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権 英寿医学部附属病院 肝胆膵外科助教
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■ 論文- Springer Science and Business Media LLC, 2025年01月, Langenbeck's Archives of Surgery, 410(1) (1)研究論文（学術雑誌）
- Abstract Purpose This study aimed to evaluate the efficacy of indocyanine green (ICG)-fluorescence imaging for the identification of hepatic boundaries during liver resection and its advantages in surgical outcomes over conventional methods. Methods This prospective, exploratory, single-arm clinical trial included 47 patients with liver tumors who underwent liver resection using ICG-fluorescence imaging (ICG-LR) between 2019 and 2020. The primary outcome measure was the successful identification of hepatic boundaries during liver resection, from the perspective of both the hepatic surface and intrahepatic boundary, using ICG-fluorescence imaging. The secondary outcomes comprised surgical outcomes. Using propensity score matching (PSM), the surgical outcomes were subsequently compared between the ICG-LR group and patients who underwent conventional liver resection (C-LR, n = 100) between 2017 and 2018. Results Hepatic boundaries were successfully identified in 28 patients (60%; 95% confidence interval, 45–72%), including 21 and 7 who underwent anatomical and non-anatomical liver resection, respectively. After PSM, 40 patients were included in each of the ICG-LR and C-LR groups. The surgical outcomes were similar between the groups. Subsequently, surgical outcomes were compared between the groups focusing on anatomical liver resection. After PSM, 21 patients were included in each group. The ICG-LR group had a lower rate of Clavien–Dindo grade ≥ IIIa complications (0% vs. 24%; P = 0.017), including ascites and bile leak, and a shorter hospital stay (12 vs. 14 days, P = 0.041) than the C-LR group did. Conclusion ICG-fluorescence imaging could be used to recognize hepatic boundaries during liver transection. Additionally, ICG-LR may be useful in preventing severe liver-associated complications. Trial registration number This study is registered at the UMIN Clinical Trials Registry: UMIN0000180139 and Japan Registry of Clinical Trials: jRCT1051180070. The Registration Data Set is available at https://jrct.niph.go.jp/.Springer Science and Business Media LLC, 2025年01月, Langenbeck's Archives of Surgery, 410(1) (1)研究論文（学術雑誌）
- Anticancer Research USA Inc., 2024年12月, Anticancer Research, 45(1) (1), 251 - 260研究論文（学術雑誌）
- Springer Science and Business Media LLC, 2024年11月, Annals of Surgical Oncology, 32(2) (2), 1116 - 1116研究論文（学術雑誌）
- Springer Science and Business Media LLC, 2024年10月, Annals of Surgical Oncology, 32(1) (1), 448 - 449研究論文（学術雑誌）
- BACKGROUND: Particle therapy (PT) as an initial hepatocellular carcinoma (HCC) treatment has been reported to be effective; however, its efficacy for the treatment of recurrent HCC remains unclear. OBJECTIVE: This study aimed to evaluate the efficacy of PT compared with repeat liver resection for treating recurrent HCC after initial LR, with a focus on prognostic outcomes. METHODS: Between 2005 and 2019, 89 and 49 patients underwent repeat LR and PT for recurrent HCC after initial LR, respectively. The 5-year overall survival (OS) and recurrence-free survival (RFS) were evaluated using propensity score matching. Treatment-related complications were scored using the National Institute Common Terminology Criteria for Adverse Events (CTCAE) and were compared between the repeat LR and PT groups. RESULTS: In the entire cohort, the 5-year OS was significantly better in the repeat LR group than in the PT group (75% vs. 48%; p = 0.0003), and the 5-year RFS was comparable in both groups (22% vs. 13%; p = 0.088). Propensity score matching created 34 pairs of patients; no significant differences in the 5-year OS (65% vs. 48%; p = 0.310) and RFS (21% vs. 8%; p = 0.271) were observed between the repeat LR and PT groups. The proportion of CTCAE grade ≥3 complications was 8.8% and 5.9% in the repeat LR and PT groups, respectively (p = 0.641). CONCLUSIONS: After initial LR, the prognosis and treatment-related complications in patients with recurrent HCC were comparable between the repeat LR and PT groups in the matched cohort; therefore, PT may remain one of the multidisciplinary treatment options for recurrent HCC.2024年10月, Annals of surgical oncology, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Preoperative recognition of the anatomy of caudate biliary branches is important for the safe and complete resection of perihilar cholangiocarcinoma (PHC). In the present study, we identified these branches using an endoscopic nasobiliary drainage tube (ENBD). METHODS: Between January 2012 and October 2022, 89 patients with suspected PHC underwent computed tomographic (CT) cholangiography through ENBD and caudate biliary branching patterns were examined. Multidetector raw CT (MDCT) scans on 85 patients with PHC without biliary drainage were also investigated. The caudate biliary branches detected by each modality were evaluated. RESULTS: ENBD-CT cholangiography detected 206 caudate branches (2.44 branches/patient), while MDCT identified 62 branches (0.78 branches/patient). ENBD-CT cholangiography showed that 89 caudate branches drained into the left hepatic duct (LHD), 87 into the posterior hepatic duct (Bpost), and 30 into the right hepatic duct. LHD and Bpost were the common roots of the caudate branches. Some branches (20%) joined the contralateral hepatic duct across the left-right border, but not the anterior hepatic duct or infraportal-type Bpost. CONCLUSIONS: ENBD-CT cholangiography clearly showed the caudate biliary branches in patients with PHC after biliary drainage.2024年09月, Journal of hepato-biliary-pancreatic sciences, 英語, 国内誌研究論文（学術雑誌）
- (一社)日本癌学会, 2024年09月, 日本癌学会総会記事, 83回, J - 1021, 英語肝細胞癌におけるDKK1-CKAP4シグナル軸の予後因子としての機能解析および新規治療標的としての可能性の検討(An analysis of DKK1-CKAP4 signaling as a prognostic factor and potential therapeutic target of hepatocellular carcinoma)
- (株)へるす出版, 2024年09月, 消化器外科, 47(9) (9), 1059 - 1070, 日本語【肝癌診療2024】肝細胞癌集学的治療の進歩
- BACKGROUND: Systemic inflammation and altered metabolism are essential hallmarks of cancer. We hypothesized that the rapid turnover protein transthyretin (TTR) (half-life: 2-3 days), compared with the conventional marker albumin (21 days), better reflects the inflammatory/metabolic dynamics of pancreatic ductal adenocarcinoma (PDAC) after neoadjuvant therapy (NAT) and is a useful prognostic marker. METHODS: Serum TTR and albumin levels were measured in 104 consecutive post-NAT PDAC patients before curative resection. The associations of preoperative TTR and albumin levels with overall survival (OS) after pancreatectomy were retrospectively analyzed. RESULTS: The mean (SD) TTR and albumin levels were 21.6 (6.4) mg/dL (normal range: ≥22.0 mg/dL) and 3.9 (0.55) g/dL. A low (<22.0 mg/dL) post-NAT TTR level was associated with an advanced tumor stage and higher CEA and CRP levels. Patients with low TTR levels showed significantly worse OS compared with normal levels (3-year OS 39 % vs. 54 %, P = 0.037), although albumin levels did not. We modified prognostic biomarkers of systemic inflammation/metabolism, such as GPS, PNI, and CONUT scores, using the serum TTR instead of albumin level and successfully showed that modified scores were better associated with OS compared with original scores using serum albumin level. CONCLUSIONS: Our data suggest that the TTR level is a promising prognostic biomarker for PDAC patients after NAT.2024年09月, Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.], 24(6) (6), 917 - 924, 英語, 国際誌研究論文（学術雑誌）
- PURPOSE: The technical difficulties of laparoscopic liver resection (LLR) are greatly associated with the location of liver tumors. Since segment 8 (S8) contains a wide area, the difficulty of LLR for S8 tumors may vary depending on the location within the segment, such as the ventral (S8v) and dorsal (S8d) area, but the difference is unclear. METHODS: We retrospectively investigated 30 patients who underwent primary laparoscopic partial liver resection for liver tumors in S8 at Kobe University Hospital between January 2018 and June 2023. RESULTS: Thirteen and 17 patients underwent LLR for S8v and S8d, respectively. The operation time was significantly longer (S8v 203[135-259] vs. S8d 261[186-415] min, P = 0.002) and the amount of blood loss was significantly higher (10[10-150] vs. 10[10-200] mL, P = 0.034) in the S8d group than in the S8v group. No significant differences were observed in postoperative complications or postoperative length of hospital stay. Additionally, intraoperative findings revealed that the rate at which the case performed partial liver mobilization in the S8d group was higher (2[15.4%] vs. 8[47.1%], P = 0.060) and the median parenchymal transection time of the S8d group was longer (102[27-148] vs. 129[37-175] min, P = 0.097) than those in the S8v group, but there were no significant differences. CONCLUSION: The safety of LLR for the S8d was comparable to that of LLR for S8v, although LLR for S8d resulted in longer operative time and more blood loss. THE TRIAL REGISTRATION NUMBER: B230165 (approved at December 26, 2023).2024年08月, Langenbeck's archives of surgery, 409(1) (1), 243 - 243, 英語, 国際誌研究論文（学術雑誌）
- 日本膵・胆管合流異常研究会, 2024年08月, 日本膵・胆管合流異常研究会プロシーディングス, 47, 16 - 16, 日本語
- 症例は49歳,男性。2021年に胆嚢癌に対して開腹胆嚢摘出術を施行された。進行癌であったため,術後3ヵ月に肝床切除,肝外胆管切除,肝十二指腸間膜リンパ節郭清を施行されたが,悪性所見は認めなかった。術後12ヵ月に造影CT,MRIで肝S8に新規腫瘤性病変を認め,胆嚢癌術後肝転移再発と診断された。当院に紹介後,GEM+CDDP(GC)療法1コース,GEM+CDDP+durvalumab(GCD)療法8コースを施行され,造影CT,MRIで転移巣は縮小し,PET検査でもFDG集積は認めなくなった。化学療法終了後2ヵ月を経ても転移巣の増大や遠隔転移を含め新たな転移を認めなかった。治癒切除が期待できたため,腹腔鏡下肝S8部分切除術を施行した。病理診断では腫瘍性病変の残存は認めず,病理学的完全奏効であった。全身化学療法で転移巣が良好に制御できれば,胆道癌肝転移に対する肝切除も治療の選択肢となり得る。(著者抄録)(株)癌と化学療法社, 2024年08月, 癌と化学療法, 51(8) (8), 843 - 845, 日本語
- PURPOSE: The impact of postoperative bile leak on the prognosis of patients with hepatocellular carcinoma who underwent liver resection is controversial. This study aimed to investigate the prognostic impact of bile leak for patients with hepatocellular carcinoma who underwent liver resection. METHODS: Patients with hepatocellular carcinoma who underwent liver resection between 2009 and 2019 at Kobe University Hospital and Hyogo Cancer Center were included. After propensity score matching between the bile leak and no bile leak groups, differences in 5-year recurrence-free and overall survival rates were evaluated using the Kaplan-Meier method. RESULTS: A total of 781 patients, including 43 with postoperative bile leak, were analyzed. In the matched cohort, 40 patients were included in each group. The 5-year recurrence-free survival rates after liver resection were 35% and 32% for the bile leak and no bile leak groups, respectively (P = 0.857). The 5-year overall survival rates were 44% and 54% for the bile leak and no bile leak groups, respectively (P = 0.216). CONCLUSION: Overall, bile leak may not have a profound negative impact on the prognosis of patients with hepatocellular carcinoma who have undergone liver resection.2024年07月, Langenbeck's archives of surgery, 409(1) (1), 233 - 233, 英語, 国際誌研究論文（学術雑誌）
- Tremelimumab plus durvalumab (Dur/Tre) is the first-line treatment for advanced hepatocellular carcinoma (HCC) worldwide. The present report describes the case of a 68-year-old man diagnosed with advanced HCC and a bile duct tumor thrombus (BDTT) who achieved a complete response to Dur/Tre therapy. The BDTT progressed to the bifurcation of the left and right hepatic ducts. Over time, both the tumors and BDTT progressively decreased in size, and a complete response was confirmed using the Response Evaluation Criteria in Solid Tumors (version 1.1.) 6 months after treatment administration. Subsequently, immune-related adverse events, including type 1 diabetes mellitus and diabetic ketoacidosis, emerged, leading to treatment discontinuation. The patient was undergoing outpatient follow-up in a drug-free state with no signs of recurrence 290 days after the initial administration of Dur/Tre. Although long-term and meticulous observations are required, the present findings could influence the choice of systemic chemotherapy for advanced HCC.2024年07月, Oncology letters, 28(1) (1), 332 - 332, 英語, 国際誌
- (一社)日本肝臓学会, 2024年05月, 肝臓, 65(5) (5), 256 - 257, 日本語急性肝不全患者に対する脳死肝移植待機中に腹直筋血腫を合併し管理に難渋した一例
- Anticancer Research USA Inc., 2024年04月, Anticancer Research, 44(5) (5), 2055 - 2061研究論文（学術雑誌）
- Anticancer Research USA Inc., 2024年04月, Anticancer Research, 44(5) (5), 2031 - 2038研究論文（学術雑誌）
- (一社)日本外科学会, 2024年04月, 日本外科学会定期学術集会抄録集, 124回, SF - 1, 日本語開腹および腹腔鏡下膵体尾部切除後のドレーンアミラーゼ値による適切なドレーン管理の検討
- BACKGROUND: Drainage fluid amylase (DFA) is useful for predicting clinically relevant postoperative pancreatic fistula (CR-POPF) after distal pancreatectomy (DP). However, difference in optimal cutoff value of DFA for predicting CR-POPF between open DP (ODP) and laparoscopic DP (LDP) has not been investigated. This study aimed to identify the optimal cutoff values of DFA for predicting CR-POPF after ODP and LDP. METHODS: Data for 294 patients (ODP, n = 127; LDP, n = 167) undergoing DP at Kobe University Hospital between 2010 and 2021 were reviewed. Propensity score matching was performed to minimize treatment selection bias. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cutoff values of DFA for predicting CR-POPF for ODP and LDP. Logistic regression analysis for CR-POPF was performed to investigate the diagnostic value of DFA on postoperative day (POD) three with identified cutoff value. RESULTS: In the matched cohort, CR-POPF rates were 24.7% and 7.9% after ODP and LDP, respectively. DFA on POD one was significantly lower after ODP than after LDP (2263 U/L vs 4243 U/L, p < 0.001), while the difference was not significant on POD three (543 U/L vs 1221 U/L, p = 0.171). ROC analysis revealed that the optimal cutoff value of DFA on POD one and three for predicting CR-POPF were different between ODP and LDP (ODP, 3697 U/L on POD one, 1114 U/L on POD three; LDP, 10564 U/L on POD one, 6020 U/L on POD three). Multivariate analysis showed that DFA on POD three with identified cutoff value was the independent predictor for CR-POPF both for ODP and LDP. CONCLUSIONS: DFA on POD three is an independent predictor for CR-POPF after both ODP and LDP. However, the optimal cutoff value for it is significantly higher after LDP than after ODP. Optimal threshold of DFA for drain removal may be different between ODP and LDP.2024年03月, Surgical endoscopy, 英語, 国際誌研究論文（学術雑誌）
- Spontaneous rupture of a primary hepatocellular carcinoma (HCC) is a frequently observed and fatal complication. However, the rupture of lymph node (LN) metastases from HCC is rare. A 79 year-old male with hepatitis B underwent three liver resections for HCC. Two years and 6 months after the last liver resection, enhanced computed tomography (CT) revealed a nodule with a diameter of 3 cm in the lower pole of the spleen. Splenic metastasis of HCC was suspected, and splenectomy was scheduled. During our hospital stay for a urinary tract infection before the scheduled operation, he complained of acute left-sided abdominal pain, and CT showed intra-abdominal hemorrhage due to rupture of the splenic tumor. Emergency splenectomy was performed, and the postoperative course was uneventful. Histopathological examination revealed a poorly differentiated HCC in the lower splenic pole lesion, which contained LN structures. The ruptured lesion was diagnosed as splenic hilar LN metastasis of HCC. Although laparoscopic partial liver resection was performed for intrahepatic recurrence, and atezolizumab plus bevacizumab therapy was administered for peritoneal metastases, the patient was alive 25 months after the splenectomy. Our case suggests that emergency surgery for LN metastatic rupture can achieve hemostasis and lead to improved survival outcomes.2024年02月, Clinical journal of gastroenterology, 英語, 国内誌研究論文（学術雑誌）
- AIM: The IMbrave150 trial revealed that atezolizumab plus bevacizumab (AtezoBv) showed a higher objective response rate (ORR) in patients with advanced hepatocellular carcinoma (HCC). Although conversion therapy after AtezoBv has been recently reported, markers predictive of its efficacy, particularly radiological imaging markers, have not yet been identified. The present study focused on tumor morphological appearance on radiological imaging and evaluated whether it could be associated with AtezoBv efficacy. METHODS: Ninety-five intrahepatic lesions in 74 patients who were given AtezoBv for advanced HCC were recruited for evaluation. The lesions were divided into two groups, simple nodular (SN group) and non-simple nodular (non-SN group), based on the gross morphology on pretreatment imaging, and retrospectively evaluated for treatment response and other relevant clinical outcomes. RESULTS: Assessing the size of individual tumors after treatment, waterfall plots showed that tumor shrinkage in the non-SN group including 56 lesions was higher than that in the SN group comprising 39 lesions. The ORR was significantly higher in the non-SN group (39.3% vs. 15.4%, p = 0.012). Additionally, the median time to nodular progression was longer in the non-SN group (21.0 months vs. 8.1 months, p = 0.119) compared to the SN group. Six patients with non-SN lesions underwent sequential local therapy. CONCLUSIONS: Atezolizumab plus bevacizumab may show increased therapeutic efficacy in patients with tumors with a higher potential for aggressive oncological behavior, such as non-SN lesions. Treatment strategies focusing on conversion therapy may be crucial in patients with non-SN lesions.2024年02月, Hepatology research : the official journal of the Japan Society of Hepatology, 英語, 国際誌研究論文（学術雑誌）
