Language：English   Publishing type：Research paper (scientific journal)  

This multicenter observational study investigated the prognosis of patients who participated in the Phase III POTENT trial, which examined combining S-1 with standard endocrine therapy in patients with estrogen receptor-positive, HER2-negative early breast cancer, over a longer follow-up period. The primary endpoint was overall survival (OS), with invasive disease-free survival (IDFS) and distant disease-free survival (DDFS) as secondary endpoints. Of the 1,930 POTENT trial participants, 1,593 patients (790 for S-1 and 803 for endocrine therapy alone) were included here. The median follow-up time was 77.5 months. Fifty-one and 58 deaths were observed in the S-1 and endocrine therapy alone groups, respectively. The 6-year OS rates were similar, with 94.4% in the S-1 group and 93.1% in the endocrine therapy alone group. Overall, both endocrine therapy alone and endocrine therapy plus S-1 resulted in favorable OS. Combining S-1 with endocrine therapy maintained the previously observed benefits of IDFS and DDFS.

DOI： 10.1038/s41523-025-00832-w

PubMed

researchmap

Language：Japanese   Publisher：日本臨床外科学会  

researchmap

Language：Japanese   Publisher：日本臨床外科学会  

researchmap

Language：Japanese   Publisher：日本臨床外科学会  

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Mammary apocrine carcinoma (AC) is a rare subtype of breast cancer characterized by distinct morphological features. Although generally considered to have a favorable prognosis, the clinicopathological characteristics and prognostic factors of AC remain poorly understood. METHODS: This single-center retrospective study analyzed 63 patients with AC diagnosed at Asahikawa Medical University Hospital between 2000 and 2024. Clinicopathological features were evaluated, which included tumor size, grade, hormone receptor status, human epidermal growth factor receptor type 2 expression, Ki-67 index, lymphatic and vascular invasion, and patient prognosis. Univariate and multivariate analyses were conducted to identify the independent prognostic factors. RESULTS: The incidence of AC among breast cancer cases was 1.4% (63/4459). All cases diagnosed as AC contained more than 50% apocrine components. Among the invasive ACs, there were 19 cases (34.5%) of pure type AC and 36 cases (65.5%) of non-pure type AC. Univariate analysis showed that a high Ki-67 index (≥ 40%), vascular invasion, and lymphatic invasion were significantly associated with poor prognosis. Multivariate analysis identified Ki-67 index ≥ 40% (HR: 8.096, p = 0.0225) as independent poor prognostic factor. CONCLUSION: Independent predictor of poor prognosis of AC may include high Ki-67 index. This finding suggests the need for individualized treatment strategies and close postoperative monitoring of high-risk patients.

DOI： 10.1007/s12672-025-03726-2

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: The Japanese Society for Sentinel Node Navigation Surgery conducted a multi-institutional prospective cohort study to compare sentinel node biopsy (SNB) with SNB followed by axillary lymph node dissection (ALND) in breast cancer patients with positive sentinel lymph node (SLN). PATIENTS AND METHODS: Female patients with breast cancer with cT1-3N0-1M0 were eligible. In cases of one to three positive micro- or macrometastases in the SLN confirmed by histological or molecular diagnosis, SNB alone (SNB group) or additional ALND (ALND group) was performed under physician's discretion. The primary endpoint was the 5-year regional node (RN) recurrence rate in the SNB group. Propensity score matching (PSM) was performed to compare the prognosis between the two groups. RESULTS: Of the 871 eligible cases registered between 2013 and 2016, 308 underwent SNB alone. At the median follow-up of 6.3 years, 5-year RN recurrence rate was 2.7%. After PSM, 209 cases were matched in each group. Breast-conserving surgery and mastectomy were performed in 225 (54%) and 193 cases (46%), respectively. One-positive SLN was recorded in 366 cases (88%), two in 48 (11%), and three in 4 (1%). Macro- and micrometastases in SLN were diagnosed in 271 (65%) and 147 cases (35%), respectively. Regional nodal irradiation (RNI) was performed in 42 (20%) and 13 (6%) cases of the SNB and ALND group. The 5-year RN recurrence rate was 2.1% and 2.0%, respectively. CONCLUSIONS: ALND is not necessary for early breast cancer patients with one-positive SLN despite type of breast surgery.

DOI： 10.1007/s12282-025-01726-2

PubMed

researchmap

Language：Japanese   Publisher：(一社)日本呼吸器学会  

researchmap

Other Link： https://search.jamas.or.jp/default/link?pub_year=2025&ichushi_jid=J05953&link_issn=&doc_id=20250724160006&doc_link_id=%2Fci6respo%2F2025%2F001404%2F006%2F0185-0189%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fci6respo%2F2025%2F001404%2F006%2F0185-0189%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本乳癌学会  

researchmap

Language：Japanese   Publisher：(一社)日本乳癌学会  

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：American Society of Clinical Oncology (ASCO)  

PURPOSE

Trastuzumab-pertuzumab (HP) plus taxane is a current standard first-line therapy for recurrent or metastatic human epidermal growth factor 2 (HER2)+ breast cancer (BC). We investigated noninferiority of eribulin to a taxane when combined with dual HER2 blockade as first-line systemic treatment for locally advanced/metastatic HER2+ BC.

METHODS

In the phase III EMERALD trial (target sample size, 480; ClinicalTrials.gov identifier: NCT03264547 /UMIN000027938), patients were randomly assigned (1:1) to receive eribulin 1.4 mg/m ² once daily on days 1 and 8 (eribulin group) or a taxane (docetaxel 75 mg/m ² once on day 1 or paclitaxel 80 mg/m ² once daily on days 1, 8, and 15; taxane group) intravenously in a 21-day cycle, each with HP on day 1. The primary end point was progression-free survival (PFS; intention-to-treat population). Secondary end points included objective response rate, overall survival (OS), patient-reported quality of life (QoL), and safety. Noninferiority was tested using the stratified Cox proportional hazards model to estimate hazard ratios (HRs) for PFS events, with a noninferiority HR margin of 1.33.

RESULTS

Between August 2017 and June 2021, 446 patients (median age, 56.0 years) were enrolled. The median PFS was 14.0 and 12.9 months in the eribulin group (n = 224) and taxane group (n = 222 [docetaxel/paclitaxel, n = 186/36]), respectively (HR, 0.95 [95% CI, 0.76 to 1.19]), which confirmed the noninferiority of the study regimen. The median OS was 65.3 months in the taxane group but has not been reached in the eribulin group. Median time to QoL deterioration was numerically longer with eribulin than with taxane. Adverse event (AE) rates were similar, despite the longer duration of eribulin use. Infusion reaction, skin-related AEs, diarrhea, and edema were more common with taxane, whereas neutropenia was more common with eribulin.

CONCLUSION

The results suggested that eribulin + HP is an option for first-line treatment of locally advanced/metastatic HER2+ BC.

DOI： 10.1200/JCO-24-01888

PubMed

researchmap

Language：Japanese   Publisher：(一社)日本呼吸器外科学会  

researchmap

Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Papillary thyroid carcinoma (PTC) is the most common histological type of malignant thyroid tumor, and the lungs are one of the most frequent sites of distant metastasis. Although the progression of the disease remains slow even after the appearance of pulmonary metastases, and there are reports of long-term survival cases, no clear criteria have been established for performing aggressive biopsies of metastatic lesions. The subject was a 79-year-old male who was detected to have left cervical lymphadenopathy of unknown origin six years back. After further examination, cervical lymph node metastasis of PTC was suspected. Five years ago, the patient underwent total thyroidectomy and left cervical lymph node dissection. Two years ago, a nodule was observed in the right upper lobe of the lung, but it was managed with observation. A chest computed tomography scan revealed an irregular nodule measuring 15×14 mm in the S1 segment of the right upper lobe. Under suspicion of primary lung cancer, it was decided to perform intraoperative rapid diagnosis, and if malignant, a right upper lobectomy with mediastinal lymph node dissection would be carried out. Intraoperative rapid diagnosis confirmed malignancy, and a right upper lobectomy and mediastinal lymph node dissection were performed. Histopathological examination revealed findings of papillary adenocarcinoma, leading to a diagnosis of secondary lung cancer (pT1cN0cM0, pStage IA3). In addition, findings suggestive of multiple metastases from PTC were also observed. Similarly, no adjuvant therapy was administered for the PTC lung metastases, and a policy of careful observation was adopted. This case is a valuable report of pulmonary metastasis from PTC discovered through detailed histopathological examination of the resected lung. Furthermore, performing aggressive surgical biopsy and detailed histopathological examination to establish a diagnosis is worth considering from the perspective of personalized medical care for each patient.

DOI： 10.7759/cureus.80112

PubMed

researchmap

Authorship：Last author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

Abstract

Occult breast cancer (OBC) is a rare form of breast cancer that is detected due to regional lymph node metastasis in the axilla. The patient was a 77-year-old woman. Twenty-four years previously, she had undergone a breast-conserving surgery and axillary lymph node dissection for left breast cancer. Her chief complaint was a mass in the right axilla. The breast magnetic resonance imaging did not show any findings suggestive of malignancy in the right breast. Therefore, an axillary dissection was performed. The results of the histopathological examination diagnosed the patient as having axillary lymph node metastasis of breast cancer. A total mastectomy of the right breast was performed. The patient was diagnosed with ductal carcinoma in situ (DCIS). She is currently undergoing postoperative endocrine therapy with an aromatase inhibitor. This report also includes a discussion of the treatment of OBC and the literature on lymph node metastasis and surgery for DCIS.

File： Occult breast cancer discovered.pdf

DOI： 10.1093/jscr/rjaf137

PubMed

researchmap

Language：English   Publisher：(一社)日本病理学会  

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Emphysematous lung cysts are considered to be a risk factor for the development of lung cancer, and there have been several reports of lung cancer cases that have developed in conjunction with large lung cysts. Emphysematous lung cysts are more common in heavy smokers, and it has been pointed out that early detection is difficult because the lung mass shadow overlaps with the lung cyst, so they are often detected in an advanced state. We report a case of this disease that was discovered incidentally. The patient was a 51-year-old man. During a health checkup, he was found to have a right lung cyst and a nodular shadow in his lung. He had a history of smoking 20 cigarettes a day for 30 years, and his Brinkman Index was 600. There were no other significant findings in the medical history. In addition to emphysema, a chest computed tomography (CT) scan revealed a large lung cyst and a lobulated, irregular nodular shadow measuring 15 x 14 mm in the S2 region of the right lung. A definitive diagnosis could not be made by transbronchial biopsy. Surgery was performed with the aid of a thoracoscope. A right upper lobectomy and mediastinal lymph node dissection were performed after a needle biopsy of the tumor was diagnosed as lung adenocarcinoma by intraoperative rapid diagnosis. The histopathological examination findings were diagnosed as adenosquamous cell carcinoma, WHO Grade 3, pT2apN0cM0. The patient is currently undergoing oral chemotherapy. In this case, it is important to detect large lung cysts using early chest CT scans. In addition, when performing surgery for lung cancer with a large lung cyst, it is necessary to be aware of the possibility of complications such as pneumothorax and peptic ulcer disease on the opposite side.

DOI： 10.7759/cureus.78340

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

INTRODUCTION: Although seminomas typically arise in the testes, primary mediastinal seminomas are classified as extragonadal germ cell tumors. Diagnosis is often challenging and requires not only blood tests and imaging but also a tumor biopsy. However, diagnosis may be particularly difficult when the tumor shows nonspecific pathological features or is accompanied by granulomatous changes. CASE PRESENTATION: The patient was a 25-year-old man who had been experiencing labored breathing when leaning forward for the past month. Physical examination revealed distended jugular veins and neck edema. Chest computed tomography revealed an irregular mass measuring 80 mm in the anterior mediastinum, suggesting invasion of the superior vena cava. Additionally, fluorodeoxyglucose-positron emission tomography showed high accumulation in the same area, with a maximum standardized uptake value of 11.3. A tumor biopsy was performed under thoracoscopic guidance for definitive diagnosis. Histopathological examination of the resected specimen revealed a seminoma with granulomatous changes. Based on these findings, a diagnosis of anterior mediastinal seminoma with superior vena cava syndrome was made. It was classified as having a good prognosis, and the patient received three courses of induction chemotherapy with etoposide, cisplatin, and ifosfamide. Complete remission was achieved. Since then, the patient has been monitored every 3 months, with no recurrence or metastasis observed for approximately 2 years. CONCLUSIONS: Immunohistochemical analysis plays a crucial role in the accurate diagnosis of mediastinal seminomas, especially in cases with unusual histological features such as granulomatous changes. Recognizing the immunoprofile of seminomas and differentiating them from thymomas and lymphomas is essential for avoiding diagnostic pitfalls.

DOI： 10.70352/scrj.cr.25-0091

PubMed

researchmap

Language：Japanese   Publisher：The Japanese Association for Chest Surgery  

We report the case of a patient who underwent sternal resection for a metastatic sternal tumor and sternal reconstruction with a titanium plate and polypropylene mesh to correct the sternal defect. The patient was a 76-year-old man. Chest computed tomography incidentally revealed a sternal mass. Biopsy led to the diagnosis of a metastatic sternal tumor originating from papillary thyroid carcinoma. As this tumor was resistant to medical treatment, surgical resection was planned. Extensive sternal defects may lead to physical fragility or paradoxical respiration, and sternal reconstruction is considered useful to prevent such conditions. At present, there are no established guidelines for reconstruction techniques, and various techniques have been reported. The reconstruction technique used in our department was effective for maintaining the respiratory function.

