| 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 |
| Publication Title | Acta Medica Okayama |
| Published Date | 2016-06 |
| 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 | English |
| Copyright Holders | CopyrightⒸ 2016 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 27339209 |
| Web of Science 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 |
| Publication Title | Acta Medica Okayama |
| Published Date | 2015-10 |
| 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 | English |
| Copyright Holders | CopyrightⒸ 2015 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 26490026 |
| Web of Science 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 |
| Publication Title | Acta Medica Okayama |
| Published Date | 2015-10 |
| 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 | English |
| Copyright Holders | CopyrightⒸ 2015 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 26490023 |
| Web of Science 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 | Japanese |
| 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 |
| Publication Title | Acta Medica Okayama |
| Published Date | 2015-06 |
| 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 | English |
| Copyright Holders | CopyrightⒸ 2015 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 26101193 |
| Web of Science 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 |
| Publication Title | Acta Medica Okayama |
| Published Date | 2015-04 |
| 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 | English |
| Copyright Holders | CopyrightⒸ 2015 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 25899633 |
| Web of Science 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 |
| JaLCDOI | 10.18926/AMO/53024 |
|---|---|
| FullText URL | 68_6_349.pdf |
| Author | Yamamoto, Tsuyoshi| Kajikawa, Yutaka| Otani, Satoru| Yamada, Yuki| Takemoto, Syunji| Hirota, Minoru| Ikeda, Masae| Iwagaki, Hiromi| Saito, Shinya| Fujiwara, Toshiyoshi| |
| Abstract | Accumulated studies have shown that ω-3 polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) have protective roles against inflammatory responses such as hyperlipidemia, diabetes mellitus (DM) and cardiovascular diseases. Here we examined the effects of administering EPA to hyperlipidemic patients and other patients undergoing cardiac surgery to determine whether this treatment would increase plasma EPA levels and to clarify the association between EPA treatment and adiponectin production in hyperlipidemic patients. We also assessed the effect of preoperative EPA administration on postoperative adverse events such as postoperative atrial fibrillation (POAF) and postoperative infection in the cardiac surgery patients. The EPA administration significantly increased the serum EPA concentrations in both patient populations (p＜0.001). In the hyperlipidemic patients, the EPA administration significantly increased plasma adiponectin levels (p＜0.05), accompanied by a decrease in insulin resistance designated by the HOMA-IR (homeostasis model assessment of insulin resistance) score (p＜0.05) and Hs-CRP (high sensitivity C-reactive protein) value (p＜0.05). In the cardiac surgery patients, no significant effect of EPA on cardiac adverse events such as POAF was observed. However, our results clearly demonstrated that both the neutrophil-to-lymphocyte ratio and the 2nd-line antibiotic requirement in the EPA group were significantly decreased compared to the untreated control group (p＜0.05). We suggest that EPA administration may exert anti-inflammatory effects in patients with hyperlipidemia and in those undergoing cardiac surgery, possibly through an increase in plasma adiponectin levels. |
| Keywords | eicosapentaenoic acid adiponectin hyperlipidemic patients cardiac surgery atrial fibrillation |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-12 |
| Volume | volume68 |
| Issue | issue6 |
| Publisher | Okayama University Medical School |
| Start Page | 349 |
| End Page | 361 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 25519029 |
| Web of Science KeyUT | 000346882200005 |
| Related Url | http://ousar.lib.okayama-u.ac.jp/metadata/53125 |
| Author | Shigeyasu, Kunitoshi| Tazawa, Hiroshi| Hashimoto, Yuuri| Mori, Yoshiko| Nishizaki, Masahiko| Kishimoto, Hiroyuki| Nagasaka, Takeshi| Kuroda, Shinji| Urata, Yasuo| Goel, Ajay| Kagawa, Shunsuke| Fujiwara, Toshiyoshi| |
|---|---|
| Published Date | 2014-05-28 |
| Publication Title | Gut |
| Content Type | Journal Article |
| Author | Yamada, Eiji| Shirakawa, Yasuhiro| Yamatsuji, Tomoki| Sakuma, Leon| Takaoka, Munenori| Yamada, Takako| Noma, Kazuhiro| Sakurama, Kazufumi| Fujiwara, Yasuhiro| Tanabe, Shunsuke| Nagasaka, Takeshi| Fujiwara, Toshiyoshi| Naomoto, Yoshio| |
