Affiliation 【 display / non-display 】

Affiliation 【 display / non-display 】

• Department of surgery, Surgical oncology and science   助教  

Papers 【 display / non-display 】

Papers 【 display / non-display 】

• Predictors of occult metastases in potentially Resectable pancreatic ductal adenocarcinoma.

  Takeshi Murakami, Yasutoshi Kimura, Masafumi Imamura, Minoru Nagayama, Toru Kato, Kazuharu Kukita, Makoto Yoshida, Yoshiharu Masaki, Hiroshi Nakase, Ichiro Takemasa

  Surgery open science   20   222 - 229  2024.08  [International journal]

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  BACKGROUND: Patients with resectable (R) or borderline resectable (BR) pancreatic ductal adenocarcinoma (PDAC) sometimes show unexpected liver, peritoneal, and para-aortic lymph node metastases intraoperatively. Despite radical pancreatectomy, a nonnegligible number of patients relapse within 6 months after surgery. The aim of this study was to identify the preoperative predictors of occult metastases (OM), defined as intraoperative distant metastases or within 6 months after pancreatectomy. MATERIALS AND METHODS: This study included patients with R and BR PDAC who underwent curative-intent pancreatectomy or staging laparoscopy between 2006 and 2021. Multivariate logistic regression and Cox hazard analyses were performed to identify the preoperative predictors of OM and to assess the impact of these factors on prognosis after pancreatectomy. RESULTS: Of the 279 patients, OM was observed intraoperatively in 47 and postoperatively in 34. In the OM group, there were no differences in prognosis between patients who had intraoperative metastases and recurrence within 6 months (median survival time [MST], 18.1 vs. 12.9 months), and between patients who underwent pancreatectomy and those who did not (MST, 13.9 vs. 18.1 months). Preoperative tumor size ≥22 mm (odds ratio [OR], 2.03; 95 % confidence interval [CI], 1.16-3.53; p = 0.013) and preoperative CA19-9 level ≥ 118.8 U/mL (OR, 2.64; 95 % CI, 1.22-5.73; p = 0.014) were significant predictors of OM. Additionally, positive OM predictors were strong independent prognostic factors for overall survival after pancreatectomy (hazard ratio, 2.47; 95 % CI, 1.54-3.98; p < 0.001). CONCLUSION: Multidisciplinary treatment strategies should be considered for patients with predictors of OM to avoid inappropriate surgical interventions.

  DOI PubMed

• A rare case of resection of a mucinous cystic neoplasm originating from the extrahepatic bile duct with cholangioscopic imaging.

  Yoshiharu Masaki, Yujiro Kawakami, Keisuke Ishigami, Ayako Murota, Masahiro Shitani, Kazuharu Kukita, Yasutoshi Kimura, Keiko Segawa, Tadashi Hasegawa, Hiroshi Nakase

  DEN open   4 ( 1 ) e349  2024.04  [International journal]

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  A 29-year-old woman was admitted to our hospital for examination of obstructive jaundice and an extrahepatic bile duct lesion. Contrast-enhanced computed tomography revealed a 20 mm cystic lesion with a thin external capsule in the common hepatic duct. Cholangioscopy revealed translucent oval masses with capillary vessels attached to the bile duct walls. The surface was mostly smooth yet partially irregular with redness, suggesting that the masses were epithelial neoplasms. Histological findings of cholangioscopy-guided targeted biopsies of the mass showed subepithelial spindle cell proliferation with no atypical epithelium. The patient underwent an extrahepatic bile duct resection to confirm the pathological diagnosis. Immunohistochemistry of surgical specimens revealed that the spindle cells were positive for estrogen and progesterone receptors. Finally, the cystic lesion with ovarian-like stroma was diagnosed as a mucinous cystic neoplasm with low-grade intraepithelial neoplasia. This is the first report of cholangioscopic imaging of a biliary mucinous cyctic neoplasm. Cholangioscopic imaging can be helpful in the differential diagnosis of biliary neoplasms and in the determination of treatment strategies.

  DOI PubMed

• A case report of carcinoma of the papilla of Vater associated with a hyperplasia-dysplasia-carcinoma sequence by pancreaticobiliary maljunction.

