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Optimal resection of gastric bronchogenic cysts based on anatomical continuity with adherent gastric muscular layer: A case report

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World Journal of Gastrointestinal Surgery 2023年第6期15卷 1216-1223页

作者： Masayoshi Terayama Koshi Kumagai Hiroshi Kawachi Rie Makuuchi Masaru Hayami Satoshi Ida Manabu Ohashi Takeshi Sano Souya Nunobe Department of gastroenterological Surgery Gastroenterological CenterCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyo 135-8550Japan Department of Pathology Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyo 135-8550Japan

BACKGROUND Bronchogenic cysts are congenital lesions requiring radical resection because of malignant ***,a method for the optimal resection of these cysts has not been completely *** SUMMARY Herein,we presented three patients with bronchogenic cysts that were located adjacent to the gastric wall and resected *** cysts were detected incidentally with no symptoms and the preoperative diagnosis was challenging to obtain via radiological *** on laparoscopic findings,the cyst was attached firmly to the gastric wall and the boundary between the gastric and cyst walls was difficult to ***,resection of cysts alone caused cystic wall injury in Patient ***,the cyst was resected completely along with a part of the gastric wall in Patient *** examination revealed the final diagnosis of bronchogenic cyst and revealed that the cyst wall shared the muscular layer with the gastric wall in Patients 1 and *** Patient 3,the cyst was located adjacent to the gastric wall but histopathologically originated from diaphragm rather than *** the patients were free from *** The findings of this study state that a safe and complete resection of bronchogenic cysts required the adherent gastric muscular layer or full-thickness dissection,if bronchogenic cysts are suspected via pre-and/or intraoperative findings.

关键词： Bronchogenic cysts Laparoscopic resection Gastric wall Muscular layer Case report

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Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?

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World Journal of Gastroenterology 2024年第10期30卷 1368-1376页

作者： Nobukazu Agatsuma Takahiro Utsumi Yoshitaka Nishikawa Takahiro Horimatsu Takeshi Seta Yukitaka Yamashita Yukari Tanaka Takahiro Inoue Yuki Nakanishi Takahiro Shimizu Mikako Ohno Akane Fukushima Takeo Nakayama Hiroshi Seno Department of Gastroenterology and Hepatology Kyoto University Graduate School of MedicineKyoto 606-8507Japan Department of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical CenterWakayama 640-8558Japan Department of Health Informatics Kyoto University School of Public HealthKyoto 606-8501Japan Institute for Advancement of Clinical and Translational Science(iACT) Kyoto University HospitalKyoto 606-8507Japan Medical Support Section Medical Affairs DivisionKyoto University HospitalKyoto 606-8507Japan

BACKGROUND Colorectal cancer(CRC)is a global health concern,with advanced-stage diagnoses contributing to poor *** efficacy of CRC screening has been well-established;nevertheless,a significant proportion of patients remain unscreened,with>70%of cases diagnosed outside *** identifying specific subgroups for whom CRC screening should be particularly recommended is crucial owing to limited resources,the association between the diagnostic routes and identification of these subgroups has been less *** the japanese cancer registry,the diagnostic routes for groups discovered outside of screening are primarily categorized into those with comorbidities found during hospital visits and those with CRC-related *** To clarify the stage at CRC diagnosis based on diagnostic *** We conducted a retrospective observational study using a cancer registry of patients with CRC between January 2016 and December 2019 at two *** diagnostic routes were primarily classified into three groups:Cancer screening,follow-up,and *** early-stage was defined as Stages 0 or *** and univariate logistic regressions were exploited to determine the odds of early-stage diagnosis in the symptomatic and cancer screening groups,referencing the follow-up *** adjusted covariates were age,sex,and tumor *** Of the 2083 patients,715(34.4%),1064(51.1%),and 304(14.6%)belonged to the follow-up,symptomatic,and cancer screening groups,*** the 2083 patients,CRCs diagnosed at an early stage were 57.3%(410 of 715),23.9%(254 of 1064),and 59.5%(181 of 304)in the follow-up,symptomatic,and cancer screening groups,*** symptomatic group exhibited a lower likelihood of early-stage diagnosis than the follow-up group[P<0.001,adjusted odds ratio(aOR),0.23;95%confidence interval(95%CI):0.19-0.29].The likelihood of diagnosis at an early stage was similar between the follow-up and cancer screening gro

