FullText URL OncoImmunol_8_12_1671760.pdf
Author Sakamoto, Shuichi| Kagawa, Shunsuke| Kuwada, Kazuya| Ito, Atene| Kajioka, Hiroki| Kakiuchi, Yoshihiko| Watanabe, Megumi| Kagawa, Tetsuya| Yoshida, Ryuichi| Kikuchi, Satoru| Kuroda, Shinji| Tazawa, Hiroshi| Fujiwara, Toshiyoshi|
Keywords Gastric cancer tumor-associated macrophages tumor microenvironment peritoneal dissemination
Published Date 2019-10-22
Publication Title OncoImmunology
Volume volume8
Issue issue12
Publisher TAYLOR & FRANCIS
Start Page e1671760
ISSN 2162402X
Content Type Journal Article
language 英語
OAI-PMH Set 岡山大学
Copyright Holders © 2019 The Author(s).
File Version publisher
DOI 10.1080/2162402X.2019.1671760
Web of Sience KeyUT 000494085400001
Related Url isVersionOf https://doi.org/10.1080/2162402X.2019.1671760
FullText URL AnnGastroenterolSurg_3_4_396.pdf
Author Fujiwara, Toshiyoshi|
Keywords adenovirus clinical trial esophageal cancer radiotherapy telomerase
Published Date 2019-07-05
Publication Title Annals of gastroenterological surgery
Volume volume3
Issue issue4
Publisher John Wiley & Sons
Start Page 396
End Page 404
ISSN 24750328
Content Type Journal Article
language 英語
OAI-PMH Set 岡山大学
Copyright Holders © 2019 The Authors
File Version publisher
PubMed ID 31346579
DOI 10.1002/ags3.12270
Web of Sience KeyUT 000475745100009
Related Url isVersionOf https://doi.org/10.1002/ags3.12270
JaLCDOI 10.18926/AMO/54981
FullText URL 71_2_127.pdf
Author Shirakawa, Yasuhiro| Noma, Kazuhiro| Maeda, Naoaki| Tanabe, Shunsuke| Kuroda, Shinji| Kagawa, Shunsuke| Katsui, Kuniaki| Katayama, Norihisa| Kanazawa, Susumu| Fujiwara, Toshiyoshi|
Abstract Currently, chemoradiation is the most widely used nonsurgical treatment for esophageal cancer. However, some patients, particularly the very elderly or those with severe vital organ dysfunction, face difficulty with the chemotherapy component. We therefore examined the outcome of radiation therapy (RT) alone for patients with esophageal cancer at our facility. Between January 2005 and December 2014, 84 patients underwent RT at our hospital, and 78 of these patients received concomitant chemotherapy. The remaining 6 patients underwent RT alone; these patients were considered to be high-risk and to have no lymph node metastasis (stage I). Five of them received irradiation up to a curative dose: 4 showed a complete response (CR) and 1 showed a partial response (PR). Of the patients exhibiting CR, 3 are currently living recurrence-free, whereas 1 patient underwent endoscopic submucosal dissection (ESD) as salvage therapy for local recurrence, with no subsequent recurrence. High-risk stage I esophageal cancer patients can be treated radically with RT alone under certain conditions. In the future, to broaden the indications for RT monotherapy to include some degree of advanced cancers, a novel concurrent therapy should be identified.
Keywords esophageal cancer radiation therapy high-risk patient
Amo Type Original Article
Published Date 2017-04
Publication Title Acta Medica Okayama
Volume volume71
Issue issue2
Publisher Okayama University Medical School
Start Page 127
End Page 133
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 28420894
Title Alternative Thoracoscopic esophagectomy was effective in a case of lower esophageal stenosis due to recurrence of achalasia after myotomy 40 years previously
Author Katsura, Yuki| Shirakawa, Yasuhiro| Tanabe, Shunsuke| Maeda, Naomi| Noma, Kazuhiro| Fujiwara, Toshiyoshi|
Abstract When planning surgery for achalasia, it is important to plan for adequate myotomy and prevention of reflux. However, achalasia may recur if the procedure was inadequate or in patients with a long-term course. The present case is a 68-year-old woman who underwent myotomy of the lower esophageal sphincter 40 years ago, but recently reported difficulty in swallowing. Dilatation of the thoracic esophagus and stenosis of the abdominal esophagus were identified by examination, and the patient was diagnosed with recurrence of achalasia. After percutaneous endoscopic gastrostomy was performed to recover nutritional status, thoracoscopic esophagectomy was carried out. The patient'spost-operative course was uneventful and oral intake was enabled. At the time of writing, there has been no re-recurrence. There is no standard therapy for post-operative recurrence of achalasia. We believe that thoracoscopic esophagectomy for the recurrence of achalasia is a safe and minimally invasive alternative to conventional surgery.