- INTRODUCTION: Surgical resection is considered an effective cure for biliary tract cancer (BTC); however, the prognosis is unsatisfactory despite improved surgical techniques and perioperative management. The recurrence rate remains high even after curative resection. The efficacy of adjuvant chemotherapy in pancreatic and gastric cancers has been previously reported, and the feasibility of adjuvant therapy with S-1 has recently been reported in patients with resected BTC. We aimed to retrospectively investigate the effects of adjuvant chemotherapy with S-1 on resected advanced BTC. METHODS: We included data from 438 BTC patients who underwent resection between 2001 and 2020. After excluding patients with pTis-pT1 (n = 112) and other exclusion criteria, 266 patients were included in the analysis. RESULTS: After propensity score matching, 48 patients received S-1 adjuvant chemotherapy (S-1 group), and 48 patients received non-S1 adjuvant chemotherapy or underwent surgery alone (Non-S-1 group). The patients in the S-1 group had significantly better overall survival (OS) than those in the non-S-1 group (MST 51 vs 37 months, hazard ratio [HR]:.54, 95% confidence interval [CI]:.30-.98, P = .04). The S-1 group had a significantly better recurrence-free survival (RFS) than the non-S-1 group (94 vs 21 months, HR: .57, 95% CI: .33-.97, P = .03). Subgroup analyses for OS and RFS exhibited the benefits of S-1 in patients aged <75 years and in patients with primary sites of extrahepatic and perineural invasion and curability of R0. DISCUSSION: S-1 adjuvant therapy is promising for improving the postoperative survival of patients with resected advanced BTC, positive nerve invasion, and R0 resection.2024年01月, The American surgeon, 31348241227188 - 31348241227188, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Venous thromboembolism (VTE) is a potentially fatal complication of hepatectomy. The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative bleeding. Therefore, we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after hepatectomy. AIM: To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after hepatectomy. METHODS: The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively analyzed. Patients were divided into two groups according to whether or not they developed VTE after hepatectomy, as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower extremities. Clinicopathological factors, including demographic data and perioperative D-dimer values, were compared between the two groups. Receiver operating characteristic curve analysis was performed to determine the D-dimer cutoff value. Univariate and multivariate analyses were performed using logistic regression analysis to identify significant predictors. RESULTS: In total, 234 patients who underwent hepatectomy were, of whom (5.6%) were diagnosed with VTE following hepatectomy. A comparison between the two groups showed significant differences in operative time (529 vs 403 min, P = 0.0274) and blood loss (530 vs 138 mL, P = 0.0067). The D-dimer levels on postoperative days (POD) 1, 3, 5, 7 were significantly higher in the VTE group than in the non-VTE group. In the multivariate analysis, intraoperative blood loss of > 275 mL [odds ratio (OR) = 5.32, 95% confidence interval (CI): 1.05-27.0, P = 0.044] and plasma D-dimer levels on POD 5 ≥ 21 μg/mL (OR = 10.1, 95%CI: 2.04-50.1, P = 0.0046) were independent risk factors for VTE after hepatectomy. CONCLUSION: Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the postoperative period.2024年01月, World journal of clinical cases, 12(2) (2), 276 - 284, 英語, 国際誌研究論文（学術雑誌）
- INTRODUCTION: The usefulness of gadolinium-ethoxybenzyl diethylenetriamine pentaacetate acid-enhanced magnetic resonance imaging (EOB-MRI) in assessing the functional future remnant liver volume (fFRLV) to predict post-hepatectomy liver failure (PHLF) has been previously reported. Herein, we evaluated the efficacy of this technique in patients with hepatocellular carcinoma (HCC) with a major portal vein tumor thrombus (PVTT). METHODS: This study included 21 patients with PVTT in the ipsilateral first-order branch (Vp3) and 30 patients with PVTT in the main trunk/contralateral branch (Vp4). To evaluate fFRLV, the signal intensity (SI) of the remnant liver was determined on T1-weighted images, using both conventional and newly developed methods. The fFRLV was calculated using the SI of the remnant liver and muscle, remnant liver volume, and body surface area. Preoperative factors predicting PHLF (≥grade B) in HCC patients with Vp3/4 PVTT were evaluated. RESULTS: In the Vp3 group, we found fFRLV AUCs above 0.70 (AUC = 0.875, 0.750) using EOB-MRI results calculated using either the plot or whole method. None of the parameters in the Vp4 group had an AUC greater than 0.70. CONCLUSION: The fFRLV calculated by EOB-MRI using the whole method can be as useful as the conventional method in predicting PHLF (≥grade B) for HCC patients with Vp3 PVTT.2024年01月, Digestive surgery, 英語, 国際誌研究論文（学術雑誌）
- 症例は72歳,男性。閉塞性黄疸で発症し,精査にて十二指腸乳頭部癌と診断した。造影CTにて腹腔動脈起始部狭窄による総肝動脈狭窄および膵頭部アーケード(PDA)拡張を認め,肝動脈血流は上腸間膜動脈からPDAを介して供給されていると推察した。正中弓状靱帯圧迫症候群を示唆する所見はなく,腹腔動脈(CA)起始部に石灰化を認めたため,成因は動脈硬化性と診断した。術中の胃十二指腸動脈(GDA)クランプテストにて明らかな肝動脈血流の低下を認めなかったが,CAの術後の開存性を懸念し,左大伏在静脈グラフトにて下膵十二指腸動脈-GDAバイパス術および亜全胃温存膵頭十二指腸切除術を施行した。術後経過は良好で,術後24日目に退院となった。自験例と同様の病態下では,本再建法は一つの選択肢として考慮できる再建法である。(著者抄録)(株)癌と化学療法社, 2023年12月, 癌と化学療法, 50(13) (13), 1534 - 1536, 日本語
- (株)医薬情報研究所, 2023年11月, 新薬と臨牀, 72(11) (11), 955 - 955, 日本語
- (一社)日本消化器外科学会, 2023年11月, 日本消化器外科学会雑誌, 56(Suppl.2) (Suppl.2), 365 - 365, 日本語当院における術後胆管狭窄症例に対する対応と検討
- (一社)日本消化器外科学会, 2023年11月, 日本消化器外科学会雑誌, 56(Suppl.2) (Suppl.2), 366 - 366, 日本語肝外胆管癌切除後S-1補助化学療法例におけるGLIM基準の有用性に関する検討
- (一社)日本消化器外科学会, 2023年11月, 日本消化器外科学会雑誌, 56(Suppl.2) (Suppl.2), 529 - 529, 日本語肝切除術後の門脈血栓症に対するエドキサバンの治療成績
- (一社)日本消化器外科学会, 2023年11月, 日本消化器外科学会雑誌, 56(Suppl.2) (Suppl.2), 536 - 536, 日本語肝門部胆管癌術後の術後胆汁漏の検討
- (一社)日本消化器外科学会, 2023年11月, 日本消化器外科学会雑誌, 56(Suppl.2) (Suppl.2), 538 - 538, 日本語肝外胆管癌における術前骨格筋量減少の術後早期再発への影響
- (一財)日本消化器病学会, 2023年10月, 日本消化器病学会雑誌, 120(臨増大会) (臨増大会), A825 - A825, 日本語
- BACKGROUND: Postoperative cholangitis is a common complication of pancreaticoduodenectomy. Frequent cholangitis impairs patients' quality of life after pancreaticoduodenectomy. However, the risk factors for recurrence of cholangitis remain unclear. Hence, this retrospective study aimed to identify risk factors for recurrence of cholangitis after pancreaticoduodenectomy. METHODS: The medical records of patients who underwent pancreaticoduodenectomy between 2015 and 2019 in our institution were retrospectively reviewed. At least two episodes of cholangitis a year after pancreaticoduodenectomy were defined as 'recurrence of cholangitis' in the present study. Univariate and multivariate analyses were performed. RESULTS: The recurrence of cholangitis occurred in 40 of 207 patients (19.3%). Multivariate analysis revealed that internal stent (external, RR: 2.16, P = 0.026; none, RR: 4.76, P = 0.011), firm pancreas (RR: 2.61, P = 0.021), constipation (RR: 3.49, P = 0.008), and postoperative total bilirubin>1.7 mg/dL (RR: 2.94, P = 0.006) were risk factors of recurrence of cholangitis. Among patients with internal stents (n = 54), those with remnant stents beyond 5 months had more frequent recurrence of cholangitis (≥5 months, 75%; <5 months, 30%). CONCLUSIONS: Internal stents, firm pancreas, constipation, and postoperative high bilirubin levels are risk factors for cholangitis recurrence after pancreaticoduodenectomy. In addition, the long-term implantation of internal stents may trigger cholangitis recurrence.2023年10月, World journal of surgery, 47(10) (10), 2499 - 2506, 英語, 国際誌研究論文（学術雑誌）
- 日本膵・胆管合流異常研究会, 2023年09月, 日本膵・胆管合流異常研究会プロシーディングス, 46, 30 - 30, 日本語
- Springer Science and Business Media LLC, 2023年07月, Surgical Endoscopy研究論文（学術雑誌）
- UNLABELLED: Wnt signaling is known to maintain two cell states, hepatocyte differentiation and proliferation, in hepatocellular carcinoma (HCC). On the other hand, activation of Wnt signaling in colon cancer promotes uncontrollable stereotypic proliferation, whereas cells remain undifferentiated. To elucidate the unique mode of Wnt signaling in HCC, we comprehensively investigated HCC-specific Wnt pathway target genes and identified GREB1. Wnt signaling induced expression of GREB1 coupled with HNF4α and FOXA2, master transcription factors that maintain hepatic differentiation. Moreover, GREB1 was enriched at the regulatory region of atypical HNF4α target genes, including progrowth genes, thereby stimulating HCC proliferation. Therefore, GREB1 acts as a unique mediator of versatile Wnt signaling in HCC progression, bridging the roles of the Wnt pathway in differentiation and proliferation. SIGNIFICANCE: GREB1 is a liver cancer-specific Wnt signaling target gene that induces an oncogenic shift of HNF4α, a putative tumor suppressor, and may represent a therapeutic target in Wnt-activated hepatocellular carcinoma.2023年07月, Cancer research, 83(14) (14), 2312 - 2327, 英語, 国際誌研究論文（学術雑誌）
- 2023年07月, Annals of surgical oncology, 30(11) (11), 6613 - 6614, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Few reports have discussed the association between total tumor volume (TTV) and prognosis in patients with colorectal liver metastases (CRLM). The present study aimed to evaluate the usefulness of TTV for predicting recurrence-free survival and overall survival (OS) in patients receiving initial hepatic resection or chemotherapy, and to investigate the value of TTV as an indicator for optimal treatment selection for patients with CRLM. PATIENTS AND METHODS: This retrospective cohort study included patients with CRLM who underwent hepatic resection (n = 93) or chemotherapy (n = 78) at the Kobe University Hospital. TTV was measured using 3D construction software and computed tomography images. RESULTS: A TTV of 100 cm3 has been previously reported as a significant cut-off value for predicting OS of CRLM patients receiving initial hepatic resection. For patients receiving hepatic resection, the OS for those with a TTV ≥ 100 cm3 was significantly reduced compared with those with a TTV < 100 cm3. For patients receiving initial chemotherapy, there were no significant differences between the groups divided according to TTV cut-offs. Regarding OS of patients with TTV ≥ 100 cm3, there was no significant difference between hepatic resection and chemotherapy (p = 0.160). CONCLUSIONS: TTV can be a predictive factor of OS for hepatic resection, unlike for initial chemotherapy treatment. The lack of significant difference in OS for CRLM patients with TTV ≥ 100 cm3, regardless of initial treatment, suggests that chemotherapeutic intervention preceding hepatic resection may be indicated for such patients.2023年06月, Annals of surgical oncology, 30(11) (11), 6603 - 6610, 英語, 国際誌研究論文（学術雑誌）
- Transarterial chemoembolization (TACE) is performed for pancreatic neuroendocrine tumor (PanNEN) liver metastases; however, the safety and efficacy of TACE procedures, especially for patients who have undergone previous pancreatic surgery, have not been established. We reviewed 48 TACE procedures (1-6 procedures/patient) performed on 11 patients with PanNEN liver metastases, including 16 TACE procedures (4-6 procedures/patient) for 3 patients with a history of biliary-enteric anastomosis. The overall tumor objective response rate was 94%. The incidence of Clavien‒Dindo grade ≥ 2 complications was 1/16 (6%) and 1/32 (3%), and the median time to untreatable progression was 31 (14-41) and 27 (2-60) months among patients with and without a history of biliary-enteric anastomosis, respectively. Although validation is needed in future studies, our experiences have shown that TACE treatment is a viable treatment option for PanNEN liver metastases, even after biliary-enteric anastomosis with experienced teams and careful patient follow-up.2023年06月, Surgery today, 英語, 国内誌研究論文（学術雑誌）
- BACKGROUND: Less intra-abdominal adhesions are expected following laparoscopic surgery. Although an initial laparoscopic approach for primary liver tumors may have advantages in patients who require repeat hepatectomies for recurrent liver tumors, this has not been sufficiently investigated. METHODS: Patients who underwent repeat hepatectomies for recurrent liver tumors at our hospital between 2010 and 2022 were retrospectively analyzed. Of 127 patients, 76 underwent laparoscopic repeat hepatectomy (LRH), of whom 34 patients initially underwent laparoscopic hepatectomy (L-LRH) and 42, open hepatectomy (O-LRH). Fifty-one patients underwent open hepatectomy as both the initial and second operation (O-ORH). We analyzed surgical outcomes between L-LRH and O-LRH groups and between L-LRH and O-ORH groups using propensity-matching analysis for each pattern. RESULTS: Twenty-one patients each were included in L-LRH and O-LRH propensity-matched cohorts. The L-LRH group had a lower rate of postoperative complications than the O-LRH group (0 vs 19%, P = 0.036). When we compared surgical outcomes between L-LRH and O-ORH groups in another matched cohort with 18 patients in each group, in addition to the lower rate of postoperative complications, the L-LRH group had additional favorable surgical outcomes including shorter operation time and lower blood loss volume than the O-ORH group (291 vs 368 min, P = 0.037 and 10 vs 485 mL, P < 0.0001). CONCLUSIONS: An initial laparoscopic approach would be favorable for patients undergoing repeat hepatectomies, as it leads to lower risk of postoperative complications. Compared with O-ORH, the advantage of the laparoscopic approach may be enhanced when it is repeatedly adopted.2023年06月, Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 27(8) (8), 1621 - 1631, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND/AIM: Recently, the Global Leadership Initiative on Malnutrition (GLIM), which includes the world's leading clinical nutrition societies, proposed the first global diagnostic criteria for malnutrition. However, the association between malnutrition diagnosed by the GLIM criteria and prognosis in patients with resected extrahepatic cholangiocarcinoma (ECC) remains unknown. This study aimed to investigate the predictive validity of the GLIM criteria for the prognosis of patients with resected ECC. PATIENTS AND METHODS: Between 2000 and 2020, 166 patients who underwent curative-intent resection for ECC were retrospectively analyzed. Prognostic significance of preoperative malnutrition diagnosed by the GLIM criteria was investigated using a multivariate Cox proportional hazards model. RESULTS: Eighty-five (51.2%) and 46 (27.7%) patients were diagnosed with moderate and severe malnutrition, respectively. Increased malnutrition severity tended to be correlated with increased lymph node metastasis rate (p-for-trend=0.0381). The severe malnutrition group had worse 1-, 3-, and 5-year overall survival rates than the normal (without malnutrition) group (82.2% vs. 91.2%, 45.6% vs. 65.1%, 29.3% vs. 61.5%, respectively, p=0.0159). In multivariate analysis, preoperative severe malnutrition was an independent predictor for poor prognosis (hazard ratio=1.68, 95% confidence interval=1.06-2.66, p=0.0282), along with intraoperative blood loss >1,000 ml, lymph node metastasis, perineural invasion, and curability. CONCLUSION: Severe preoperative malnutrition diagnosed by the GLIM criteria was associated with poor prognosis in patients who underwent curative-intent resection for ECC.2023年05月, Anticancer research, 43(5) (5), 2299 - 2308, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Post-transplantation weight control is important for long-term outcomes; however, few reports have examined postoperative weight change. This study aimed to identify perioperative factors contributing to post-transplantation weight change. METHODS: Twenty-nine patients who underwent liver transplantation between 2015 and 2019 with an overall survival of >3 years were analyzed. RESULTS: The median age, model for end-stage liver disease score, and preoperative body mass index (BMI) of the recipients were 57, 25, and 23.7, respectively. Although all but one recipient lost weight, the percentage of recipients who gained weight increased to 55% (1 month), 72% (6 months), and 83% (12 months). Among perioperative factors, recipient age ≤50 years and BMI ≤25 were identified as risk factors for weight gain within 12 months (P < .05), and patients with age ≤50 years or BMI ≤25 recipients gained weight more rapidly (P < .05). The recovery time of serum albumin level ≥4.0 mg/dL was not statistically different between the 2 groups. The weight change during the first 3 years after discharge was represented by an approximately straight line, with 18 and 11 recipients showing a positive and negative slope, respectively. Body mass index ≤23 was identified as a risk factor for a positive slope of weight gain (P <.05). CONCLUSIONS: Although postoperative weight gain implies recovery after transplantation, recipients with a lower preoperative BMI should strictly manage body weight as they may be at higher risk of rapid weight increase.2023年04月, Transplantation proceedings, 55(4) (4), 924 - 929, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本外科学会, 2023年04月, 日本外科学会定期学術集会抄録集, 123回, HFT - 2, 日本語Under 40外科医が専門医取得の次に目指すもの
- (一社)日本外科学会, 2023年04月, 日本外科学会定期学術集会抄録集, 123回, SY - 2, 日本語正確な局所解剖に基づいた肝細胞癌に対する合理的肝切除術とは 初回再発形式からみる表在性肝細胞癌に対する非系統的切除術の妥当性に関する検討
- (一社)日本外科学会, 2023年04月, 日本外科学会定期学術集会抄録集, 123回, SF - 6[Y], 日本語胆道癌に対するS-1術後補助化学療法と早期再発の関連
- (一社)日本外科学会, 2023年04月, 日本外科学会定期学術集会抄録集, 123回, DP - 7, 日本語肝移植後長期成績向上のために,何が必要か
- (一社)日本外科学会, 2023年04月, 日本外科学会定期学術集会抄録集, 123回, DP - 3, 日本語治療成績から見た大腸癌肝転移における切除可能性分類と治療戦略
- (一社)日本外科学会, 2023年04月, 日本外科学会定期学術集会抄録集, 123回, DP - 3, 日本語当科における吸収性スペーサー留置術22例の臨床経過
- (一社)日本外科学会, 2023年04月, 日本外科学会定期学術集会抄録集, 123回, DP - 3, 日本語肝細胞癌切除症例におけるGLIM基準と予後の関連
- (一社)日本外科学会, 2023年04月, 日本外科学会定期学術集会抄録集, 123回, DP - 2, 日本語右肝葉切除を施行した肝門部領域胆管癌の再考 左側からの切除の可能性
- (一社)日本外科学会, 2023年04月, 日本外科学会定期学術集会抄録集, 123回, DP - 8, 日本語肝門部領域胆管癌に対する術前門脈塞栓術施行例の検討
- (一社)日本外科学会, 2023年04月, 日本外科学会定期学術集会抄録集, 123回, DP - 6, 日本語肝外胆管癌切除後の早期再発予測におけるGLIM基準の有用性
- (一社)日本外科学会, 2023年04月, 日本外科学会定期学術集会抄録集, 123回, DP - 7, 日本語肝外胆管癌切除後予後因子としてのGLIM基準の有用性に関する検討
- (一社)日本外科学会, 2023年04月, 日本外科学会定期学術集会抄録集, 123回, DP - 2, 日本語十二指腸乳頭部癌におけるC-reactive protein to albumin ratio(CAR)の予後への影響
- (一社)日本外科学会, 2023年04月, 日本外科学会定期学術集会抄録集, 123回, DP - 5, 日本語術前NLR値と胆嚢癌の予後との関連
- (一社)日本外科学会, 2023年04月, 日本外科学会定期学術集会抄録集, 123回, DP - 3, 日本語胆道癌における術後静脈血栓症と血漿Dダイマーの関連性の検討
- (一社)日本肝臓学会, 2023年04月, 肝臓, 64(Suppl.1) (Suppl.1), A416 - A416, 日本語切除不能肝内胆管癌に対する粒子線治療の成績
- (一社)日本肝臓学会, 2023年04月, 肝臓, 64(Suppl.1) (Suppl.1), A385 - A385, 日本語肝細胞癌肉眼分類とアテゾリズマブ・ベバシズマブ併用療法の治療効果に関する検討
- (一財)日本消化器病学会, 2023年03月, 日本消化器病学会雑誌, 120(臨増総会) (臨増総会), A328 - A328, 日本語
- (一財)日本消化器病学会, 2023年03月, 日本消化器病学会雑誌, 120(臨増総会) (臨増総会), A400 - A400, 日本語
- (一財)日本消化器病学会, 2023年03月, 日本消化器病学会雑誌, 120(臨増総会) (臨増総会), A413 - A413, 日本語
