer involving the urinary bladder massively associated with multiple liver metastases, and esophageal cancer successfully treated by neoadjuvant chemotherapy followed by two-stage resection. Although complete resection of each of the lesions was considered possible by performing anterior pelvic exenteration, liver resection, and esophagectomy, it might be impossible for the patient to endure the stress of all of these operative procedures at once. Therefore, we planned to perform staged treatment with prioritizing consideration. First, we instituted chemotherapy with the FOLFOX(oxaliplatin + fluorouracil + leucovorin) plus cetuximab regimen, which could adequately control both rectal and esophageal cancer. After 6 cycles of chemotherapy, high anterior resection combined with cystoprostatectomy and lateral segmentectomy plus partial hepatectomy was performed followed by staged esophagectomy with three-field lymph node dissection. It was possible to use oxaliplatin and cetuximab safely as neoadjuvant therapy not only for advanced rectal cancer but for esophageal cancer, and it was effective.

关键词： Rectal cancer Esophageal cancer Neoadjuvant chemotherapy Cetuximab Oxaliplatin

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胆道肿瘤临床实践指南(英文第三版)

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中华消化外科杂志 2021年第4期20卷 359-375页

作者： masato nagino Satoshi Hirano Hideyuki Yoshitomi Taku Aoki Katsuhiko Uesaka Michiaki Unno Tomoki Ebata Masaru Konishi Keiji Sano Kazuaki Shimada Hiroaki Shimizu Ryota Higuchi Toshifumi Wakai Hiroyuki Isayama Takuji Okusaka Toshio Tsuyuguchi Yoshiki Hirooka Junji Furuse Hiroyuki Maguchi Kojiro Suzuki Hideya Yamazaki Hiroshi Kijima Akio Yanagisawa Masahiro Yoshida Yukihiro Yokoyama Takashi Mizuno Itaru Endo 杨翼飞(译) 仇毓东(译) 赵梦珂(译) 伏旭(译) 蔡正华(译) 毛凉(审校) 爱知癌症中心日本名古屋北海道大学医学院胃肠外二科日本札幌独协医科大学琦玉医学中心普通外科日本越谷独协医科大学普通外二科日本米布静冈癌症中心肝胆胰外科日本长崎东北大学医学院外科系日本仙台名古屋大学医学院外科系日本名古屋国立癌症中心医院东院区肝胆胰外科日本柏市京都大学医学院外科系日本东京国立癌症中心医院日本东京帝京大学千叶医学中心外科系日本市原东京女子医科大学胃肠病研究所普通外科日本东京新泻大学医学与牙科研究生院消化与普通外科日本新泻均天道大学医学研究生院消化内科日本东京国立癌症中心医院肝胆胰肿瘤科日本东京千叶县锯原医院消化内科日本锯原藤田医科大学消化内科及消化肿瘤科日本丰明杏林大学医学院肿瘤内科日本三鹰泰恩金凯医院教育研究中心日本札幌爱知医科大学放射科日本长谷京都府立医科大学医学研究生院放射科日本京都广崎大学医学研究部病理学与生物科学系日本广崎日本红十字会京都第二医院病理科日本京都国际医疗福利大学肝胆胰胃肠外科日本一川横滨市立大学医学研究生院消化外科日本横滨南京大学医学院附属鼓楼医院肝胆胰中心

日本肝胆胰外科学会(JSHBPS)于2007年出版第一版胆道肿瘤(胆管癌、胆囊癌及壶腹癌)临床实践指南,于2014年更新第二版,2021年英文第三版胆道肿瘤临床实践指南围绕6个主题提出若干临床问题,基于相关循证医学证据并组织专家讨论后,最终确... 详细信息

日本肝胆胰外科学会(JSHBPS)于2007年出版第一版胆道肿瘤(胆管癌、胆囊癌及壶腹癌)临床实践指南,于2014年更新第二版,2021年英文第三版胆道肿瘤临床实践指南围绕6个主题提出若干临床问题,基于相关循证医学证据并组织专家讨论后,最终确定推荐意见、推荐强度以及推荐说明。根据证据推荐分级的评估、制订与评价(GRADE)系统,推荐强度被分为1级(强)或者2级(弱)。英文第三版胆道肿瘤临床实践指南中提出的31个临床问题涵盖:(1)预防性治疗;(2)诊断;(3)胆道引流;(4)外科治疗;(5)化疗;(6)放疗。31个临床问题中,14个问题给予推荐强度为强的推荐意见,14个问题给予推荐强度为弱的推荐意见,剩余的3个问题未给予推荐意见。每条推荐意见都进行推荐强度说明。最新版指南基于循证医学证据,为临床提供了重要建议。未来与癌症登记数据库协作将是评估指南和建立新证据的关键。

关键词：胆道肿瘤临床实践指南预防性治疗循证医学证据肝胆胰外科胆道引流推荐意见壶腹癌

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