Keywords 食道アカラシア (achalasia) 再手術 (reoperation) 食道亜全摘 (esophagectomy)
Publication Title Journal of Okayama Medical Association
Published Date 2017-04-03
Volume volume129
Issue issue1
Start Page 41
End Page 44
ISSN 0030-1558
language 日本語
Copyright Holders Copyright (c) 2017 岡山医学会
File Version publisher
DOI 10.4044/joma.129.41
Author Takagi, Kosei| Yagi, Takahito| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Nobuoka, Daisuke| Watanabe, Nobuyuki| Kuise, Takashi| Fuji, Tomokazu| Araki, Hiroyuki| Fujiwara, Toshiyoshi|
Published Date 2017-02
Publication Title Acta Medica Okayama
Volume volume71
Issue issue1
Content Type Journal Article
JaLCDOI 10.18926/AMO/54830
JaLCDOI 10.18926/AMO/54601
FullText URL 70_5_401.pdf
Author Kuroda, Shinji| Kikuchi, Satoru| Nishizaki, Masahiko| Kagawa, Shunsuke| Hinotsu, Shiro| Fujiwara, Toshiyoshi|
Abstract Although intermittent pneumatic compression (IPC) has become common as perioperative prophylaxis for venous thromboembolism (VTE) consisting of pulmonary thromboembolism (PE) and deep vein thrombosis (DVT), the prophylactic effect against VTE, especially lethal PE, is not yet satisfactory. Therefore, pharmacologic prophylaxis, such as with enoxaparin, is desirable. While the efficacy and safety of enoxaparin have been proven in several clinical trials, concern about bleeding with longterm (at least 7 days) use have potentially decreased its widespread adoption. We have launched a phase II study to evaluate the efficacy and safety of short-term (3 days) enoxaparin, in which a total of 70 gastric cancer patients undergoing gastrectomy will be recruited, and the primary endpoint is the incidence of DVT. This study could contribute to making pharmacologic prophylaxis for VTE more common.
Keywords venous thromboembolism enoxaparin short-term use gastric cancer surgery
Amo Type Clinical Study Protocols
Published Date 2016-10
Publication Title Acta Medica Okayama
Volume volume70
Issue issue5
Publisher Okayama University Medical School
Start Page 401
End Page 404
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27777435
Web of Sience KeyUT 000388098700012
JaLCDOI 10.18926/AMO/54594
FullText URL 70_5_363.pdf
Author Takagi, Kosei| Yagi, Takahito| Yoshida, Ryuichi| Shinoura, Susumu| Umeda, Yuzo| Nobuoka, Daisuke| Kuise, Takashi| Watanabe, Nobuyuki| Fujiwara, Toshiyoshi|
Abstract Sarcopenia following liver surgery has been reported as a predictor of poor prognosis. Here we investigated predictors of outcomes in patients with hepatocellular carcinoma (HCC) and attempted to establish a new comprehensive preoperative assessment protocol. We retrospectively analyzed the cases of 254 patients who underwent curative hepatectomy for HCC with Child-Pugh classification A at our hospital between January 2007 and December 2013. Sarcopenia was evaluated by computed tomography measurement. The influence of sarcopenia on outcomes was evaluated. We used multivariate analyses to assess the impact of prognostic factors associated with outcomes, including sarcopenia. Of the 254 patients, 118 (46.5%) met the criteria for sarcopenia, and 32 had an American Society of Anesthesiologists (ASA) physical status ≥3. The sarcopenic group had a significantly lower 5-year overall survival rate than the non-sarcopenic group (58.2% vs. 82.4% , p=0.0002). In multivariate analyses of prognostic factors, sarcopenia was an independent predictor of poor survival (hazard ratio [HR]=2.28, p=0.002) and poor ASA status (HR=3.17, p=0.001). Sarcopenia and poor ASA status are independent preoperative predictors for poor outcomes after hepatectomy. The preoperative identification of sarcopenia and ASA status might enable the development of comprehensive approaches to assess surgical eligibility.