- 兵庫県外科医会, 2023年03月, 兵庫県外科医会会誌, 57, 21 - 21, 日本語横隔膜腹腔側に発生したsolitary fibrous tumorの1例
- 72歳女性。右季肋部痛を主訴に前医を受診し、右横隔膜原発の腫瘍を指摘され、精査加療目的で当院へ紹介となった。腹部CT検査では右横隔膜と連続した9cm大で、不均一な造影効果を伴う境界明瞭な腫瘤が認められた。また、腹部MRI検査ではT1強調画像にて筋組織と同程度の低信号ほか、T2強調画像にて高信号を呈する腫瘤が認められた。以上、これらの所見を踏まえて、針生検を施行したところ、採取されたのは壊死組織のみで、診断には困難であった。そこで、右横隔膜原発の腫瘍とみなし、開腹下に腫瘍を切除した結果、病理組織学的に右横隔膜腹腔側に発生したsolitary fibrous tumorと確定診断された。術後1年経過現在、無再発生存中である。兵庫県外科医会, 2023年03月, 兵庫県外科医会会誌, 57, 13 - 15, 日本語
- Hepatocellular carcinoma (HCC) is the most prevalent malignant liver neoplasm. Despite the advances in diagnosis and treatment, the prognosis of HCC patients remains poor. Cytoskeleton-associated membrane protein 4 (CKAP4) is a receptor of the glycosylated secretory protein Dickkopf-1 (DKK1), and the DKK1-CKAP4 axis is activated in pancreatic, lung, and esophageal cancer cells. DKK1 and CKAP4 expression have been examined in HCC in independent studies that yielded contradictory results. In this study, the relationship between the DKK1-CKAP4 axis and HCC was comprehensively examined. In 412 HCC cases, patients whose tumors were positive for both DKK1 and CKAP4 had a poor prognosis compared to those who were positive for only one of these markers or negative for both. Deletion of either DKK1 or CKAP4 inhibited HCC cell growth. In contrast to wild-type DKK1, DKK1 lacking the CKAP4 binding region did not rescue the phenotypes caused by DKK1 depletion, suggesting that binding of DKK1 to CKAP4 is required for HCC cell proliferation. Anti-CKAP4 antibody inhibited HCC growth, and its antitumor effect was clearly enhanced when combined with lenvatinib, a multi-kinase inhibitor. These results indicate that simultaneous expression of DKK1 and CKAP4 is involved in the aggressiveness of HCC, and that the combination of anti-CKAP4 antibody and other therapeutics including lenvatinib may represent a promising strategy for treating advanced HCC.2023年01月, Cancer science, 114(5) (5), 2063 - 2077, 英語, 国際誌研究論文（学術雑誌）
- Successful Management of Refractory Autoimmune Hemolytic Anemia with Cold Agglutinin Disease with Splenectomy: A Case Report with Review of Literature.BACKGROUND: Cold agglutinin disease (CAD) is a rare autoimmune hemolytic anemia characterized by agglutination of red blood cells at temperatures below the normal core body temperature. In patients with CAD, splenectomy is not indicated because of its low therapeutic effect on hemolytic anemia induced by extravascular hemolysis. Herein, we report a case of refractory hemolytic anemia with CAD successfully managed with splenectomy. CLINICAL CASE: A 60-year-old man visited a municipal hospital with the chief complaint of fatigue. He was found to have hemolytic anemia and icterus with increased cold agglutination and was diagnosed with CAD. Malignant lymphoma was suspected as the underlying disease; however, no clear underlying disease was identified. Hemolytic anemia progressed during the subsequent winter seasons, and he was treated with temperature control, warming, and weekly blood transfusions. However, despite the blood transfusions, his hemoglobin level did not improve during the summer 2 years after diagnosis, and his previously observed splenomegaly had progressed. He was referred to our department, and a splenectomy was performed to diagnose any occult malignant lymphoma and improve the refractory hemolytic anemia. Because histopathological examination revealed no evidence of malignant lymphoma, a diagnosis of primary CAD was made. The hemolytic anemia improved, and no blood transfusion was required after splenectomy. CONCLUSIONS: Splenectomy significantly improved the patient's refractory hemolytic anemia due to primary CAD. Thus, it may be an effective treatment option in such cases, although further cases and studies are required to evaluate the effects of splenectomy.2023年01月, The Kobe journal of medical sciences, 68(1) (1), E30-E34, 英語, 国内誌研究論文（学術雑誌）
- BACKGROUND: Bile leakage is a major complication after liver transplantation and remains as a significant source of morbidity and mortality. In 2011, the International Study Group of Liver Surgery (ISGLS) defined bile leakage as a drain/serum bilirubin ratio ≥3. However, to our knowledge there is no literature assessing serum and drain bilirubin concentrations after liver transplantation. The aim of this study was to describe the natural postoperative changes in serum and drain fluid bilirubin concentrations in patients after liver transplantation. METHODS: We included 32 patients who underwent liver transplantation at Kobe University Hospital from January 2007 to December 2020. We enrolled 34 living donors who had no complications as the control group. RESULTS: The recipient serum total/direct bilirubin concentration were higher compared with the donors from postoperative day (POD) 1 to 5 with a statistical difference (P < .05). The recipient drain/serum total bilirubin ratio was lower than donors on POD 3 (0.89 ± 0.07 vs 1.53 ± 0.07: P < .0001), which was also confirmed by the recipient drain/serum direct bilirubin ratio (0.64 ± 0.10 vs 1.18 ± 0.09: P < .0001). On POD 3, the drain fluid volume (647.38 ± 89.47 vs 113.43 ± 86.8 mL: P < .001) and serum total bilirubin concentration (6.73 ± 0.61 vs 1.23 ± 0.60 mg/dL: P < .001) was higher in the recipients than in donors. Categorized in 2 groups, the higher drain fluid volume and bilirubin concentration recipients showed lower drain/serum total bilirubin ratio compared with the other group (P = .03) CONCLUSION: The drain/serum bilirubin ratio in the transplanted patients could be calculated lower compared with the hepatectomy patients because of high drain fluid volume and hyperbilirubinemia. Great care should be taken when assessing the bile leakage in liver transplant recipients using the ISGLS definition.2023年01月, Transplantation proceedings, 55(1) (1), 184 - 190, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Laparoscopic caudate lobe resection is a challenging procedure. Several researchers have reported the safety of laparoscopic liver resections;1.Transl Gastroenterol Hepatol. 1:56;2.Asian J Endosc Surg. 12:232-236;3.Ann Surg Oncol. 26:2980; however, a standardized procedure has not yet been established. Herein, we present a video showing laparoscopic Spiegel lobectomy in a patient with 6-cm hepatocellular carcinoma (HCC) using a novel approach. PATIENT AND METHODS: A 63-year-old man with a caudate lobe HCC was referred to our hospital. Computed tomography showed a 5 × 6 cm2 HCC located in the Spiegel lobe, which profoundly displaced the inferior vena cava (IVC) to the lower right side, and mobilization of the Spiegel lobe was considered difficult. To perform the dissection between the Siegel lobe and IVC safely, we performed parenchymal transection along the ventral side of the IVC initially. The Spiegel lobe was then dislocated to the left side of the IVC. We dissected the left lateral side of the IVC, including the proper hepatic vein draining the caudate lobe and the left IVC ligament with a safe operative field, and successfully removed the Spiegel lobe with large HCC. RESULTS: The operation time was 383 min. The blood loss was 10 mL. The patient was discharged on the seventh postoperative day without any complications. Histopathological examination revealed well-differentiated HCC with a negative surgical margin. CONCLUSIONS: Laparoscopic medial-to-lateral approach with initial parenchymal transection at the medial side of the Spiegel lobe followed by dissection of the left lateral side of the IVC is considered as a safe and effective procedure for large tumors in the Spiegel lobe.2023年01月, Annals of surgical oncology, 30(1) (1), 381 - 382, 英語, 国際誌研究論文（学術雑誌）
- 2023年01月, Annals of surgical oncology, 30(1) (1), 383 - 383, 英語, 国際誌研究論文（学術雑誌）
- INTRODUCTION: With the aging of the population in Japan, gallbladder cancer (GBC) in the elderly is increasing. However, the available clinical data are limited, and the optimal treatment is still controversial. The aim of this study was to evaluate the benefit of surgical resection in GBC patients ≥75 years of age. METHODS: A retrospective single center analysis of patients who had undergone surgical resection for GBC between 2000 and 2019 was carried out. Patients aged ≥75 years (elderly group, n = 24) or <75 years (younger group, n = 50) were compared. RESULTS: Both younger and elderly patients exhibited similar clinicopathological characteristics, but comorbidity in the latter was significantly greater, as was the frequency of less invasive surgery. Nonetheless, the incidence of postoperative complications was similar in elderly and younger patients. The proportion of patients receiving adjuvant chemotherapy was lower in the elderly. Overall survival of elderly and younger patients was not significantly different (65.0 vs 62.4% at 5 years, P = .600). In multivariate analysis, residual tumor status but not age was an independent prognostic factor. DISCUSSION: This study demonstrated that appropriate surgical treatment of elderly GBC patients was safe and effective, despite their having more comorbidities and lower rates of adjuvant chemotherapy than younger patients.2022年11月, The American surgeon, 31348221136570 - 31348221136570, 英語, 国際誌研究論文（学術雑誌）
- (株)医薬情報研究所, 2022年11月, 新薬と臨牀, 71(11) (11), 1234 - 1234, 日本語
- BACKGROUND: Anatomic liver resection (ALR) has been established to eliminate the tumor-bearing hepatic region with preservation of the remnant liver volume for liver malignancies. Recently, laparoscopic ALR has been widely applied; however, there are few reports on laparoscopic segmentectomy 2. This study aimed to present the standardization of laparoscopic segmentectomy 2 with surgical outcomes. METHODS: This study included seven patients who underwent pure laparoscopic segmentectomy 2 by the Glissonean approach from January 2020 to December 2021. Four of them had hepatocellular carcinoma, two had colorectal liver metastasis, and one had hepatic angiomyolipoma, which was preoperatively diagnosed with hepatocellular carcinoma. In all patients, preoperative three-dimensional (3D) simulation images from dynamic CT were reconstructed using a 3D workstation. The layer between the hepatic parenchyma and the Glissonean pedicle of segment 2 (G2) was dissected to encircle the root of G2. After clamping or ligation of the G2, 2.5 mg of indocyanine green was injected intravenously to identify the boundaries between segments 2 and 3 with a negative staining method under near-infrared light. Parenchymal transection was performed from the caudal side to the cranial side according to the demarcation on the liver surface, and the left hepatic vein was exposed on the cut surface if possible. RESULTS: The mean operative time for all patients was 281 min. The mean blood loss was 37 mL, and no transfusion was necessary. Estimated liver resection volumes significantly correlated with actual liver resection volumes (r = 0.61, P = 0.035). After the operation, one patient presented with asymptomatic deep venous and pulmonary thrombosis, which was treated with anticoagulant therapy. The mean length of hospital stay was 8.9 days. CONCLUSION: Laparoscopic segmentectomy 2 by the Glissonean approach is a feasible and safe procedure with the preservation of the nontumor-bearing segment 3 for liver tumors in segment 2.2022年11月, Surgical endoscopy, 36(11) (11), 8600 - 8606, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND/AIM: Atezolizumab plus bevacizumab and lenvatinib are the key drugs in the current systemic chemotherapeutic regimen for hepatocellular carcinoma (HCC). Studies have reported the potential effectiveness of lenvatinib introduction after an atezolizumab plus bevacizumab treatment; however, the therapeutic effectiveness of a lenvatinib rechallenge after an atezolizumab plus bevacizumab treatment remains unclear. PATIENTS AND METHODS: Thirteen consecutive patients who were rechallenged with lenvatinib after clinical failure following treatments with lenvatinib and atezolizumab plus bevacizumab were included. A comparative study was conducted on the duration and treatment efficacy of the first and second lenvatinib treatments and on the pre- and post-treatment liver function. RESULTS: The median ratios of the 1-month post-treatment alpha-fetoprotein (AFP) levels to the pretreatment AFP levels were 0.750 and 0.667 for the first and second lenvatinib treatments, respectively, without significant difference (p=0.9327). Meanwhile, the median ratios of the 1-month post-treatment albumin-bilirubin (ALBI) scores to the pretreatment ALBI scores were 1.063 and 0.827 for the first and second lenvatinib treatments, respectively, with significant difference (p=0.015). The median duration of the second lenvatinib treatment was significantly shorter than that of the first lenvatinib treatment [2.8 months (range=0.9-4.7 months) vs. 8.7 months (range=3.1-29.7 months)]. CONCLUSION: Lenvatinib re-administration after atezolizumab plus bevacizumab treatment can act as a double-edged sword, as it exerts an anti-tumor effect while being associated with potential liver function deterioration. However, this treatment sequence can be useful, and requires careful monitoring of the transitions in the liver function and the patient's performance status.2022年11月, Anticancer research, 42(11) (11), 5479 - 5486, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本肝臓学会, 2022年10月, 肝臓, 63(Suppl.3) (Suppl.3), A744 - A744, 日本語初回再発形式からみる肝細胞癌の腫瘍位置と初回再発形式に関する検討
- (一社)日本癌治療学会, 2022年10月, 日本癌治療学会学術集会抄録集, 60回, OWS14 - 7, 英語進行肝細胞がんに対する新しい治療戦略と集学的治療の明日 神戸大学における肝癌集学的治療の現状
- (一社)日本癌治療学会, 2022年10月, 日本癌治療学会学術集会抄録集, 60回, O66 - 3, 英語膵・胆道癌の腹腔洗浄細胞診における、剥離細胞分析装置LC-1000の有用性に関する研究
- (一社)日本消化器外科学会, 2022年10月, 日本消化器外科学会雑誌, 55(Suppl.2) (Suppl.2), 180 - 180, 日本語膵頭十二指腸切除術後の早期胆管炎リスク因子の検討
- (一社)日本消化器外科学会, 2022年10月, 日本消化器外科学会雑誌, 55(Suppl.2) (Suppl.2), 226 - 226, 日本語肝動脈化学塞栓療法を中心とした膵神経内分泌腫瘍肝転移に対する集学的治療
- (一社)日本Acute Care Surgery学会, 2022年09月, Japanese Journal of Acute Care Surgery, 12(Suppl.) (Suppl.), 149 - 149, 日本語がん化学療法中の急性胆嚢炎症例の検討
- Portal vein thrombosis (PVT) is a lethal complication of hepatectomy if not properly treated. An 81-year-old woman diagnosed with postoperative PVT after right hepatectomy and caudate lobectomy for perihilar cholangiocarcinoma. Elevation of serum total bilirubin levels, D-dimer levels, and glossy ascites appeared on postoperative day 5 (POD5), and a contrast-enhanced CT confirmed PVT. Thrombi were found from the umbilical portion of the portal vein to the superior mesenteric vein. There were signs of acute liver failure due to thrombi obstructing the portal vein. Therefore, emergent catheter thrombus aspiration was performed under laparotomy. An aspiration catheter was inserted into the superior mesenteric vein from the ileocolic vein. We performed direct aspiration thrombectomy, followed by anticoagulant administration using urokinase via the catheter. Partial recanalization of the portal vein and superior mesenteric vein was observed. To dissolve residual thrombi, edoxaban administration was started on POD6. Contrast-enhanced CT 16 days after her additional operation showed the thrombi had completely disappeared. The patient was discharged on POD76. She had no recurrence of PVT over the next 6 months. Combination therapy of early intervention using aspiration catheter and systemic anticoagulant medication was useful for severe postoperative PVT accompanied with liver failure.2022年06月, Clinical journal of gastroenterology, 15(5) (5), 981 - 987, 英語, 国内誌研究論文（学術雑誌）
- BACKGROUND: Resecting liver tumors located in Couinaud's segment VII is challenging; the efficacy and safety of laparoscopic liver resection for segment VII lesions compared to open liver resection remain unclear. METHODS: Medical records of 84 patients who underwent liver resection of segment VII at Kobe University Hospital and Hyogo Cancer Center between 2010 and 2021 were retrospectively analyzed. Surgical outcomes were compared between laparoscopic liver resection and open liver resection groups using propensity matching analysis. RESULTS: Thirty-one and 53 patients underwent laparoscopic liver resection and open liver resection, respectively. After propensity matching, 29 patients were included in each group. The laparoscopic liver resection group had a significantly longer operation time (407 vs. 305 min, P = 0.002), lower blood loss (100 vs. 230 mL, P = 0.004), and higher postoperative alanine aminotransferase levels (436 vs. 252 IU/L, P = 0.008) than the open liver resection group. In patients with liver cirrhosis, the proportion of patients with postoperative liver-specific complications was higher in the laparoscopic liver resection group than in the open liver resection group (57% vs 11%, P = 0.049), although there was no significant difference in postoperative liver-specific complication rates between the groups in patients without liver cirrhosis. CONCLUSIONS: For liver resection of segment VII, laparoscopic liver resection led to higher postoperative liver damage than open liver resection. Open liver resection may be better for patients with liver cirrhosis to avoid postoperative liver-specific complications. Laparoscopic liver resection could be an acceptable procedure for patients without liver cirrhosis, with some merits such as less blood loss.2022年06月, Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 26(11) (11), 2274 - 2281, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本外科学会, 2022年04月, 日本外科学会定期学術集会抄録集, 122回, SF - 2, 日本語膵頭十二指腸切除術後の早期胆管炎リスク因子の検討
- (一社)日本外科学会, 2022年04月, 日本外科学会定期学術集会抄録集, 122回, SF - 4, 日本語膵・胆道癌における剥離細胞分析装置LC-1000の腹水細胞診支援システムとしての臨床応用可能性に関する探求的研究
- (一社)日本外科学会, 2022年04月, 日本外科学会定期学術集会抄録集, 122回, DP - 7, 日本語当院における術前補助療法後に切除を施行したBR膵癌とconversion手術を施行したUR-LA膵癌の治療成績の比較
- (一社)日本外科学会, 2022年04月, 日本外科学会定期学術集会抄録集, 122回, DP - 7, 日本語膵頭十二指腸切除後患者に対するアミノ酸製剤を用いた術後栄養療法の有用性