DOI： 10.2995/jacsurg.38.640

CiNii Research

researchmap

Other Link： https://search.jamas.or.jp/link/ui/2025061325

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

PURPOSE: This study aimed to determine whether the 21-Gene Breast Recurrence Score® assay from primary breast tissue predicts the prognosis of patients with hormone receptor-positive and human epidermal growth factor 2-negative advanced breast cancers (ABCs) treated with fulvestrant monotherapy (Group A) and the addition of palbociclib combined with fulvestrant (Group B), which included those who had progression in Group A from the Japan Breast Cancer Research Group-M07 (FUTURE trial). METHODS: Progression-free survival (PFS) and overall survival (OS) were compared using the log-rank test and Cox regression analysis based on original recurrence score (RS) categories (Low: 0-17, Intermediate: 18-30, High: 31-100) by treatment groups (A and B) and types of ABCs (recurrence and de novo stage IV). RESULTS: In total, 102 patients [Low: n = 44 (43.1%), Intermediate: n = 38 (37.5%), High: n = 20 (19.6%)] in Group A, and 45 in Group B, who had progression in Group A were analyzed. The median follow-up time was 23.8 months for Group A and 8.9 months for Group B. Multivariate analysis in Group A showed that low-risk [hazard ratio (HR) 0.15, 95% confidence interval (CI) 0.04-0.53, P = 0.003] and intermediate-risk (HR 0.22, 95% CI 0.06-0.78) with de novo stage IV breast cancer were significantly associated with better prognosis compared to high-risk. However, no significant difference was observed among patients with recurrence. No prognostic significance was observed in Group B. CONCLUSION: We found a distinct prognostic value of the 21-Gene Breast Recurrence Score® assay by the types of ABCs and a poor prognostic value of the high RS for patients with de novo stage IV BC treated with fulvestrant monotherapy. Further validations of these findings are required.

DOI： 10.1007/s10549-024-07414-7

PubMed

researchmap

Other Link： https://link.springer.com/article/10.1007/s10549-024-07414-7/fulltext.html

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

The TP53 signature is considered a predictor of neoadjuvant chemotherapy (NAC) response and prognostic factor in breast cancer. The objective of this study was to confirm TP53 signature can predict pathological complete response (pCR) and prognosis in cohorts of breast cancer patients who received NAC in prospective studies. Development cohorts (retrospective [n = 37] and prospective [n = 216] cohorts) and validation cohorts (NAC administered prospective study cohorts [n = 407] and retrospective perioperative chemotherapy (PC)-naïve, hormone receptor (HrR)-positive cohort [PC-naïve_HrR+ cohort] [n = 322]) were used. TP53 signature diagnosis kit was developed using the development cohorts. TP53 signature predictability for pCR and the relationship between recurrence-free survival (RFS), overall survival (OS), and the TP53 signature were analyzed. The pCR rate of the mutant (mt) signature group was significantly higher than that of the wild-type (wt) signature group (odds ratio, 5.599; 95 % confidence interval = 1.876-16.705; P = 0.0008). The comparison of the RFS and OS between the HrR+ and HER2- subgroup of the NAC cohort and of the PC-naïve_HrR+ cohort indicated that the RFS and OS benefit of NAC was greater in the mt signature group than in the wt signature group. From post hoc analyses, the RFS and OS benefit from adding capecitabine to FEC+T as NAC might be observed only in the mt signature group. The TP53 signature can predict the pCR after NAC, and the RFS and OS benefit from NAC may be greater in the mt signature group than in the wt signature group.

DOI： 10.1016/j.tranon.2024.102060

PubMed

researchmap

Language：Japanese   Publisher：日本臨床外科学会  

researchmap

Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Informa UK Limited  

Invasive cribriform carcinoma (ICC) is a type of malignant tumor with slow growth and good prognosis. The study was a single center retrospective study. The percentage of ICC among patients diagnosed with breast cancer was 0.3% (8/2454 patients). All patients tested positive for estrogen or progesterone receptors and 12.5% (1/8) patients tested positive for human epidermal growth factor receptor type2 (HER2). The present study suggests that the clinicopathological features of ICC are low-grade hormone receptor-positive luminal type with a good prognosis. However, some patients were HER2-positive and require careful follow-up.

DOI： 10.1080/07357907.2024.2383930

PubMed

researchmap

Publisher：南江堂  

DOI： 10.15106/j_kyobu77_563

CiNii Research

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

BACKGROUND: Eribulin prolongs overall survival (OS) of patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC), particularly in later chemotherapy (ChT) treatment. However, the health-related quality of life (HRQoL) and efficacy of first or second-line therapy in eribulin-treated patients remain unknown. Using eribulin in the first- or second-line may demonstrate the non-inferiority of HRQoL compared to S-1, an oral 5-fluorouracil derivative, while maintaining OS. METHODS: This randomised, controlled, open-label, phase III trial was conducted at 50 hospitals in Japan. Patients were enrolled from June 2016 and October 2019. Patients with HER2-negative MBC once under or no previous ChT were randomly assigned (1:1) to receive eribulin or S-1. HRQoL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) every six weeks until week 24 and every nine weeks until week 42. The primary endpoint was the deterioration defined as more than 10 points worsening of the general health score of QLQ-C30 or death within one year after randomisation. The secondary endpoints included OS. (Trial ID: UMIN000021398). FINDINGS: Three hundred and two patients were enrolled, with 152 and 148 assigned to the eribulin and S-1 groups, respectively. The questionnaire compliance rate was 85.6%. Risk difference of global health status deterioration through one year was -0.66% (95% CI: -12.47-11.16; non-inferiority P = 0.077) for eribulin compared to S-1 groups. Median time to first deterioration for global health status score was 5.64 (95% CI: 3.51-8.00) and 5.28 months (95% CI: 3.28-7.80) in the eribulin and S-1 groups, respectively. The median OS was 34.7 and 27.8 months, (HR: 0.72, 95% CI: 0.54-0.96; P = 0.026); the median progression-free survival was 7.57 and 6.75 months in the eribulin and S-1 groups, (HR: 0.88, 95% CI: 0.67-1.16; P = 0.35), respectively. No new adverse events occurred. INTERPRETATION: The time of the first clinical deterioration was similar between the two groups and OS significantly increased in eribulin-treated patients. FUNDING: This study was funded by CSPOR-BC and Eisai CO., Ltd.

DOI： 10.1016/j.eclinm.2024.102715

PubMed

researchmap

Language：Japanese   Publisher：The Japanese Association for Chest Surgery  

Lymph node metastasis, in which the pathological diagnosis is inconsistent with lung cancer lesions, may lead to the discovery of other intrapulmonary lesions. Conversely, there are no reports of cases in which oropharyngeal cancer was discovered after lymph node metastasis was diagnosed in the hilar lymph nodes. The patient was a 73-year-old man. Chest computed tomography revealed a mass at the base of the right lung, and transbronchial lung biopsy revealed adenocarcinoma. Lower lobectomy of the right lung and lymph node dissection were conducted. Histopathological examination revealed that the tumor was an adenocarcinoma, but the right main peribronchial lymph node (#Rt10) showed a squamous cell carcinoma (SCC). Postoperative fiberoptic laryngeal examination revealed a neoplastic lesion on the lateral wall of the right middle pharynx. Biopsy results confirmed the diagnosis of moderately to highly differentiated SCC; therefore, lumpectomy was performed. Histopathological examination revealed a morphologically similar lesion to #Rt10. Although it is straightforward to determine multiple lung cancers due to discrepancies between the pathological diagnosis of a tumor and lymph node metastasis, there are few reports of multiple cancers found in other organs, as in the present case. Preoperative diagnosis of patients at high risk of cancer should be performed more cautiously.

DOI： 10.2995/jacsurg.38.459

CiNii Research

researchmap

Other Link： https://search.jamas.or.jp/link/ui/2024311522

Language：Japanese   Publisher：(一社)日本乳癌学会  

researchmap

Language：Japanese   Publisher：(一社)日本乳癌学会  

researchmap

Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

Abstract

During breast cancer recurrence, drug therapy is planned based on the biological characteristics of the primary tumor. However, the mechanisms underlying these changes have not yet been clarified. A 59-year-old woman underwent breast cancer surgery 23 years previously and received postoperative hormone therapy for 2 years. She had abdominal distention and ascites effusion and was diagnosed with carcinomatous peritonitis due to luminal-type breast cancer after ascites puncture. She received up to the fourth line of treatment. Subsequently, pleural effusion was observed and human epidermal growth factor receptor 2 type breast cancer was diagnosed because of pleurodesis. This case suggests that the cell block diagnostic method based on thoracic and ascites fluid cytology is useful not only for confirming the primary tumor but also for diagnosing the biological characteristics of breast cancer. In the treatment of breast cancer recurrence, it is important to plan the treatment, including aggressive re-biopsy of metastases.

DOI： 10.1093/jscr/rjae432

PubMed

researchmap

Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

An esophagobronchial fistula, an abnormal passageway formed between the esophagus and bronchus, can cause severe respiratory symptoms. This fistula is a complication that can occur during chemoradiotherapy for esophageal and lung cancers; however, to our knowledge, no esophagobronchial fistulas during preoperative chemotherapy for lung cancer have been reported. The patient was a 55-year-old man whose chest computed tomography (CT) revealed a mass on the dorsal bronchus and right side of the esophagus. A transesophageal needle biopsy confirmed the diagnosis of lung adenocarcinoma, and preoperative chemotherapy, which included pembrolizumab, was administered. One week after the first course of chemotherapy, the patient developed a severe cough after drinking water. Chest CT revealed an esophagobronchial fistula, which prompted the discontinuation of the preoperative chemotherapy. Subsequent conservative treatment resulted in no improvement, and the patient was referred to our department. One month thereafter, a two-stage reconstruction of the esophagus was performed via the posterior sternal route. The resected specimen showed no residual tumor in the lungs, and the treatment was determined to result in a complete pathological response. The patient is currently undergoing maintenance therapy with pembrolizumab as a single agent. This is a rare case of esophagobronchial fistula identified during preoperative chemotherapy that included pembrolizumab for lung cancer. In addition to suturing the fistula, filling it with a distal hyoid valve was effective in treating the esophagobronchial fistula.

DOI： 10.7759/cureus.59666

PubMed

researchmap

Authorship：Last author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press (OUP)  

Abstract

No reports on granulocyte colony-stimulating factor-producing lung cancer associated with antiphospholipid antibody syndrome. A 73-year-old man was referred to our department to undergo surgery for lung cancer in the right upper lobe. His examination results suggested that his condition was caused by an elevated white blood cell count and an increased inflammatory response due to granulocyte colony-stimulating factor production. The presence of antiphospholipid antibody syndrome was suspected, and the decrease in coagulation factors was considered to be inhibited by the lupus anticoagulant. Perioperatively, the patient was treated with heparin and steroids, and a thoracoscopically assisted right upper lobectomy was performed. Postoperatively, histopathological examination revealed pleomorphic carcinoma, and the patient tested negative for anticardiolipin IgG antibodies. In lung cancer patients with elevated white blood cell counts, fever, and an inflammatory response, granulocyte colony-stimulating factor-producing lung cancer is an important differential diagnosis. Additionally, when coagulation abnormalities are observed preoperatively, a thorough examination is necessary to prepare for perioperative management.

File： Granulocyte colony-stimulating factor-producing.pdf

DOI： 10.1093/jscr/rjae361

PubMed

researchmap

Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Abstract

Background

Epipericardial fat necrosis (EFN) is a rare disease in which local inflammation and necrosis occur in the adipose tissue surrounding the heart, particularly epicardial fat. Few cases of EFN in which surgical resection was performed have been reported. We report a case of EFN after surgical resection of a right extrapulmonary tumor, in which a malignant disease could not be excluded.

Case presentation

A 75-year-old male patient presented with fever and chest pain. A contrast-enhanced computed tomography scan of the chest revealed a lesion, 53 × 48 mm in size, with mixed fatty density spanning the middle and lower lobes of the right lung. Thoracic magnetic resonance imaging (MRI) revealed a mass with mixed fat and soft tissue density in the same area; the lesion was contiguous with pericardial fatty tissue. The tumor was diagnosed as a liposarcoma or teratocarcinoma based on imaging results; however, the possibility of lung cancer could not be excluded. Finally, EFN was diagnosed based on the postoperative histopathological examination. The patient underwent surgical resection of the suspected right extrapulmonary tumor. The intraoperative findings revealed a mediastinal mass contiguous with pericardial fat located between the middle and lower lobes. Intraoperative pathological examination of the lesion was performed using a needle biopsy; however, no definitive diagnosis was made. The tumor may have invaded the middle lobe of the right lung, and partial resection of the right lower lobe was performed in addition to resection of the middle lobe of the right lung. The patient was followed up every 3 months without adjuvant therapy. No recurrence was reported at 1 year after surgery.

Conclusion

EFN should be considered in the differential diagnosis of an extrapulmonary tumor when continuity with the pericardial space is observed on MRI or other imaging studies. Surgical resection is useful in the diagnosis and treatment of EFNs. Preoperative three-dimensional reconstructive imaging and MRI should be used to identify vascular structures and confirm the continuity of the lesion with the surrounding tissues to ensure safe and rapid tumor removal.

DOI： 10.1186/s40792-024-01859-0

PubMed

researchmap

Other Link： https://link.springer.com/article/10.1186/s40792-024-01859-0/fulltext.html

Authorship：Last author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Wilson-Mikity syndrome (WMS) is a rare condition characterized by various respiratory and pulmonary abnormalities in neonates and infants. However, the diagnosis is based on the findings of physiological tests, such as respiratory function tests. Reports describing the histopathological features of WMS are limited. The patient was a 22-year-old woman with a history of WMS. She had been on a ventilator for the first three months of life due to pulmonary hypertension after early delivery at 24 weeks of gestation and required oxygen therapy until three years of age. One month before presenting at our clinic, the patient experienced chest pain and respiratory distress, and a left spontaneous pneumothorax was diagnosed based on a chest X-ray examination. The pneumothorax improved after the insertion of a thoracic drain but recurred soon thereafter. A histopathological examination revealed emphysematous changes associated with WMS in the background lungs, consistent with brevity. No postoperative complications were observed. The thoracic drain was removed on the second day, and the patient was discharged on the eighth postoperative day. Postoperatively, the patient was started on inhaled medication and was carefully monitored every three months. The present case suggests that childhood interviews are very important for adult patients who develop pneumothorax and that early surgical treatment may be selected based on a detailed interview. Moreover, postoperative follow-up should be carefully performed in collaboration with respiratory medicine in patients with pneumothorax originating from chronic obstructive pulmonary diseases such as WMS.