  Takahiro Korai, Yasutoshi Kimura, Kazunori Watanabe, Siew-Kee Low, Masafumi Imamura, Minoru Nagayama, Kazuharu Kukita, Takeshi Murakami, Toru Kato, Yuta Kondo, Daisuke Kyuno, Taro Sugawara, Ayako Murota, Yujiro Kawakami, Yoshiharu Masaki, Hiroshi Nakase, Ichiro Takemasa

  World journal of surgical oncology   22 ( 1 ) 63 - 63  2024.02  [International journal]

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  BACKGROUND: Pancreaticobiliary maljunction (PBM) is a known risk factor for biliary tract cancer. However, its association with carcinoma of the papilla of Vater (PVca) remains unknown. We report a case with PVca that was thought to be caused by the hyperplasia-dysplasia-carcinoma sequence, which is considered a mechanism underlying PBM-induced biliary tract cancer. CASE PRESENTATION: A 70-year-old woman presented with white stool and had a history of cholecystectomy for the diagnosis of a non-dilated biliary tract with PBM. Esophagogastroduodenoscopy revealed a tumor in the papilla of Vater, and PVca was histologically proven by biopsy. We finally diagnosed her with PVca concurrent with non-biliary dilated PBM (cT1aN0M0, cStage IA, according to the Union for International Cancer Control, 8th edition), and subsequently performed subtotal stomach-preserving pancreaticoduodenectomy. Pathological findings of the resected specimen revealed no adenomas and dysplastic and hyperplastic mucosae in the common channel slightly upstream of the main tumor, suggesting a PBM related carcinogenic pathway with hyperplasia-dysplasia-carcinoma sequence. Immunostaining revealed positivity for CEA. CK7 positivity, CK20 negativity, and MUC2 negativity indicated that this PVca was of the pancreatobiliary type. Genetic mutations were exclusively detected in tumors and not in normal tissues, and bile ducts from formalin-fixed paraffin-embedded samples included mutated-ERBB2 (Mutant allele frequency, 81.95%). Moreover, of the cell-free deoxyribonucleic acid (cfDNA) extracted from liquid biopsy mutated-ERBB2 was considered the circulating-tumor deoxyribonucleic acid (ctDNA) of this tumor. CONCLUSIONS: Herein, we report the first case of PVca with PBM potentially caused by a "hyperplasia-dysplasia-carcinoma sequence" detected using immunostaining and next-generation sequencing. Careful follow-up is required if pancreaticobiliary reflux persists, considering the possible development of PVca.

  DOI PubMed

• Reconsidering resectable oncological conditions in pancreatic tail cancer: A multicenter retrospective study on prognostic factors in pancreatic tail cancer after resection (HOPS Pt-01).

  Yasutoshi Kimura, Toru Nakamura, Masafumi Imamura, Minoru Nagayama, Takeshi Murakami, Tsuyoshi Hayashi, Toru Kato, Kimitaka Tanaka, Makoto Yoshida, Kazuharu Kukita, Koji Imai, Makoto Yoshida, Yoshiharu Masaki, Masayo Motoya, Masaki Kuwatani, Masayuki Koyama, Hirofumi Ohnishi, Ichiro Takemasa

  Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]   24 ( 1 ) 109 - 118  2024.02  [International journal]

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  BACKGROUND: Pancreatic tail cancer (Pt-PC) is generally considered resectable when metastasis is absent, but doubts persist in clinical practice due to the variability in local tumor extent. We conducted a multicenter retrospective study to comprehensively identify prognostic factors associated with Pt-PC after resection. METHODS: We enrolled 100 patients that underwent distal pancreatectomy. The optimal combination of factors influencing relapse-free survival (RFS) was determined using the maximum likelihood method (MLM) and corrected Akaike and Bayesian information criteria (AICc and BIC). Prognostic elements were then validated to predict oncological outcomes. RESULTS: Therapeutic interventions included neoadjuvant treatment in 16 patients and concomitant visceral resection (CVR) in 37 patients; 89 patients achieved R0. Median RFS and OS after surgery were 23.1 and 37.1 months, respectively. AICc/BIC were minimized in the model with ASA-PS (≥2), CA19-9 (≥112 U/mL at baseline, non-normalized postoperatively), need for CVR, 6 pathological items (tumor diameter ≥19.5 mm, histology G1, invasion of the anterior pancreatic border, splenic vein invasion, splenic artery invasion, lymph node metastasis), and completed adjuvant treatment (cAT) for RFS. Regarding the predictive value of these 11 factors, area under the curve was 0.842 for 5-year RFS. Multivariate analysis of these 11 factors showed that predictors of RFS include CVR (hazard ratio, 2.13; 95 % confidence interval, 1.08-4.19; p = 0.028) and cAT (0.38, 0.19-0.76; p = 0.006). CONCLUSIONS: The MLM identified certain Pt-PC cases warranting consideration beyond resectable during clinical management. Particular attention should be paid to conditions requiring CVR, even though immortal time bias remains unresolved with adjuvant treatment.