- BACKGROUND: Optimal treatment strategies for advanced hepatocellular carcinoma (HCC) with macroscopic portal vein tumor thrombus (PVTT) remain controversial. Therefore, this study aimed to assess the impact and predictive factors of hepatectomy for HCC with macroscopic PVTT. METHODS: This study included 100 patients who presented with intraoperatively confirmed PVTT extending to the first portal branch (Vp3), main portal trunk, or opposite-side portal branch (Vp4) between June 2000 and December 2019. Their postoperative outcomes and predictive factors for survival were evaluated. RESULTS: Of the 100 patients, 37 (37%) and 63 (63%) had Vp3 and Vp4 PVTTs, respectively. Moreover, 42 (42%) and 58 (58%) patients underwent R0/1 and R2 hepatectomies, respectively. The median survival time (MST) of all patients with Vp3/4 PVTT was 14.5 months; the 1- and 3-year overall survival rates were 59.6 and 16.8%, respectively. The MSTs of patients with Vp3 and Vp4 PVTTs were 16.1 and 14.3 months, respectively (P = 0.7098). The MSTs of patients who underwent R0/1 and R2 hepatectomies were 14.3 and 14.9 months, respectively (P = 0.3831). All assessed tumor factors (including the Vp status [Vp3 or Vp4], type of resection [R0/1 or R2], intrahepatic maximal tumor size, intrahepatic tumor number, and the existence of extrahepatic metastasis) did not influence the overall survival significantly. CONCLUSIONS: Tumor factors, such as the presence of a Vp3/4 PVTT, have a strong impact on survival; however, other multiple tumor factors have a limited impact. Hepatectomy can be an effective treatment option for HCC with Vp3/4 PVTT, and its indications should be considered.2022年04月, Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 26(4) (4), 822 - 830, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) has a high recurrence rate even after curative resection. Lung recurrence may have better outcomes than other recurrences. However, its detailed clinicopathological features are unclear. We investigated the clinicopathological features and risk factors for lung recurrence after pancreatectomy for PDAC. METHODS: The study included 161 patients with potentially and borderline resectable PDAC who had undergone R0 or R1 pancreatectomy between January 2008 and December 2016. We retrospectively examined the prognosis and predictors for lung recurrence after curative resection. RESULTS: Seventeen patients (10.6%) had isolated lung recurrence. The median overall and recurrence-free survivals were 38.0 and 16.1 months, respectively. In multivariate analysis, para-aortic lymph node (PALN) metastasis (p = 0.006) and female sex (p = 0.027) were independent factors for lung recurrence. CONCLUSION: Lung recurrence had a better prognosis than other recurrences. PALN metastasis and female sex are independent risk factors for lung recurrence after curative resection for PDAC.2022年03月, Asian journal of surgery, 46(1) (1), 207 - 212, 英語, 国際誌研究論文（学術雑誌）
- 日本消化器病学会-近畿支部, 2022年02月, 日本消化器病学会近畿支部例会プログラム・抄録集, 116回, 131 - 131, 日本語膵中央切除術後に多発残膵再発をきたし残膵全摘術を施行した膵胆道型(pancreatobiliary type)IPMCの1例
- INTRODUCTION: Although the relationship between systemic inflammatory responses and prognosis has been known in various cancers, it remains unclear which scores are most valuable for determining the prognosis of extrahepatic cholangiocarcinoma. We aimed to verify the usefulness of various inflammation-based scores as prognostic factors in patients with resected extrahepatic cholangiocarcinoma. METHODS: We analyzed consecutive patients undergoing surgical resection for extrahepatic cholangiocarcinoma at our institution between January 2000 and December 2019. The usefulness of the following inflammation-based scores as prognostic factor was investigated: Glasgow prognostic score (GPS), modified Glasgow prognostic score (mGPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), prognostic nutrition index (PNI), C-reactive protein to albumin ratio (CAR), controlling nutritional status (CONUT), and prognostic index (PI). RESULTS: A total of 169 patients were enrolled in this study. Of the nine scores, CAR and CONUT indicated prognostic value. Furthermore, multivariate analysis for overall survival revealed that high CAR (>0.23) was an independent prognostic factor (HR: 1.816, 95%CI: 1.135-2.906, p=0.0129), along with lymph node metastasis and curability. There was no difference in tumor staging and short-term outcomes between the low CAR (≤ 0.23) and high CAR groups. CONCLUSIONS: CAR was the most valuable prognostic score in patients with resected extrahepatic cholangiocarcinoma.2022年01月, Digestive surgery, 39(2-3) (2-3), 65 - 74, 英語, 国際誌研究論文（学術雑誌）
- 未分化多形肉腫(UPS)は四肢軟部組織に好発する非上皮性悪性腫瘍である。高率に転移を来し、好発部位は肺、リンパ節、肝・骨とされ、膵転移はまれである。症例は71歳、女性。4年前に右足底UPSに対して広範囲切除および術後放射線療法や化学療法が行われた。その後全身の皮下、筋、骨に多発転移を来し、有症状の部位に対して切除や放射線療法が行われていた。初回手術より3年3ヵ月のFDG-PET検査で膵尾部に異常集積を認めた。6ヵ月後のCT検査で腫瘍増大を認め、超音波内視鏡下針生検で軟部肉腫の診断に至り、腹腔鏡下尾側膵切除を施行した。術後は順調に経過し、14日目に退院した。現在初回手術より5年6ヵ月経過し、腹腔外転移巣は残存しているが生存中である。(著者抄録)(株)癌と化学療法社, 2022年01月, 癌と化学療法, 49(1) (1), 80 - 82, 日本語
- [Laparoscopic Distal Pancreatectomy for Pancreatic Metastasis of Undifferentiated Pleomorphic Sarcoma-A Case Report].Undifferentiated pleomorphic sarcoma(UPS)is a non-epithelial malignant tumor with a high rate of recurrence and metastasis. The frequent metastasis site is lung, lymph node, liver and bone. Pancreatic metastasis is rare. 71-year-old woman whose course after right foot UPS resection had been followed up at our hospital. But multiple bone and muscle metastasis occurred 1 year after operation. She had resection or radiation for the recurrence. 3 years after the first operation, PET-CT and EUS-FNA revealed pancreatic tail metastasis. The tumor grew up in 6 months, so we performed laparoscopic distal pancreatectomy. The patient recovered uneventfully and was discharged on post-operative day 14. Currently 5 years and 6 months have passed since the first surgery and she is alive. Function-preserving and minimally invasive surgery for UPS pancreatic metastasis is considered to be essential.2022年01月, Gan to kagaku ryoho. Cancer & chemotherapy, 49(1) (1), 80 - 82, 日本語, 国内誌研究論文（学術雑誌）
- 症例は80歳代、女性。膵尾部腫瘤に対し経胃的にendoscopic ultrasound-guided fine needle aspiration(EUS-FNA)で膵尾部癌と診断し、腹腔鏡下膵体尾部切除を施行した。術後補助化学療法を完遂し経過観察中であったが、術後1年の造影CTで胃体中部後壁に15mm大の腫瘤を認めた。EUSでは第4層を主座とする低エコー腫瘤として描出され、FNAで腺癌と診断された。EUS-FNA後のneedle tract seeding(NTS)による胃壁再発を疑い、胃部分切除術を施行した。病理組織検査で膵癌の胃壁再発と診断された。EUS-FNA後のNTSはほとんどが孤立性胃壁再発として診断されるが、腹膜播種再発を含む実際の頻度は不明で、リスクが過小評価されている可能性がある。術前の画像診断で切除可能膵癌が強く疑われる膵体尾部腫瘍では、確定診断のベネフィットとNTSのリスクを考慮して、EUS-FNAの適応を慎重に判断すべきである。(著者抄録)(株)癌と化学療法社, 2021年12月, 癌と化学療法, 48(13) (13), 2011 - 2013, 日本語
- [A Case of Pancreatic Cancer with Gastric Wall Recurrence after Laparoscopic Distal Pancreatectomy Due to Needle Tract Seeding following EUS-FNA].A woman in her 80s was diagnosed with pancreatic tail cancer by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). We performed laparoscopic distal pancreatectomy followed by adjuvant chemotherapy with S-1 for 6 months. One year after surgery, contrast-enhanced computed tomography revealed a 15 mm mass in the posterior wall of the gastric body. EUS showed a hypoechoic mass in the muscular layer in the gastric wall, which was diagnosed as adenocarcinoma by FNA. We diagnosed gastric wall recurrence due to needle tract seeding(NTS)following EUS-FNA and performed partial gastrectomy. Histopathological diagnosis was gastric wall recurrence of pancreatic cancer. Since NTS following EUS-FNA can be proven only by the presence of gastric wall recurrence after surgery for pancreatic body or tail cancer, the actual risk of NTS including peritoneal dissemination is not clear and may have been underestimated. In case of resectable pancreatic body or tail cancer, indication for EUS-FNA should be carefully considered.2021年12月, Gan to kagaku ryoho. Cancer & chemotherapy, 48(13) (13), 2011 - 2013, 日本語, 国内誌研究論文（学術雑誌）
- BACKGROUND: Although liver transplantation is widely accepted as the therapeutic strategy for end-stage liver failure, complication of hepatic venous outflow obstruction remains lethal. Currently, ensuring a single wide orifice in both the graft and recipient inferior vena cava has been proposed to avoid hepatic venous outflow obstruction with no theoretical concept. METHODS: We herein report a standardization technique for the reconstruction of the hepatic vein based on the causal analysis. RESULTS: During the put-in process, the graft must be positioned in contact with the recipient diaphragm and slightly pushed to the cranial direction to simulate the state after abdominal closure. Because there is no extra space between the graft and diaphragm, the graft could not rotate about the anastomotic site of the inferior vena cava toward the diaphragm after abdominal closure as the intestinal pressure increases, and accordingly hepatic venous outflow obstruction does not develop. CONCLUSIONS: With this concept, all transplant surgeons can successfully and easily perform hepatic vein reconstruction without total clamping of the inferior vena cava and without outflow block.2021年12月, Transplantation proceedings, 53(10) (10), 2934 - 2938, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本消化器外科学会, 2021年11月, 日本消化器外科学会雑誌, 54(Suppl.2) (Suppl.2), 217 - 217, 日本語膵頭十二指腸切除後に孤立性門脈内再発をきたした膵神経内分泌腫瘍の1例
- (一社)日本消化器外科学会, 2021年11月, 日本消化器外科学会雑誌, 54(Suppl.2) (Suppl.2), 234 - 234, 日本語膵癌術前治療が及ぼす骨格筋量変化と手術成績に関する検討
- (一社)日本消化器外科学会, 2021年11月, 日本消化器外科学会雑誌, 54(Suppl.2) (Suppl.2), 234 - 234, 日本語膵癌患者における膵切除後の耐糖能の変化についての検討
- BACKGROUND/AIM: Sarcopenia has been reported to be a significant prognostic factor in patients with hepatocellular carcinoma in recent years. This study aimed to clarify the prognostic significance of sarcopenia in advanced hepatocellular carcinoma treated with reductive hepatectomy. PATIENTS AND METHODS: We retrospectively analyzed 93 patients who underwent reductive hepatectomy for advanced hepatocellular carcinoma. RESULTS: Median survival time of the sarcopenia group (16.4 months) was significantly shorter than that of the non-sarcopenia group (20.4 months). The overall survival rates at 1, 3, and 5 years of the sarcopenia group were significantly lower than those of the non-sarcopenia group (57.9%, 8.6%, and 2.9% vs. 67.3%, 29.2%, and 15.7%, respectively; p=0.035). On multivariate analysis, sarcopenia was a significant risk factor of overall survival (hazard ratio=1.60, 95% confidence interval=1.00-2.56, p=0.049). CONCLUSION: Sarcopenia was a significant prognostic factor of survival after reductive hepatectomy in advanced hepatocellular carcinoma.2021年11月, Anticancer research, 41(11) (11), 5775 - 5783, 英語, 国際誌研究論文（学術雑誌）
- We herein report three cases of mature teratomas with pineal gland differentiation, which is a less recognized phenomenon. Case 1 was a 6-year-old male with a neck mass, Case 2 was a 23-year-old female with a retroperitoneal mass, and Case 3 was a 45-year-old female with a retroperitoneal mass. Each case showed the typical macroscopic and histological findings of mature teratoma, such as solid and cystic lesions mainly lined with a mature squamous epithelium. All cases also showed glial differentiation. Small foci of lobulated cell nests were detected in the center of or adjacent to mature glial tissue. Cells had a clear to pale eosinophilic cytoplasm with small round nuclei. Immunohistochemically, cells were positive for synaptophysin, neurofilament protein with a perivascular "club-shaped swelling" pattern, and cone-rod homeobox protein. To the best of our knowledge, this is the first report of pineal gland differentiation arising in mature teratoma, which may be easily overlooked or misdiagnosed as somatic-type tumors, particularly neuroendocrine tumors. To avoid overtreatment, pathologists need to be aware that pineal gland differentiation may occur in mature teratomas.2021年09月, Pathology international, 71(11) (11), 771 - 776, 英語, 国際誌
- BACKGROUND/AIM: While there is increasing evidence supporting the role of several first- and second-line treatment regimens for advanced hepatocellular carcinomas (HCC), the clinical relevance of rechallenge treatment with previously administered drugs, however, remains to be explored. PATIENTS AND METHODS: Five consecutive patients with advanced HCC who received lenvatinib rechallenge treatment after ramucirumab were assessed. RESULTS: All patients were clinically diagnosed with failure after ramucirumab treatment, and the frequencies of ramucirumab administration before lenvatinib re-administration ranged from 3 to 11. The alfa-fetoprotein level in four of five patients decreased 1 month after the lenvatinib rechallenge. Radiological findings via the modified Response Evaluation Criteria in Solid Tumors showed stable diseases in four patients and a partial response in one. CONCLUSION: Rechallenge treatment with lenvatinib after ramucirumab can be effective, and may be a treatment option for HCC in cases wherein the disease progressed after an initial response to lenvatinib treatment.2021年09月, Anticancer research, 41(9) (9), 4555 - 4562, 英語, 国際誌研究論文（学術雑誌）
- Indication of Surgical Hepatectomy for the Patients of Hepatocellular Carcinoma with Inferior Vena Cava Tumor Thrombosis.The prognosis of hepatocellular carcinoma (HCC) presenting with inferior vena cava tumor thrombus (IVCTT) is extremely poor. The aim of this study was to reveal the postoperative course and to identify patients who have survived surgical hepatectomy among HCC patients with IVCTT. Between January 2006 and December 2018, 643 patients underwent surgical hepatectomy for HCC at Kobe University Hospital. Among them, 20 patients were categorized as Vv3 according to the Japanese staging system. We retrospectively collected detailed data on these patients. The statistical, clinical, and pathological data were recorded prospectively and analyzed retrospectively. The median survival time was 9.8 months. Among all patients, 11 (55%) achieved R0 resection, and only two survivors were from this group. The number of tumors (solitary vs. multiple; p=0.050) and pathological Vp (pVp0 vs. other; p=0.009) were identified as risk factors for overall survival in the univariate analysis. In the multivariate analysis, pathological Vp (pVp0 vs. other; p=0.037) was identified as a significant prognostic factor for survival. Pathological Vp affected overall survival among IVCTT patients; the median survival time was 53.7 months with pVp0, 10.2 months with pVp1, and 8.8 months with pVp2-4 (p=0.035). For patients with IVCTT, surgical hepatectomy should be indicated only for those who do not have portal vein invasion and could achieve R0 resection.2021年06月, The Kobe journal of medical sciences, 67(1) (1), E10-E17, 英語, 国内誌研究論文（学術雑誌）
- Beta-catenin-activated hepatocellular adenoma is potentially malignant and warrants careful follow-up and surgical resection. Here, we report a 48-year-old man in whom a 55 mm single liver tumor was incidentally detected in the S1 segment. Contrast-enhanced computed tomography scans showed no enhancement in the early phase and a slight defection in the late phase. The tumor was enhanced hyperintensity in the hepatobiliary phase on Gd-ethoxybenzyl-diethylenetriaminepentaacetic acid-enhanced magnetic resonance imaging. The histologic features of ultrasound-guided fine-needle aspiration biopsy indicated hepatocellular adenoma, and the tumor was immunohistochemically positive for glutamine synthetase and β-catenin. Considering the risk of malignant transformation, he underwent laparoscopic-assisted partial liver resection. The resected tumor did not contain any malignant lesions. This case indicates that aspiration needle biopsy and immunohistochemistry were useful for histological diagnosis and treatment decisions based on the molecular definition of hepatocellular adenoma.2021年06月, Clinical journal of gastroenterology, 14(3) (3), 831 - 835, 英語, 国内誌研究論文（学術雑誌）
- BACKGROUND/AIM: Few studies have established a definite conclusion regarding the limitation of surgical treatment for patients with Barcelona Clinic Liver Cancer (BCLC) stage B and C hepatocellular carcinoma (HCC). PATIENTS AND METHODS: A retrospective analysis was performed on 717 consecutive patients who underwent initial hepatectomy for HCC. RESULTS: Reductive hepatectomy was performed in 103 patients, with a median survival time (MST) of 18.0 months. Total bilirubin and albumin levels were identified as independent prognostic factors. The predictive score of these factors ranged from 0 to 2. Subsequent local treatment was performed in 91.0, 75.0, and 25.0% of patients who scored 0, 1, and 2, respectively. The MST for patients with a score of 0, 1, and 2 was 20.1, 14.8, and 2.7 months, respectively, with a significant difference. CONCLUSION: Patients with BCLC stage B and C could be properly treated with reductive hepatectomy and subsequent local treatments.2021年04月, Anticancer research, 41(4) (4), 1975 - 1983, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本病理学会, 2021年03月, 日本病理学会会誌, 110(1) (1), 261 - 261, 日本語松果体分化を伴う成熟奇形腫の3例
- ＜文献概要＞高度進行状態である脈管侵襲陽性肝細胞癌(門脈腫瘍栓・下大静脈腫瘍栓)は,対象患者の肝機能因子や腫瘍学的因子などの背景因子が大きく異なるため,病態に応じた治療法選択が必要である.また,腫瘍栓の進展度により病態が大きくかわるため,腫瘍学的根治性と時間的治療域確保の二元軸で治療方針を検討する必要がある.いずれの治療法を選択したとしても,治療後再発は高率であり,再発に応じた集学的治療が必須な病態である.(株)南江堂, 2020年11月, 外科, 82(12) (12), 1228 - 1233, 日本語
- (一社)日本移植学会, 2020年10月, 移植, 55(総会臨時) (総会臨時), 257 - 257, 日本語
- (一社)日本移植学会, 2020年10月, 移植, 55(総会臨時) (総会臨時), 277 - 277, 日本語
- BACKGROUND: We compared surgical outcomes, with a focus on tumor characteristics, of laparoscopic repeat hepatectomy (LRH) and open repeat hepatectomy (ORH) to identify recurrent hepatocellular carcinoma (HCC) cases where the LRH procedure would be more favorable than ORH. METHODS: Eighty-one HCC patients who underwent repeat hepatectomy in our hospital from 2008 to 2019 were retrospectively analyzed in this study. Of these patients, 30 and 51 patients underwent LRH and ORH, respectively. We analyzed surgical outcomes of LRH and ORH, focusing on tumor characteristics such as tumor size, location, distance from major vessels, and contralateral or ipsilateral tumor recurrence to determine what factors could affect surgical outcomes. Subsequently, using a propensity-matched cohort, we compared the impact of those factors on LRH and ORH outcomes. RESULTS: In the entire cohort, the LRH operation time was significantly shorter in contralateral recurrent HCC cases than in ipsilateral recurrent HCC cases (252 vs. 398 min, P = 0.008); however, such a difference was not observed in the ORH operation time. We subsequently compared the surgical outcomes, in terms of the location of tumor recurrence, between the LRH and ORH groups in a propensity-matched cohort. In total, 23 patients were included in each of these groups. We found that the LRH procedure had significantly shorter operative time than the ORH procedure in the contralateral recurrent HCC cases (253 vs. 391 min, P = 0.018); however, we did not observe such a difference in the ipsilateral recurrent HCC cases (372 vs. 333 min, P = 0.669). LRH had lower blood loss, similar postoperative complications and shorter hospital stay than ORH in both contralateral and ipsilateral recurrent HCC cases. CONCLUSIONS: LRH is likely considered a more favorable approach than ORH in treating patients with contralateral recurrent HCC.2020年06月, Surgical endoscopy, 35(6) (6), 2896 - 2906, 英語, 国際誌研究論文（学術雑誌）