DOI： 10.7759/cureus.54641

PubMed

researchmap

Language：Japanese   Publisher：Japan Surgical Association  

Breast schwannoma is an extremely rare disease, accounting for only 0.2% of all benign breast tumors. Our case involved a 35-year-old man who presented with a left breast lump of which he had been aware for the last four years. Mammography revealed a round, circumscribed, and high-density lesion at the left 12 o'clock position, while ultrasonography identified a hypoechoic mass measuring 7 mm in diameter. The tumor was suspected to be a fibroadenoma, and the patient was observed. Two years later, the lesion increased to 13 mm, became tender, and showed erythema of the overlying skin. A core needle biopsy (CNB) suggested schwannoma and surgical excision was performed. Histopathologically, spindle cell proliferation, palisading nuclei, and Verocay bodies were observed. Immunohistochemical staining demonstrated positive for S-100 protein, leading to the diagnosis of breast schwannoma. There are no specific imaging findings for schwannomas. Histopathologic examination is believed to be useful for diagnosis, while distinguishing between benign and malignant lesions is often difficult. Therefore, surgical excision is appropriate for both diagnosis and treatment. There have been 56 reported cases of breast schwannoma, with only 9 cases in males, including this report. While breast lumps in males are rare, it is important to consider breast schwannoma as a differential diagnosis.

DOI： 10.3919/jjsa.85.1340

CiNii Research

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Primary chondrosarcoma of the ribs is relatively rare, and its basic treatment is surgical resection. In cases with positive resection margins, additional resection is considered, but its indications are unclear. However, reported cases with positive resection margins have been limited. We report a 71-year-old man whose medical checkup revealed an abnormal shadow in the chest. The findings from chest computed tomography, axial T2-weighted magnetic resonance imaging (MRI), and contrast-enhanced MRI led to a diagnosis of chondrosarcoma of the right fourth rib, and surgical resection was performed. The chest wall defect was reconstructed with a Marlex mesh. Postoperative histopathologic diagnosis was grade 2 chondrosarcoma. Gross resection margins, which were marginal, were negative, and the resection margin was grade 1. The patient was followed up without adjuvant therapy and did not undergo additional surgery. For chondrosarcomas with negative gross margins but a marginal margin, additional resection should be considered depending on the histologic grade of the margins. In cases with extensive resection of the chest wall, it is useful to reconstruct the chest wall while paying careful attention to infection control.

DOI： 10.7759/cureus.51251

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: The addition of pertuzumab to trastuzumab in neoadjuvant chemotherapy (NAC) for anti-human epidermal receptor 2 (HER2) positive breast cancer has shown a significant improvement in the pathologic complete response (pCR) rate. However, the add-on effect of an anthracycline-based regimen (standard-of-care regimen) remains unclear. In this retrospective, observational study, participants received pertuzumab combination therapy as NAC for HER2-positive primary breast cancer. METHODS: This study was conducted from January 1, 2020, to December 31, 2022. Patients who had not received at least three courses of pertuzumab owing to adverse events or those who had received preoperative radiotherapy were excluded. RESULTS: The pCR rate was 35.3% (12/34 patients). The pCR group had a significantly higher percentage of histopathologic grade III (1/11 patients, p=0.030) and a significantly higher percentage of hormone receptor-negative patients (7/12 patients, p=0.015) than the non-pCR group. The non-pCR group had a significantly higher incidence of vascular invasion than the pCR group (7/22 patients, p=0.036). Menopausal status, stage, and ki-67 values were not significantly different between the two groups. CONCLUSIONS: This study suggests an unlikely add-on effect of an anthracycline-based regimen for NAC in HER2-positive breast cancer. Moreover, our results support that the pCR rate is high in patients with hormone receptor-negative, HER2-positive breast cancer.

DOI： 10.7759/cureus.48255

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Radiation-associated breast angiosarcomas are rare following breast-conserving surgery. These angiosarcomas are considered adverse events associated with radiation therapy and are characterized by a high risk of both local and distant recurrence, even after complete resection. Despite this, there is currently no established standard treatment for them. The patient was a 70-year-old woman who had breast-conserving surgery for right breast cancer 10 years before presentation. She was followed up for 10 years after receiving 50 Gy of residual breast irradiation and an aromatase inhibitor for 5 years. During follow-up, a painless purplish area with induration, measuring 10 cm by 5.4 cm, was noted on the right nipple. A skin biopsy confirmed hemangiosarcoma. Treatment included surgery with a 2.0 cm margin from the area, followed by skin excision and total mastectomy. A final diagnosis of radiation-associated breast angiosarcoma was made. Radiation-associated breast angiosarcoma is a rare disease with a poor prognosis that lacks standard treatment. An aggressive skin biopsy should be considered when skin findings such as purpura are seen after breast cancer radiotherapy, as in this case.

DOI： 10.7759/cureus.46673

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

INTRODUCTION: To investigate the feasibility of early surgical treatment and perioperative steroid use in patients with interstitial lung disease (ILD) complicated by pneumothorax. METHODS: We retrospectively examined data, including patient characteristics, laboratory findings, surgical treatment details, postoperative complications, and deaths, of nine patients with ILD complicated by secondary pneumothorax. The patients had been treated at our hospital during the past 10 years. RESULTS: All nine patients were male (median age, 69.0 years). A total of nine patients had a histopathologic diagnosis of ILD after surgery. Of these, five were clinically diagnosed with ILD before surgery. Collagen disease was diagnosed in one case, drug-induced in one case, and idiopathic ILD (IILD) in three cases. All nine patients were diagnosed with postoperative ILD, including one case of collagen disease, one case of drug-induced, three cases of idiopathic pulmonary fibrosis (IPF)/cryptogenic fibrosing alveolitis, one case of nonspecific interstitial pneumonia (NSIP), and three cases of cryptogenic organizing pneumonia (COP). Regarding preoperative clinical characteristics, the performance status (PS) was 0 or 1 in all patients. Overall, three patients received oxygen (0-3 L/min), whereas steroids were administered to five patients. The mean drainage period was 23.5 days, and this was consistent with the time taken from pneumothorax occurrence to surgery. Video-assisted thoracic surgery (VATS) and thoracoscopic-assisted surgery were performed in seven and two patients, respectively. No postoperative recurrence or surgery-related deaths occurred. CONCLUSIONS: Early surgery for secondary pneumothorax complicated by ILD may be a viable option for patients in good preoperative condition. For patients who are preoperatively treated with steroids, continued use of steroids should be carefully considered.

DOI： 10.7759/cureus.46816

PubMed

researchmap

Language：Japanese   Publisher：The Japanese Association for Chest Surgery  

A 52-year-old woman aged 42 years had undergone breast-conserving surgery after preoperative drug therapy (Fluorouracil/Epirubicin/Cyclophosphamide followed by eight courses of Docetaxel) for luminal HER2-type cancer in the left breast, with the chemotherapeutic grade classified as ypT1aN0M0 (ypStageIA). She underwent postoperative adjuvant hormone therapy (tamoxifen for 5 years and a luteinizing hormone releasing hormone derivative for 2 years) and anti-HER2 therapy (trastuzumab for 1 year) and was being followed up. A 10-mm nodule appeared in the upper lobe of her right lung on computed tomography at her 10-year follow-up examination, which was considered to be breast cancer metastasis. Partial lung resection was performed using thoracoscopy to confirm the diagnosis. Positron emission tomography showed a mass lesion with a standardized uptake value of 4.6 in the right retroperitoneum and upper pelvis, and the urologist resected the right renal ureter on suspicion of retroperitoneal tumor invasion. A diagnosis of metastatic lung tumor of retroperitoneal origin was made. Based on this case, when we suspect a solitary metastatic pulmonary nodule, we should also keep in mind that the nodule may have metastasized from an unexpected tumor.

DOI： 10.2995/jacsurg.37.527

CiNii Research

researchmap

Other Link： https://search.jamas.or.jp/link/ui/2024029589

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Synchronous multiple lung cancers are rare and refer to the simultaneous presence of two or more primary lung tumors, which present significant challenges in terms of diagnosis and treatment. CASE SUMMARY: We report a case of multiple synchronous lung cancers with hilar lymph node metastasis of small cell carcinoma of unknown origin in a 73-year-old man. Transbronchial lung biopsy revealed squamous cell carcinoma. Although enlargement of lymph node 12u was detected, no distant metastases were observed. The patient was preoperatively diagnosed with T1cN0M0 and underwent thoracoscopic right upper lobectomy with nodal dissection (ND2a). Based on histopathological findings, the primary lesion was squamous cell carcinoma. A microinvasive adenocarcinoma was also observed on the cranial side of the primary lesion. Tumors were detected in two resected lymph nodes (#12u and #11s). Both tumors were pathologically diagnosed as small cell carcinomas. The primary lesion of the small cell carcinoma could not be identified even by whole-body imaging; however, chemotherapy was initiated for hilar lymph node metastasis of the small cell carcinoma of unknown origin. CONCLUSION: Multiple synchronous lung cancers can be accompanied by hilar lymph node metastasis of small cell carcinomas of unknown origin.

DOI： 10.12998/wjcc.v11.i25.5919

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Background and Objectives: Granulomatous mastitis is a benign disease with a clinical presentation similar to that of breast cancer, and is most commonly observed in women of childbearing age. Although it has been suggested that autoimmune diseases are involved in its pathogenesis, no specific treatments have been established. The occurrence of this disease during pregnancy has rarely been reported. We presented the case of a 37-year-old woman who complained of left breast induration at 24 weeks' gestation. Materials and Methods: She was pregnant and manifested a dichorionic, diamniotic placenta. At 24 weeks of gestation, the patient experienced a sensation of hardness in her left breast. Mastitis was suspected, and she was treated with cephem antibiotics. Simultaneously, she was diagnosed with erythema nodosum in the extremities. As her symptoms did not improve, an incisional drainage was performed. Bacterial cultures were obtained at 31 weeks of gestation, and Corynebacterium kroppenstedtii was detected. Results: An elective cesarean section was performed at 37 weeks of gestation, and the baby was delivered safely. After delivery, a needle biopsy was performed, and the patient was diagnosed with granulomatous mastitis. She was completely cured with prednisolone after weaning. In this case, the patient's condition was maintained through incision and drainage, as well as antibiotic, anti-inflammatory, and analgesic drugs during pregnancy. This approach was chosen, taking into consideration the potential side effects of steroids. Conclusions: This case suggests that incisional drainage and antibiotic therapy, as well as steroids and surgery, may be considered in the treatment of granulomatous mastitis occurring during pregnancy. This may also be true for management during delivery. After delivery, breastfeeding and steroidal therapy proved to be effective in treating the condition.

DOI： 10.3390/medicina59081418

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Gastric metastases from breast cancer are difficult to distinguish from primary gastric cancer. We report two cases of gastric metastasis of breast cancer with a review of the literature. In the first case, a 77-year-old woman was diagnosed with adenocarcinoma after upper gastrointestinal endoscopy, which revealed an erosive lesion in the gastric corpus. She was treated with an aromatase inhibitor and a CDK4/6 inhibitor, but five years later, she developed multiple bone metastases and gastric lesions, and she is currently receiving weekly paclitaxel (PTX) and bev. In the second case, a 63-year-old woman underwent total mastectomy and axillary lymphadenectomy [invasive lobular carcinoma (ILC)]. Eleven years after the surgery, the patient complained of pharyngeal tightness, and upper gastrointestinal endoscopy revealed a type 4 gastric tumor in the gastric body and posterior wall. In conclusion, when a patient with ILC or advanced breast cancer presents with gastric symptoms and anemia, it is important to examine and treat the patient based on the possibility of gastric metastasis.

DOI： 10.7759/cureus.43434

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

RATIONALE: Preoperative differentiation between pulmonary fractionation and solitary fibrous tumors (SFTs) is challenging. Diaphragmatic primary tumors are relatively rare among SFTs, with limited reports of abnormal vascularity. PATIENT CONCERNS: A 28-year-old male patient was referred to our department for surgical resection of a tumor near the right diaphragm, Thoracoabdominal contrast-enhanced computed tomography (CT) scan revealed a 10 × 8 cm mass lesion at the base of the right lung. The inflow artery to the mass was an anomalous vessel in which the left gastric artery bifurcated from the abdominal aorta, and its origin was the common trunk and right inferior transverse artery. DIAGNOSIS: The tumor was diagnosed as right pulmonary fractionation disease based on the clinical findings. The postoperative pathological examination determined a diagnosis of SFT. INTERVENTIONS: The pulmonary vein was used to irrigate the mass. The patient was diagnosed with pulmonary fractionation and underwent surgical resection. Intraoperative findings revealed a stalked, web-like venous hyperplasia anterior to the diaphragm, contiguous with the lesion. An inflow artery was found at the same site. The patient was subsequently treated using a double ligation technique. The mass was partially contiguous with S10 in the right lower lung and stalked. An outflow vein was identified at the same site, and the mass was removed using an automatic suture machine. OUTCOMES: The patient received follow-up examinations that involved a chest CT scan every 6 months, and no tumor recurrence was reported during 1 year of postoperative follow-up. LESSONS: Differentiating between SFT and pulmonary fractionation disease may be challenging during preoperative diagnosis; therefore, aggressive surgical resection should be considered as SFTs may be malignant. Identification of abnormal vessels using contrast-enhanced CT scans may be effective in reducing surgical time and improving the safety of the surgical procedure.

DOI： 10.1097/MD.0000000000034290

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Invasive mucinous adenocarcinoma often presents with pneumonia-like findings on imaging, which complicates its diagnosis. This case demonstrates that aggressive bronchoscopy is useful for examining infiltrating shadows in the lung field and large tumors occupying the entire lung lobe should be treated cautiously when lung parenchyma develops.

DOI： 10.1002/ccr3.7707

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

A subareolar breast abscess (SBA) is caused by the formation of an inflammatory abscess around the milk duct. SBAs usually occur in females, and reports of SBAs in males are very rare. This study reports the case of a 62-year-old male patient who presented with a subcutaneous nodule and diffuse erythema around the left nipple. Ultrasonography revealed a mixed lesion measuring 2.5 x 1.5 cm, mostly cystic. A computed tomography scan of the chest showed an irregular, nodular structure in the same area. Magnetic resonance imaging with contrast enhancement suggested an abscess. A needle biopsy was performed on the lesion, and results showed moderate inflammatory cell infiltration, including lymphocytes, plasma cells, neutrophils, and abscess formation, thus leading to the diagnosis of SBA. The patient did not strongly desire a surgical procedure. He was treated with the cephem antibiotic cefaclor and antipyretic analgesics. During the six-month healing period, cefaclor was administered for a total of six weeks. Once he improved, recurrence was observed two years after the onset of the disease; however, the symptoms improved with conservative treatment, such as warm compresses. Preventive measures should be considered as SBAs are prone to recurrence.