关键词： Colorectal neoplasms Cancer registry Diagnostic route Cancer screening Stage at diagnosis

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Role of surgical resection for non-colorectal non-neuroendocrine liver metastases

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World Journal of Hepatology 2017年第5期9卷 242-251页

作者： Nobuyuki Takemura Akio Saiura Department of gastroenterological Surgery JR Tokyo General Hospital Department of gastroenterological Surgery Cancer Institute Ariake Hospital Japanese Foundation for Cancer Research

It is widely accepted that the indications for hepatectomy in colorectal cancer liver metastases and liver metastases of neuro-endocrine tumors result in relatively better prognoses, whereas, the indications and prognoses of hepatectomy for non-colorectal non-neuroendocrine liver metastases(NCNNLM) remain controversial owing to the limited number of cases and the heterogeneity of the primary diseases. There have been many publications on NCNNLM; however, its background heterogeneity makes it difficult to reach a specific conclusion. This heterogeneous disease group should be discussed in the order from its general to specific aspect. The present review paper describes the general prognosis and risk factors associated with NCNNLM while specifically focusing on the liver metastases of each primary disease. A multidisciplinary approach that takes into consideration appropriate timing for hepatectomy combined with chemotherapy may prolong survival and/or contribute to the improvement of the quality of life while giving respite from systemic chemotherapy.

关键词： Non-colorectal non-neuroendocrine 肝转移变形的肝肿瘤 Hepatectomy 胃的癌症肝转移胃肠的 stromal 肿瘤肝转移乳癌肝转移黑瘤肝转移肉瘤肝转移肾的房间癌肝转移卵巢的癌症肝转移

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Is rectal cancer prone to metastasize to lymph nodes than colon cancer?

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World Journal of Gastroenterology 2011年第29期17卷 3465-3466页

作者： Takashi Akiyoshi Toshiaki Watanabe Masashi Ueno Tetsuichiro Muto gastroenterological Center Department of Gastroenterological SurgeryCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyo 135-8550Japan Department of Surgery Teikyo University School of MedicineTokyo 173-8605Japan

The biology of colorectal cancer differs according to its location within the large intestine.A report published in a previous issue of World Journal of Gastroenterology (November 2010) evaluated the importance of tumor location as a risk factor for lymph node metastasis in colorectal cancer,and showed that rectal cancer is prone to metastasize to lymph nodes as compared with colon ***,in order to conclude that the tumor location is independently associated with the occurrence of lymph node metastasis,it is necessary to consider a selection bias or other patientand tumorrelated factors carefully.

关键词：淋巴结结肠癌直肠癌生物学特性大肠癌胃肠病学危险因素位置

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Skeletal muscle mass and quality before preoperative chemotherapy influence postoperative long-term outcomes in esophageal squamous cell carcinoma patients

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World Journal of Gastrointestinal Surgery 2023年第4期15卷 621-633页

作者： Daichi Ichinohe Takahiro Muroya Harue Akasaka Kenichi Hakamada Department of gastroenterological Surgery Hirosaki University Graduate School of MedicineHirosaki 0368562AomoriJapan