- BACKGROUND: Although total tumour volume (TTV) may have prognostic value for hepatic resection in certain solid cancers, its importance in colorectal liver metastases (CRLM) remains unexplored. This study investigated its prognostic value in patients with resectable CRLM. METHOD: This was a retrospective review of patients who underwent hepatic resection for CRLM between 2008 and 2017 in a single institution. TTV was measured from CT images using three-dimensional construction software; cut-off values were determined using receiver operating characteristic (ROC) curve analyses. Potential prognostic factors, overall survival (OS) and recurrence-free survival (RFS) were determined using multivariable and Kaplan-Meier analyses. RESULTS: Some 94 patients were included. TTV cut-off values for OS and RFS were 100 and 10 ml respectively. Right colonic primary tumours, primary lymph node metastasis and bilobar liver metastasis were included in the multivariable analysis of OS; a TTV of 100 ml or above was independently associated with poorer OS (hazard ratio (HR) 6·34, 95 per cent c.i. 2·08 to 17·90; P = 0·002). Right colonic primary tumours and primary lymph node metastasis were included in the RFS analysis; a TTV of 10 ml or more independently predicted poorer RFS (HR 1·90, 1·12 to 3·57; P = 0·017). The 5-year OS rate for a TTV of 100 ml or more was 41 per cent, compared with 67 per cent for a TTV below 100 ml (P = 0·006). Corresponding RFS rates with TTV of 10 ml or more, or less than 10 ml, were 14 and 58 per cent respectively (P = 0·009). A TTV of at least 100 ml conferred a higher rate of unresectable initial recurrences (12 of 15, 80 per cent) after initial hepatic resection. CONCLUSION: TTV was associated with RFS and OS after initial hepatic resection for CRLM; TTV of 100 ml or above was associated with a higher rate of unresectable recurrence.2020年04月, BJS open[Epub ahead of print], 英語, 国際誌[査読有り]
- BACKGROUND: The albumin-bilirubin (ALBI) grade, stratified from the ALBI score, may have prognostic value in patients with hepatocellular carcinoma. We aim to evaluate the prognostic abilities of the ALBI score/grade among living-donor liver transplantation patients. METHODS: We retrospectively collected data of 81 patients who underwent living-donor liver transplant at Kobe University Hospital between June 2000 and October 2018. The efficacy of the ALBI score/grade as a prognostic factor was assessed and compared with that of the well-established Model for End-Stage Liver Disease (MELD) score. MAIN FINDINGS: Multivariate analysis indicated that recipient age (P = .003), donor age (P = .003), ALBI score ≥ -1.28 (P = .002), and ALBI grade III (P = .004) were independently associated with post-transplant survival. A high MELD score was not associated with post-transplant survival in univariate or multivariate analyses. Although there was no significant difference in the overall survival rate relative to recipient and donor age, ALBI score/grade was significantly associated with the 1- and 5-year survival rates (P = .023, P = .005). ALBI scores specifically detected fatal complications of post-transplant graft dysfunction (P = .031) and infection (P = .020). CONCLUSION: ALBI score/grade predicted patient survival more precisely than the MELD score did, suggesting that it is a more useful prognostic factor compared to the MELD score in living-donor liver transplantation cases.2020年04月, Transplantation proceedings, 52(3) (3), 910 - 919, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- BACKGROUND: The present study aimed to assess the clinical features of patients who received lenvatinib treatment for unresectable hepatocellular carcinoma (HCC). METHODS: The clinical characteristics, adverse events, and radiological responses were evaluated for 51 consecutive patients. RESULTS: Of the study subjects, 37 patients had Child-Pugh class A (CPA) liver function, and 14 patients had Child-Pugh class B (CPB) liver function. The overall response rates in the CPA and CPB groups were 42.9% and 25.0%, respectively, and disease control rates were 82.9% and 83.3%, respectively, without significant difference (p = 0.2621 and 0.9697). There was no significant difference between CPA and CPB groups regarding the incidence of adverse events, except for hepatic coma. No significant difference was observed in the relative dose intensity between the CPA and CPB groups, for the first month, 1-2 months, or 2-3 months (p = 0.2368, 0.9368, and 0.9293). CONCLUSION: The comparable outcomes between the CPA and CPB groups suggest the acceptability of lenvatinib treatment in patients with impaired liver function, at least in the acute phase. With careful follow-up, the dose can be relatively intensified, even in patients with impaired liver function and this may contribute to offering comparable treatment.2020年03月, HPB : the official journal of the International Hepato Pancreato Biliary Association[Epub ahead of print], 22(10) (10), 1450 - 1456, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- (一社)日本腹部救急医学会, 2020年02月, 日本腹部救急医学会雑誌, 40(2) (2), 385 - 385, 日本語出血性胆嚢炎の1手術例
- BACKGROUND: This study evaluated the prognosis of hepatocellular carcinoma (HCC) patients with extrahepatic metastases who can undergo hepatectomy. METHODS: A total of 32 patients who underwent hepatectomy for HCC with extrahepatic metastases, including lymph node and/or distant metastases were recruited for this study. RESULTS: Fourteen patients had lymph node metastasis only, 16 had distant metastasis only, and 2 had both metastasis types during preoperative diagnosis. The 3-year overall survival (OS) rate of all patients was 17.9%, and the median survival time (MST) was 11.8 months. Univariate analysis revealed that intrahepatic maximal tumor size, intrahepatic tumor number, and intrahepatic tumor control after hepatectomy were significant factors influencing OS (p < 0.05). Multivariate analysis revealed that independent risk factors for OS were intrahepatic maximal tumor size and intrahepatic tumor number (p < 0.05). The MST and 3-year OS rate of patients with maximal tumor size <100 mm and intrahepatic tumor number ≤2 were 39.0 months and 51.9%, respectively. CONCLUSIONS: Hepatectomy is not recommended for HCC patients with extrahepatic metastasis with ≥3 intrahepatic tumors, even when all intrahepatic tumors can be eliminated via hepatectomy. Aggressive surgery may be justified for HCC patients with ≤2 intrahepatic tumors and maximal tumor size <100 mm, irrespective of vascular invasion.2020年, Digestive surgery, 37(5) (5), 411 - 419, 英語, 国際誌研究論文（学術雑誌）
- (一社)日本内視鏡外科学会, 2019年12月, 日本内視鏡外科学会雑誌, 24(7) (7), SF006 - 1, 日本語当施設における腹腔鏡下肝切除の適応
- (一社)日本内視鏡外科学会, 2019年12月, 日本内視鏡外科学会雑誌, 24(7) (7), SF078 - 4, 日本語初回切除部に対する再発部位から見た再発肝細胞癌に対する腹腔鏡手術適応の有効性について
- (一社)日本内視鏡外科学会, 2019年12月, 日本内視鏡外科学会雑誌, 24(7) (7), SF006 - 1, 日本語当施設における腹腔鏡下肝切除の適応[査読有り]
- (一社)日本内視鏡外科学会, 2019年12月, 日本内視鏡外科学会雑誌, 24(7) (7), SF078 - 4, 日本語初回切除部に対する再発部位から見た再発肝細胞癌に対する腹腔鏡手術適応の有効性について[査読有り]
- (株)医薬情報研究所, 2019年11月, 新薬と臨牀, 68(11) (11), 1429 - 1429, 日本語[査読有り]
- 日本臨床外科学会, 2019年10月, 日本臨床外科学会雑誌, 80(増刊) (増刊), 433 - 433, 日本語大血管に浸潤した悪性腫瘍の手術 肝細胞癌の下大静脈腫瘍栓に対する外科切除[査読有り]
- 日本臨床外科学会, 2019年10月, 日本臨床外科学会雑誌, 80(増刊) (増刊), 446 - 446, 日本語肝細胞癌術後遠隔転移再発に対するソラフェニブ投与後の長期生存例[査読有り]
- 日本臨床外科学会, 2019年10月, 日本臨床外科学会雑誌, 80(増刊) (増刊), 461 - 461, 日本語肝細胞癌におけるArl4c発現の臨床的意義についての検討[査読有り]
- 日本臨床外科学会, 2019年10月, 日本臨床外科学会雑誌, 80(増刊) (増刊), 509 - 509, 日本語進行肝細胞癌に対する減量切除術の有用性の検討[査読有り]
- 日本消化器病学会-近畿支部, 2019年10月, 日本消化器病学会近畿支部例会プログラム・抄録集, 111回, 112 - 112, 日本語脾動脈瘤胃穿破にてTAE後の広範な脾梗塞に対し保存的加療を行った1例[査読有り]
- 日本消化器病学会-近畿支部, 2019年10月, 日本消化器病学会近畿支部例会プログラム・抄録集, 111回, 114 - 114, 日本語下大静脈腫瘍栓を有する進行肝細胞癌に対する当科での治療成績[査読有り]
- 日本消化器病学会-近畿支部, 2019年10月, 日本消化器病学会近畿支部例会プログラム・抄録集, 111回, 115 - 115, 日本語肝切除後10年以上長期生存した症例の検討[査読有り]
- 日本消化器病学会-近畿支部, 2019年10月, 日本消化器病学会近畿支部例会プログラム・抄録集, 111回, 116 - 116, 日本語腹腔鏡下脾温存尾側膵切除術を施行した子宮平滑筋肉腫膵転移の1例[査読有り]
- BACKGROUND: This study aimed to evaluate the clinical relevance of hepatectomy for Barcelona Clinic Liver Cancer (BCLC) stages B and C advanced hepatocellular carcinoma (HCC). METHODS: A total of 314 patients (149 and 165 BCLC stages B and C, respectively) who underwent hepatectomy were included. Complete hepatectomy (without residual tumors after hepatectomy) and reductive hepatectomy (apparent residual tumors after hepatectomy) were performed for 212 and 102 patients, respectively. Short-term operative and postoperative outcomes, as well as long-term outcomes, were evaluated. RESULTS: The median survival times of patients with stage B disease undergoing complete hepatectomy and reductive hepatectomy were 48.9 and 20.1 months, respectively (p = 0.0075), whereas those of patients with stage C disease were 19.5 and 17.6 months, respectively (p = 0.0140). The 3-year overall survival rates of patients with stage B disease undergoing reductive hepatectomy with and without subsequent local treatments after surgery were 47.5% and 0%, respectively, whereas those of patients with stage C diseases were 18.6% and 0%, respectively. CONCLUSIONS: Survival benefits are obvious for both BCLC stages B and C HCC when complete hepatectomy can be performed safely. Reductive hepatectomy is also acceptable for BCLC stages B and C when subsequent local treatment for remnant liver tumors can be performed safely after reductive hepatectomy. Without subsequent local treatment, reductive hepatectomy has little clinical relevance. Thus, a cautious approach to patient selection is required for this aggressive strategy.2019年10月, World journal of surgery, 43(10) (10), 2571 - 2578, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- INTRODUCTION: In-vivo fluorescence imaging techniques using indocyanine green (ICG) to identify liver tumours and hepatic segment boundaries have been recently developed. The purpose of this study is to evaluate the efficacy of fusion ICG-fluorescence imaging for navigation during hepatectomy. METHODS AND ANALYSIS: This will be an exploratory single-arm clinical trial; patients with liver tumours will undergo hepatectomy using the ICG-fluorescence imaging system. In total, 110 patients with liver tumours scheduled for elective hepatectomy will be included in this study. Preoperatively, ICG will be intravenously injected at a dose of 0.5 mg/kg body weight within 2 days. To detect liver tumours intraoperatively, the hepatic surface will be initially observed using the ICG-fluorescence imaging system. After identifying and clamping the portal pedicle corresponding to the hepatic segments, including the liver tumours to be resected, additional ICG will be injected intravenously at a dose of 0.5 mg/kg body weight to identify the boundaries of the hepatic segments. The primary outcome measure will be the success or failure of the ICG-fluorescence imaging system in identifying hepatic segments. The secondary outcomes will be the success or failure in identifying liver tumours, liver function indicators, operative time, blood loss, rate of postoperative complications and recurrence-free survival. The findings obtained through this study are expected to help to establish the utility of ICG-fluorescence imaging systems, and therefore contribute to prognostic outcome improvements in patients undergoing hepatectomy for various causes. ETHICS AND DISSEMINATION: The protocol has been approved by the Kobe University Clinical Research Ethical Committee. The findings of this study will be disseminated widely through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER: UMIN000031054 and jRCT1051180070.2019年08月, BMJ open, 9(8) (8), e030233, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- (一社)日本消化器外科学会, 2019年07月, 日本消化器外科学会総会, 74回, RS4 - 7, 日本語腹腔鏡下肝切除術におけるHARMNICHD 1000iを用いたClamp Crush法の手術成績[査読有り]
- (一社)日本消化器外科学会, 2019年07月, 日本消化器外科学会総会, 74回, O22 - 6, 日本語急性肝不全に対する集学的治療の現状と課題 移植の適応とは?[査読有り]
- INTRODUCTION: Bile leak is still a major complication after liver resection to be improved. To intraoperatively detect this adverse complication, leak test is commonly performed after hepatic resection. However, by the conventional leak test, it is often difficult to know whether the test reagent reaches to intrahepatic bile duct near cut surface of liver with adequate volume and pressure to identify the existence of bile leak. Thus, in order to perform leak test more accurately, this study aims to evaluate the efficacy and safety of the leak test using contrast-enhanced intraoperative ultrasonic cholangiography (CE-IOUSC), which was reported by our group as a procedure for detection of bile duct. METHODS AND ANALYSIS: The current study is a non-randomised, prospective, off-label, single-arm clinical trial for patients who undergo liver resection. A total of 100 patients will be enrolled. After completion of liver resection, the leak test is performed with CE-IOUSC using Sonazoid as a contrast agent to visualise dye injection into the intrahepatic bile duct. The primary endpoint is the success of the leak test, defined as clear visualisation of intrahepatic bile duct around cut surface by ultrasonography that indicates enough volume of dye injection. Secondary endpoints are postoperative bile leak and all adverse events related to CE-IOUSC. The findings obtained through this study will establish this procedure to assist surgeons for adequately performing the leak test, precisely detecting intraoperative biliary leak strictly and reducing postoperative bile leak. ETHICS AND DISSEMINATION: The protocol is approved by Institutional Review Boards of Kobe University Hospital (No.290069). Our findings will be widely disseminated through conference presentations and peer-reviewed publications. TRIAL REGISTRATION NUMBER: UMIN000031236 and jRCTs051180027.2019年06月, BMJ open, 9(6) (6), e029330, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- ADP-ribosylation factor-like 4c (ARL4C) is identified as a small GTP-binding protein, which is expressed by Wnt and EGF signaling and plays an important role in tubulogenesis of cultured cells and the ureters. ARL4C is little expressed in adult tissues, but it is highly expressed in lung cancer and colorectal cancer and shown to represent a molecular target for cancer therapy based on siRNA experiments. This study revealed that ARL4C is highly expressed in primary hepatocellular carcinoma (HCC) tumors and colorectal cancer liver metastases, and that ARL4C expression is associated with poor prognosis for these cancers. Chemically modified antisense oligonucleotides (ASO) against ARL4C effectively reduced ARL4C expression in both HCC and colorectal cancer cells and inhibited proliferation and migration of these cancer cells in vitro ARL4C ASOs decreased the PIK3CD mRNA levels and inhibited the activity of AKT in HCC cells, suggesting that the downstream signaling of ARL4C in HCC cells is different from that in lung and colon cancer cells. In addition, subcutaneous injection of ARL4C ASO was effective in reducing the growth of primary HCC and metastatic colorectal cancer in the liver of immunodeficient mice. ARL4C ASO accumulated in cancer cells more efficiently than the surrounding normal cells in the liver and decreased ARL4C expression in the tumor. These results suggest that ARL4C ASO represents a novel targeted nucleic acid medicine for the treatment of primary and metastatic liver cancers.2019年03月, Molecular cancer therapeutics, 18(3) (3), 602 - 612, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- 肝細胞癌(HCC)治療の第一選択は肝切除術であるが、超高齢者(80歳以上)は多彩な基礎疾患や心肺機能の低下があることが多く、手術のリスクが高い。今回、超高齢者HCC患者に対して肝切除術を施行した症例を対象として検討し、その安全性と有効性を検討した。当院で2009〜2015年までに初回肝切除術を施行したHCC症例348例のうち、手術施行時に80歳以上の23例(Group 1)と80歳未満の325例(Group 2)の安全性と予後についての項目を比較検討した。出血、手術時間は両群間に差を認めなかった。術中輸血はGroup 1 56.5%、Group 2 29.2%(p=0.0060)と高齢者に多い傾向にあった。Clavien-Dindo分類Grade III以上の合併症は両群に有意差は認めなかった。Group 1の肝切除後の生存期間中央値45ヵ月、5年生存率は30.7%で、Group 2の生存期間中央値52ヵ月、5年生存率47.2%とGroup 2に良好な傾向は認めたが、有意差は認めなかった。さらにpropensity score(PS)による調整、マッチングを行った後に同様の項目を比較したところ、両群の合併症、入院期間、予後に有意差は認めなかった。適切な腫瘍学的因子、患者のリスクファクター評価により、超高齢者HCCに対する肝切除術も安全かつ有効に施行可能であった。他に予後を規定する他疾患がなければ非超高齢者と同等な予後が期待できると考えられる。超高齢者というだけで治療法を制限せず、積極的な治療も考慮するべきだと考えられる。(著者抄録)(株)癌と化学療法社, 2019年02月, 癌と化学療法, 46(2) (2), 315 - 317, 日本語
- 日本消化器病学会-近畿支部, 2019年02月, 日本消化器病学会近畿支部例会プログラム・抄録集, 110回, 107 - 107, 日本語レゴラフェニブが著効した肝細胞癌術後肺転移の1例[査読有り]
- [Analysis of Hepatectomy for Extreme Elderly Patients with Hepatocellular Carcinoma].Although the first-line treatment for hepatocellular carcinoma(HCC)is hepatectomy, extreme elderly(80 years or older) patients often tend to have a variety of underlying diseases and decreased cardiopulmonary function, which means that surgery involves a high risk. In this case, we examined the safety and efficacy of hepatectomy performed in an extreme elderly patient with HCC. Of the patients with HCC that underwent initial hepatectomy at Kobe University Hospital(n=348)between 2009 and 2015, 23 patients aged 80 years or older at the time of surgery(Group 1, n=23)and those younger than 80 years at the time(Group 2, n=325)were compared, based on parameters related to safety and prognosis. We did not identify differences between the 2 groups with respect to blood loss and operating time. Intraoperative blood transfusion was more common in Group 1. There was no significant difference between the 2 groups with respect to complications of Grade Ⅲ or higher. The median survival of Group 2 patients following hepatectomy(42 months)was better than that of Group 1 patients(34 months), but there was no significant difference between the 2 groups(p=0.429). Furthermore, when the same parameters were compared after adjusting for and matching propensity scores, there were no significant differences in complications, hospitalization periods, and prognosis between the 2 groups. Through proper assessment of oncologic factors and patient risk factors, hepatectomy can be performed safely and effectively even for extreme elderly patients with HCC. If there is no other disease regulating the prognosis, we can expect to achieve similar prognosis in non-extreme elderly patients. Hence, treatments should not be limited solely based on a patient being extremely elderly; rather, proactive treatments should be considered.2019年02月, Gan to kagaku ryoho. Cancer & chemotherapy, 46(2) (2), 315 - 317, 日本語, 国内誌[査読有り]研究論文（学術雑誌）