DOI： 10.7759/cureus.42623

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Granulomatous mastitis (GM) is a benign inflammatory breast disease that often poses diagnostic challenges due to its similar clinical and radiographic features to breast cancer. We report the case of a 34-year-old female with concurrent GM and ductal carcinoma in situ (DCIS). Initially, breast cancer was suspected based on imaging; however, a needle biopsy confirmed GM. Corticosteroid treatment led to a reduction in tumor size, but subsequent imaging continued to suggest the presence of breast cancer. Surgical excision ultimately revealed the coexistence of GM and DCIS. It is essential to consider the possibility of concurrent breast cancer in cases of GM with discordant imaging and pathology findings.

DOI： 10.7759/cureus.38377

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Pneumothorax is a known complication of coronavirus disease 2019 (COVID-19). The concept of pneumothorax ex vacuo has also been proposed to describe pneumothorax that occurs after malignant pleural effusion drainage. Herein, we present the case of a 67-year-old woman who had abdominal distension for 2 months. A detailed examination led to the suspicion of an ovarian tumor and revealed an accumulation of pleural effusion and ascitic fluid. Thoracentesis was performed, raising the suspicion of metastasis of high-grade serous carcinoma arising from the ovary. An ovarian biopsy was scheduled to select subsequent pharmacotherapy, and a drain was inserted preoperatively into the left thoracic cavity. Thereafter, a polymerase chain reaction analysis revealed that the patient was positive for COVID-19. Thus, the surgery was postponed. After the thoracic cavity drain was removed, pneumothorax occurred, and mediastinal and subcutaneous emphysema was observed. Thoracic cavity drains were then placed again. The patient's condition was conservatively relieved without surgery. This patient may have developed pneumothorax ex vacuo during the course of a COVID-19 infection. Since chronic inflammation in the thoracic cavity is involved in the onset of pneumothorax ex vacuo, careful consideration is required for the thoracic cavity drainage of malignant pleural effusion and other fluid retention.

DOI： 10.3390/medicina59040709

PubMed

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

Multiple endocrine neoplasia (MEN) type 1 is a hereditary syndrome characterized by hyperplasia and adenoma of the parathyroid gland, pancreatic tumor, and pituitary tumor. We report a rare case of thymic neuroendocrine tumor diagnosed after removal of a thymic tumor following pancreatic and parathyroid surgery. A 35-year-old man was diagnosed with MEN type 1 by hypercalcemia and gastrinemia with a ureteral tone. Two well defined nodules in the anterior mediastinum on computed tomography (CT), and a high degree of accumulation on positron emission tomography (PET) was noted. Surgery was performed through a median sternotomy with anterior mediastinal tumor resection. Pathology showed thymic neuroendocrine tumor (NET). Immunostaining results were different from pancreatic NET and duodenal NET, and a diagnosis of primary thymic NET was made. Postoperative radiation therapy was completed as adjuvant therapy, and the patient is alive without reccurrence.

DOI： 10.15106/j_kyobu76_324

PubMed

CiNii Research

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Human telomerase reverse transcriptase (hTERT) is highly expressed in various cancers, including breast cancer. Although telomere elongation is an essential role for hTERT, the nuclear export after oxdative stress has also been shown in several cancer cell lines and is associated with drug-resistance in vitro. As only a few reports focused on the subcellular localization of hTERT in clinical specimens, we performed immunohistochemistry (IHC) and analyzed the correlation between intracellular hTERT expression and the clinicopathological characteristics to identify the clinical significance of hTERT subcellular expression in breast cancers. 144 invasive breast cancers classified by IHC subtype without primary systemic therapy (PST), were selected from a surgical resection cohort and were immunostained for hTERT, p-STAT3, p-AKT and p-ERK. The nuclear and/or cytoplasmic staining intensity and proportion of hTERT were scored and compared with clinicopathological parameters. The nuclear hTERT expression was significantly correlated with HER2 expression (p = 0.00156), and the scores were significantly correlated with p-STAT3 and p-AKT expression scores (r = 0.532, p = 0.000587 and r = 0.345, p = 0.0339, respectively) in the HER2-immunopositive breast cancer including luminal-HER2 and HER2 subtypes. Furthermore, hTERT was expressed more in cytoplasm in the specimens after PST than those before PST, and the score tended to be negatively correlated with tumor shrinkage rate in HER2 subtype (r = -0.593, p = 0.0705). These results suggest that nuclear and/or cytoplasmic hTERT may play a different role before and after PST including the tumorigenesis and drug-resistance in breast cancer. Suppression of cytoplasmic hTERT expression may lead to more effective strategy for drug-resistant HER2 subtype in breast cancer.

DOI： 10.1016/j.humpath.2022.12.010

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Liposarcoma often occurs in the extremities and retroperitoneum. Primary mediastinal liposarcoma is uncommon, and there is no settled opinion regarding adjuvant therapy after surgery. We have recently experienced a relatively rare case of primary dedifferentiated liposarcoma of the posterior mediastinum. The patient was a 76-year-old woman. An abnormal shadow was noted in the posterior mediastinum. Esophageal submucosal tumor and gastrointestinal stromal tumor were suspected; endoscopic ultrasound-guided fine needle aspiration was performed, but a definitive diagnosis could not be obtained. As the tumor tended to slowly grow, surgical resection was performed. Based on histopathological findings, the patient was diagnosed with primary dedifferentiated liposarcoma of the posterior mediastinum. Owing to the presence of a positive surgical margin, postoperative radiotherapy (60 Gy/24 fr/6 w) was administered. No recurrence was observed after three and a half years of follow-up. The prognosis of primary dedifferentiated liposarcoma of the posterior mediastinum with a positive surgical margin is poor, but postoperative radiotherapy may be useful.

DOI： 10.7759/cureus.36611

PubMed

researchmap

Language：Japanese   Publisher：Japan Surgical Association  

A 57-year-old woman presented to our hospital with dyspnea and chest pain of which she had been aware. A chest CT scan revealed an 18 × 13 cm chest wall tumor in the right thoracic cavity. CT-guided percutaneous needle biopsy led to a diagnosis of solitary fibrous tumor (SFT). It was difficult to differentiate whether the tumor was benign or malignant based on CT, MRI and FDG-PET findings. In December 2020, we performed thoracoscopic-assisted tumor excision. The histopathological study revealed patternless proliferation of spindle-shaped cells. The mitotic figure was 16/10HPF. Immunostaining studies showed CD34 positive and STAT6 positive. From these findings, we diagnosed the case as high-risk malignant SFT. The surgical stump was negative, indicating that a surgical complete resection could be achieved. No adjuvant chemotherapy was added, and the patient has been followed without any therapies.

Malignant SFT is an extremely rare entity, and its diagnostic criteria are still obscure. However, the risk of recurrence has been described in a variety of reports. We here present a case of SFT which was diagnosed as malignant and treated by surgical resection, with literature review.

DOI： 10.3919/jjsa.84.1032

CiNii Research

researchmap

Other Link： https://ndlsearch.ndl.go.jp/books/R000000004-I033000142

Language：English   Publishing type：Research paper (scientific journal)  

Chemotherapy-induced peripheral neuropathy (CIPN) is an important clinical challenge that threatens patients' quality of life. This sub-study of the ABROAD trial investigated the influence of single nucleotide polymorphisms (SNPs) on CIPN, using genotype data from a randomized study to determine the optimal dose of a 3-week-cycle regimen of nab-paclitaxel (q3w nab-PTX) in patients with metastatic breast cancer (MBC). Patients with HER2-negative MBC were randomly assigned to three doses of q3w nab-PTX (SD: 260 mg/m2 vs. MD: 220 mg/m2 vs. LD: 180 mg/m2). Five SNPs (EPHA4-rs17348202, EPHA5-rs7349683, EPHA6-rs301927, LIMK2-rs5749248, and XKR4-rs4737264) were analyzed based on the results of a previous genome-wide association study. Per-allele SNP associations were assessed by a Cox regression to model the cumulative dose of nab-PTX up to the onset of severe or worsening sensory neuropathy. A total of 141 patients were enrolled in the parent study; 91(65%) were included in this sub-study. Worsening of CIPN was significantly greater in the cases with XKR4 AC compared to those with a homozygote AA (HR 1.86, 95%CI: 1.00001-3.46, p=0.049). There was no significant correlation of CIPN with any other SNP. A multivariate analysis showed that the cumulative dose of nab-PTX was most strongly correlated with CIPN (p<0.01).

DOI： 10.18926/AMO/64116

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s10147-022-02237-2

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Although neoantigens are one of the most favorable targets in cancer immunotherapy, it is less versatile and costly to apply neoantigen-derived cancer vaccines to patients due to individual variation. It is, therefore, important to find highly immunogenic antigens between tumor-specific or associated antigens that are shared among patients. Considering the cancer immunoediting theory, immunogenic tumor cells cannot survive in the early phase of tumor progression including two processes: elimination and equilibrium. We hypothesized that highly immunogenic molecules are allowed to be expressed in tumor cells after an immune suppressive tumor microenvironment was established, if these molecules contribute to tumor survival. In the current study, we focused on TWIST1 as a candidate for highly immunogenic antigens because it is upregulated in tumor cells under hypoxia and promotes tumor metastasis, which is observed in the late phase of tumor progression. We demonstrated that TWIST1 had an immunogenic peptide sequence TWIST1140-162 , which effectively activated TWIST1-specific CD4+ T-cells. In a short-term culture system, we detected more TWIST1-specific responses in breast cancer patients compared with in healthy donors. Vaccination with the TWIST1 peptide also showed efficient expansion of TWIST1-reactive HTLs in humanized mice. These findings indicate that TWIST1 is a highly immunogenic shared antigen and a favorable target for cancer immunotherapy.

DOI： 10.1111/cas.15429

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Anticancer treatment regimens typically cause unpleasant side-effects. We aimed to investigate the benefit of switch maintenance endocrine therapy plus bevacizumab after fixed cycles of first-line induction chemotherapy with weekly paclitaxel plus bevacizumab in patients with oestrogen receptor (ER)-positive, HER2-negative advanced or metastatic breast cancer. METHODS: BOOSTER was a prospective, open-label, multicentre, randomised, controlled, phase 2 study done in 53 hospitals in Japan. Eligible patients were women aged 20-75 years, with an Eastern Cooperative Oncology Group performance status of 0-1, who had not received chemotherapy for ER-positive, HER2-negative advanced or metastatic breast cancer. All patients received four to six cycles (in which 4 weeks of treatment constitute one cycle) of weekly paclitaxel plus bevacizumab induction therapy (weekly paclitaxel 90 mg/m2, administered intravenously on days 1, 8, and 15 of each cycle, plus bevacizumab 10 mg/kg administered intravenously on days 1 and 15 of each cycle; first registration). Patients with a complete response, partial response, or stable disease after induction therapy (responders) were then randomly assigned (1:1) using the randomisation enrolment form to either continue weekly paclitaxel plus bevacizumab or switch to maintenance endocrine therapy (an aromatase inhibitor or fulvestrant with or without ovarian-function suppression) plus bevacizumab. Randomisation was stratified by induction therapy period, response to induction therapy, age, history of endocrine therapy, and study site. Patients could receive weekly paclitaxel plus bevacizumab reinduction if they had disease progression with maintenance endocrine therapy plus bevacizumab. The primary endpoint was time to failure of strategy (TFS). Efficacy and safety analyses were done in all treated patients (full analysis set). This study is registered with ClinicalTrials.gov, NCT01989780, and registration and follow-up are closed. FINDINGS: Between Jan 1, 2014, and Dec 31, 2015, we enrolled 160 patients who began weekly paclitaxel plus bevacizumab induction therapy. 125 (78%) patients (responders) were randomly assigned to endocrine therapy plus bevacizumab (n=62; n=61 in the full analysis set) or weekly paclitaxel plus bevacizumab (n=63; n=63 in the full analysis set). Among 61 patients in the switch maintenance endocrine therapy plus bevacizumab group, 32 (52%) were reinitiated on weekly paclitaxel plus bevacizumab. At a median follow-up of 21·3 months (IQR 13·0-28·2), TFS was significantly longer in the endocrine therapy plus bevacizumab group than in the weekly paclitaxel plus bevacizumab group (median 16·8 months [95% CI 12·9-19·0] vs 8·9 months [5·7-13·8]; hazard ratio 0·51 [0·34-0·75]; p=0·0006). The most common grade 3-4 non-haematological adverse events after randomisation were proteinuria (in ten [16%] of 61 patients in the endocrine therapy plus bevacizumab group vs eight [13%] of 63 patients in the weekly paclitaxel plus bevacizumab group), hypertension (six [10%] vs six [10%]), and peripheral neuropathy (one [2%] vs six [10%]). One treatment-related death was reported in the weekly paclitaxel plus bevacizumab group (duodenal ulcer perforation). INTERPRETATION: Switch to maintenance endocrine therapy plus bevacizumab with the possibility of weekly paclitaxel reinduction if needed is an efficacious alternative, with a better safety profile, to continuing weekly paclitaxel plus bevacizumab in patients with ER-positive, HER2-negative advanced or metastatic breast cancer who have responded to induction therapy. FUNDING: Chugai Pharmaceutical. TRANSLATION: For the Japanese translation of the abstract see Supplementary Materials section.