Keywords sarcopenia American Society of Anesthesiologists physical status hepatectomy hepatocellular carcinoma prognostic factor
Amo Type Original Articles
Published Date 2016-10
Publication Title Acta Medica Okayama
Volume volume70
Issue issue5
Publisher Okayama University Medical School
Start Page 363
End Page 370
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27777428
Web of Sience KeyUT 000388098700005
JaLCDOI 10.18926/AMO/54514
FullText URL 70_4_327.pdf
Author Watanabe, Mototsugu| Yamamoto, Hiromasa| Eikawa, Shingo| Shien, Kazuhiko| Shien, Tadahiko| Soh, Junichi| Hotta, Katsuyuki| Wada, Jun| Hinotsu, Shiro| Fujiwara, Toshiyoshi| Kiura, Katsuyuki| Doihara, Hiroyoshi| Miyoshi, Shinichiro| Udono, Heiichiro| Toyooka, Shinichi|
Abstract A study to evaluate the effect of metformin on the immune system was commenced in July 2014. Metformin is one of the most commonly prescribed drugs for type 2 diabetes, and previous studies have reported that metformin has an anti-tumor effect. The aim of this study is to evaluate the efficacy of metformin on the immune system in human cancer patients in vivo. The primary outcome parameter will be the rate change in the population of CD8+ T cells, which produce multiple cytokines.
Keywords metformin CD8+ T cells cancer immunology
Amo Type Clinical Study Protocols
Published Date 2016-08
Publication Title Acta Medica Okayama
Volume volume70
Issue issue4
Publisher Okayama University Medical School
Start Page 327
End Page 330
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27549683
Web of Sience KeyUT 000384748600018
Title Alternative Incisional hernia repair after wide excision of the iliac bone
FullText URL 128_117.pdf
Author Tsukuda, Kazunori| Asano, Hiroaki| Mandai, Yasuhiro| Fujiwara, Toshiyoshi|
Abstract  The patient was a 46-year old Japanese female who had undergone wide excision of the iliac bone and hip transposition at our institute's orthopedics department 2 years earlier. She presented with a growing incisional hernia and was transferred to our gastroenterological surgery department for surgical treatment. We planned a mesh repair for the incisional hernia, which protruded over the right iliac bone. The dimensions of the abdominal defect were 15×9 cm, and we used prolene mesh to repair the defect. The mesh was fixed at the inner part of the iliac bone, folded back at the iliac horn and fixed to the abdominal oblique muscles. The postoperative course was smooth, and recurrence was not seen at 3.5 years after the operation. An incisional hernia as seen in this patient's case is very rare, but we found that the underlay technique and prolene mesh were very useful for the three-dimensional hernia repair.
Keywords 腹壁瘢痕ヘルニア(incisional hernia) 腸骨軟骨肉腫(chondrosarcoma of the iliac bone) 腸骨広範囲切除術(wide excision of the iliac bone) プロリーンメッシュ(prolene mesh)
Publication Title Journal of Okayama Medical Association
Published Date 2016-08-01
Volume volume128
Issue issue2
Start Page 117
End Page 120
ISSN 0030-1558
Related Url isVersionOf https://doi.org/10.4044/joma.128.117
language 日本語
Copyright Holders Copyright (c) 2016 岡山医学会
File Version publisher
DOI 10.4044/joma.128.117
NAID 130005262528
JaLCDOI 10.18926/AMO/54421
FullText URL 70_3_213.pdf
Author Kikuchi, Satoru| Kagawa, Shunsuke| Ohara, Toshiaki| Kubota, Tetsushi| Kuwada, Kazuya| Kagawa, Tetsuya| Kuroda, Shinji| Shirakawa, Yasuhiro| Nishizaki, Masahiko| Fujiwara, Toshiyoshi|
Abstract A 69-year-old man underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) at the lesser curvature in the angle of stomach. Histological examination revealed tub1, pM, ly0, v0, pLM(-), pVM(-), and the resection was considered curative. The scar after ESD was followed by esophagogastroduodenoscopy (EGD) and biopsy. Twenty months later, EGD showed an ulcerative lesion in the vicinity of the ESD scar, and histological examination of the biopsy specimen showed adenocarcinoma. A distal gastrectomy with lymph node dissection was then performed. Postoperative pathology showed tub1, pM, pN0, ly0, v0, and Stage 1A. Skip lesions were seen in the specimen resected by ESD, and the histological review confirmed so-called “dysplasia-like atypia” (DLA) between the lesions. It has been reported recently that in DLA, the dysplasia-like change involves only the bases of the pits, without upper pit or surface epithelium involvement, and it is said that the rate of DLA is higher in gastric cancer patients. We speculated that a precancerous lesion close to the resected cancer developed into a local recurrence.