- 症例は63歳、男性。近医で慢性C型肝炎に対してIFN+リバビリン併用療法を施行されたが、皮膚症状のため中止となった。スクリーニングのエコー、CTで肝S5に2cm大の腫瘍を指摘され、精査にてS5、S8、S3に早期病変を認めたが、治療を希望せず経過観察とした。その後、外来フォロー中にPIVKA-IIが59,994mAU/mLと著明に上昇し、CTでS8病変の増大および門脈浸潤(vp2)、S3に高分化型肝細胞癌を疑う所見を認めたが明らかな遠隔転移はなく、肝右葉切除術、肝S3部分切除術、胆嚢摘出術を施行した。術後3ヵ月目のCTで多発肺転移を認めたため、sorafenibを800mg/dayで開始した。術後6ヵ月目のCTで肺転移の増大を認めsorafenib不応と判断し、regorafenib(120mg/day)に変更した。術後8.5ヵ月目のCTで肺転移の著明な縮小を認め、regorafenib継続とした。術後1年、regorafenibへの変更後6ヵ月、肺転移はほぼ消失し、肝内再発なく経過している。門脈浸潤(vp2)を伴う多発肝細胞癌術後、早期の多発肺転移に対するsorafenibが不応となり、regorafenib投与でほぼCRに近い治療効果を得た1例を経験した。(著者抄録)(株)癌と化学療法社, 2018年12月, 癌と化学療法, 45(13) (13), 2408 - 2410, 日本語[査読有り]
- (一社)日本内視鏡外科学会, 2018年12月, 日本内視鏡外科学会雑誌, 23(7) (7), OS43 - 3, 日本語腹腔鏡下肝切除における非脱転先行切除[査読有り]
- (一社)日本内視鏡外科学会, 2018年12月, 日本内視鏡外科学会雑誌, 23(7) (7), OS93 - 5, 日本語再発肝細胞癌に対する腹腔鏡手術適応の有効性について[査読有り]
- [A Case of Multiple Lung Metastases after Liver Resection for Multiple Hepatocellular Carcinomas with Remarkable Effects of Regorafenib].The patient was a 63-year-old man with hepatitis C. He discontinued combination therapy containing interferon and ribavirin because of the development of skin symptoms. A screening examination showed multiple early-stage hepatocellular carcinomas. He refused treatment and was followed up as an outpatient. During follow-up, his PIVKA-Ⅱ level remarkably elevated to 59,994mAU/mL. Computed tomography(CT)showed an enlarged tumor with portal invasion(vp2)in segment 8 and intrahepaticmetastasis. We performed right and partial hepatectomy. Three months later, CT showed multiple lung metastases. We initiated the daily administration of 800 mg of sorafenib. However, 6 months after hepatectomy, the lung metastases increased in size and number. We considered the therapeutic effect as progressive disease(PD)according to the RECIST criteria. We then initiated administering 120 mg of regorafenib daily as second-line therapy. In a course of the treatment containing sorafenib and regorafenib, the dose was reduced due to hand-foot skin reactions. 8.5 months after hepatectomy, the lung metastases significantly decreased in size. One year after hepatectomy, almost complete response(CR) was obtained, and no intrahepatic recurrence was found.2018年12月, Gan to kagaku ryoho. Cancer & chemotherapy, 45(13) (13), 2408 - 2410, 日本語, 国内誌[査読有り]研究論文（学術雑誌）
- (一社)日本消化器外科学会, 2018年11月, 日本消化器外科学会雑誌, 51(Suppl.2) (Suppl.2), 312 - 312, 日本語進行胆嚢癌に対してconversion surgeryを施行した5例の検討
- BACKGROUND: Progression of portal vein tumor thrombus directly affects the prognosis and treatment for patients with hepatocellular carcinoma; there are no data on the growth velocity of portal vein tumor thrombus. We analyzed the growth velocity of portal vein tumor thrombus and its risk factors to propose the best timing of surgical treatment for hepatocellular carcinoma with portal vein tumor thrombus. METHODS: We retrospectively collected data on 57 hepatocellular carcinoma patients with portal vein tumor thrombus who underwent computed tomography twice preoperatively and hepatectomy between 2005 and 2015. To calculate the growth velocity of portal vein tumor thrombus, migration lengths of portal vein tumor thrombus were divided by the number of days. To identify risk factors for rapid growth of portal vein tumor thrombus, patients were classified according to the velocity: rapid (≥ 1.0 mm/day, n = 23) and slow (< 1.0 mm/day, n = 34). RESULTS: Median survival times of patients with portal vein tumor thrombus that invaded the ipsilateral second portal branch, ipsilateral first portal branch, and portal trunk were 42.9, 11.7, and 12.3 months, respectively. The average growth velocity of portal vein tumor thrombus was 0.9 ± 1.0 mm/day. Median estimated times required from ipsilateral second portal branch to ipsilateral first portal branch and ipsilateral first portal branch to portal trunk were 8.2 and 11.5 days, respectively. Liver fibrosis, alpha-fetoprotein, and extent of portal vein tumor thrombus were independent risk factors for rapid progression of portal vein tumor thrombus. Proteins induced by vitamin K absence or antagonist II, extent of portal vein tumor thrombus, and liver fibrosis, not rapid growth of portal vein tumor thrombus, were independent prognostic factors. CONCLUSION: An understanding of the rapid progression of portal vein tumor thrombus and its risk factors can be helpful in deciding an appropriate timing of surgical treatment for hepatocellular carcinoma with portal vein tumor thrombus.2018年11月, Surgery, 164(5) (5), 1014 - 1022, 英語, 国際誌[査読有り]研究論文（学術雑誌）
- 日本臨床外科学会, 2018年10月, 日本臨床外科学会雑誌, 79(増刊) (増刊), 296 - 296, 日本語肝細胞癌切除成績向上のためのストラテジー 肝細胞癌門脈腫瘍栓の進展速度に影響する因子についての検討[査読有り]
- 日本臨床外科学会, 2018年10月, 日本臨床外科学会雑誌, 79(増刊) (増刊), 449 - 449, 日本語巨大肝癌に対する系統的切除における肝静脈系出血の対策[査読有り]
- 日本臨床外科学会, 2018年10月, 日本臨床外科学会雑誌, 79(増刊) (増刊), 485 - 485, 日本語下大静脈腫瘍栓を有する進行肝細胞癌に対する当科での治療成績[査読有り]
- (一社)日本消化器外科学会, 2018年07月, 日本消化器外科学会総会, 73回, 578 - 578, 日本語再肝切除に対する腹腔鏡手術適応の妥当性について[査読有り]
- (一社)日本外科学会, 2018年04月, 日本外科学会定期学術集会抄録集, 118回, 1229 - 1229, 日本語高度進行肝癌に対する肝切除とPIHPを組み合わせた治療戦略[査読有り]
- (一社)日本外科学会, 2018年04月, 日本外科学会定期学術集会抄録集, 118回, 1239 - 1239, 日本語当施設における巨大肝癌に対する切除成績[査読有り]
- (一社)日本外科学会, 2018年04月, 日本外科学会定期学術集会抄録集, 118回, 1664 - 1664, 日本語肝細胞癌門脈腫瘍栓の進展速度に関わる因子に関する後ろ向き研究[査読有り]
- (一財)日本消化器病学会, 2018年03月, 日本消化器病学会雑誌, 115(臨増総会) (臨増総会), A310 - A310, 日本語C型慢性肝炎に対するDAA治療 肝細胞癌根治切除例の検討[査読有り]
- (一社)日本内視鏡外科学会, 2017年12月, 日本内視鏡外科学会雑誌, 22(7) (7), EP116 - 05, 日本語Rouviere溝からアプローチする腹腔鏡下肝後区域切除[査読有り]
- (一社)日本内視鏡外科学会, 2017年12月, 日本内視鏡外科学会雑誌, 22(7) (7), EP182 - 04, 日本語当院における腹腔鏡下肝切除の定型化と適応拡大への工夫[査読有り]
- 2017年11月, Gan to kagaku ryoho. Cancer & chemotherapy, 44(12) (12), 1431 - 1433[Surgical Dissection for an Abdominal Para-Aortic Lymph Node Recurrence after Curative Resection for Early Gastric Cancer - Report of a Case].[査読有り]
- 日本臨床外科学会, 2017年10月, 日本臨床外科学会雑誌, 78(増刊) (増刊), 353 - 353, 日本語開腹手術での起死回生の一手(肝) 肝切除時の下大静脈損傷に対する出血制御[査読有り]
- 日本臨床外科学会, 2017年10月, 日本臨床外科学会雑誌, 78(増刊) (増刊), 444 - 444, 日本語ここを工夫した私の手術手技(肝) 当施設における腹腔鏡下肝切除の定型化[査読有り]
- 日本臨床外科学会, 2017年10月, 日本臨床外科学会雑誌, 78(増刊) (増刊), 360 - 360, 日本語生体肝移植の問題点 生体肝移植後胆管合併症の対策と予防[査読有り]
- 日本臨床外科学会, 2017年10月, 日本臨床外科学会雑誌, 78(増刊) (増刊), 412 - 412, 日本語安全正確な系統的肝癌手術 当施設における肝前/後区域切除術での検討[査読有り]
- 日本臨床外科学会, 2017年10月, 日本臨床外科学会雑誌, 78(増刊) (増刊), 415 - 415, 日本語高度進行肝細胞癌に対する集学的治療 高度進行肝細胞癌における減量肝切除術の意義[査読有り]
- 日本臨床外科学会, 2017年10月, 日本臨床外科学会雑誌, 78(増刊) (増刊), 532 - 532, 日本語胆管侵襲を伴う進行肝細胞癌に対する治療戦略[査読有り]
- 日本臨床外科学会, 2017年10月, 日本臨床外科学会雑誌, 78(増刊) (増刊), 574 - 574, 日本語10cm以上の大型肝細胞癌に対する肝切除の意義[査読有り]
- (一社)日本移植学会, 2017年08月, 移植, 52(総会臨時) (総会臨時), 405 - 405, 日本語ドナーを増やすために移植医が出来ること[査読有り]
- (一社)日本移植学会, 2017年08月, 移植, 52(総会臨時) (総会臨時), 338 - 338, 日本語当院におけるアルコール性肝硬変に対する肝移植患者の社会復帰の現状[査読有り]
- (一社)日本移植学会, 2017年08月, 移植, 52(総会臨時) (総会臨時), 381 - 381, 日本語当院の脳死肝移植チームにおける現状から見えてきたもの[査読有り]
- A case of recurrent colorectal cancer with bilateral ovarian metastases that were reduced with regorafenib therapyA 63-year-old woman had recurrences of metastatic rectal cancer in the lung, peritoneum, and ovary. Regorafenib was administered at 160 mg/day as third-line chemotherapy. The patient developed Grade (Gr) 3 hand-foot syndrome (HFS) and Gr 2 rash, but the abdominal distension and pain were relieved by the 1st course. Analgesics could be reduced and regorafenib was administrated at reduced dosage. The patient received keishi-bukuryo-gan (EK-25) and sai-rei-tou (TJ-114) for HFS. At the beginning of therapy, ovarian metastases were not reduced and showed poor contrast enhancement on CT. Serum levels of lactate dehydrogenase (LDH) and tumor markers were increased. During the 4th course of therapy, ovarian metastases tended to shrink and serum levels of LDH and tumor markers were decreased. Ovarian metastases showed a partial response (PR) after the 6th course. Lung metastases showed a progressive disease during the 2nd course, but a PR after the 3rd course, and were not apparent after the 6th course. Reduction of metastases was maintained at 16 months after the start of therapy, and HFS was assessed at Gr 2 or lower. Physical, laboratory, and imaging findings should be carefully evaluated prior to long-term administration of regorafenib.Japanese Journal of Cancer and Chemotherapy Publishers Inc., 2017年07月, Japanese Journal of Cancer and Chemotherapy, 44(7) (7), 607 - 610, 日本語[査読有り]研究論文（学術雑誌）
- 2017年04月, 消化器外科, 40(4) (4), 483 - 488, 日本語原発巣より8㎝遠位側に壁内転移を認めた直腸S状部癌の1例[査読有り]
- [Successful Multimodal Treatment for Aggressive Extrahepatic Metastatic Hepatocellular Carcinoma - A Case Report].A 38-year-old man underwent right hepatectomy for a huge hepatocellular carcinoma(HCC)in the right hepatic lobe. Four months later, recurrent and metastatic disease were observed in the remnant liver and right lung, respectively. We performed a hepatectomy for the recurrent lesion because transcatheter arterial chemoembolization (TACE) was not effective. After surgery, we initiated sorafenib treatment for the lung metastases. One year later, the lung metastases worsened and metastases were observed in the mediastinal lymph nodes, and both metastatic lesions were resected. Seven months later, para-aortic lymph nodal metastasis was observed and dissected. Three months later, metastasis to the supraclavicular lymph node was observed. We performed particle radiation therapy and a complete response was achieved. One year later, metastases in both lungs were observed and resected. Despite continued sorafenib administration throughout the clinical course, a metastasis to the left adrenal gland was observed. This lesion was extirpated because no other recurrent lesions were detected. At 4 years and 6 months after the first operation, no other recurrences have occurred. Currently, sorafenib is the initial drug of choice for HCC with extrahepatic metastases. It is possible to improve the prognosis of patients with HCC and extrahepatic metastases by applying surgical treatment during the course of sorafenib administration.2015年09月, Gan to kagaku ryoho. Cancer & chemotherapy, 42(9) (9), 1111 - 4, 日本語, 国内誌[査読有り]研究論文（学術雑誌）
- Single epithelial-derived tumor cells have been shown to induce apical and basolateral (AB) polarity by expression of polarization-related proteins. However, physiological cues and molecular mechanisms for AB polarization of single normal epithelial cells are unclear. When intestinal epithelial cells 6 (IEC6 cells) were seeded on basement membrane proteins (Matrigel), single cells formed an F-actin cap on the upper cell surface, where apical markers accumulated, and a basolateral marker was localized to the rest of the cell surface region, in a Wnt5a signaling-dependent manner. However, these phenotypes were not induced by type I collagen. Rac1 activity in the noncap region was higher than that in the cap region, whereas Rho activity increased toward the cap region. Wnt5a signaling activated and inhibited Rac1 and RhoA, respectively, independently through Tiam1 and p190RhoGAP-A, which formed a tertiary complex with Dishevelled. Furthermore, Wnt5a signaling through Rac1 and RhoA was required for cystogenesis of IEC6 cells. These results suggest that Wnt5a promotes the AB polarization of IEC6 cells through regulation of Rac and Rho activities in a manner dependent on adhesion to specific extracellular matrix proteins.AMER SOC CELL BIOLOGY, 2013年12月, MOLECULAR BIOLOGY OF THE CELL, 24(23) (23), 3764 - 3774, 英語[査読有り]研究論文（学術雑誌）
- Wnts activate at least two signaling pathways, the beta-catenin-dependent and -independent pathways. Although the b-catenin-dependent pathway is known to contribute to G1-S transition, involvement of the beta-catenin-independent pathway in cell cycle regulation remains unclear. Here, we show that Wnt5a signaling, which activates the beta-catenin-independent pathway, is required for cytokinesis. Dishevelled 2 (Dvl2), a mediator of Wnt signaling pathways, was localized to the midbody during cytokinesis. Beside the localization of Dvl2, Fz2, a Wnt receptor, was detected in the midbody with the endosomal sorting complex required for transport III (ESCRT-III) subunit, CHMP4B. Depletion of Wnt5a, its receptors, and Dvl increased multinucleation. The phenotype observed in Wnt5a-depleted cells was rescued by the addition of purified Wnt5a but not Wnt3a, which is a ligand for the beta-catenin-dependent pathway. Moreover, depletion of Wnt5a signaling caused loss of stabilized microtubules and mislocalization of CHMP4B at the midbody, which affected abscission. Inhibition of the stabilization of microtubules at the midbody led to the mislocalization of CHMP4B, while depletion of CHMP4B did not affect the stabilization of microtubules, suggesting that the correct localization of CHMP4B depends on microtubules. Fz2 was localized to the midbody in a Rab11-dependent manner, probably along stabilized microtubules. Fz2 formed a complex with CHMP4B upon Wnt5a stimulation and was required for proper localization of CHMP4B at the midbody, while CHMP4B was not necessary for the localization of Fz2. These results suggest that Wnt5a signaling positions ESCRT-III in the midbody properly for abscission by stabilizing midbody microtubules.COMPANY OF BIOLOGISTS LTD, 2012年10月, JOURNAL OF CELL SCIENCE, 125(20) (20), 4822 - 4832, 英語[査読有り]研究論文（学術雑誌）
- (一社)日本外科学会, 2012年03月, 日本外科学会雑誌, 113(臨増2) (臨増2), 163 - 163, 日本語肝細胞癌の治療戦略 その進歩と今後の方向性 高度進行肝癌に対する減量肝切除とPIHPによる2段階治療の有効性と予後因子の解析
- (一社)日本移植学会, 2011年12月, 移植, 46(6) (6), 652 - 653, 日本語生体肝移植後腎機能障害に対する新たな治療戦略[査読有り]
- 肺癌肝転移の診断でRFAを施行した肝内胆管癌の1例症例は43歳、男性。2008年12月健診で肺野に結節影を指摘され前医受診。CTで右肺上葉に上大静脈浸潤を伴う35mm大の腫瘤、および肝S7に32mm大の腫瘤を指摘された。肝腫瘤に対し生検を施行しadenocarcinomaと診断されたため、原発性肺癌、肝転移の診断で、2009年1月より全身化学療法を開始した。肝S7腫瘤に対し2月にラジオ波焼灼療法(RFA)、肺腫瘤に対し12月に放射線照射を施行。肺病変は著明に縮小したが、肝病変は10月に再発が確認された後、発育進展を続け8月には80mm大にまで増大した。肝病変に対する治療目的で当科紹介となり、10月に肝右葉、右横隔膜、右肺合併切除術を施行。病理組織診断、免疫染色にて肝内胆管癌と最終診断された。2011年1月現在多発残肝再発、腹膜転移、多発肺転移を認めている。肝内胆管癌に対する確立された治療は肝切除のみであり、RFAの是非については統一した見解が得られていない。多発癌に対しては慎重に臨床診断を行うべきであると考えられた。(著者抄録)(株)癌と化学療法社, 2011年11月, 癌と化学療法, 38(12) (12), 2030 - 2032, 日本語[査読有り]
- [A case report of multiple advanced hepatocellular carcinomas treated by combination therapy with hepatectomy and particle therapy].We report a case of multiple advanced hepatocellular carcinomas (HCC) with bilobar distribution treated by combination therapy of hepatectomy and particle therapy (carbon ion therapy). A 73-year-old man who had been pointed out hepatic tumors on abdominal CT was referred to our hospital in February 2010. Advanced HCCs; 8 cm Vp3 and 6 cm in the left lobe, 4 cm in the posterior segment, and 1 .5 cm in the S8 area, were detected by abdominal dynamic CT and EOB-MRI etc. Curative resection was not applied due to insufficiency of liver function and unfavorable anatomical tumor locations. Accordingly we have developed a novel combination therapy of hepatectomy and particle therapy. First we performed left lobectomy in March 2010, followed by administration of particle therapy to the posterior segment for local control in May. Then, transcatheter arterial chemoembolization was administered 4 times for residual tumors. The patient survives for 15 months after the initial therapy with good local control.2011年11月, Gan to kagaku ryoho. Cancer & chemotherapy, 38(12) (12), 2065 - 7, 日本語, 国内誌[査読有り]研究論文（学術雑誌）
- [A case report of intrahepatic cholangiocarcinoma diagnosed as lung cancer with liver metastasis treated with radiofrequency ablation].In December 2008, a 43-year-old male who had been pointed out a nodular shadow in the right upper field on a chest radiography was admitted to hospital. A 35 mm mass infiltrating to superior vena cava in the right upper lobe of the lung, and 32 mm mass in the liver at S7 were detected by CT. Pathological diagnosis of the liver tumor was adenocarcinoma. Under the diagnosis of lung carcinoma and liver metastasis, systemic chemotherapy was started from January 2009. Radiofrequency ablation (RFA) therapy was added for liver S7 mass in February, and radiation therapy was performed for lung mass in December. The lung lesion has markedly reduced, but the liver lesion recurred in October 2009, which continued to grow up to 80 mm until August 2010. He presented to our hospital with the diagnosis of liver metastasis of controlled primary lung cancer. In October, we performed right hepatectomy with diaphragma and right lung resection. The pathological diagnosis was intrahepatic cholangiocarcinoma. Multiple recurrences in remnant liver, lung and peritoneal metastasis were detected in January 2011. For intrahepatic cholangiocarcinoma, hepatectomy is the only established treatment, and RFA treatment remains controversial. Clinical diagnosis of multiple cancers should be decided with caution.2011年11月, Gan to kagaku ryoho. Cancer & chemotherapy, 38(12) (12), 2030 - 2, 日本語, 国内誌[査読有り]研究論文（学術雑誌）
- (一社)日本消化器外科学会, 2011年10月, 日本消化器外科学会雑誌, 44(Suppl.2) (Suppl.2), 306 - 306, 日本語神経内分泌腫瘍肝転移に対する肝切除の意義
- (一社)日本肝胆膵外科学会, 2011年06月, 日本肝胆膵外科学会・学術集会プログラム・抄録集, 23回, 328 - 328, 日本語大腸癌肝転移における術前化学療法後の肝切除術[査読有り]
- (一社)日本肝胆膵外科学会, 2011年06月, 日本肝胆膵外科学会・学術集会プログラム・抄録集, 23回, 364 - 364, 日本語著明な肝外発育をきたした重量8kgを超える巨大肝細胞癌の一切除例[査読有り]
- (一社)日本肝胆膵外科学会, 2011年06月, 日本肝胆膵外科学会・学術集会プログラム・抄録集, 23回, 365 - 365, 日本語陽子線治療にてVp4門脈腫瘍栓を制御後、経皮的肝灌流化学療法(PIHP)を施行した1例[査読有り]
- A case of gastric carcinoma with peritoneal metastasis successfully treated by combination chemotherapy of S-1 and cisplatinThis case is a 69-year-old woman. We diagnosed gastric cancer and cholecystolithiasis by close inspection of abdominal pain. Because preoperative diagnosis was T2N0M0, Stage I B, we performed an operation. Many lesser tubercles were shown, and were diagnosed as peritoneal metastases pathologically. The tumor in corpus ventriculi infiltrated out of gastric serosa. We judged that curative resection was impossible and finished the operation after giving an intra-abdominal dosage of cisplatin (CDDP) at 85 mg. After operation, 3 courses of performed S-1/CDDP combination chemotherapy were performed. Because we observed contraction of the main lesion and could not point out the peritoneal metastases and ascitis, we performed a second look operation. All the nodules found with peritoneal and rectouterine excavation had disappeared and we performed distal gastrectomy. The postoperative diagnosis was pT2 (MP), pN0CY0, Stage I B, Cur A, therapy grade 1a. Chemotherapy does succeed, and this is a valuable case in which a radical operation could be performed.Japanese Journal of Cancer and Chemotherapy Publishers Inc., 2011年05月, Japanese Journal of Cancer and Chemotherapy, 38(5) (5), 815 - 818, 日本語[査読有り]研究論文（学術雑誌）