|---|---|
| Published Date | 2012-12 |
| Publication Title | Journal of Surgical Research |
| Volume | volume178 |
| Issue | issue2 |
| Content Type | Journal Article |
| JaLCDOI | 10.18926/AMO/52898 |
|---|---|
| FullText URL | 68_5_291.pdf |
| Author | Tsuzaki, Ryuichiro| Takaki, Akinobu| Yagi, Takahito| Ikeda, Fusao| Koike, Kazuko| Iwasaki, Yoshiaki| Shiraha, Hidenori| Miyake, Yasuhiro| Sadamori, Hiroshi| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Nobuoka, Daisuke| Utsumi, Masashi| Nakayama, Eiichi| Fujiwara, Toshiyoshi| Yamamoto, Kazuhide| |
| Abstract | It is not known how the immune system targets hepatitis C virus (HCV)-infected HLA-mismatched hepatocytes under immune-suppressed conditions after orthotopic liver transplantation (OLT). In addition, the relationship between the HCV-specific immune response and IL28B variants as predictors of HCV clearance has not been well-characterized. We determined the IL28B polymorphisms for 57 post-OLT HCV carriers, and we assessed the HCV-specific immune responses by measuring the peripheral blood mononuclear cell-derived HCV-specific interferon-gamma (IFN-γ) response using an enzyme-linked immunospot assay. At 1-3 years after OLT, patients with no active hepatitis showed higher total spots on the immunospot assay. At＞3 years after OLT, patients with resolved HCV showed higher levels of core, NS3, NS5A, and total spots compared to the chronic hepatitis patients. The IL28B major genotype in the donors correlated with higher spot counts for NS5A and NS5B proteins at 1-3 years after OLT. In the post-OLT setting, the HCV-specific immune response could be strongly induced in patients with no active hepatitis with an IL28B major donor or sustained virological response. Strong immune responses in the patients with no active hepatitis could only be maintained for 3 years and diminished later. It may be beneficial to administer IFN treatment starting 3 years after OLT, to induce the maximum immunological effect. |
| Keywords | interferon gamma ELISPOT assay single nucleotide polymorphisms dendritic cell CD4 T cell |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-10 |
| Volume | volume68 |
| Issue | issue5 |
| Publisher | Okayama University Medical School |
| Start Page | 291 |
| End Page | 302 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 25338486 |
| Web of Science KeyUT | 000343269300006 |
| Related Url | http://ousar.lib.okayama-u.ac.jp/metadata/53129 |
| Author | Itoh, Mitsuya| Iwamoto, Takayuki| Matsuoka, Junji| Nogami, Tomohiro| Motoki, Takayuki| Shien, Tadahiko| Taira, Naruto| Niikura, Naoki| Hayashi, Naoki| Ohtani, Shoichiro| Higaki, Kenji| Fujiwara, Toshiyoshi| Doihara, Hiroyoshi| Symmans, W. Fraser| Pusztai, Lajos| |
|---|---|
| Published Date | 2014-01 |
| Publication Title | Breast Cancer Research and Treatment |
| Volume | volume143 |
| Issue | issue2 |
| Content Type | Journal Article |
| Author | Yano, Shuya| Tazawa, Hiroshi| Hashimoto, Yuuri| Shirakawa, Yasuhiro| Kuroda, Shinji| Nishizaki, Masahiko| Kishimoto, Hiroyuki| Uno, Futoshi| Nagasaka, Takeshi| Urata, Yasuo| Kagawa, Shunsuke| Hoffman, Robert M.| Fujiwara, Toshiyoshi| |
|---|---|
| Published Date | 2013-12-01 |
| Publication Title | Clinical Cancer Research |
| Volume | volume19 |
| Issue | issue23 |
| Content Type | Journal Article |
| JaLCDOI | 10.18926/AMO/52407 |
|---|---|
| FullText URL | 68_2_111.pdf |
| Author | Shirakawa, Yasuhiro| Noma, Kazuhiro| Maeda, Naoaki| Katsube, Ryoichi| Tanabe, Shunsuke| Ohara, Toshiaki| Sakurama, Kazufumi| Fujiwara, Toshiyoshi| |
| Abstract | Thoracoscopic esophagectomy in the prone position (TEPP) might enable solo-surgery in cases requiring resection of the esophagus and the surrounding lymph nodes due to the associated advantages of good exposure of the surgical field and ergonomic considerations for the surgeon. However, no one approach can be for all patients requiring extensive lymphadenectomy. We recently developed an assistant-based procedure to standardize exposure of the surgical field. Patients were divided into 1 of 2 groups:a pre-standardization group (n＝37) and a post-standardization group (n＝28). The thoracoscopic operative time was significantly shorter (p＝0.0037) in the post-standardization group (n＝28; 267±31min) than in the pre-standardization group (n＝37;301±53min). Further, learning curve analysis using the moving average method showed stabilization of the thoracoscopic operative time after the standardization. No significant differences were found in the number of mediastinal lymph nodes dissected or intraoperative blood loss between the 2 groups. There were also no significant differences in the complication rate. Assistant-based surgery and standardization of the procedure resulted in a well-exposed and safe surgical field. TEPP decreased the operative time, even in patients requiring extensive lymphadenectomy. |