DOI： 10.1016/S1470-2045(22)00196-6

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: To report our findings on quality of life (QoL) in a randomized phase II study to determine the optimal dose of 3-week cycle nab-paclitaxel (q3w nab-PTX) in patients with metastatic breast cancer (MBC). METHODS: Patients with HER2-negative MBC were randomly assigned to three different doses of q3w nab-PTX (SD 260 mg/m2 vs. MD: 220 mg/m2 vs. LD 180 mg/m2). QoL was assessed at baseline and during the second, fourth and sixth courses of treatment using the Functional Assessment of Cancer Therapy-Taxane (FACT-Taxane), Cancer Fatigue Scale (CFS) and EuroQol 5-Dimension (EQ-5D). Comparisons were performed with mixed-model repeated measures (MMRM). RESULTS: A total of 141 patients were enrolled in the parent study, and 136 (96%) (44, 45 and 47 in the SD, MD, and LD groups) were included in the analysis. MMRM analysis showed that the difference from the baseline FACT-Taxane trial outcome index at MD and LD were significantly higher than that at SD (MD vs. SD P < 0.001, LD vs. SD P < 0.001). Differences from baseline for FACT-Taxane total, physical and emotional well-being, and taxane subscale scores at MD and LD were also higher than at SD. The difference from baseline for the CFS score at LD was lower than at SD (P = 0.013) and those for EQ-5D utility scores at MD and LD were higher than at SD (MD vs. SD P = 0.011, LD vs. SD P < 0.001). CONCLUSION: QoL of patients treated with 220 or 180 mg/m2 of q3w nab-PTX was significantly better than that of patients treated with 260 mg/m2. TRIAL REGISTRATION: The protocol was registered at the website of the University Hospital Medical Information Network (UMIN), Japan (protocol ID: UMIN000015516), on 01/11/2014. Details are available at the following address: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000017916.

DOI： 10.1007/s12282-021-01290-5

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Purpose This study investigated the relationship between the pharmacokinetics and pharmacodynamics of everolimus in patients with metastatic breast cancer (mBC) in real-world practice.Methods Twenty-two patients with mBC treated with everolimus plus exemestane were enrolled. Blood everolimus concentrations were measured at outpatient visits. The inhibition of the mammalian target of rapamycin (mTOR) activity in peripheral blood mononuclear cells (PBMCs) was examined. The efficacy and safety endpoints were progression-free survival (PFS) and the cumulative incidence of dose-limiting toxicities (DLTs), respectively. Results Blood samples were obtained from 19 consenting patients. Everolimus did not completely inhibit mTOR activity in PBMCs at therapeutic concentrations (~ 56 % maximal inhibition). The most common adverse event was stomatitis (any grade 77 %). The trough concentration (Ctrough) was significantly higher in patients experiencing DLTs than in those without any DLTs (P = 0.030). The optimal Ctrough cutoff predicting DLT development was 17.3 ng/mL. The cumulative incidence of DLTs was significantly higher in patients with Ctrough ≥17.3 ng/mL than in other patients (sub-hazard ratio 4.87, 95 % confidence interval [CI] 1.53-15.5; P = 0.007). Furthermore, the median PFS was numerically longer in patients who maintained a steady-state Ctrough below the threshold than in those who did not (327 days [95 % CI 103-355 days] vs. 194 days [95 % CI 45 days-not estimable]; P = 0.35). Conclusions The suggested upper threshold for the therapeutic window of everolimus Ctrough was 17.3 ng/mL. Pharmacokinetically guided dosing may improve the efficacy and safety of everolimus for mBC, warranting further investigation in a larger study.Clinical trial registry: Not applicable.

DOI： 10.1007/s10637-021-01131-4

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Activation of STING signaling plays an important role in anti-tumor immunity, and we previously reported the anti-tumor effects of STING through accumulation of M1-like macrophages in tumor tissue treated with a STING agonist. However, myeloid cells express SIRPα, an inhibitory receptor for phagocytosis, and its receptor, CD47, is overexpressed in various cancer types. Based on our findings that breast cancer patients with highly expressed CD47 have poor survival, we evaluated the therapeutic efficacy and underlying mechanisms of combination therapy with the STING ligand cGAMP and an antagonistic anti-CD47 mAb using E0771 mouse breast cancer cells. Anti-CD47 mAb monotherapy did not suppress tumor growth in our setting, whereas cGAMP and anti-CD47 mAb combination therapy inhibited tumor growth. The combination therapy enhanced phagocytosis of tumor cells and induced systemic anti-tumor immune responses, which rely on STING and type I IFN signaling. Taken together, our findings indicate that coadministration of cGAMP and an antagonistic anti-CD47 mAb may be promising for effective cancer immunotherapy.

DOI： 10.1084/jem.20200792

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Anthracycline (A) or taxane T-based regimens are the standard early-line chemotherapy for metastatic breast cancer (BC). A previous study has shown a survival benefit of eribulin in heavily pretreated advanced/recurrent BC patients. The present study aimed to compare the benefit of eribulin with treatment of physician's choice (TPC) as first- or second-line chemotherapy for recurrent HER2-negative BC. METHODS: Patients with recurrent HER2-negative BC previously receiving anthracycline and taxane AT-based chemotherapy in the adjuvant or first-line setting were eligible for this open-label, randomized, parallel-group study. Patients were randomized 1:1 by the minimization method to receive either eribulin (1.4 mg/m2 on day one and eight of each 21-day cycle) or TPC (paclitaxel, docetaxel, nab-paclitaxel or vinorelbine) until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS). Secondary endpoints included time to treatment failure (TTF), overall response rate (ORR), duration of response, and safety (UMIN000009886). RESULTS: Between May 2013 and January 2017, 58 patients were randomized, 57 of whom (26 eribulin and 31 TPC) were analyzed for efficacy. The median PFS was 6.6 months with eribulin versus 4.2 months with TPC (hazard ratio: 0.72 [95% confidence interval (CI), 0.40-1.30], p = 0.276). Median TTF was 6.0 months with eribulin versus 3.6 months with TPC (hazard ratio: 0.66 [95% CI, 0.39-1.14], p = 0.136). Other endpoints were also similar between groups. The most common grade ≥ 3 adverse event was neutropenia (22.2% with eribulin versus 16.1% with TPC). CONCLUSIONS: Eribulin seemed to improve PFS or TTF compared with TPC without statistical significance. Further validation studies are needed.

DOI： 10.1007/s10147-021-01920-0

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s10147-021-01940-w

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Triple-negative breast cancer (TNBC) has a poorer prognosis than other breast cancer subtypes; therefore, identifying markers of early recurrence is important. The present study aimed to establish a liquid biopsy protocol for droplet digital PCR-based detection of frequently mutated genes in patients with TNBC. Tumor DNA from 36 patients with TNBC who relapsed within 2 years after surgical resection was retrospectively analyzed. Somatic mutational profiles were evaluated using targeted sequencing to identify frequently mutated genes and genes associated with molecularly targeted therapies. The association between genetic alterations and associated protein phosphorylation was investigated using immunohistochemical analysis. Recurrent hot spot mutations in the plasma were monitored over time. Mutation-specific probes were used to successfully detect mutations in the blood samples of patients who were positive for PIK3CA H1047R and AKT1 E17K mutations. Somatic mutations in AKT1 (14.9%) and PIK3CA (25.5%) were frequently identified in the data. Robust phosphorylation of AKT and S6RP was more common in tumors with PIK3CA H1047R and AKT1 E17K mutational background than in tumors with wild-type PIK3CA and AKT1. In conclusion, the present study evaluated a high-sensitivity detection system for frequently mutated genes that was also applicable for cell-free DNA. The PI3K/AKT pathway was revealed to be activated in patients harboring PIK3CA H1047R and AKT1 E17K mutations; therefore, the PI3K/AKT pathway may be a promising candidate for targeted therapy in these patients.

DOI： 10.3892/ol.2021.12681

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Purpose To date, it is not clear which anticancer agent is useful in combination with trastuzumab and pertuzumab As the first and second selective regimens for advanced or metastatic breast cancer (AMBC), this multicenter, open-label, phase II trial (JBCRG-M03: UMIN000012232) presents a prespecified analysis of eribulin in combination with pertuzumab and trastuzumab. Methods We enrolled 50 patients with no or single prior chemotherapy for HER2-positive AMBC during November 2013-April 2016. All patients received adjuvant or first-line chemotherapy with trastuzumab and a taxane. The treatment comprised eribulin on days 1 and 8 of a 21-day cycle and trastuzumabplus pertuzumab once every 3 weeks, all administered intravenously. While the primary endpoint was the progression-free survival (PFS), secondary endpoints were the response rate and safety. Results Of 50 patients, 49 were eligible for safety analysis, and the full analysis set (FAS) included 46 patients. We treated 8 (16%) and 41 (84%) patients in first- and second-line settings, respectively. While 11 patients (23.9%) had advanced disease, 35 (76.1%) had metastatic disease. The median PFS was 9.2 months for all patients [95% confidence interval (CI): 7.0-11.4]. In the FAS, 44 patients had the measurable lesions and the complete response rate (CR) was 17.4%, and partial response rate (PR) was 43.5%. The grade 3/4 adverse events were neutropenia (5 patients, 10.2%), including febrile neutropenia (2 patients, 4.1%), hypertension (3 patients, 6.1%), and other (1 patient). The average of the left ventricular ejection fraction did not decline markedly. No symptomatic left ventricular systolic dysfunction was observed. Conclusions In patients with HER2-positive AMBC, eribulin, pertuzumab, and trastuzumab combination therapy exhibited substantial antitumor activity with an acceptable safety profile. Hence, we have started a randomized phase III study comparing eribulin and a taxane in combination with pertuzumab and trastuzumab for the treatment of HER2-positive AMBC. Trial registration ID: UMIN-CTR: UMIN000012232.

DOI： 10.1007/s10637-020-00991-6

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Chemotherapy-induced peripheral neuropathy is commonly observed in patients treated with nanoparticle albumin-bound paclitaxel (nab-PTX). We conducted a multicenter randomized controlled study to evaluate the optimal dose of nab-PTX. METHODS: We compared three different doses of q3w nab-PTX (Standard: 260 mg/m2 [SD260] vs Medium: 220 mg/m2 [MD220] vs Low: 180 mg/m2 [LD180]) in patients with HER2-negative metastatic breast cancer (MBC). Primary endpoint was progression-free survival (PFS). Grade 3/4 neuropathy rates in the three doses were estimated using the logistic regression model. The optimal dose was selected in two steps. Initially, if the hazard ratio (HR) for PFS was <0.75 or >1.33, the inferior dose was excluded, and we proceeded with the non-inferior dose. Then, if the estimated incidence rate of grade 3/4 neurotoxicity exceeded 10%, that dose was also excluded. RESULTS: One hundred forty-one patients were randomly assigned to SD260 (n = 47), MD220 (n = 46), and LD180 (n = 48) groups, and their median PFS was 6.66, 7.34, and 6.82 months, respectively. The HRs were 0.73 (95% confidence interval [CI]: 0.42-1.28) in MD220 vs SD260, 0.77 (95% CI 0.47-1.28) in LD180 vs SD260, and 0.96 (95% CI 0.56-1.66) in LD180 vs MD220. SD260 was inferior to MD220 and was excluded. The estimated incidence rate of grade 3/4 neurotoxicity was 29.5% in SD260, 14.0% in MD220, and 5.9% in LD180. The final selected dose was LD180. CONCLUSIONS: Intravenous administration of low-dose nab-PTX at 180 mg/m2 q3w may be the optimal therapy with meaningful efficacy and favorable toxicity in patients with MBC.

DOI： 10.1016/j.breast.2020.12.002

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Oral fluoropyrimidines, such as S-1, have been shown to have a role in controlling disease progression in metastatic breast cancer. We examined adjuvant treatment with S-1 in patients with oestrogen receptor (ER)-positive and HER2-negative primary breast cancer. METHODS: We did a multicentre, open-label, randomised, controlled, phase 3 trial in 139 sites (137 hospitals and two clinics). Eligible patients were women aged 20-75 years with histologically diagnosed stage I to IIIB invasive breast cancer (intermediate to high risk of recurrence). Patients were temporarily registered at participating institutions and biopsy or surgical samples were collected and sent for central pathological assessment. Patients received 5 years of standard adjuvant endocrine therapy (selective oestrogen receptor modulators with or without ovarian suppression and aromatase inhibitors) with or without 1 year of S-1. Oral S-1 80-120 mg/day was administered twice a day for 14 days with 7 days off. Randomisation (1:1) using the minimisation method was done with six stratification factors (age, axillary lymph node metastasis at surgery or sentinel lymph node biopsy, preoperative or postoperative (neoadjuvant or adjuvant) chemotherapy, preoperative endocrine therapy, proportion of ER-positive cells, and study site). The primary endpoint was invasive disease-free survival, in the full analysis set (all randomly assigned patients, excluding those with significant protocol deviations). The safety analysis set consisted of all patients who received at least one dose of study treatment. Here, we report the results from the interim analysis at the data cutoff date Jan 31, 2019. This trial is registered with Japan Registry of Clinical Trials, jRCTs051180057, and the University hospital Medical Information Network, UMIN000003969. FINDINGS: Between Feb 1, 2012, and Feb 1, 2016, 1930 patients were enrolled in the full analysis set, 957 (50%) received endocrine therapy plus S-1 and 973 (50%) received endocrine therapy alone. Median follow-up was 52·2 months (IQR 42·1-58·9). 155 (16%) patients in the endocrine therapy alone group and in 101 (11%) patients in the endocrine therapy plus S-1 group had invasive disease-free survival events (hazard ratio 0·63, 95% CI 0·49-0·81, p=0·0003). As the primary endpoint was met at interim analysis, the trial was terminated early. The most common grade 3 or worse adverse events were decreased neutrophil count (72 [8%] of 954 patients in the endocrine therapy plus S-1 group vs seven [1%] of 970 patients in the endocrine therapy alone group), diarrhoea (18 [2%] vs none), decreased white blood cells (15 [2%] vs two [<1%]), and fatigue (six [<1%] vs none). Serious adverse events were reported in nine (1%) of 970 patients in the endocrine therapy alone group and 25 (3%) of 954 patients in the endocrine therapy plus S-1 group. There was one (<1%) possible treatment-related death in the endocrine therapy plus S-1 group due to suspected pulmonary artery thrombosis. INTERPRETATION: These data suggest that this combination of S-1 with endocrine therapy could be a potential treatment option for this intermediate and high-risk group of patients with ER-positive, HER2-negative primary breast cancer. FUNDING: Public Health Research Foundation (Japan), Taiho Pharmaceutical.

DOI： 10.1016/S1470-2045(20)30534-9

PubMed

researchmap

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

We experienced a surgical case of a rare primary tracheal tumor. A 77-year-old woman visited a local clinic with chief complaints of coughing, wheezing, and discomfort in the throat. Computed tomography revealed a mass measuring approximately 1.5 cm in the mediastinal trachea, extending from the membranous portion of the trachea to the esophagus. Bronchofibroscopy showed a flat, smooth-surfaced, round mass arising from the membranous portion. Surgery was performed because of the possibility of airway obstruction and suffocation. Sleeve resection of five tracheal rings was performed via median sternotomy and interrupted suture was performed using 3-0 absorbable suture material. The postoperative course was favorable and there has been no evidence of recurrence. The pathological diagnosis was solitary fibrous tumor. A primary solitary fibrous tumor of the trachea is extremely rare. Here, we report this disease with a literature review.