- (一社)日本外科学会, 2011年05月, 日本外科学会雑誌, 112(臨増1-2) (臨増1-2), 550 - 550, 日本語巨大腫瘍を伴う両葉多発高度進行肝癌に対する新戦略 術前・術後経皮的肝灌流化学療法(PIHP)併用3段階療法[査読有り]
- S-1-based chemotherapy for recurrent gastric cancer with peritoneal dissemination resulting in long-term survival-report of a caseA 52-year-old man underwent distal gastrectomy for gastric cancer in July 2000. In July 2005, abdominal CT and barium study of the colon revealed peritoneal recurrence, and chemotherapy of S-1 was started. Within 2 courses, the serum CEA level increased, so combination chemotherapy of S-1 and cisplatin (CDDP) was begun. After 7 courses, the regimen was switched to S-1+paclitaxel (PTX). However, the patient developed digital numbness within 8 courses and single-agent chemotherapy with S-1 was restarted. In July 2007, he developed abdominal distension, and abdominal CT showed a large amount of ascites. S-1+CDDP was administered again, however, and we had to change the regimen within 3 courses due to fatigue and appetite loss. S-1 was restarted, but soon severe fatigue and appetite loss restricted the use of chemotherapeutic agents, and he died in December. This patient had been alive for 2 years and 5 months since peritoneal recurrence was diagnosed. We concluded that S-1-based sequential chemotherapy was effective for recurrent gastric cancer.Japanese Journal of Cancer and Chemotherapy Publishers Inc., 2010年07月, Japanese Journal of Cancer and Chemotherapy, 37(7) (7), 1361 - 1364, 日本語[査読有り]研究論文（学術雑誌）
- We report a case of local cystic duct cancer recurrence resected after curative resection. A 81-year-old-man underwent resection of the gallbladder and the extrahepatic bile duct with lymph node dissection for cystic duct cancer in August 2005. In March 2007, serum AFP and CA19-9 became elevated and dynamic computed tomography (CT) showed a 5cm mass at the gallbladder fossa. Local recurrence of cystic duct cancer was suspected and the tumor was resected together with liver segment S4a and 5 and the jejunum wall around the tumor near the hepaticojejunostomy. The resected specimen was pathologically diagnosed as the expected local recurrence invading into the liver and the jejunum wall. The tumor had immunoreactivity to AFP. The patient has been free from recurrence in the 24 months following the second surgery. © 2010 The Japanese Society of Gastroenterological Surgery.Japanese Society of Gastroenterological Surgery, 2010年, Japanese Journal of Gastroenterological Surgery, 43(5) (5), 531 - 535, 日本語[査読有り]研究論文（学術雑誌）
- 金原出版, 2009年10月, 手術, 63(11) (11), 1709 - 1713, 日本語手術症例報告 膵炎により発症した成人型論状膵の1例
- 患者は併存疾患としてアルコール性肝硬変および糖尿病を持つ52歳男性．2007年4月腹痛を主訴に当院救急外来を受診．腹部単純Ｘ線検査にて左横隔膜下に腹腔内遊離ガス像を認めたため，消化管穿孔の診断のもと同日緊急開腹術を施行．術中，十二指腸球部前壁の穿孔を確認し，同部の縫合閉鎖および大網充填を行った．術後抗生剤治療を継続するも感染徴候および血液検査所見の改善はみられなかった．術8日後に腹腔内膿瘍形成を疑い腹部造影CT検査を施行．その結果，膵周囲，左腎周囲，さらに左腸腰筋に沿った後腹膜腔に膿瘍形成を認めたため，経皮的に左前腎傍腔にドレナージカテーテルを挿入した．カテーテルからのドレナージは良好であったが，感染徴候の改善はみられなかった．そこで術16日後に後腹膜アプローチで左腎周囲および左腸腰筋前面の膿瘍腔にドレーンを留置した．術後ドレナージは良好で，感染徴候および血液検査所見も改善し，術32日後に軽快退院となった．Japan Surgical Association, 2009年, 日本臨床外科学会雑誌, 70(1) (1), 73 - 78, 日本語[査読有り]
- A case of hyperammonemia with encephalopathy related to FOLFIRI chemotherapy for advanced colon cancerA 50-year-old man undergoing operations for sigmoid colon cancer, small intestine invasion, and liver metastasis was given adjuvant chemotherapy postoperatively. During the course, lung, brain and bone metastasis were found, FOLFIRI therapy was started. Fifth FOLFIRI therapy was performed, but on the night of the next day, he was transported on an emergency basis to our hospital because of a coma. Laboratory examination revealed hyperammonemia, so aminoleban was started for its treatment. After 3 days in the hospital, consciousness and serum ammonia were improved. Cases of hyperammonemia caused by 5-FU have been reported in the literature, and this case was diagnosed with the same. Hyperammonemia should be taken into account as a differential diagnosis in the disturbance of consciousness in chemotherapy.Japanese Journal of Cancer and Chemotherapy Publishers Inc., 2009年, Japanese Journal of Cancer and Chemotherapy, 36(7) (7), 1167 - 1169, 日本語[査読有り]研究論文（学術雑誌）
- 2024年, 癌と化学療法, 51(13) (13)腹腔鏡補助下膵頭十二指腸切除術でR0切除となった胆管原発神経内分泌癌の1例
- 日本胆道学会, 2021年08月, 胆道, 35(3) (3), 438 - 438, 日本語総胆管嚢腫に対する胆管切除術後に発症した胆管癌の1例
- 日本胆道学会, 2021年08月, 胆道, 35(3) (3), 561 - 561, 日本語胆道癌におけるSystematic inflammation-based scoresの意義
- (一社)日本外科学会, 2021年04月, 日本外科学会定期学術集会抄録集, 121回, SF - 2, 日本語切除を企図し得るカテゴリとしての切除可能境界膵癌の再検討
- (一社)日本外科学会, 2021年04月, 日本外科学会定期学術集会抄録集, 121回, SF - 1, 日本語切除不能肝門部領域胆管癌に対するスペーサ手術および粒子線治療
- (一社)日本外科学会, 2021年04月, 日本外科学会定期学術集会抄録集, 121回, SF - 6, 日本語治癒切除後の胆道癌における、Controlling Nutritional Status(CONUT)scoreの術前予後因子としての有用性の検討
- (一社)日本外科学会, 2021年04月, 日本外科学会定期学術集会抄録集, 121回, PS - 7, 日本語膵管内乳頭粘液性癌に対する亜全胃温存膵頭十二指腸切除術後に細胆管癌を発症し、肝切除後胆汁瘻を合併した1例
- (一社)日本外科学会, 2021年04月, 日本外科学会定期学術集会抄録集, 121回, PS - 7, 日本語術前分枝鎖アミノ酸飲料の使用は肝胆膵外科手術中の乳酸産生を抑制する
- (一社)日本外科学会, 2021年04月, 日本外科学会定期学術集会抄録集, 121回, PS - 8, 日本語高齢者胆嚢癌における切除の意義についての検討
- (一社)日本外科学会, 2021年04月, 日本外科学会定期学術集会抄録集, 121回, PS - 5, 日本語高齢者に対する肝門部領域胆管癌手術の検討
- (一社)日本外科学会, 2021年04月, 日本外科学会定期学術集会抄録集, 121回, PS - 6, 日本語進行胆道癌に対する集学的治療とConversion Surgeryの意義
- (一社)日本外科学会, 2021年04月, 日本外科学会定期学術集会抄録集, 121回, PS - 1, 日本語肝細胞癌再発に対する腹腔鏡下再肝切除適応の条件についての検討
- 日本臨床外科学会, 2020年10月, 日本臨床外科学会雑誌, 81(増刊) (増刊), 236 - 236, 日本語膵癌に対する腹腔鏡下膵体尾部切除 膵癌に対する腹腔鏡下膵体尾部切除の当科の標準手技
- 日本臨床外科学会, 2020年10月, 日本臨床外科学会雑誌, 81(増刊) (増刊), 245 - 245, 日本語肝癌に対する肝移植の長期成績と再発予防 移植適応疾患の変遷によるこれからの肝癌に対する肝移植治療
- (一社)日本移植学会, 2020年10月, 移植, 55(総会臨時) (総会臨時), 282 - 282, 日本語
- (一社)日本移植学会, 2020年10月, 移植, 55(総会臨時) (総会臨時), 292 - 292, 日本語
- (一社)日本癌学会, 2020年10月, 日本癌学会総会記事, 79回, OJ14 - 1, 英語DKK1-CKAP4シグナルは肝癌の予後不良因子であり、CKAP4は新たな治療標的となりうる
- 2020年01月門脈腫瘍栓合併肝細胞癌に対する外科治療—門脈腫瘍栓の進展度，形態および進展速度を考慮した治療戦略
- 日本消化器病学会-近畿支部, 2019年10月, 日本消化器病学会近畿支部例会プログラム・抄録集, 111回, 76 - 76, 日本語術前に肝細胞癌と鑑別困難であった肝pseudolymphomaの一例
- 日本臨床外科学会, 2019年10月, 日本臨床外科学会雑誌, 80(増刊) (増刊), 785 - 785, 日本語難治性胆汁漏後の胆管狭窄に対して狭窄部穿刺が有効であった一例
- (一社)日本移植学会, 2019年09月, 移植, 54(総会臨時) (総会臨時), 157 - 157, 日本語脳死移植Organ procurementの問題点と改善策 摘出体制を再構築するための課題 如何にして現地入りする移植医数は削減できるのか
- (一社)日本移植学会, 2019年09月, 移植, 54(総会臨時) (総会臨時), 267 - 267, 日本語肝移植後における長期合併症としての肺炎 いかにして発症を予防できるのか
- (一社)日本移植学会, 2019年09月, 移植, 54(総会臨時) (総会臨時), 270 - 270, 日本語生体肝移植後の難治性胆管吻合部狭窄に対して施行した磁石圧迫吻合術の長期成績
- 【肝炎・肝癌】肝細胞癌に対する外科治療の最前線2017年に改定された肝癌診療ガイドライン第4版では、新たに治療アルゴリズムの章が設けられ肝細胞癌治療指針が示された。本稿では、本邦における肝細胞癌に対する外科治療の現況についてガイドラインに則して概説する。また、最新のトピックスとして腹腔鏡下肝切除、術前シミュレーション、術中ナビゲーションの臨床応用についても言及する。(著者抄録)(株)北隆館, 2019年07月, BIO Clinica, 34(7) (7), 691 - 696, 日本語
- 金原出版(株), 2019年06月, 手術, 73(7) (7), 959 - 969, 日本語【肝胆膵外科手術におけるトラブルシューティング】肝臓 開腹肝切除術における下大静脈出血に対する対処法
- (一社)日本外科学会, 2019年04月, 日本外科学会定期学術集会抄録集, 119回, PS - 6, 日本語肝細胞癌vp1症例における術後再発形式の検討
- (一社)日本外科学会, 2019年04月, 日本外科学会定期学術集会抄録集, 119回, PS - 8, 日本語門脈腫瘍栓合併肝細胞癌における門脈腫瘍栓進展速度に関する検討
- (一社)日本外科学会, 2019年04月, 日本外科学会定期学術集会抄録集, 119回, PS - 3, 日本語肝癌粒子線治療後局所再発に対するサルベージ肝切除例の検討
- (一社)日本外科学会, 2019年04月, 日本外科学会定期学術集会抄録集, 119回, PS - 2, 日本語切除不能胆嚢癌に対するconversion surgery施行例の検討
- (一社)日本外科学会, 2019年04月, 日本外科学会定期学術集会抄録集, 119回, PS - 3, 日本語大腸癌肝転移初回切除例における全腫瘍体積の予後因子としての有用性の検討
- (株)医薬情報研究所, 2018年12月, 新薬と臨牀, 67(12) (12), 1531 - 1531, 日本語再肝切除に対する腹腔鏡手術適応の有効性について
- (一社)日本移植学会, 2018年09月, 移植, 53(総会臨時) (総会臨時), 471 - 471, 日本語移植ドナー増加に向けて移植医のドブ板活動
- (株)へるす出版, 2018年07月, 中毒研究, 31(2) (2), 206 - 206, 日本語日本の脳死移植の課題と対策
- (一社)日本肝臓学会, 2018年04月, 肝臓, 59(Suppl.1) (Suppl.1), A511 - A511, 日本語当科の非B非C肝細胞癌切除症例からみた肝癌発症リスク因子の検討
- (株)医薬情報研究所, 2017年11月, 新薬と臨牀, 66(11) (11), 1438 - 1438, 日本語C型慢性肝炎に対するDAA治療 肝細胞癌根治切除例の検討
- 臨床情報センター, 2016年, 漢方医学, 40(2) (2), 106 - 110, 日本語Clinical Research 術後逆流性食道炎あるいは蠕動障害に対する漢方薬
- 肝細胞癌肝外転移巣に対し集学的治療を行い長期生存した1例症例は38歳、男性。肝右葉を占拠する巨大肝細胞癌(HCC)の診断にて肝右葉切除術を施行。術後4ヵ月で残肝再発および右肺転移を認めた。肝内再発が肝動脈化学塞栓術(TACE)不応であったため肝切除を行い、その後ソラフェニブを開始。1年後に肺転移巣の増悪および縦隔リンパ節転移を認めたため、これらを切除した。その7ヵ月後に腹腔内傍大動脈リンパ節転移を認め、摘出。さらに3ヵ月後には右鎖骨上窩リンパ節転移を認めたが、粒子線治療により完全寛解を得た。その1年後には両肺に1ヶ所ずつ転移巣が出現したため、再度病変を切除。さらに6ヵ月後に左副腎転移を認め、摘出。現在、初回手術より4年6ヵ月経過したが、明らかな再発なく経過している。肝外転移巣の治療はソラフェニブが第一選択であるが、本症例のように積極的に外科的切除を追加することで長期生存を得る可能性が示唆された。(著者抄録)(株)癌と化学療法社, 2015年09月, 癌と化学療法, 42(9) (9), 1111 - 1114, 日本語
- 肝切除および粒子線治療併用にて治療効果を認めた両葉多発肝細胞癌の1例肝切除と粒子線治療併用にて治療効果を認めた両葉多発の肝細胞癌(hepatocellular carcinoma:HCC)の1例を経験した。症例は73歳、男性。2010年2月腹部CT検査にて両葉多発肝腫瘍を指摘され、当科に紹介された。精査にて肝左葉に門脈腫瘍栓(Vp3)を伴う径8cm大と径6cm大、後区域に径4cm大、S8に径1.5cm大の計4個のHCCを認め、T4N0M0、Stage IVAと診断された。肝予備能の低下、腫瘍の局在から根治切除は困難であったため、今回われわれは新しい治療戦略として肝切除と粒子線治療の併用療法を考案した。3月に肝左葉切除術を施行し、5月に後区域のHCCに対して局所制御目的に粒子線治療を施行した。その後追加治療としてTACEを4回施行することで、初回治療後15ヵ月経過した現在も腫瘍の局所制御は良好である。(著者抄録)(株)癌と化学療法社, 2011年11月, 癌と化学療法, 38(12) (12), 2065 - 2067, 日本語
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会Under 40外科医が専門医取得の次に目指すもの
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会正確な局所解剖に基づいた肝細胞癌に対する合理的肝切除術とは 初回再発形式からみる表在性肝細胞癌に対する非系統的切除術の妥当性に関する検討
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会胆道癌に対するS-1術後補助化学療法と早期再発の関連
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会肝移植後長期成績向上のために,何が必要か
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会術前化学療法後に切除を施行したBR-A膵癌,UR-LA膵癌における早期再発risk因子の検討
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会ロボット支援下膵体尾部切除導入期に直面する技術的問題点
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会大腸癌肝転移における予後予測因子としての全腫瘍体積の有用性と,適切な化学療法導入時期に関する観察研究
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会治療成績から見た大腸癌肝転移における切除可能性分類と治療戦略
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会当科における吸収性スペーサー留置術22例の臨床経過
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会肝細胞癌切除症例におけるGLIM基準と予後の関連
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会右肝葉切除を施行した肝門部領域胆管癌の再考 左側からの切除の可能性
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会肝門部領域胆管癌に対する術前門脈塞栓術施行例の検討
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会肝外胆管癌切除後の早期再発予測におけるGLIM基準の有用性
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会肝外胆管癌切除後予後因子としてのGLIM基準の有用性に関する検討
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会十二指腸乳頭部癌におけるC-reactive protein to albumin ratio(CAR)の予後への影響
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会術前NLR値と胆嚢癌の予後との関連
- 日本外科学会定期学術集会抄録集, 2023年04月, 日本語, (一社)日本外科学会胆道癌における術後静脈血栓症と血漿Dダイマーの関連性の検討
- 肝臓, 2023年04月, 日本語, (一社)日本肝臓学会切除不能肝内胆管癌に対する粒子線治療の成績
- 日本消化器病学会雑誌, 2023年03月, 日本語, (一財)日本消化器病学会術前骨格筋量減少が肝外胆管癌切除後の長期予後に与える影響に関する観察研究
- 日本消化器病学会雑誌, 2023年03月, 日本語, (一財)日本消化器病学会アルコール性肝硬変に対する肝移植医療の現状と課題
- 日本消化器病学会雑誌, 2023年03月, 日本語, (一財)日本消化器病学会食道胃静脈瘤に対するHassab手術が術後肝機能に与える影響についての検討
- 新薬と臨牀, 2022年11月, 日本語, (株)医薬情報研究所進行肝細胞癌におけるconversion surgeryの妥当性
- 肝臓, 2022年10月, 日本語, (一社)日本肝臓学会初回再発形式からみる肝細胞癌の腫瘍位置と初回再発形式に関する検討
- 日本癌治療学会学術集会抄録集, 2022年10月, 英語, (一社)日本癌治療学会進行肝細胞がんに対する新しい治療戦略と集学的治療の明日 神戸大学における肝癌集学的治療の現状
- 癌と化学療法, 2022年01月, 日本語, (株)癌と化学療法社, 未分化多形肉腫(UPS)は四肢軟部組織に好発する非上皮性悪性腫瘍である。高率に転移を来し、好発部位は肺、リンパ節、肝・骨とされ、膵転移はまれである。症例は71歳、女性。4年前に右足底UPSに対して広範囲切除および術後放射線療法や化学療法が行われた。その後全身の皮下、筋、骨に多発転移を来し、有症状の部位に対して切除や放射線療法が行われていた。初回手術より3年3ヵ月のFDG-PET検査で膵尾部に異常集積を認めた。6ヵ月後のCT検査で腫瘍増大を認め、超音波内視鏡下針生検で軟部肉腫の診断に至り、腹腔鏡下尾側膵切除を施行した。術後は順調に経過し、14日目に退院した。現在初回手術より5年6ヵ月経過し、腹腔外転移巣は残存しているが生存中である。(著者抄録)未分化多形肉腫膵転移に対して腹腔鏡下尾側膵切除を行った1例
- 癌と化学療法, 2021年12月, 日本語, (株)癌と化学療法社, 症例は80歳代、女性。膵尾部腫瘤に対し経胃的にendoscopic ultrasound-guided fine needle aspiration(EUS-FNA)で膵尾部癌と診断し、腹腔鏡下膵体尾部切除を施行した。術後補助化学療法を完遂し経過観察中であったが、術後1年の造影CTで胃体中部後壁に15mm大の腫瘤を認めた。EUSでは第4層を主座とする低エコー腫瘤として描出され、FNAで腺癌と診断された。EUS-FNA後のneedle tract seeding(NTS)による胃壁再発を疑い、胃部分切除術を施行した。病理組織検査で膵癌の胃壁再発と診断された。EUS-FNA後のNTSはほとんどが孤立性胃壁再発として診断されるが、腹膜播種再発を含む実際の頻度は不明で、リスクが過小評価されている可能性がある。術前の画像診断で切除可能膵癌が強く疑われる膵体尾部腫瘍では、確定診断のベネフィットとNTSのリスクを考慮して、EUS-FNAの適応を慎重に判断すべきである。(著者抄録)腹腔鏡下膵体尾部切除後、Needle Tract Seedingによる胃壁再発を来した膵癌の1例
- 胆道, 2021年08月, 日本語, 日本胆道学会総胆管嚢腫に対する胆管切除術後に発症した胆管癌の1例
- 胆道, 2021年08月, 日本語, 日本胆道学会胆道癌におけるSystematic inflammation-based scoresの意義
- 日本外科学会定期学術集会抄録集, 2021年04月, 日本語, (一社)日本外科学会切除を企図し得るカテゴリとしての切除可能境界膵癌の再検討
- 日本外科学会定期学術集会抄録集, 2021年04月, 日本語, (一社)日本外科学会切除不能肝門部領域胆管癌に対するスペーサ手術および粒子線治療
- 日本外科学会定期学術集会抄録集, 2021年04月, 日本語, (一社)日本外科学会治癒切除後の胆道癌における、Controlling Nutritional Status(CONUT)scoreの術前予後因子としての有用性の検討
- 日本外科学会定期学術集会抄録集, 2021年04月, 日本語, (一社)日本外科学会膵管内乳頭粘液性癌に対する亜全胃温存膵頭十二指腸切除術後に細胆管癌を発症し、肝切除後胆汁瘻を合併した1例
- 日本外科学会定期学術集会抄録集, 2021年04月, 日本語, (一社)日本外科学会高齢者胆嚢癌における切除の意義についての検討
- 日本外科学会定期学術集会抄録集, 2021年04月, 日本語, (一社)日本外科学会高齢者に対する肝門部領域胆管癌手術の検討
- 日本外科学会定期学術集会抄録集, 2021年04月, 日本語, (一社)日本外科学会進行胆道癌に対する集学的治療とConversion Surgeryの意義
- 日本外科学会定期学術集会抄録集, 2021年04月, 日本語, (一社)日本外科学会肝細胞癌再発に対する腹腔鏡下再肝切除適応の条件についての検討
- 日本外科学会定期学術集会抄録集, 2021年04月, 日本語, (一社)日本外科学会術前分枝鎖アミノ酸飲料の使用は肝胆膵外科手術中の乳酸産生を抑制する
- 第5回神戸肝胆膵外科ビデオクリニック, 2021年03月, 日本語, 国内会議司会その他
- 第33回日本内視鏡外科学会, 2021年03月, 英語Oncological outcomes of laparoscopic distal pancreatectomy for pancreatic cancerシンポジウム・ワークショップパネル（公募）
- 日本病理学会会誌, 2021年03月, 日本語, (一社)日本病理学会松果体分化を伴う成熟奇形腫の3例
- 第32回日本肝胆膵外科学会, 2021年02月, 日本語, 国内会議Contrast-Enhanced Intraoperative ultrasonic cholangiography for real time biliary navigation in hepatobiliary surgeryシンポジウム・ワークショップパネル（公募）
- 第32回日本肝胆膵外科学会, 2021年02月, 日本語, 国内会議Multiple resections for isolated lung metastases originated from pancreatic cancer: report a case.ポスター発表
- 第32回日本肝胆膵外科学会, 2021年02月, 日本語, 国内会議The outcomes of surgical resection for locally recurrent bile duct cancerポスター発表
- 第32回日本肝胆膵外科学会, 2021年02月, 日本語, 国内会議Clinical significance of hepatectomy for hepatocellular carcinoma associated with lymph node and/or distant metastases口頭発表（招待・特別）
- 第56回日本肝癌研究会, 2020年12月, 日本語, 国内会議肝外転移を有する高度進行肝細胞癌に対する肝切除術の意義シンポジウム・ワークショップパネル（公募）
- 第56回日本肝癌研究会, 2020年12月, 日本語, 国内会議DAA治療によるC型肝炎SVR後肝癌に対する肝切除例の検討シンポジウム・ワークショップパネル（公募）
- 第75回日本消化器外科学会総会, 2020年12月, 日本語, 国内会議DAA治療後肝癌に対する肝切除例の検討シンポジウム・ワークショップパネル（公募）
- 第75回日本消化器外科学会総会, 2020年12月, 日本語, 国内会議肝移植後長期予後を目指した現状と課題;肝移植外来における多職種連携の必要性口頭発表（一般）
- 第75回日本消化器外科学会総会, 2020年12月, 日本語, 国内会議肝悪性疾患の再発に対する腹腔鏡下再肝切除口頭発表（一般）
- 第18回日本消化器外科学会大会（JDDW2020）, 2020年11月, 日本語, 国内会議高齢肝門部領域胆管癌患者に対する肝切除術の検討ポスター発表
- 外科, 2020年11月, 日本語, (株)南江堂, ＜文献概要＞高度進行状態である脈管侵襲陽性肝細胞癌(門脈腫瘍栓・下大静脈腫瘍栓)は,対象患者の肝機能因子や腫瘍学的因子などの背景因子が大きく異なるため,病態に応じた治療法選択が必要である.また,腫瘍栓の進展度により病態が大きくかわるため,腫瘍学的根治性と時間的治療域確保の二元軸で治療方針を検討する必要がある.いずれの治療法を選択したとしても,治療後再発は高率であり,再発に応じた集学的治療が必須な病態である.【肝癌治療の最前線】脈管侵襲陽性進行肝細胞癌に対する治療
- 第56回日本移植学会総会, 2020年11月, 日本語, 国内会議当科におけるアルコール性肝障害に対する肝移植後再飲酒に関する検討口頭発表（一般）
- 第56回日本移植学会総会, 2020年11月, 日本語, 国内会議急性肝不全患者に対する肝移植を見据えた院内および他施設との連携体制の現状と課題口頭発表（一般）
- 第56回日本移植学会総会, 2020年11月, 日本語, 国内会議脳死肝移植待機患者の管理。消化器内科・肝臓外科・関連施設との連携体制の構築口頭発表（一般）
- 第56回日本移植学会総会, 2020年11月, 日本語, 国内会議HLA one way 0 mismatched donor からの SPK 後 GVHD の経験口頭発表（一般）
- 第82回日本臨床外科学会総会, 2020年10月, 日本語, 国内会議移殖適応疾患の変遷によるこれからの肝癌に対する肝移植治療シンポジウム・ワークショップパネル（公募）
- 第82回日本臨床外科学会総会, 2020年10月, 日本語, 国内会議膵癌に対する腹腔鏡下膵体尾部切除の当科の標準手技シンポジウム・ワークショップパネル（公募）
- 第56回日本腹部救急医学会総会, 2020年10月, 日本語, 国内会議出血性胆嚢炎の1手術例口頭発表（一般）
- 日本癌学会総会記事, 2020年10月, 英語, (一社)日本癌学会DKK1-CKAP4シグナルは肝癌の予後不良因子であり、CKAP4は新たな治療標的となりうる
- 日本臨床外科学会雑誌, 2020年10月, 日本語, 日本臨床外科学会膵癌に対する腹腔鏡下膵体尾部切除 膵癌に対する腹腔鏡下膵体尾部切除の当科の標準手技
- 日本臨床外科学会雑誌, 2020年10月, 日本語, 日本臨床外科学会肝癌に対する肝移植の長期成績と再発予防 移植適応疾患の変遷によるこれからの肝癌に対する肝移植治療
- 移植, 2020年10月, 日本語, (一社)日本移植学会脳死肝移植待機患者の管理 消化器内科・肝臓外科・関連施設との連携体制の構築
- 移植, 2020年10月, 日本語, (一社)日本移植学会当科におけるアルコール性肝障害に対する肝移植後再飲酒に関する検討
- 移植, 2020年10月, 日本語, (一社)日本移植学会急性肝不全患者に対する肝移植を見据えた院内および他施設との連携体制の現状と課題
- 移植, 2020年10月, 日本語, (一社)日本移植学会HLA one way 0 mismatched donorからのSPK後GVHDの経験
- 第79回日本癌学会学術集会, 2020年10月, 日本語, 国内会議DKK1-CKAP4 シグナルは肝癌の予後不良因子であり,CKAP4 は 新たな治療標的となりうる。口頭発表（一般）
- 第120回日本外科学会定期学術集会, 2020年08月, 日本語, 国内会議狭心症治療歴のある肝細胞癌患者の切除症例の検討ポスター発表
- 第120回日本外科学会定期学術集会, 2020年08月, 日本語, 国内会議膵癌肺転移に対する切除例の検討ポスター発表
- 第120回日本外科学会定期学術集会, 2020年08月, 日本語, 国内会議超高齢者に対する肝細胞癌の高難度肝切除術の治療成績の検討ポスター発表
- 第120回日本外科学会定期学術集会, 2020年08月, 日本語, 国内会議切除可能な大腸癌肝転移の治療における全腫瘍体積の有用性についての検討ポスター発表
- 第120回日本外科学会定期学術集会, 2020年08月, 日本語, 国内会議肝硬変合併肝細胞癌に対する腹腔鏡下肝切除の有用性についての検討ポスター発表
- 第120回日本外科学会定期学術集会, 2020年08月, 日本語, 国内会議高齢胆道癌患者に対する高難度手術成績の検討ポスター発表
- 第120回日本外科学会定期学術集会, 2020年08月, 日本語, 国内会議脳死移植における働き方改革を実現するためになすべき移植医の環境整備ポスター発表
- 第120回日本外科学会定期学術集会, 2020年08月, 日本語, 国内会議肝癌粒子線治療後局所再発に対するサルベージ切除例の特徴と問題点口頭発表（一般）
- 日本消化器病学会近畿支部第112回例会, 2020年02月, 日本語, 国内会議肝細胞癌根治切除例における慢性C型肝炎に対するDAA治療の検討口頭発表（一般）
- 第48回近畿肝臓外科研究会, 2020年02月, 日本語, 国内会議当院における腹腔鏡下再肝切除の工夫口頭発表（招待・特別）
- 日本腹部救急医学会雑誌, 2020年02月, 日本語, (一社)日本腹部救急医学会出血性胆嚢炎の1手術例
- 日本癌学会学術総会抄録集(Web), 2020年DKK1-CKAP4シグナルは肝癌の予後不良因子であり,CKAP4は新たな治療標的となりうる。
- 臨床外科, 2020年01月, 日本語, (株)医学書院, ＜文献概要＞ポイント ◆門脈腫瘍栓合併肝細胞癌の治療では,急速な腫瘍栓の進展を考慮した治療選択が必要となる.◆門脈腫瘍栓合併肝細胞癌の肝切除では腫瘍栓の形態や進展度によって適切な摘出法を選択する.◆門脈腫瘍栓の進展の速い症例であっても,迅速に手術加療を含む集学的治療を行うことで予後が期待できる.【"超"高難度手術!他臓器合併切除術を極める】肝胆膵の拡大手術 門脈腫瘍栓合併肝細胞癌に対する外科治療 門脈腫瘍栓の進展度,形態および進展速度を考慮した治療戦略
- 日本内視鏡外科学会雑誌, 2019年12月, 日本語, (一社)日本内視鏡外科学会当施設における腹腔鏡下肝切除の適応
- 日本内視鏡外科学会雑誌, 2019年12月, 日本語, (一社)日本内視鏡外科学会初回切除部に対する再発部位から見た再発肝細胞癌に対する腹腔鏡手術適応の有効性について
- 日本内視鏡外科学会雑誌, 2019年12月, 日本語, (一社)日本内視鏡外科学会当施設における腹腔鏡下肝切除の適応
- 日本内視鏡外科学会雑誌, 2019年12月, 日本語, (一社)日本内視鏡外科学会初回切除部に対する再発部位から見た再発肝細胞癌に対する腹腔鏡手術適応の有効性について
- 新薬と臨牀, 2019年11月, 日本語, (株)医薬情報研究所進行肝細胞癌に対する減量肝切除術の有用性の検討
- 日本臨床外科学会雑誌, 2019年10月, 日本語, 日本臨床外科学会大血管に浸潤した悪性腫瘍の手術 肝細胞癌の下大静脈腫瘍栓に対する外科切除
- 日本臨床外科学会雑誌, 2019年10月, 日本語, 日本臨床外科学会肝細胞癌術後遠隔転移再発に対するソラフェニブ投与後の長期生存例
- 日本臨床外科学会雑誌, 2019年10月, 日本語, 日本臨床外科学会肝細胞癌におけるArl4c発現の臨床的意義についての検討
- 日本臨床外科学会雑誌, 2019年10月, 日本語, 日本臨床外科学会進行肝細胞癌に対する減量切除術の有用性の検討
- 日本臨床外科学会雑誌, 2019年10月, 日本語, 日本臨床外科学会難治性胆汁漏後の胆管狭窄に対して狭窄部穿刺が有効であった一例
- 日本消化器病学会近畿支部例会プログラム・抄録集, 2019年10月, 日本語, 日本消化器病学会-近畿支部術前に肝細胞癌と鑑別困難であった肝pseudolymphomaの一例
- 日本消化器病学会近畿支部例会プログラム・抄録集, 2019年10月, 日本語, 日本消化器病学会-近畿支部外科的切除を行ったβ-catenin活性型肝細胞腺腫の一例
- 日本消化器病学会近畿支部例会プログラム・抄録集, 2019年10月, 日本語, 日本消化器病学会-近畿支部脾動脈瘤胃穿破にてTAE後の広範な脾梗塞に対し保存的加療を行った1例
- 日本消化器病学会近畿支部例会プログラム・抄録集, 2019年10月, 日本語, 日本消化器病学会-近畿支部下大静脈腫瘍栓を有する進行肝細胞癌に対する当科での治療成績
- 日本消化器病学会近畿支部例会プログラム・抄録集, 2019年10月, 日本語, 日本消化器病学会-近畿支部肝切除後10年以上長期生存した症例の検討
- 日本消化器病学会近畿支部例会プログラム・抄録集, 2019年10月, 日本語, 日本消化器病学会-近畿支部腹腔鏡下脾温存尾側膵切除術を施行した子宮平滑筋肉腫膵転移の1例
- 移植, 2019年09月, 日本語, (一社)日本移植学会脳死移植Organ procurementの問題点と改善策 摘出体制を再構築するための課題 如何にして現地入りする移植医数は削減できるのか
- 移植, 2019年09月, 日本語, (一社)日本移植学会肝移植後における長期合併症としての肺炎 いかにして発症を予防できるのか
- 移植, 2019年09月, 日本語, (一社)日本移植学会生体肝移植後の難治性胆管吻合部狭窄に対して施行した磁石圧迫吻合術の長期成績
- 日本消化器外科学会総会, 2019年07月, 日本語, (一社)日本消化器外科学会腹腔鏡下肝切除術におけるHARMNICHD 1000iを用いたClamp Crush法の手術成績
- 日本消化器外科学会総会, 2019年07月, 日本語, (一社)日本消化器外科学会急性肝不全に対する集学的治療の現状と課題 移植の適応とは?