  DOI PubMed

• Cancer-associated oxidoreductase ERO1-α promotes immune escape through up-regulation of PD-L1 in human breast cancer.

  Tsutomu Tanaka, Goro Kutomi, Toshimitsu Kajiwara, Kazuharu Kukita, Vitaly Kochin, Takayuki Kanaseki, Tomohide Tsukahara, Yoshihiko Hirohashi, Toshihiko Torigoe, Yoshiharu Okamoto, Koichi Hirata, Noriyuki Sato, Yasuaki Tamura

  Oncotarget   8 ( 15 ) 24706 - 24718  2017.04  [International journal]

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  Many human cancers have been reported to have enhanced expression of the immune checkpoint molecule programmed death-ligand 1 (PD-L1), which binds to programmed cell death-1 (PD-1) expressed on immune cells. PD-L1/PD-1 plays a role in inhibition of antitumor immunity by inducing T cell apoptosis and tolerance. Thus, it is crucial to elucidate mechanisms of PD-L1 expression on cancer cells. ERO1-α is an oxidase located in the endoplasmic reticulum. It is overexpressed in a variety of tumor types and it plays a role in disulfide bond formation in collaboration with PDI. Here, we investigated the influence of ERO1-α on expression of PD-L1 and immune escape. We demonstrated that ERO1-α augmented the expression of PD-L1 via facilitation of oxidative protein folding within PD-L1. In addition, we showed that overexpression of ERO1-α increased HIF-1α protein expression, resulting in an increase of PD-L1 mRNA as well as protein. In clinical cases, we observed that the expression of ERO1-α in triple negative breast cancer was related to the expression of PD-L1. Moreover, apoptosis of Jurkat leukemia T cells, which express PD-1, induced by tumor PD-L1 was inhibited when ERO1-α was depleted. The results suggest that targeting ERO1-α in tumor cells can be a novel approach for cancer immunotherapy. Therefore, the role of ERO1-α in tumor-mediated immunosuppression should be further explored.

  DOI PubMed

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Misc 【 display / non-display 】

Misc 【 display / non-display 】

• Precision medicine時代における肝胆膵癌外科切除の役割 切除企図膵癌における術前ctDNAを用いた潜在性遠隔転移予測の多施設共同研究

  村上 武志, 木村 康利, 今村 将史, 渡邊 一永, 中村 透, Low Siew-Kee, 近藤 裕太, 古来 貴寛, 加藤 透, 久木田 和晴, 平野 聡, 竹政 伊知朗

  日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 )  124回   SY - 2  2024.04

• 尾側膵切除における電動自動縫合器切離とPGAシート被覆の効果

  今村 将史, 久木田 和晴, 村上 武志, 加藤 透, 古来 貴寛, 近藤 裕太, 伊東 竜哉, 奥谷 浩一, 木村 康利, 竹政 伊知朗

  日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 )  124回   SF - 1  2024.04

• 膵頭十二指腸切除術における挙上空腸再建経路の比較検討

  久木田 和晴, 今村 将史, 近藤 裕太, 古来 貴寛, 加藤 透, 村上 武志, 伊東 竜哉, 奥谷 浩一, 木村 康利, 竹政 伊知朗

  日本外科学会定期学術集会抄録集 ( (一社)日本外科学会 )  124回   PS - 7  2024.04

• 人工肛門閉鎖創を利用した低侵襲肝切除の検討

  加藤 透, 永山 稔, 木村 康利, 今村 将史, 久木田 和晴, 村上 武志, 古来 貴寛, 近藤 裕太, 水口 徹, 竹政 伊知朗

  日本臨床外科学会雑誌 ( 日本臨床外科学会 )  85 ( 3 ) 430 - 430  2024.03

• 肝外胆管に発生した粘液性嚢胞性腫瘍の1例

  久木田 和晴, 今村 将史, 加藤 透, 村上 武志, 永山 稔, 柾木 喜晴, 木村 康利, 竹政 伊知朗

  日本臨床外科学会雑誌 ( 日本臨床外科学会 )  85 ( 2 ) 294 - 294  2024.02

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