DOI： 10.1007/s11748-019-01274-5

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

An amendment to this paper has been published and can be accessed via the original article.

DOI： 10.1186/s13063-020-04408-w

PubMed

researchmap

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Trastuzumab (Tmab), pertuzumab (Pmab), and taxane has been a standard first-line treatment for recurrent or metastatic human epidermal growth factor (HER2)-positive breast cancer (HER2+ mBC) but has some safety issues due to taxane-induced toxicities. This has led to ongoing efforts to seek less toxic alternatives to taxanes that are equally effective when used in combination with Tmab plus Pmab. This study aims to show the non-inferiority of eribulin, a non-taxane microtubule inhibitor, against taxane, as a partner for dual HER2 blockade. METHODS/DESIGN: This multicenter, randomized, open-label, parallel-group, phase III study will involve a total of 480 Japanese women with HER2+ mBC who meet the following requirements: (1) age 20-70 years; (2) no prior cytotoxic chemotherapy (excluding trastuzumab-emtansine) for mBC; (3) ≥ 6 months after prior neoadjuvant or adjuvant cytotoxic chemotherapy; (4) presence of any radiologically evaluable lesion; (5) left ventricular ejection fraction ≥ 50%; (6) Eastern Cooperative Oncology Group performance status score of 0 or 1; (7) adequate organ function; and (8) life expectancy of at least 6 months. They will be randomized 1:1 to receive eribulin (1.4 mg/m2 on days 1 and 8) or taxane (docetaxel 75 mg/m2 on day 1 or paclitaxel 80 mg/m2 on days 1, 8, and 15) in combination with Tmab (8 mg/kg then 6 mg/kg) plus Pmab (840 mg then 420 mg) on day 1 of each 21-day cycle. The treatment will be continued until disease progression or unmanageable toxicity. The primary endpoint is progression-free survival as per investigator according to RECIST v1.1 criteria. Key secondary endpoints include objective response rate, overall survival, quality of life and safety. Non-inferiority will be tested with two margins of 1.33 and 1.25 in a stepwise manner. If non-inferiority is shown with a margin of 1.25, superiority will then be tested. DISCUSSION: If this study shows the non-inferiority, or even superiority, of Tmab, Pmab, and eribulin against the existing taxane-containing regimen, this new regimen may become a standard first- or second-line treatment option for HER2+ mBC in Japan. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03264547. Registered on 28 June 2017.

DOI： 10.1186/s13063-020-04341-y

PubMed

researchmap

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: A recent technical advance in mRNA in situ hybridization (mRNA-ISH) assays provides simultaneous signal amplification and background suppression with a unique probe design that enables single-molecule visualization. We assessed the utility of the mRNA-ISH assay as a diagnostic tool for detecting anaplastic lymphoma receptor tyrosine kinase (ALK) mRNA in non-small-cell lung carcinoma (NSCLC). We compared the mRNA-ISH assay with immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). METHODS: The study included 279 surgically resected lung adenocarcinomas and 44 transbronchial-biopsied (TBB) adenocarcinomas. mRNA-ISH was conducted using the RNAscope 2.0 system, which includes pre-designed probes for detecting the tyrosine kinase domain encoded in ALK mRNA. IHC was conducted on all 323 samples using ALK-specific antibodies. mRNA-ISH was performed on 279 surgical samples and 6 TBB samples. Break-apart FISH was used to examine samples that were mRNA-ISH-positive or IHC-positive. RESULTS: ALK protein expression was detected in 11 of 279 specimens (3.9%). ALK mRNA was also detected with mRNA-ISH in ALK-positive samples, and 9 of the 11 specimens (81%) were also positive for ALK using break-apart FISH. Using the IHC results as a reference, the sensitivity and specificity of mRNA-ISH was 100%. In the TBB cohort, ALK protein expression was observed in 3 of 44 specimens (6.8%), in which ALK mRNA expression was also detected. CONCLUSIONS: The ALK mRNA-ISH data were highly correlated with the IHC data, and ALK mRNA-ISH detected ALK mRNA expression in every FISH-positive sample. We conclude that mRNA-ISH could serve as an alternative or complementary method for diagnosing ALK rearrangements in NSCLC.

DOI： 10.21037/tlcr.2020.03.04

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: Intraoperative evaluation of sentinel lymph nodes (SLNs) for patients with breast cancer is widely performed with frozen section (FS), cytology, or a combination of both. Touch imprint cytology (TIC) reportedly has an equivalent sensitivity to FS. We studied its diagnostic utility to detect SLN metastases. MATERIALS AND METHODS: Cases of 367 patients with breast cancer who underwent intraoperative valuation of SLNs (507 LNs) were evaluated. All FS and corresponding TIC slides of SLNs of each case were reviewed microscopically for the presence of metastases of any size. If present, the metastatic focus was measured on the FS. RESULTS: Of these 507 SLNs, 82 LNs (16.2%) from 69 women were found to have metastases in the FS and consisted of 5 LNs of isolated tumor cells, 15 of micrometastasis, and 62 of macrometastasis. TIC identified metastases in 69 of these 82 SLNs (sensitivity: 84.1%, specificity: 100%, and accuracy: 97.4%). All macrometastases could be detected by TIC, whereas TIC identified approximately 50% of micrometastases and none of isolated tumor cells. The size detection limit of metastatic foci, defined as the smallest dimension of metastasis detected without false negatives, was 2 mm. The smallest metastatic focus identified was 0.8 mm. CONCLUSIONS: TIC of SLNs is of great use given its negative predictive value of 100% for identification of macrometastasis in our study. For intraoperative evaluation of SLNs, based on our data, a practical two-step approach is proposed: SLN evaluation should be initially performed by TIC and then proceed to FS histological analysis only when cytologically positive to determine the size of metastatic focus.

DOI： 10.25259/Cytojournal_80_2019

PubMed

researchmap

Language：English  

DOI： 10.1158/1538-7445.SABCS19-P2-15-04

Web of Science

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

researchmap

Language：English  

DOI： 10.1200/JCO.2019.37.15_suppl.1070

Web of Science

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

A 68-year-old woman was found a nodule of the right lower lobe. Malignancy was suspected by positive positron emission tomography-computed tomography finding. Wedge resection was performed to establish the diagnosis, and the pathological diagnosis was a type AB thymoma. At 13 months after operation, no recurrence was observed.

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Visceral pleural invasion (PL) is a prognostic factor in lung cancer. In the lung, lymph flows along the pleura, in addition to the flow toward the pulmonary hilum just as the pulmonary arteries and veins run toward it. Even with the same tumor diameter, a PL1 or higher level of pleural invasion is indicative of a more advanced disease stage. Final diagnosis based on the PL level is made by pathological examination of excised specimens. However, if an intraoperative diagnosis can be established, proper selection of the surgical procedure can be made, and unnecessary surgeries for disseminated lesions can be avoided. We investigated optical diagnostic techniques for identifying the presence or absence of visceral pleural invasion in lung cancer by capitalizing on the phenomenon of 5-amino-levulinic acid (5-ALA) being metabolized to a photosensitizing substance or protoporphyrin IX within malignant tumors, generating red luminescence in response to excitation light. METHOD: This study included 38 patients with primary lung cancer who underwent surgery. They received 5-ALA (20mg/kg) orally 4h before surgery and then we assessed the presence or absence of pleural invasion using an autofluorescence observation system. At visceral pleural invasion sites, we were able to confirm tumor sites visualized in red with a clear border in contrast to the green autofluorescence generated in normal tissues. RESULT: Red luminescence could be confirmed in 100% of PL1-PL3 patients (14/14) and 41.6% of PL0 patients (10/24) with primary lung cancer. PL0 patients in whom visualization was possible were preoperatively diagnosed as having PL1 and many of them showed vascular channel invasion. The sensitivity, specificity, positive predictive value, and negative predictive value of this diagnostic technique were 100%, 58.0%, 63.1%, and 100%, respectively. Red fluorescence emission was observed significantly more often in pleural invasion cases. CONCLUSION: Accurate intraoperative diagnosis for visceral pleural invasion in lung cancer may contribute to determining the indications for limited operations such as segmental resection. In addition, accurate local diagnosis has the possibility of being applicable to photodynamic therapy.

DOI： 10.1016/j.pdpdt.2017.08.013

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Anaplastic lymphoma kinase (ALK) fusion oncogenes occur in approximately 3-5% of non-small cell lung cancer (NSCLC) cases. Various ALK inhibitors are in clinical use for the treatment of ALK-NSCLC, including the first generation ALK inhibitor, crizotinib, and recently the more highly potent alectinib and ceritinib. However, most tumors eventually become resistant to ALK specific inhibitors. To address the mechanisms underlying the development of ALK inhibitor resistance, we used iTRAQ quantitative mass spectrometry and phosphor-receptor tyrosine kinase arrays to investigate intracellular signaling alterations in ALK inhibitor resistant NSCLC cell lines. Src signaling was identified as an alectinib resistance mechanism, and combination treatment with ALK and Src inhibitors was highly effective for inhibiting the growth of ALK inhibitor resistant cells in vitro and in mouse xenograft models. Furthermore, phospho-receptor tyrosine kinase activation and downstream PI3K/AKT signaling was effectively blocked by inhibiting Src in alectinib resistant cells. Finally, we showed that the combined use of ALK and Src inhibitors inhibited the growth of other ALK-NSCLC cell lines, including those that were ceritinib or lorlatinib resistant. Our data suggest that targeting Src signaling may be an effective approach to the treatment of ALK-NSCLC with acquired resistance to ALK inhibitors.

DOI： 10.3892/ijo.2017.4140

PubMed

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

A 65-year-old woman was found to have a mass shadow on chest computed tomography. The patient had been diagnosed as having myelodysplastic syndrome 3 years before admission. She was transferred to our hospital for further examination of the mass in the lower lobe of left lung. The mass was positron emission tomography-positive (SUVmax of 8.6)suggesting a malignant neoplasm. Serum concentrations of carcinoembryonic antigen was elevated to 8.7 ng/ml. Preoperative laboratory studies showed anemia (hemoglobin 6.9 g/dl). Transfusion of red blood cells was performed prior to surgery. Under the video-assited thoracoscopic surgery, left lower lobectomy and lymph node dissection were perfomed. The histopathological diagnosis was mucoepidermoid carcinoma, and the hilar lymph node metastasis positive. There were no postoperative complications, such as infection or bleeding. Chemotherapy with tegafur/uracil was performed after the operation. The patient is currently alive without any recurrence 2 years after the operation.

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: We observed red autofluorescence emanating from bronchial cancer lesions using a sensitive color-fluorescence endoscopy system. We investigated to clarify the origin of the red autofluorescence. METHODS: The wavelengths of the red autofluorescence emanating from lesions were measured in eight patients using a spectrum analyzer and compared based on pathologic findings. Red autofluorescence at 617.3, 617.4, 619.0, and 617.1 nm was emitted by normal bronchus, inflamed tissue, tissue exhibiting mild dysplasia, and malignant lesions, respectively. Protoporphyrin, uroporphyrin, and coproporphyrin, the major porphyrin derivatives in human blood, were purchased to determine which porphyrin derivative is the source of red fluorescence when acquired de novo. We synthesized photoporphyrin, Zn-protoporphyrin and Zn-photoprotoporphyrin from protoporphyrin. RESULTS: Coproporphyrin and uroporphyrin emitted only weak fluorescence. Fluorescence was emitted by our synthesized Zn-photoprotoporphyrin at 625.5 nm and by photoprotoporphyrin at 664.0 nm. CONCLUSIONS: From these results, we conclude that Zn-photoprotoporphyrin was the source of the red autofluorescence observed in bronchial lesions. Zn-protoporphyrin is converted to Zn-photoprotoporphyrin by radiation with excitation light. Our results suggest that red autofluorescence emanating from Zn-photoprotoporphyrin in human tissues could interfere with photodynamic diagnosis using porphyrin derivatives such as Photofrin® and Lazerphyrin® with a sensitive endoscopy system, because color cameras cannot differentiate Zn-photoprotoporphyrin red fluorescence from that of other porphyrin derivatives.

DOI： 10.1186/s12885-017-3277-6

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Nodular fasciitis is a benign reactive proliferative lesion of fibroblast cells, which can occur throughout the body. However, it has rarely been reported in the breast of an elderly woman. CASE PRESENTATION: Our patient was an 88-year-old Asian woman who had noticed a mass in her right breast for 1 month before presentation to our hospital. The mass was elastic-hard and 20 mm in size. No qualitative diagnosis was made by core needle biopsy. Because of potentially malignant findings on mammography and ultrasonography, she underwent an excisional biopsy. Microscopically, spindle cell proliferation with abundant elastic fibers were observed. The tumor cells were positive for α-smooth muscle actin and negative for pancytokeratin, β-catenin, and cluster of differentiation 34. Based on these morphological and immunohistochemical features, a diagnosis of nodular fasciitis was made. All resection margins in the specimen were tumor-free. The patient has been disease-free for over 12 months. CONCLUSIONS: Nodular fasciitis shows clinical features and imaging findings similar to those of breast cancer. To avoid unnecessary surgery, nodular fasciitis should be taken into consideration when there is spindle cell proliferation found by biopsy.

DOI： 10.1186/s13256-017-1219-1

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Tumor immune escape has been a major problem for developing effective immunotherapy. The human leukocyte antigen G (HLA-G) is a non-classical MHC class I molecule whose primary function is to protect the fetus from the mother's immune system. While HLA-G is hardly found in normal adult tissues, various tumor cells are known to express it, aiding their escape from the immune system. Thus, HLA-G is an attractive immunotherapy target. CD4(+) helper T lymphocytes (HTLs) play an important role in the immune reaction against tumors by assisting in the generation and persistence of CD8(+) cytotoxic T lymphocytes (CTLs) or by displaying direct antitumor effects. We report here that HLA-G expression in breast cancer significantly correlates with a poor prognosis. Also, we describe that the MHC class II-binding peptide HLA-G26-40 was effective in eliciting tumor-reactive CD4(+) T cell responses. Furthermore, treatment with the DNA methyltransferase inhibitor 5-aza-2'-deoxycytidine increased HLA-G expression in tumors and subsequently enhanced recognition by HLA-G26-40-specific HTLs. These findings predict that a combination immunotherapy targeting HLA-G together with a DNA methyltransferase inhibitor could be useful against some cancers.