- 日本外科学会定期学術集会抄録集, 2019年04月, 日本語, (一社)日本外科学会肝細胞癌vp1症例における術後再発形式の検討
- 日本外科学会定期学術集会抄録集, 2019年04月, 日本語, (一社)日本外科学会門脈腫瘍栓合併肝細胞癌における門脈腫瘍栓進展速度に関する検討
- 日本外科学会定期学術集会抄録集, 2019年04月, 日本語, (一社)日本外科学会肝癌粒子線治療後局所再発に対するサルベージ肝切除例の検討
- 日本外科学会定期学術集会抄録集, 2019年04月, 日本語, (一社)日本外科学会切除不能胆嚢癌に対するconversion surgery施行例の検討
- 日本外科学会定期学術集会抄録集, 2019年04月, 日本語, (一社)日本外科学会大腸癌肝転移初回切除例における全腫瘍体積の予後因子としての有用性の検討
- 日本消化器病学会近畿支部例会プログラム・抄録集, 2019年02月, 日本語, 日本消化器病学会-近畿支部レゴラフェニブが著効した肝細胞癌術後肺転移の1例
- 癌と化学療法, 2019年02月, 日本語, (株)癌と化学療法社, 肝細胞癌(HCC)治療の第一選択は肝切除術であるが、超高齢者(80歳以上)は多彩な基礎疾患や心肺機能の低下があることが多く、手術のリスクが高い。今回、超高齢者HCC患者に対して肝切除術を施行した症例を対象として検討し、その安全性と有効性を検討した。当院で2009〜2015年までに初回肝切除術を施行したHCC症例348例のうち、手術施行時に80歳以上の23例(Group 1)と80歳未満の325例(Group 2)の安全性と予後についての項目を比較検討した。出血、手術時間は両群間に差を認めなかった。術中輸血はGroup 1 56.5%、Group 2 29.2%(p=0.0060)と高齢者に多い傾向にあった。Clavien-Dindo分類Grade III以上の合併症は両群に有意差は認めなかった。Group 1の肝切除後の生存期間中央値45ヵ月、5年生存率は30.7%で、Group 2の生存期間中央値52ヵ月、5年生存率47.2%とGroup 2に良好な傾向は認めたが、有意差は認めなかった。さらにpropensity score(PS)による調整、マッチングを行った後に同様の項目を比較したところ、両群の合併症、入院期間、予後に有意差は認めなかった。適切な腫瘍学的因子、患者のリスクファクター評価により、超高齢者HCCに対する肝切除術も安全かつ有効に施行可能であった。他に予後を規定する他疾患がなければ非超高齢者と同等な予後が期待できると考えられる。超高齢者というだけで治療法を制限せず、積極的な治療も考慮するべきだと考えられる。(著者抄録)超高齢者肝細胞癌患者に対する肝切除術の検討
- 新薬と臨牀, 2018年12月, 日本語, (株)医薬情報研究所再肝切除に対する腹腔鏡手術適応の有効性について
- 日本内視鏡外科学会雑誌, 2018年12月, 日本語, (一社)日本内視鏡外科学会腹腔鏡下肝切除における非脱転先行切除
- 日本内視鏡外科学会雑誌, 2018年12月, 日本語, (一社)日本内視鏡外科学会再発肝細胞癌に対する腹腔鏡手術適応の有効性について
- 癌と化学療法, 2018年12月, 日本語, (株)癌と化学療法社, 症例は63歳、男性。近医で慢性C型肝炎に対してIFN+リバビリン併用療法を施行されたが、皮膚症状のため中止となった。スクリーニングのエコー、CTで肝S5に2cm大の腫瘍を指摘され、精査にてS5、S8、S3に早期病変を認めたが、治療を希望せず経過観察とした。その後、外来フォロー中にPIVKA-IIが59,994mAU/mLと著明に上昇し、CTでS8病変の増大および門脈浸潤(vp2)、S3に高分化型肝細胞癌を疑う所見を認めたが明らかな遠隔転移はなく、肝右葉切除術、肝S3部分切除術、胆嚢摘出術を施行した。術後3ヵ月目のCTで多発肺転移を認めたため、sorafenibを800mg/dayで開始した。術後6ヵ月目のCTで肺転移の増大を認めsorafenib不応と判断し、regorafenib(120mg/day)に変更した。術後8.5ヵ月目のCTで肺転移の著明な縮小を認め、regorafenib継続とした。術後1年、regorafenibへの変更後6ヵ月、肺転移はほぼ消失し、肝内再発なく経過している。門脈浸潤(vp2)を伴う多発肝細胞癌術後、早期の多発肺転移に対するsorafenibが不応となり、regorafenib投与でほぼCRに近い治療効果を得た1例を経験した。(著者抄録)Regorafenibが著効した肝細胞癌術後肺転移の1例
- 日本消化器外科学会雑誌, 2018年11月, 日本語, (一社)日本消化器外科学会進行胆嚢癌に対してconversion surgeryを施行した5例の検討
- 日本臨床外科学会雑誌, 2018年10月, 日本語, 日本臨床外科学会肝細胞癌切除成績向上のためのストラテジー 肝細胞癌門脈腫瘍栓の進展速度に影響する因子についての検討
- 日本臨床外科学会雑誌, 2018年10月, 日本語, 日本臨床外科学会巨大肝癌に対する系統的切除における肝静脈系出血の対策
- 日本臨床外科学会雑誌, 2018年10月, 日本語, 日本臨床外科学会下大静脈腫瘍栓を有する進行肝細胞癌に対する当科での治療成績
- 移植, 2018年09月, 日本語, (一社)日本移植学会移植ドナー増加に向けて移植医のドブ板活動
- 中毒研究, 2018年07月, 日本語, (株)へるす出版日本の脳死移植の課題と対策
- 日本消化器外科学会総会, 2018年07月, 日本語, (一社)日本消化器外科学会再肝切除に対する腹腔鏡手術適応の妥当性について
- 肝臓, 2018年04月, 日本語, (一社)日本肝臓学会当科の非B非C肝細胞癌切除症例からみた肝癌発症リスク因子の検討
- 日本外科学会定期学術集会抄録集, 2018年04月, 日本語, (一社)日本外科学会高度進行肝癌に対する肝切除とPIHPを組み合わせた治療戦略
- 日本外科学会定期学術集会抄録集, 2018年04月, 日本語, (一社)日本外科学会当施設における巨大肝癌に対する切除成績
- 日本外科学会定期学術集会抄録集, 2018年04月, 日本語, (一社)日本外科学会肝細胞癌門脈腫瘍栓の進展速度に関わる因子に関する後ろ向き研究
- 日本消化器病学会雑誌, 2018年03月, 日本語, (一財)日本消化器病学会C型慢性肝炎に対するDAA治療 肝細胞癌根治切除例の検討
- 日本内視鏡外科学会雑誌, 2017年12月, 日本語, (一社)日本内視鏡外科学会Rouviere溝からアプローチする腹腔鏡下肝後区域切除
- 日本内視鏡外科学会雑誌, 2017年12月, 日本語, (一社)日本内視鏡外科学会当院における腹腔鏡下肝切除の定型化と適応拡大への工夫
- 新薬と臨牀, 2017年11月, 日本語, (株)医薬情報研究所C型慢性肝炎に対するDAA治療 肝細胞癌根治切除例の検討
- 日本臨床外科学会雑誌, 2017年10月, 日本語, 日本臨床外科学会開腹手術での起死回生の一手(肝) 肝切除時の下大静脈損傷に対する出血制御
- 日本臨床外科学会雑誌, 2017年10月, 日本語, 日本臨床外科学会生体肝移植の問題点 生体肝移植後胆管合併症の対策と予防
- 日本臨床外科学会雑誌, 2017年10月, 日本語, 日本臨床外科学会安全正確な系統的肝癌手術 当施設における肝前/後区域切除術での検討
- 日本臨床外科学会雑誌, 2017年10月, 日本語, 日本臨床外科学会高度進行肝細胞癌に対する集学的治療 高度進行肝細胞癌における減量肝切除術の意義
- 日本臨床外科学会雑誌, 2017年10月, 日本語, 日本臨床外科学会ここを工夫した私の手術手技(肝) 当施設における腹腔鏡下肝切除の定型化
- 日本臨床外科学会雑誌, 2017年10月, 日本語, 日本臨床外科学会胆管侵襲を伴う進行肝細胞癌に対する治療戦略
- 日本臨床外科学会雑誌, 2017年10月, 日本語, 日本臨床外科学会10cm以上の大型肝細胞癌に対する肝切除の意義
- 移植, 2017年08月, 日本語, (一社)日本移植学会当院におけるアルコール性肝硬変に対する肝移植患者の社会復帰の現状
- 移植, 2017年08月, 日本語, (一社)日本移植学会当院の脳死肝移植チームにおける現状から見えてきたもの
- 移植, 2017年08月, 日本語, (一社)日本移植学会ドナーを増やすために移植医が出来ること
- 癌と化学療法, 2015年09月, 日本語, (株)癌と化学療法社, 症例は38歳、男性。肝右葉を占拠する巨大肝細胞癌(HCC)の診断にて肝右葉切除術を施行。術後4ヵ月で残肝再発および右肺転移を認めた。肝内再発が肝動脈化学塞栓術(TACE)不応であったため肝切除を行い、その後ソラフェニブを開始。1年後に肺転移巣の増悪および縦隔リンパ節転移を認めたため、これらを切除した。その7ヵ月後に腹腔内傍大動脈リンパ節転移を認め、摘出。さらに3ヵ月後には右鎖骨上窩リンパ節転移を認めたが、粒子線治療により完全寛解を得た。その1年後には両肺に1ヶ所ずつ転移巣が出現したため、再度病変を切除。さらに6ヵ月後に左副腎転移を認め、摘出。現在、初回手術より4年6ヵ月経過したが、明らかな再発なく経過している。肝外転移巣の治療はソラフェニブが第一選択であるが、本症例のように積極的に外科的切除を追加することで長期生存を得る可能性が示唆された。(著者抄録)肝細胞癌肝外転移巣に対し集学的治療を行い長期生存した1例
- 日本生化学会大会(Web), 2013年, 日本語Wnt5aシグナルは基底膜誘導性の単一細胞レベルでの頂底極性形成を制御する
- 日本外科学会雑誌, 2012年03月, 日本語, (一社)日本外科学会肝細胞癌の治療戦略 その進歩と今後の方向性 高度進行肝癌に対する減量肝切除とPIHPによる2段階治療の有効性と予後因子の解析
- 日本生化学会大会(Web), 2012年, 日本語3次元基底膜マトリックス誘導性の単一細胞レベルでの頂底極性形成におけるWnt5aシグナルの役割
- 移植, 2011年12月, 日本語, (一社)日本移植学会生体肝移植後腎機能障害に対する新たな治療戦略
- 癌と化学療法, 2011年11月, 日本語, (株)癌と化学療法社, 症例は43歳、男性。2008年12月健診で肺野に結節影を指摘され前医受診。CTで右肺上葉に上大静脈浸潤を伴う35mm大の腫瘤、および肝S7に32mm大の腫瘤を指摘された。肝腫瘤に対し生検を施行しadenocarcinomaと診断されたため、原発性肺癌、肝転移の診断で、2009年1月より全身化学療法を開始した。肝S7腫瘤に対し2月にラジオ波焼灼療法(RFA)、肺腫瘤に対し12月に放射線照射を施行。肺病変は著明に縮小したが、肝病変は10月に再発が確認された後、発育進展を続け8月には80mm大にまで増大した。肝病変に対する治療目的で当科紹介となり、10月に肝右葉、右横隔膜、右肺合併切除術を施行。病理組織診断、免疫染色にて肝内胆管癌と最終診断された。2011年1月現在多発残肝再発、腹膜転移、多発肺転移を認めている。肝内胆管癌に対する確立された治療は肝切除のみであり、RFAの是非については統一した見解が得られていない。多発癌に対しては慎重に臨床診断を行うべきであると考えられた。(著者抄録)肺癌肝転移の診断でRFAを施行した肝内胆管癌の1例
- 癌と化学療法, 2011年11月, 日本語, (株)癌と化学療法社, 肝切除と粒子線治療併用にて治療効果を認めた両葉多発の肝細胞癌(hepatocellular carcinoma:HCC)の1例を経験した。症例は73歳、男性。2010年2月腹部CT検査にて両葉多発肝腫瘍を指摘され、当科に紹介された。精査にて肝左葉に門脈腫瘍栓(Vp3)を伴う径8cm大と径6cm大、後区域に径4cm大、S8に径1.5cm大の計4個のHCCを認め、T4N0M0、Stage IVAと診断された。肝予備能の低下、腫瘍の局在から根治切除は困難であったため、今回われわれは新しい治療戦略として肝切除と粒子線治療の併用療法を考案した。3月に肝左葉切除術を施行し、5月に後区域のHCCに対して局所制御目的に粒子線治療を施行した。その後追加治療としてTACEを4回施行することで、初回治療後15ヵ月経過した現在も腫瘍の局所制御は良好である。(著者抄録)肝切除および粒子線治療併用にて治療効果を認めた両葉多発肝細胞癌の1例
- 日本消化器外科学会雑誌, 2011年10月, 日本語, (一社)日本消化器外科学会神経内分泌腫瘍肝転移に対する肝切除の意義
- 日本肝胆膵外科学会・学術集会プログラム・抄録集, 2011年06月, 日本語, (一社)日本肝胆膵外科学会大腸癌肝転移における術前化学療法後の肝切除術
- 日本肝胆膵外科学会・学術集会プログラム・抄録集, 2011年06月, 日本語, (一社)日本肝胆膵外科学会著明な肝外発育をきたした重量8kgを超える巨大肝細胞癌の一切除例
- 日本肝胆膵外科学会・学術集会プログラム・抄録集, 2011年06月, 日本語, (一社)日本肝胆膵外科学会陽子線治療にてVp4門脈腫瘍栓を制御後、経皮的肝灌流化学療法(PIHP)を施行した1例
- 日本外科学会雑誌, 2011年05月, 日本語, (一社)日本外科学会巨大腫瘍を伴う両葉多発高度進行肝癌に対する新戦略 術前・術後経皮的肝灌流化学療法(PIHP)併用3段階療法
- 癌と化学療法, 2010年07月, 日本語, (株)癌と化学療法社, 症例は52歳、男性。2000年7月に胃癌に対して幽門側胃切除術を受けた。2005年7月腹部CTおよび注腸検査にて腹水および腹膜播種と診断されたためS-1内服を開始、2コース投与を行うもCEAの上昇傾向を認めS-1+cisplatin(CDDP)投与を開始した。同治療にて腹水および播種は消失し、7コース終了後2006年7月よりS-1+paclitaxel(PTX)投与を開始、しかし8コース投与後、指先のしびれが出現、増強したため12月よりS-1単剤に変更した。2007年7月腹部膨満感を自覚、CT上多量の腹水を指摘されたため再度S-1+CDDP併用療法に変更。しかし、3コース施行後に倦怠感および食欲不振が増強したため再度10月よりS-1単剤に変更した。11月にさらに嘔気、嘔吐が出現、これ以上の抗癌剤投与は困難と判断しbest supportive care(BSC)に移行。徐々に全身状態は悪化し、12月永眠された。本症例は高度の腹膜播種再発と診断されてから化学療法により約2年5ヵ月の長期生存が得られた比較的まれな症例である。S-1をbaseとした化学療法は再発胃癌に対して有効であったと考えられた。(著者抄録)S-1をBaseとした化学療法により長期生存が得られた胃癌腹膜播種再発の1例
- 日本外科学会雑誌, 2010年03月, 日本語, 一般社団法人日本外科学会VD-005-3 当院における腹腔鏡下左側結腸切除時における左結腸動脈温存についてのポイント(鏡視下手術・大腸-2,一般ビデオ,第110回日本外科学会定期学術集会)
- 日本外科学会雑誌, 2010年03月, 日本語, 一般社団法人日本外科学会OP-254-4 肝切除術・スペーサー留置術と粒子線治療の併用療法を施行した多発性肝類上皮血管内皮腫の1例(肝その他,一般口演,第110回日本外科学会定期学術集会)
- 日本内視鏡外科学会雑誌, 2009年12月, 日本語, (一社)日本内視鏡外科学会当院における腹腔鏡下直腸切除術についてのポイントについて
- 日本内視鏡外科学会雑誌, 2009年12月, 日本語, (一社)日本内視鏡外科学会当院における大腸がんに対する腹腔鏡補助下大腸切除術についての検討
- 日本臨床外科学会雑誌, 2009年10月, 日本語, 日本臨床外科学会当院における腹腔鏡下直腸切除術についてのポイント
- 日本臨床外科学会雑誌, 2009年10月, 日本語, 日本臨床外科学会S-1をbaseとした化学療法により長期生存が得られた胃癌腹膜播種再発の一例
- 日本消化器外科学会雑誌, 2009年07月, 日本語, 一般社団法人日本消化器外科学会P-1-119 TS-1/CDDP併用療法により腹膜転移が消失し,根治切除できた胃癌の1例(胃・十二指腸 化学療法1,一般演題(ポスター),第64回日本消化器外科学会総会)
- 日本消化器外科学会雑誌, 2009年07月, 日本語, 一般社団法人日本消化器外科学会P-2-287 直腸内分泌細胞癌と肝細胞癌の重複癌の1例(大腸癌症例3,一般演題(ポスター),第64回日本消化器外科学会総会)
- 日本消化器外科学会雑誌, 2008年07月, 日本語, 一般社団法人日本消化器外科学会P-2-116 胃癌に対する噴門側胃切除空腸パウチ間置再建術後,逆流性食道炎にて再手術を要した1例(胃 合併症,一般演題(ポスター),第63回日本消化器外科学会総会)
- 日本消化器外科学会雑誌, 2008年07月, 日本語, 一般社団法人日本消化器外科学会P-1-451 十二指腸GISTの3例(GIST 3,一般演題(ポスター),第63回日本消化器外科学会総会)
- 日本消化器外科学会雑誌, 2008年07月, 日本語, 一般社団法人日本消化器外科学会O-2-223 当院における腹腔鏡下大腸切除術クリニカルパスの現況と患者満足度について(大腸 術式手技2,一般演題(口演),第63回日本消化器外科学会総会)
- 日本消化器外科学会雑誌, 2008年07月, 日本語, 一般社団法人日本消化器外科学会P-1-587 肝内胆管癌再切除例4例の検討(肝腫瘍1,一般演題(ポスター),第63回日本消化器外科学会総会)
- 日本消化器外科学会雑誌, 2008年07月, 日本語, 一般社団法人日本消化器外科学会O-3-191 閉塞性大腸癌に対する術前腸管減圧の有用性の検討(大腸 悪性8,一般演題(口演),第63回日本消化器外科学会総会)
- 日本消化器外科学会雑誌, 2008年07月, 日本語, 一般社団法人日本消化器外科学会P-1-406 総胆管嚢腫術16年後に挙上空腸狭窄により発生した胆嚢床部腺癌の1例(胆嚢 悪性2,一般演題(ポスター),第63回日本消化器外科学会総会)
- 日本外科学会雑誌, 2008年04月, 日本語, 一般社団法人日本外科学会DP-151-3 腎障害を有する高度進行・再発大腸癌患者に対するmFOLFOX6療法の安全性,有効性についての検討(第108回日本外科学会定期学術集会)
- 日本外科学会雑誌, 2008年04月, 日本語, 一般社団法人日本外科学会VD-004-4 肝癌に対する小範囲肝切除における腹腔鏡下手術の応用(第108回日本外科学会定期学術集会)
- 日本消化器外科学会雑誌, 2007年07月, 日本語, 一般社団法人日本消化器外科学会P-1-429 膵dermoid cystの1例(膵 稀な腫瘍1,一般演題(ポスター),第62回日本消化器外科学会定期学術総会)
- 日本小児外科学会雑誌, 2007年, 日本語, 特定非営利活動法人 日本小児外科学会P-113B 心身障害児における術後イレウス(胃,十二指腸,小腸, 第44回日本小児外科学会学術集会)
- 日本小児外科学会雑誌, 2007年, 日本語, 特定非営利活動法人 日本小児外科学会R-008 超低出生体重児の腸閉塞症例に対する外科的治療戦略について(低侵襲手術II, 第44回日本小児外科学会学術集会)
- 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 2025年04月 - 2028年03月DKK1/CKAP4シグナルを標的とした新規胆道癌治療法の開発
- 日本学術振興会, 科学研究費助成事業, 基盤研究(C), 神戸大学, 2021年04月01日 - 2024年03月31日DKK1/CKAP4シグナルを標的とした肝細胞癌に対する新規抗癌治療の開発肝細胞癌412例の免疫組織染色の結果、DKK1発現陽性例は53%であった。DKK1発現陽性例は陰性例と比較して、有意に5年生存率、無再発生存率が低かった。また、CKAP4発現強陽性例は22%であり、CKAP4強陽性例はそれ以外の症例と比較して、5年生存率、無再発生存率ともに有意に低かった。さらにDKK1、CKAP4の共染色性のパターンに分けて評価を行なった結果、DKK1-CKAP4を共発現する症例を11%認めた。カプランマイヤー法を用いて共発現の予後への影響を検討した結果、共発現例はその他の症例と比較して、5年生存率、無再発生存率ともに有意に予後不良であった。Cox比例ハザード解析では、単変量解析において、年齢60歳以上、腫瘍数2個以上、腫瘍径5cm以上、リンパ節転移陽性、脈管侵襲陽性、UICC stageIIIA以上、DKK1-CKAP4共発現が有意に予後悪化に関連する因子として確認された。多変量解析では、年齢60歳以上、腫瘍数2個以上、脈管侵襲陽性、DKK1-CKAP4共発現が有意差をもって予後悪化に関連する因子として確認された。これらの結果から、DKK1-CKAP4の共発現が肝細胞癌の予後に関連している可能性が考えられた。 並行してDKK1-CKAP4シグナルによる腫瘍形成制御機構の解析を行なった。肝細胞癌由来株であるJHH7を用いて、DKK1、CKAP4ノックダウンによる腫瘍細胞の増殖への影響について検討を行なった。Colony formation assayによる評価では、DKK1ノックダウン、CKAP4ノックダウン共に腫瘍細胞の増殖を抑制した。さらに、JHH7のin vivoゼノグラフトモデルにおいても、CKAP4のノックダウンは腫瘍細胞の増殖を抑制した。これらの結果は、DKK1、CKAP4シグナルが肝細胞癌の腫瘍増殖に関連することを示唆していると考えられた。