| Keywords | thoracoscopic esophagectomy prone position standardization |
| Amo Type | Original Article |
| Publication Title | Acta Medica Okayama |
| Published Date | 2014-04 |
| Volume | volume68 |
| Issue | issue2 |
| Publisher | Okayama University Medical School |
| Start Page | 111 |
| End Page | 117 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| Content Type | Journal Article |
| language | English |
| Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
| File Version | publisher |
| Refereed | True |
| PubMed ID | 24743786 |
| Web of Science KeyUT | 000334652700006 |
| Author | Fujiwara, Y.| Yamada, T.| Naomoto, Y.| Yamatsuji, T.| Shirakawa, Y.| Tanabe, S.| Noma, K.| Kimura, T.| Aoki, H.| Matsukawa, H.| Kimura, M.| Nonaka, Y.| Sasaki, H.| Onoda, T.| Otawa, Y.| Takaoka, M.| Fukazawa, T.| Ohno, Y.| Fujiwara, T.| |
|---|---|
| Published Date | 2013-12 |
| Publication Title | Journal of Hospital Infection |
| Volume | volume85 |
| Issue | issue4 |
| Content Type | Journal Article |
| Title Alternative | A patient with primary malignant melanoma of the esophagus who underwent esophagectomy |
|---|---|
| FullText URL | 126_45.pdf |
| Author | Maeda, Naoaki| Shirakawa, Yasuhiro| Koujima, Takeshi| Ohara, Toshiaki| Tanabe, Shunsuke| Noma, Kazuhiro| Sakurama, Kazuhumi| Fujiwara, Toshiyosi| |
| Abstract | We report the case of a 61-old-man with a primary malignant melanoma of the esophagus, an extremely rare and highly aggressive malignancy. He presented with dysphagia, and we performed an upper gastrointestinal endoscopy that detected a tumor in the thoracic part of the esophagus. The biopsy showed malignant melanoma. PET/CT, endoscopy and an esophagogram showed that a 70-mm scaled type 2+1 tumor in the thoracic esophagus and no metastases. We diagnosed a cT3cN0cM0 cStage II tumor. We then performed a subtotal esophagectomy with two-field lymph node dissection and esophagogastrostomy via a retrosternal route. The pathological examination of the resected specimens confirmed that the type 2+1 tumor was PMME (pT2N0M0 pStage II). We administered six courses of postoperative adjuvant chemotherapy with dacarbazine, and the patient has had no recurrence for 17 months after the surgery. |
| Keywords | 食道（esophagus） 悪性黒色腫（malignant melanoma） |
| Publication Title | 岡山医学会雑誌 |
| Published Date | 2014-04-01 |
| Volume | volume126 |
| Issue | issue1 |
| Start Page | 45 |
| End Page | 48 |
| ISSN | 0030-1558 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2014 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.126.45 |
| NAID | 130004505808 |
| Title Alternative | Complete response of primary esophageal endocrine cell carcinoma resected after neoadjuvant chemotherapy with docetaxel/cisplatin/5-fluorouracil |
|---|---|
| FullText URL | 126_39.pdf |
| Author | Maeda, Naoaki| Shirakawa, Yasuhiro| Koujima, Takeshi| Ohara, Toshiaki| Tanabe, Shunsuke| Noma, Kazuhiro| Sakurama, Kazuhumi| Fujiwara, Toshiyosi| |
| Abstract | Esophageal endocrine cell carcinoma is extremely rare. We report a case of esophageal endocrine cell carcinoma showing histological complete response to neoadjuvant chemotherapy with docetaxel/cisplatin/5-fluorouracil (DCF). A 66-year-old man had been experiencing epigastralgia, and a type 2 tumor in the thoracic part of esophagus was detected by upper endoscopy. The biopsy showed endocrine cell carcinoma. PET/CT, endoscopy and an esophagogram showed that the patient had a 70-mm scaled type 2 tumor in the middle thoracic esophagus, and they also revealed lymph node metastases (no. 106recR). We diagnosed a cT3cN1cM0 cStage III tumor. With two courses of DCF treatment, both the primary tumor and lymph node metastases showed a partial response. We performed a subtotal esophagectomy with three-field lymph node dissection. The pathological examination of the resected specimens revealed no malignant cells in the esophagus or lymph nodes, and we concluded that the pathological effect of the DCF treatment was Grade 3. |
| Keywords | 食道癌（esophageal cancer） 内分泌細胞癌（endocrine cell carcinoma） DCF療法（DCF treatment） |
| Publication Title | 岡山医学会雑誌 |
| Published Date | 2014-04-01 |
| Volume | volume126 |
| Issue | issue1 |
| Start Page | 39 |
| End Page | 43 |
| ISSN | 0030-1558 |
| language | Japanese |
| Copyright Holders | Copyright (c) 2014 岡山医学会 |
| File Version | publisher |
| DOI | 10.4044/joma.126.39 |
| NAID | 130004505807 |