DOI： 10.1080/2162402X.2016.1169356

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Non-islet cell tumor hypoglycemia (NICTH) is defined as a form of hypoglycemia caused by an extrapancreatic tumor. Solitary fibrous tumor (SFT) associated with hypoglycemia is rare. CASE PRESENTATION: A 76-year-old woman, who had frequently experienced hypoglycemic symptoms such as presyncope for the prior 6 months, visited our hospital to undergo detailed examinations. Her fasting glucose level was low at 49 mg/dl. The blood levels of IRI and C-peptide were also low at 0.2 μU/ml and 0.21 ng/ml, respectively. Chest computed tomography revealed a mass measuring 15 cm in the left thoracic cavity. Percutaneous needle biopsy yielded a diagnosis of intrathoracic SFT associated with NICTH. The tumor was removed by video-assisted thoracoscopic surgery. Histological examination showed a tumor composed of simple spindle-shaped cells with an irregular arrangement. Immunohistochemical staining was positive for CD34, bcl-2, and vimentin and negative for alpha SMA and mesothelin. These results confirmed the diagnosis of SFT. Her hypoglycemic symptoms resolved rapidly after surgery. The clinical course has since remained favorable with no signs of recurrence. CONCLUSION: We report a case of non-islet cell tumor hypoglycemia caused by intrathoracic SFT. The high-molecular-weight IGF-II produced by the tumor has been regarded as the cause of NICTH.

DOI： 10.1186/s13019-016-0463-6

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Primary hyperparathyroidism is a rare disease characterized by excessive secretion of parathyroid hormone from parathyroid adenoma, hyperplasia, or malignancy. The clinical symptoms of the condition are those of hypercalcemia. Although the lesions are commonly located in the neck region, in about 1-2 % of cases, the lesions are ectopically located within the mediastinum, where surgical excision using the cervical approach is difficult. The principal treatment of the condition is surgical excision of the lesion. However, some patients require additional surgery because of recurrence due to intraoperative dissemination. Therefore, safe and accurate excision is essential for the treatment. We reviewed the surgical treatment used at our institution for mediastinal parathyroid adenoma that caused primary hyperparathyroidism. METHOD: The subjects were four patients with primary hyperparathyroidism due to mediastinal parathyroid adenoma who underwent surgery at our institution within a period of 10 years, between January 2005 and December 2014. All of the patients were female, with a mean age of 64.5 years (range, 55-74 years). The examined variables included background factors, clinical condition, surgical method, and clinical outcome. RESULT: In all of the patients, primary hyperparathyroidism was detected with symptoms of hypercalcemia. Laboratory tests revealed a mean serum calcium level of 11.85 mg/dL (range, 11.2-13.2 mg/dL) and a mean parathyroid hormone (intact PTH) level of 304.8 pg/mL (range, 126-586 pg/mL), indicating elevated levels for all patients. Chest computed tomography (CT) revealed tumors with a mean diameter of 2.8 cm (range, 10-45 mm) in the anterior mediastinum in all of the patients. On 99mTC-methoxy isobutyl isonitrile (MIBI) scintigraphy, abnormal accumulation was observed in all of the patients. Regarding the surgical methods, median sternotomy was used for three cases and upper partial sternotomy was used for one case. The surgery was safely and accurately performed, without postoperative complications. After surgery, the serum calcium levels immediately returned to normal and the symptoms improved. CONCLUSION: We performed excision safely and accurately in all of the patients. In tumor identification, 99mTC-MIBI scintigraphy was useful. Accurate tumor identification and selection of the optimal surgical method are important for prevention of recurrence due to intraoperative dissemination.

DOI： 10.1186/s13019-016-0461-8

PubMed

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

A 61-year-old man underwent right pneumonectomy for primary lung cancer. Four weeks later, he was referred to our hospital for empyema. After 2 months of irrigation with saline, vacuum-assited closure therapy followed by the open thoracotomy was started. After cleaning thoracic cavity bacteriologically, the thoracoplasty and muscle flap transposition was performed, and the empyema completely disappeared.

PubMed

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

A 46-year-old woman was referred to our hospital for a tumor in the anterior mediastinum. She had no symptoms of myasthenia gravis(MG). Acetylcholine receptor antibody(AchR-Ab) was within the normal range. The tumor was completely resected by thymectomy. Pathological examination of the tumor identified it as a type AB thymoma (Masaoka stage I). Five days after the surgery, she experienced post-thymectomy MG (raised AchR-Ab and positive tensilon test). Her symptoms improved with anti-cholinesterase and tacrolimus therapy.

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

We present a surgical case of a rare primary tracheal tumor. In a 44-year-old asymptomatic man, computed tomography (CT), performed as part of health check-up, revealed a tumor measuring 1.5 cm in diameter in the mediastinal trachea. Biopsy failed to yield a definitive diagnosis, but the tumor tended to grow rapidly; therefore, surgery was performed. Five tracheal rings were resected through median sternotomy, followed by interrupted suture with 3-0 absorbable thread. The postoperative course has been favorable with no evidence of recurrence. The pathological diagnosis was leiomyoma. We report this case with literature review.

DOI： 10.1186/s13019-015-0283-0

PubMed

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

According to the Japanese Breast Cancer Society national breast cancer registration, 71.8%of breast cancer cases reported in 2004 and 79.8% of cases reported in 2010 were estrogen receptor(ER)positive. The frequency of ER-positive breast cancer is increasing annually in Japan. Many clinical trials have proven that adjuvant hormonal treatment affects both progression- free survival and overall survival in ER-positive breast cancer cases. However, some clinical questions remain, including those regarding the definition of preoperative hormonal treatment, appropriate dosage period, and therapeutic drug choice. In January 2013, we conducted a questionnaire survey of 53 medical doctors engaged in breast cancer treatment at 15 Japanese Breast Cancer Society-authorized facilities in Hokkaido. This survey included 6 clinical questions about preoperative hormonal treatment, 5 clinical questions about postoperative hormonal treatment for premenopausal breast cancer, and 4 clinical questions about postoperative hormonal treatment for postmenopausal breast cancer. We obtained replies from 35 medical doctors at 27 facilities. The response rate was 66%. We accumulated and analyzed these data. The discussion of questionnaire results in the medical administration field facilitates the sharing of information regarding differences in the approaches of different facilities to breast cancer patients. As a result, standardization of the breast cancer medical treatment system in this area has been accomplished.

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: We have developed a new diagnostic method using the photosensitizer 5-aminolevulinic acid (5ALA) for diagnosing intrathoracic malignant lesions. When ingested exogenously, 5ALA is metabolized to a heme precursor, protoporphyrin IX, which stays in malignant cells and emits red to pink luminescence of about 630 nm. METHODS: We enrolled 40 patients who underwent respiratory surgery and consented to participate in this study. Twenty-eight patients had primary lung cancer, 8 metastatic lung tumors, 2 malignant pleural tumors, and 2 benign tumors. Localization of malignant lesions was attempted by observing such lesions with an autofluorescence imaging system and by comparing the color tone of the autofluorescence between malignant lesions and normal tissues after oral administration of 5ALA. Malignant lesions on the pleural surface emitted pink autofluorescence in contrast to the green autofluorescence of the surrounding normal tissues. RESULTS: When 28 patients with primary lung cancer were examined according to the degree of pleural infiltration (pl), red fluorescence was confirmed in 10 of 10 patients (100%) with p11-p13 and 5 of 18 patients (27.7%) with p10. The latter 5 patients had been diagnosed with PL1 preoperatively or intraoperatively. CONCLUSION: This system achieved accurate localization of malignant lesions, suggesting that it may also be applicable to photodynamic therapy.

DOI： 10.1186/s12885-015-1194-0

PubMed

researchmap

Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Radiation therapy (RT) is considered a risk factor for the development of sarcoma in patients with breast cancer. However, there are few reports regarding post-irradiation sarcoma (PIS). CASE PRESENTATION: The patient was a 59-year-old woman who presented with a chief complaint of induration in the lower outer quadrant of the left breast. She underwent breast-conserving surgery (BCS) for breast cancer located in the left upper inner region and received endocrine therapy following RT (50 Gy/25 fractions/5 weeks) for breast conservation 6 years previously. Core needle biopsy revealed leiomyosarcoma. There was no distant metastasis. Repeat BCS including part of the pectoralis major muscle was performed. Chest wall resection was not performed because of the lack of invasion. Based on the morphological and immunohistochemical features, a diagnosis of leiomyosarcoma was made. All of the resection margins in the specimen were tumor-free. She has been disease-free for over 20 months. CONCLUSIONS: Post-irradiation leiomyosarcoma is an extremely rare tumor with high malignant potential, and thus, multidisciplinary therapy and close follow-up are advised.

DOI： 10.1186/s40792-015-0072-y

PubMed

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：[札幌] : 北海道外科学会  

CiNii Books

CiNii Research

researchmap

Other Link： http://id.ndl.go.jp/bib/026260727

Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Sentinel node biopsy is a standard procedure in clinically node-negative breast cancer patients. It has eliminated unnecessary axillary lymph node dissection in more than half of the early breast cancers. However, one of the unresolved issues in sentinel node biopsy is how to manage axilla surgery for sentinel node-positive patients and clinically node-negative patients. To evaluate the outcome of no axillary lymph node dissection in sentinel node-positive breast cancer, a prospective cohort study registering early breast cancer patients with positive sentinel nodes has been conducted (UMIN 000011782). Patients with 1-3 positive micrometastases or macrometastases in sentinel lymph nodes are eligible for the study. The primary endpoint is the recurrence rate of regional lymph nodes in patients treated with sentinel node biopsy. Patients treated with sentinel node biopsy followed by axillary lymph node dissection are also registered simultaneously to compare the prognosis. The propensity score matching is used to make the distributions of baseline risk factors comparable.

DOI： 10.1093/jjco/hyu090

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Spindle cell carcinoma of the breast is a rare tumor. This tumor can proliferate rapidly and cause cystic changes because of internal tissue necrosis. We evaluated a 54-year-old woman with right breast lump. Mammography showed a category four mass with a diameter of 2.5 cm. Ultrasonography (US) revealed a complex cystic lesion, and fine-needle aspiration (FNA) cytology demonstrated bloody fluid and malignant cells. Partial breast resection and sentinel lymph node biopsy were performed. Immunohistology revealed spindle cells with positive results for cytokeratin (AE1/AE3) and vimentin, partially positive results for s-100, and negative results for desmin and α-actin. The pathological stage was IIA, and biochemical characterization showed that the tumor was triple negative. Six courses of FEC-100 chemotherapy (5-fluorouracil 500 mg/m(2), epirubicin 100 mg/m(2), and cyclophosphamide 500 mg/m(2)) were administered. Radiotherapy was performed. This case is discussed with reference to the literature.

DOI： 10.7497/j.issn.2095-3941.2014.02.008

PubMed

researchmap

Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Posttranslational modifications regulate the function and stability of proteins, and the immune system is able to recognize some of these modifications. Therefore, the presence of posttranslational modifications increases the diversity of potential immune responses to a determinant antigen. The stimulation of tumor-specific CD4(+) helper T lymphocytes (HTLs) is considered important for the production of anti-tumor antibodies by B cells and for the generation and persistence of CD8(+) cytotoxic T lymphocytes, and in some instances, HTLs can directly reduce tumor cell growth. Identification of MHC class II-restricted peptide epitopes from tumor-associated antigens including those generated from posttranslational protein modifications should enable the improvement of peptide-based cancer immunotherapy. We describe here an MHC class II binding peptide from the tumor protein p53, which possesses an acetylated lysine at position 120 (p53110-124/AcK120) that is effective in eliciting CD4(+) T cell responses specific for the acetylated peptide. Most importantly, the acetylated peptide-reactive CD4 HTLs recognized the corresponding naturally processed posttranslational modified epitope presented by either dendritic cells loaded with tumor cell lysates or directly on tumors expressing p53 and the restricting MHC class II molecules. Treatment of tumor cells with a histone deacetylase inhibitor augmented their recognition by the p53110-124/AcK120-reactive CD4(+) T cells. These findings prove that the epitope p53110-124/AcK120 is immunogenic for anti-tumor responses and is likely to be useful for cancer immunotherapy.

DOI： 10.1007/s00262-014-1533-z

PubMed

researchmap

Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: The 2011 St. Gallen Consensus Statement advocated using histological grade (HG) as a proliferation marker of breast cancer (BC) if reliable Ki67 labeling index (Ki67-LI) assessment is not available. However, it has been difficult to evaluate tumor aggressiveness in case of HG2. METHODS: A total of 259 cases of BC were assessed for HG, Ki67-LI and other clinicopathological features. The cut point for Ki67-LI was interpreted as low and high using a 14% threshold. RESULTS: The average age at diagnosis was 58.2 years (range 28-86); 64.9% of the patients were postmenopausal. Of the 259 cases, 151 were stage I, 78 were stage II, 29 were stage III, and 1 was stage IV. The subtypes based on immunohistochemical staining were 60 cases of luminal A (LA) type (23.2%), 37 cases of luminal B (LB) (HER2-) type (14.3%), 91 cases of LB (HER2+) type (35.1%), 40 cases of human epidermal growth factor receptor 2 (HER2) type (15.4%) and 31 cases of triple negative (TN) type (12%). HG was 1 (89 cases, 34.4 %), 2 (117 cases, 45.2%) and 3 (53 cases, 20.5%). High Ki67-LI cases were observed in HG1 (37.1%), HG2 (56.4%) and HG3 (96.2%). Especially in cases of HG2, high Ki67-LI cases were observed in 0 % of LA type, 100% of LB (HER2-) type, 71.2% of LB (HER2+) type, 68.8% of HER2 type and 40.0% of TN type. The average Ki67-LI was 6.0 ± 3.8 (LA type), 31.4 ± 15.7 [LB (HER2-) type], 20.2 ± 14.8 [LB (HER2+) type], 32.7 ± 21.9 (HER2 type) and 55.7 ± 32.2 (TN type). All LA-type cases and 66.7% of LB (HER2+)-type cases were low Ki67-LI. CONCLUSIONS: Our study demonstrates that all LA-type cases and most HG1 of LB (HER2+)-type cases are low proliferative. However, HG was not informative enough for estimating tumor proliferation in cases of LB (HER2-), HER2 and TN types. It is necessary to add other proliferation tools such as the gene expression profiling tool and Ki67-LI except in LA and HG1 of LB (HER2+)-type cases.