BACKGROUND Previous reports have focused on muscle mass as a prognostic factor in esophageal *** To investigate how preoperative body type influences the prognosis of patients with esophageal squamous cell carcinoma who underwent neoadjuvant chemotherapy(NAC)and *** The subjects were 131 patients with clinical stage Ⅱ/Ⅲ esophageal squamous cell carcinoma who underwent subtotal esophagectomy after *** muscle mass and quality were calculated based on computed tomography images prior to NAC,and their statistical association with long-term outcomes was examined retrospectively in this case-control *** The disease-free survival rates in the low psoas muscle mass index(PMI)group vs the high PMI group were 41.3%vs 58.8%(P=0.036),*** the high intramuscular adipose tissue content(IMAC)group vs the low IMAC group,the disease-free survival rates were 28.5%vs 57.6%(P=0.021),*** overall survival(OS)rates for the low PMI group vs the high PMI group were 41.3%vs 64.5%(P=0.008),respectively,and for the high IMAC group vs the low IMAC group,they were 29.9%vs 61.9%(P=0.024),*** of the OS rate revealed significant differences in patients aged 60 years or older(P=0.018),those with pT3 or above disease(P=0.021),or those with lymph node metastasis(P=0.006),aside from PMI and *** analysis demonstrated that pT3 or above hazard ratio(HR):1.966,95%confidence interval(CI):1.089-3.550,(P=0.025),lymph node metastasis(HR:2.154,95%CI:1.118-4.148,P=0.022),low PMI(HR:2.266,95%CI:1.282-4.006,P=0.005),and high IMAC(HR:2.089,95%CI:1.036-4.214,P=0.022)were significant prognostic factors for esophageal squamous cell *** muscle mass and quality before NAC in patients with esophageal squamous cellcarcinoma are significant prognostic factors for postoperative OS.

关键词： Esophageal squamous cell carcinoma Muscle mass Muscle quality Neoadjuvant chemotherapy Body composition

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Preliminary prospective study of real-time post-gastrectomy glycemic fluctuations during dumping symptoms using continuous glucose monitoring

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World Journal of Gastroenterology 2021年第23期27卷 3386-3395页

作者： Motonari Ri Souya Nunobe Satoshi Ida Naoki Ishizuka Shinichiro Atsumi Rie Makuuchi Koshi Kumagai Manabu Ohashi Takeshi Sano Department of gastroenterological Surgery Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyo 135-8550Japan Clinical Trial Planning and Management Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyo 135-8550Japan

BACKGROUND Although dumping symptoms constitute the most common post-gastrectomy syndromes impairing patient quality of life,the causes,including blood sugar fluctuations,are difficult to elucidate due to limitations in examining dumping symptoms as they *** To investigate relationships between glucose fluctuations and the occurrence of dumping symptoms in patients undergoing gastrectomy for gastric *** Patients receiving distal gastrectomy with Billroth-I(DG-BI)or Roux-en-Y reconstruction(DG-RY)and total gastrectomy with RY(TG-RY)for gastric cancer(March 2018-January 2020)were prospectively *** tissue glycemic profiles were measured every 15 min,up to 14 d,by continuous glucose *** episodes were recorded on 5 patient-selected days by *** 3 h postprandially,dumping-associated glycemic changes were defined as a dumping profile,those without symptoms as a control *** profiles were *** Thirty patients were enrolled(10 DG-BI,10 DG-RY,10 TG-RY).The 47 early dumping profiles of DG-BI showed immediately sharp rises after a meal,which 47 control profiles did not(P<0.05).Curves of the 15 late dumping profiles of DG-BI were similar to those of early dumping profiles,with lower glycemic *** and TG-RY late dumping profiles(7 and 13,respectively)showed rapid glycemic decreases from a high glycemic state postprandially to hypoglycemia,with a steeper drop in TG-RY than in *** Postprandial glycemic changes suggest dumping symptoms after standard gastrectomy for gastric ***,glycemic profiles during dumping may differ depending on reconstruction methods after gastrectomy.

关键词： Gastric cancer Gastrectomy Billroth-I reconstruction Roux-en-Y reconstruction Dumping syndrome Continuous glucose monitoring

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Nomograms predicting prognosis of patients with pathological stages T1N2-3 and T3N0 gastric cancer

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World Journal of Gastrointestinal Surgery 2022年第2期14卷 143-160页

作者： Yu-Fei Wang Xin Yin Tian-Yi Fang Yi-Min Wang Dao-Xu Zhang Yao Zhang Xi-Bo Wang Hao Wang Ying-Wei Xue Department of gastroenterological Surgery Harbin Medical University Cancer HospitalHarbin 150081Heilongjiang ProvinceChina