Keywords dysplasia-like atypia early gastric cancer endoscopic submucosal dissection local recurrence
Amo Type Case Report
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 213
End Page 216
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339211
Web of Sience KeyUT 000379406100009
JaLCDOI 10.18926/AMO/54419
FullText URL 70_3_197.pdf
Author Takagi, Kosei| Yagi, Takahito| Yoshida, Ryuichi| Shinoura, Susumu| Umeda, Yuzo| Nobuoka, Daisuke| Kuise, Takashi| Watanabe, Nobuyuki| Sui, Kenta| Fuji, Tomokazu| Fujiwara, Toshiyoshi|
Abstract The operative mortality and morbidity of pancreaticoduodenectomy (PD) remain high. We analyzed PD patientsʼ clinical characteristics and surgical outcomes and discuss how PD clinical outcomes could be improved. We retrospectively reviewed the cases of 400 patients who underwent a PD between January 1998 and April 2014 at Okayama University Hospital, a very-high-volume center. We identified and compared the clinical outcomes between two time periods (period 1: 1998-2006 vs. period 2: 2007-2014). The total postoperative mortality and major complication rates were 0.75 and 15.8 , respectively, and the median postoperative length of stay (LOS) was 32 days. Subsequently, patients who underwent a PD during period 2 had a significantly shorter LOS than those who underwent a PD during period 1 (29 days vs. 38.5 days, p<0.001). The incidence of mortality and major complications did not differ between the two periods. In our multivariate analysis, period 1 was an independent factor associated with a long LOS (p<0.001). The improvement of the surgical procedure and perioperative care might be related to the shorter LOS in period 2 and ot the consistently maintained low mortality rate after PD. The development of multimodal strategies to accelerate postoperative recovery may further improve PDʼs clinical outcomes.
Keywords pancreaticoduodenectomy surgical outcome mortality major complication length of stay
Amo Type Original Article
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 197
End Page 203
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27339209
Web of Sience KeyUT 000379406100007
Author Fujiwara, Toshiyoshi|
Published Date 2015-02
Publication Title Okayama University Medical Research Updates
Volume volume7
Content Type Others
Author Fujiwara, Toshiyoshi|
Published Date 2014-07
Publication Title Okayama University Medical Research Updates
Volume volume1
Content Type Others
JaLCDOI 10.18926/AMO/53675
FullText URL 69_5_291.pdf
Author Sugiu, Kumi| Iwamoto, Takayuki| Kelly, Catherine M.| Watanabe, Naoki| Motoki, Takayuki| Itoh, Mitsuya| Ohtani, Shoichiro| Higaki, Kenji| Imada, Takako| Yuasa, Takeshi| Omori, Masako| Sonobe, Hiroshi| Fujiwara, Toshiyoshi| Matsuoka, Junji|
Abstract Although in the neoadjuvant setting for estrogen receptor (ER)-positive breast cancers, chemotherapy or hormone therapy alone does not result in satisfactory tumor response, it is unknown whether concurrent chemo-endocrine therapy is superior to chemotherapy alone in clinical outcomes. We conducted a randomized phase II trial to test the responses of ER-positive patients to concurrent administration of chemo-endocrine therapy in the neoadjuvant setting. Women with stage II-III, ER-positive, invasive breast cancer (n=28) received paclitaxel followed by fluorouracil, epirubicin, cyclophosphamide (T-FEC) and were randomized to receive concurrent chemo-endocrine therapy consisting of goserelin administered subcutaneously for premenopausal women or an aromatase inhibitor for postmenopausal women. The primary endpoint was the pathological complete response (pCR) rate after neoadjuvant therapy. Twenty-eight patients were randomized. There were no significant differences in pCR rate between the concurrent group (12.5%;2/16) and the chemotherapy alone group (8.3%;1/12). Tumor size after therapy was significantly reduced in the concurrent therapy group (p=0.035), but not in the chemotherapy-alone group (p=0.622). Neoadjuvant chemotherapy with concurrent hormone therapy provided no significant improvement in pCR rate in ER-positive breast cancers. These preliminary results should be followed up by further studies.
Keywords breast cancer neoadjuvant chemotherapy concurrent hormone therapy estrogen receptor positive tumor response
Amo Type Original Article
Published Date 2015-10
Publication Title Acta Medica Okayama
Volume volume69
Issue issue5
Publisher Okayama University Medical School
Start Page 291
End Page 299
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26490026
Web of Sience KeyUT 000365519600005
JaLCDOI 10.18926/AMO/53672
FullText URL 69_5_267.pdf
Author Inada, Ryo| Nagasaka, Takeshi| Kondo, Yoshitaka| Watanabe, Ayako| Toshima, Toshiaki| Kubota, Nobuhito| Kikuchi, Satoru| Ishida, Michihiro| Kuroda, Shinji| Mori, Yoshiko| Kishimoto, Hiroyuki| Fujiwara, Toshiyoshi|
Abstract The aim of this single-institution, retrospective, observational case-control study was to evaluate the safety and feasibility of laparoscopic proctocolectomy (PC) for ulcerative colitis (UC), by comparing it with a case-control series of open PC. Twenty UC patients who underwent laparoscopic PC were retrospectively compared with the open PC group of 12 patients matched for age, sex, and urgency of the operation. In the laparoscopic PC group, the operative time was significantly longer, but the amount of blood loss was significantly smaller. The open PC patients underwent an intraoperative blood transfusion significantly more often, and the serum C-reactive protein level on the first postoperative day was significantly higher in the open PC group. In the laparoscopic PC group, the rate of severe postoperative morbidities, grades 3 and 4 on the Clavien-Dindo classification, was significantly lower, and the median length of hospital stay was significantly shorter. Laparoscopic PC for patients with UC showed superior perioperative outcomes to open PC, except for longer operative time.
Keywords laparoscopic surgery total proctocolectomy open proctocolectomy ulcerative colitis case-matched study
Amo Type Original Article
Published Date 2015-10
Publication Title Acta Medica Okayama
Volume volume69
Issue issue5
Publisher Okayama University Medical School
Start Page 267
End Page 273
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26490023
Web of Sience KeyUT 000365519600002
Title Alternative Successful laparoscopic resection of a cecal tumor in a 95-year-old man
FullText URL 127_117.pdf
Author Watanabe, Ayako| Inada, Ryo| Nagasaka, Takeshi| Yagi, Tomohiko| Matsumoto, Hijiri| Toshima, Toshiaki| Kikuchi, Satoru| Kuroda, Shinshi| Kondo, Yoshitaka| Mori, Yoshiko| Kishimoto, Hiroyuki| Fujiwara, Toshiyoshi|
Abstract We report a successful laparoscopic resection of a cecal tumor in a 95-year-old Japanese man. The patient visited an initial hospital with a complaint of constipation in March 2014. Computed tomography scan and colonoscopy showed a stenotic ileocecal cancer with pericolic lymph node metastases, and he was referred to our department for management. Since his general condition was maintained, we performed a laparoscopic ileocecal resection with regional lymph node dissection for the patient. The operation achieved curative resection, and the tumor was diagnosed as a moderately differentiated adenocarcinoma and graded as pStage IIIa (pT3, pN0, pM0) according to the Japanese Classification of Colorectal Carcinoma, eighth edition. He was discharged on the 11th postoperative day without perioperative complications. Several large-scale randomized controlled trials (RCTs) revealed that laparoscopic surgeries for colorectal cancers have some advantages compared to open surgeries, including superior short-term outcomes and comparable long-term outcomes. Unfortunately, since these RCTs did not include enough elderly patients, the safety and feasibility of laparoscopic surgery for extremely elderly patients are still unknown. With respect to less-invasive procedures, these advantages of laparoscopic surgery are also thought to be the advantages for elderly colorectal cancer patients.