BACKGROUND Patients with pathological stages T1N2-3(pT1N2-3)and pT3N0 gastric cancer(GC)have not been routinely included in the target population for postoperative chemotherapy according to the japanese Gastric Cancer Treatment Guideline,and their prognosis is significantly *** To identify the high-risk patients after radical surgery by analyzing biomarkers and clinicopathological features and construct prognostic models for *** A total of 459 patients with pT1N2-3/pT3N0 GC were retrospectively selected for the *** Chi-square test was used to analyze the differences in the clinicopathological features between the pT1N2-3 and pT3N0 *** Kaplan–Meier analysis and log-rank test were used to analyze overall survival(OS).The independent risk factors for patient prognosis were analyzed by univariate and multivariate analyses based on the Cox proportional hazards regression *** cutoff values of continuous variables were identified by receiver operating characteristic *** nomogram models were constructed with R *** There was no statistically significant difference in OS between the pT1N2-3 and pT3N0 groups(P=0.374).Prealbumin(P=0.040),carcino-embryonic antigen(CEA)(P=0.021),and metastatic lymph node ratio(mLNR)(P=0.035)were independent risk factors for prognosis in the pT1N2-3 ***(P=0.039),body mass index(BMI)(P=0.002),and gastrectomy(P<0.001)were independent risk factors for prognosis in the pT3N0 *** area under the curve values of the nomogram models for predicting the 5-year prognosis of the pT1N2-3 group and pT3N0 group were 0.765 and 0.699,*** Nomogram model combining prealbumin,CEA,and mLNR levels can be used to predict the prognosis of pT1N2-3 *** model combining age,BMI,and gastrectomy can be used to predict the prognosis of pT3N0 GC.

关键词： Gastric cancer Biomarker Clinicopathological feature Adjuvant chemotherapy Prognosis Nomogram

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Recent updates of therapeutic strategy of esophagogastric junction adenocarcinoma

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Journal of Cancer Metastasis and Treatment 2021年第1期7卷 727-736页

作者： Suguru Maruyama Yu Imamura Yasukazu Kanie Kei Sakamoto Daisuke Fujiwara Akihiko Okamura JunKanamori Masayuki Watanabe Department of gastroenterological Surgery Cancer Institute Hospital of Japanese Foundation of Cancer ResearchTokyo 135-8550Japan.

The incidence of esophagogastric junction(EGJ)adenocarcinoma has been increasing in Asian *** the recent advances in multidisciplinary treatments,EGJ adenocarcinoma remains aggressive with unfavorable *** surgical strategy,EGJ adenocarcinoma arises between the esophagus and the stomach,and thus tumor cells spread through the lymphatic system both upward to the mediastinum and downward to the ***,an optimal extent of lymphadenectomy remains *** drug therapy,the latest topic in gastric and EGJ adenocarcinoma is trastuzumab deruxtecan,which is an antibody-drug conjugate consisting of an anti-HER2 *** addition,many clinical trials have recently demonstrated the efficacy of immune checkpoint ***,recent advances in sequencing technology have revealed that gastroesophageal adenocarcinoma could be categorized into four molecular subtypes:epstein-Barr virus-associated,high-level microsatellite instability,genomically stable,and chromosomal instability ***,these subtypes show distinct clinical phenotypes and molecular *** review the current surgical strategy and drug treatment such as molecular-targeted agents,immune checkpoint inhibitors,and molecular-subtype-based therapeutic strategies in EGJ *** and molecular characteristics and response to immune checkpoint inhibitors differ among molecular *** strategies based on molecular subtypes may be clinically beneficial for patients with EGJ adenocarcinoma.

关键词： Esophagogastric junction adenocarcinoma Barrett’s esophagus microsatellite instability molecular subtype

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Serum squamous cell carcinoma antigen is a predictive factor of outcomes in patients with locally advanced unresectable esophageal squamous cell carcinoma treated by definitive chemoradiotherapy

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Journal of Cancer Metastasis and Treatment 2022年第1期8卷 81-90页

作者： Takeshi Suzuki Akihiko Okamura Masayuki Watanabe Takao Asari Izuma Nakayama Mariko Ogura Akira Ooki Daisuke Takahari Kensei Yamaguchi Keisho Chin Department of gastroenterological Medicine Cancer Institute Hospital of the Japanese Foundation for Cancer ResearchKoto-kuTokyo 135-8550Japan Department of gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer ResearchKoto-kuTokyo 135-8550Japan Department of Radiation Oncology Cancer Institute Hospital of the Japanese Foundation for Cancer ResearchKoto-kuTokyo 135-8550Japan

Aim:Definitive chemoradiotherapy(dCRT)is the standard treatment for locally advanced unresectable esophageal squamous cell carcinoma(LU-ESCC).This study aimed to describe the results of dCRT for T4 ESCC and evaluate the pretherapeutic predictive factors of the ***:A total of 133 patients with T4 ESCC who received dCRT were grouped into those who achieved a complete response(CR)or those who had residual disease(RD).The clinicopathologic variables were compared between the groups and the overall survival(OS)was *** predictive factor of RD was assessed and the prognostic factor for OS was ***:Among the 133 patients,31(23%)achieved *** CR group had a significantly better OS than the RD group(89.9 months vs.10.7 months;hazard ratio=0.096;95%confidence interval:0.05-0.19;P1.6 ng/mL)(OR=2.86;P=0.018),and metastatic node invasion(OR=3.19;P=0.048)were independent predictors of *** increased level of pretherapeutic serum squamous cell carcinoma antigen(>1.6 ng/mL)(OR=1.61;P=0.022)was an independent predictor of poor ***:Among the patients who underwent dCRT for LU-ESCC,23%achieved CR,and the long-term outcome of these patients was *** levels of pretherapeutic serum squamous cell carcinoma antigen were also found to be predictive of treatment failure.

关键词： Esophageal cancer chemoradiotherapy esophageal squamous cell carcinoma predictive factor

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Prognostic significance of serum inflammation indices for different tumor infiltrative pattern types of gastric cancer

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World Journal of Gastrointestinal Oncology 2022年第4期14卷 897-919页

作者： Yu-Fei Wang Xin Yin Tian-Yi Fang Yi-Min Wang Lei Zhang Xing-Hai Zhang Dao-Xu Zhang Yao Zhang Xi-Bo Wang Hao Wang Ying-Wei Xue Department of gastroenterological Surgery Harbin Medical University Cancer HospitalHarbin 150081Heilongjiang ProvinceChina Department of Pathology Harbin Medical University Cancer HospitalHarbin 150081Heilongjiang ProvinceChina

BACKGROUND Inflammatory indices are considered to be potential prognostic biomarkers for patients with gastric cancer(GC).However,there is no evidence defining the prognostic significance of inflammatory indices for GC with different tumor infiltrative pattern(INF)*** To evaluate the significance of inflammatory indices and INF types in predicting the prognosis of patients with *** A total of 962 patients who underwent radical gastrectomy were retrospectively selected for this *** were categorized into the expansive growth type(INFa),the intermediate type(INFb),and the infiltrative growth type(INFc)*** cutoff values of inflammatory indices were analyzed by receiver operating characteristic *** Kaplan–Meier method and log-rank test were used to analyze overall survival(OS).The chi-square test was used to analyze the association between inflammatory indices and clinical *** independent risk factors for prognosis in each group were analyzed by univariate and multivariate analyses based on logistic *** models were constructed by R *** The INFc group had the worst OS(P<0.001).The systemic immune-inflammation index(P=0.039)and metastatic lymph node ratio(mLNR)(P=0.003)were independent risk factors for prognosis in the INFa *** platelet-lymphocyte ratio(PLR)(P=0.018),age(P=0.026),body mass index(P=0.003),and postsurgical tumor node metastasis(pTNM)stage(P<0.001)were independent risk factors for prognosis in the INFb *** PLR(P=0.021),pTNM stage(P=0.028),age(P=0.021),and mLNR(P=0.002)were independent risk factors for prognosis in the INFc *** area under the curve of the nomogram model for predicting 5-year survival in the INFa group,INFb group,and INFc group was 0.787,0.823,and 0.781,*** The outcome of different INF types GC patients could be assessed by nomograms based on different inflammatory indices and clinicopathologic features.

关键词： Gastric cancer Tumor infiltrative pattern Systemic immune-inflammation index Plateletlymphocyte ratio Prognosis Nomogram

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