Keywords 超高齢者(extremely elderly patient) 大腸癌(colorectal cancer) 腹腔鏡手術(laparoscopic surgery)
Publication Title 岡山医学会雑誌
Published Date 2015-08-03
Volume volume127
Issue issue2
Start Page 117
End Page 121
ISSN 0030-1558
Related Url isVersionOf https://doi.org/10.4044/joma.127.117
language 日本語
Copyright Holders Copyright (c) 2015 岡山医学会
File Version publisher
DOI 10.4044/joma.127.117
NAID 130005096253
JaLCDOI 10.18926/AMO/53524
FullText URL 69_3_173.pdf
Author Shirakawa, Yasuhiro| Noma, Kazuhiro| Ohara, Toshiaki| Kashima, Hajime| Maeda, Naoaki| Tanabe, Shunsuke| Kagawa, Shunsuke| Fujiwara, Toshiyoshi|
Abstract A chyle leak can occur as a complication after neck or chest surgery. Such a leak prolongs the hospital stay and is sometimes life-threatening. The treatment options are conservative management, interventional radiologic embolization, and surgery. Thoracoscopic ligation of the thoracic duct has emerged as a promising and definitive treatment. The case of a 65-year-old Japanese male patient with a rare congenital right aortic arch (typeⅢB1 of Edwardʼs classification) and a severe chyle leak that occurred after a total pharyngolaryngo-esophagectomy (TPLE) is described. The chyle leak was successfully managed by thoracoscopic ligation of the thoracic duct via a left-side approach with the patient in the prone position.
Keywords chyle leak thoracic duct thoracoscopy prone position
Amo Type Case Report
Published Date 2015-06
Publication Title Acta Medica Okayama
Volume volume69
Issue issue3
Publisher Okayama University Medical School
Start Page 173
End Page 176
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26101193
Web of Sience KeyUT 000356903000006
JaLCDOI 10.18926/AMO/53340
FullText URL 69_2_113.pdf
Author Inada, Ryo| Nagasaka, Takeshi| Toshima, Toshiaki| Mori, Yoshiko| Kondo, Yoshitaka| Kishimoto, Hiroyuki| Hiraki, Takao| Oshiro, Taihei| Kanemitsu, Yukihide| Fujiwara, Toshiyoshi|
Abstract A case of advanced rectal cancer treated by aggressive local and systemic treatment who has survived more than 7 years from initial recurrence is presented. A 55-year-old woman was diagnosed with advanced lower rectal cancer and underwent a low anterior resection with complete removal of all regional lymph nodes and total mesorectal excision. The tumor was diagnosed as a moderately differentiated adenocarcinoma, pStage IIIB (T3, N2a, M0). Twenty-six months after the initial surgery, local recurrence in the pelvis was detected by computed tomography, and total pelvic exenteration with distal sacrectomy (TPES) was performed after systemic chemotherapy with a molecular-targeted drug. Six months after the TPES, multiple lung metastases were detected. Consequently, the patient underwent radiofrequency ablation (RFA) and chemotherapy. The disease has since been controlled for 38 months. As volume control is essential for cancer treatment, it may be important to combine appropriate local therapy with systemic therapy to metastatic or recurrent sites in order to achieve much longer disease control.
Keywords colorectal cancer recurrence total pelvic exenteration radiofrequency ablation systemic chemotherapy
Amo Type Case Report
Published Date 2015-04
Publication Title Acta Medica Okayama
Volume volume69
Issue issue2
Publisher Okayama University Medical School
Start Page 113
End Page 118
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25899633
Web of Sience KeyUT 000353181700006
Author Kikuchi, Satoru| Kishimoto, Hiroyuki| Tazawa, Hiroshi| Hashimoto, Yuuri| Kuroda, Shinji| Nishizaki, Masahiko| Nagasaka, Takeshi| Shirakawa, Yasuhiro| Kagawa, Shunsuke| Urata, Yasuo| Robert M Hoffman| Fujiwara, Toshiyoshi|
Published Date 2014-12-19
Publication Title Molecular Therapy
Content Type Journal Article
Author Kondo, Yoshitaka| Nagasaka, Takeshi| Kobayashi, Satoru| Kobayashi, Naoya| Fujiwara, Toshiyoshi|
Published Date 2014-03
Publication Title Hepato-Gastroenterology
Volume volume61
Issue issue130
Content Type Journal Article