DOI： 10.1007/s12282-012-0353-2

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: We conducted a study on photodynamic diagnosis (PDD) using autofluorescence in video-assisted thoracic surgery for minute intrathoracic small dissemination or early malignant pleural mesothelioma. METHODS: Autofluorescence is the spontaneous emission of light that occurs when mitochondria, lysosomes, and other intracellular organelles absorb light. In normal tissues, green autofluorescence of approximately 520 nm is observed in response to 400-450 nm blue excitation rays. However, in cancer lesions, green autofluorescence is reduced due to thickening of the mucosal epithelium, a decrease in autofluorescent substances, etc., and the color spectrum thus shifts to red-violet. This phenomenon is the basis of PDD. RESULTS: The color spectrum shift was observed in all tumors located on the pleural surface but not in cases with pleural fibrous disease. Among patients with primary lung cancer, those with pleural infiltration (pl) scores of 1 or greater showed color spectrum shifts due to reduced autofluorescence. CONCLUSION: Localization of pleural lesions by autofluorescence imaging was found to be useful. In primary lung cancer cases, differentiation between pl0 and pl1 lesions appears to be useful for determining therapeutic strategies including surgical procedures.

DOI： 10.5761/atcs.oa.14-00162

PubMed

researchmap

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

悪性胸膜中皮腫（Malignant pleural mesothelioma: MPM）は中皮細胞のがん化により生じ、男性に多く、石綿（アスベスト）暴露が大きな発生誘因である。悪性中皮腫の約70%以上を占め、腹膜、心膜、精巣鞘膜に発生する事もある。全生存期間の中央値は約1年間で治癒が稀な難治性腫瘍である1-2)。暴露から発症までの潜伏期間は30-40年と言われており、アスベストの暴露量や暴露歴が長いほど高リスクである。1970年台までアスベスト鉱山が実在していた日本では（北海道では富良野地方の野沢鉱山、山部鉱山など）、今後も罹患数の増加が容易に予想され、また、本疾患の大半の症例は受診時に既に進行状態であり治療が困難である事から、早期発見と標準治療の確立が希求されている。本稿では、2014年度版NCCNガイドライン3)を参考に、現在の悪性胸膜中皮腫の診断と治療の概説、当科の外科治療成績、光学的手技を応用した新しい診断と治療の開発について述べる。

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Most tumorous lesions of the esophagus are esophageal cancers. Benign primary tumors of the esophagus are uncommon, and account for approximately 2% of all esophageal tumors. More than 80% of benign esophageal tumors are leiomyomas, with schwannomas being rare. A 55-year-old woman visited our internal medicine department with complaints of palpitations and discomfort during swallowing. A chest computed tomography scan showed a lobulated tumor (75 × 57 × 80 mm) in the upper to middle mediastinum, with homogenous inner opacity, compressing the esophagus. Upper gastrointestinal endoscopy revealed a smooth-surfaced elevated lesion covered with normal mucosa, and a schwannoma was diagnosed based on the biopsy result. The tumor was large. It was thus considered to be difficult to repair the esophagus by direct anastomosis after tumor resection. Therefore, subtotal esophagectomy and esophagogastrostomy in the right thorax were performed. Histopathological examination revealed spindle-shaped cells in a fasciculated and disarrayed architecture and nuclei in a palisading pattern. Immunohistochemical studies revealed S100 protein positivity and the absence of staining for α smooth muscle actin (αSMA), CD34 and CD117, thereby establishing the diagnosis of benign schwannoma. Her postoperative course was uneventful and there has been no evidence of recurrence to date.

DOI： 10.1186/1477-7819-11-253

PubMed

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Combined large cell neuroendocrine carcinoma of the lungs (combined LCNEC) with giant cell carcinoma is extremely rare. A 65-year-old man was found to have an abnormal shadow in his left lung field. Computed tomography revealed a solid, round mass measuring 2.8 × 2.2 cm that was located in the left S9. The patient underwent left lower lobectomy and mediastinal lymph node dissection. Histopathological examination revealed an LCNEC, combined with giant cell carcinoma. The patient received by S-1 (TS-1, an oral fluoropyrimidine) chemotherapy, and he has been disease-free for over 8 months. Combined LCNEC with giant cell carcinoma is an extremely rare tumor with high malignant potential, and thus, multidisciplinary therapy and close follow-up are advised.

DOI： 10.1186/1477-7819-11-205

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Immunoglobulin G4 (IgG4)-related lung disease is a disease in which IgG4-positive plasma cells and lymphocytes infiltrate lung tissues along with immunohistochemically evident fibrous interstitial proliferation in the background, in addition to hyper-IgG4 disease. The diagnosis of this disease can be difficult. Here, we report 2 cases with IgG4-related lung disease that was difficult to differentiate from malignant tumors because both cases had pulmonary lesions showing high standardized uptake values (SUV) on positron emission tomography (PET). Case 1: A 75-year-old man under treatment for autoimmune pancreatitis and diabetes mellitus was noted to have multiple nodular opacities in both lungs and a mass density in the right paravertebral region on computed tomography (CT). As high SUVmax was noted for both lesions on exploration by fluorodeoxyglucose (FDG)-PET/CT, an advanced malignant tumor was diagnosed and a video-assisted thoracoscopic (VATS) biopsy was performed and diagnosed IgG4-related lung disease. Case 2: A 48-year-old woman consulted our clinic with a chief complaint of bloody sputum. Chest CT revealed a mass density with 12-, 13-, and 16-mm spiculations in the S2 segment of the right upper lobe and irregular thickening of the pleura including the paravertebral region. The lesion was a mass showing high SUV in the S2 segment on FDG-PET. Malignancy was suspected from the imaging findings, and a VATS biopsy was performed and diagnosed IgG4-related lung disease. Actively undertaking VATS biopsy in cases with this disease is valuable for making the differential diagnosis between malignant tumors and IgG4-related lung disease, since the diagnosis can be difficult in some patients showing high SUV.

DOI： 10.1186/1749-8090-8-160

PubMed

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

44歳女。右腋窩痛を主訴とした。超音波検査で右腋窩に14.9mm大の境界明瞭・辺縁整な内部均一の低エコー腫瘤像を認め、造影MRマンモグラフィで右腋窩に軽度造影効果を呈する境界明瞭・辺縁整な腫瘤像を認めた。穿刺吸引細胞診を行ったところ、異型の乏しい上皮性細胞の集塊を認めた。背景にリンパ球は認めなかった。また、腺上皮細胞と筋上皮細胞との二層性が保たれていた。免疫組織化学染色ではCK7とGCDFP15が陽性、CK20とTTF-1が陰性であったことから、乳腺上皮由来の細胞と考えられた。増大傾向を認めたため腫瘍性病変を否定できず、診断的治療目的で右腋窩腫瘤摘出術を行った。病理組織検査では間質の線維成分の過剰増生と間隙様の細長い管腔を認めた。管腔の腺上皮と筋上皮の二層性は保たれていた。異型細胞の存在は認めなかった。以上より、副乳原発線維腺腫と診断した。術後経過は良好で、術後2年の現在、再発は認めていない。

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

The efficacy of adjuvant chemotherapy with S-1 in patients with completely resected non-small cell lung cancer (NSCLC) has yet to be clarified, and the appropriate schedule for the adjuvant chemotherapy with S-1 remains unknown. A phase II study was conducted to evaluate the feasibility and efficacy of adjuvant chemotherapy with S-1. Patients enrolled in this study were 20-75 years old, had pathological stage IB-IIIA NSCLC, and had received complete resection of NSCLC. S-1 (80 mg/m2) was administered orally to the patients for four weeks followed by a two-week rest period (conventional schedule), for a maximum of eight cycles. The primary endpoint was relative dose intensity (RDI), while the secondary endpoints were safety and 1 year of disease-free survival (1y-DFS). Between May 2007 and October 2009, 28 patients were enrolled. The RDI was 63.1% (95% CI, 48.6-77.7). No grade 3 or worse hematological toxicity was observed. Grade 3 non-hematological toxicities were observed in four patients. No grade 4 or worse hematological toxicity was detected. The probability of 1y-DFS was 85.7% (95% CI, 72.8-98.6). In the subgroup analysis, the median RDI of patients over 65 years old was lower compared to the other patients (44.8 vs. 100%; P=0.013; Mann-Whitney U test). Creatinine clearance (CCr) was lower in the older group, with more grade 2 or 3 non-hematological toxicities in the elderly patients. These results suggest that the conventional schedule of adjuvant chemotherapy with S-1 is not likely to be feasible in older patients with completely resected NSCLC.

PubMed

researchmap

Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Mammographic breast arterial calcifications (BACs) are regarded as aging-related benign changes in breast cancer screening practices. BACs have recently attracted attention, because several researchers proposed using them as a surrogate marker of arteriosclerosis or osteoporosis. No studies have thus far evaluated an association between BACs and breast cancer, however. METHOD: The percentage of BAC positivity was compared between a group of women aged 40 years or older with breast cancer detected in 2004 through 2009, and a group of women of the same age range in whom breast cancer was not detected by screening mammography in 2009. RESULTS: The BAC-positive rate in the group of 243 breast cancer patients was 9.88% (24 of the 243) and was lower than that in the group of women without breast cancer, 14.34% (506 of 3528 women). The analysis by age revealed that the differences in this parameter between the two groups were significant in women aged 60 years or older. Multivariate analysis including demographic characteristics revealed that when adjusted for age and body weight, BAC positivity was a significant risk factor for breast cancer. CONCLUSION: The study results suggest that BAC positivity and, in turn, arteriosclerosis may have an antinomic relationship with breast cancer.

DOI： 10.1007/s12282-011-0281-6

PubMed

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

症例は40歳男性。呼吸困難を主訴に前医を受診した。呼吸不全、右膿胸、両側肺動静脈瘻、肝膿瘍の診断で胸腔ドレナージ、人工呼吸管理を行ったが軽快しないため当院に紹介搬送された。既往歴、家族歴、現症から遺伝性出血性末梢血管拡張症に起因する肺動静脈瘻により呼吸不全となっていると診断し、肺部分切除による右下葉の肺動静脈瘻切除を行った。術後も人工呼吸管理を続けたところ次第に症状は軽快し、療養のため転院となった。(著者抄録)

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

手術を施行した乳腺分泌癌8例(女、平均57.5歳)について報告した。超音波検査では低エコー腫瘤像を呈し、造影MRマンモグラフィでは早期造影効果を伴い、腫瘤辺縁に不整な索状陰影を示した。細胞診はclass Vが6例、class IIIが2例、生検ではInvasive ductal carcinomaで、確定診断には至らなかった。手術はBt+Ax+Icが2例、Bt+Axが3例、Bp+Axが3例で、センチネルリンパ節生検は2例に施行し、術中迅速病理では転移陰性であった。術前化学療法は1例に施行し、腫瘍径の縮小が認められた。術後ホルモン療法施行例はなく、化学療法は中間リスク群の3例に、放射線照射は乳房温存の3例に施行した。病理所見はpT1が6例、pT2が2例、腫瘍径は平均14.9mm、組織学的異型度はgrade 1が6例、grade 2が2例であった。脈管浸潤v(+)は1例のみで、全例リンパ管浸潤ly(-)であった。術後観察期間平均57.6ヵ月で全例無再発生存中である。

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: T-cell based immunotherapy for lung cancer (LC) could be a promising and novel therapeutic approach. Six-transmembrane epithelial antigen of the prostate (STEAP) and the polycomb group protein enhancer of zeste homolog 2 (EZH2) are highly expressed in LC and since the expression of molecules in normal tissue is significantly lower as compared to tumor cells, these proteins are considered as potential tumor-associated antigens (TAAs) for developing T-cell based immunotherapy. METHODS: We assessed the capacity of predicted CD4 T-cell epitopes from STEAP and EZH2 to induce anti-tumor immune responses to LC cell lines. RESULTS: Out of several predicted epitopes, two synthetic peptides, STEAP281-296 and EZH295-109, were effective in inducing CD4 T-cell responses that were restricted by HLA-DR1, DR15, or DR53 molecules, indicating that the peptides function as promiscuous T-cell epitopes. Moreover, STEAP281-296 and EZH295-109-reactive T-cells could directly recognize STEAP or EZH2 expressing LC cells in an HLA-DR restricted manner. In addition, some STEAP-reactive T-cells responded to STEAP+ tumor cell lysates presented by autologous dendric cells. Most significantly, both of these peptides were capable of stimulating in vitro T-cell responses in patients with LC. CONCLUSIONS: Peptides STEAP281-296 and EZH295-109 function as strong CD4 T-cell epitopes that can elicit effective anti-tumor T-cell responses against STEAP or EZH2 expressing LC. These observations may facilitate the translation of T-cell based immunotherapy into the clinic for the treatment of LC.

DOI： 10.1186/1479-5876-9-191

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Mucoepidermoid carcinoma of the lung (MEC) is a tumor of low malignant potential of bronchial gland origin. MEC and adenoid cystic carcinoma are both considered to be salivary gland-type neoplasms. MECs are comparatively rare with an incidence of all lung cancers. We recently encountered a case of this type of lung cancer. A 60-year-old man was found to have an abnormal shadow in the left lower lung field on a regular check-up for lung cancer at his company. Chest radiography and CT revealed a mass shadow measuring 30 mm in diameter in the left lower lung field. Bronchoscopy revealed a protuberant tumor in the S9 bronchus, leading to a diagnosis of low-grade MEC by transbronchial lung biopsy. He underwent left lower lobe resection and mediastinal lymph node dissection using VATS. Tumor cells had a scattering of mucus-producing epithelial components in papillary growth of stratified squamous epithelia with anisokaryosis and minimal pleomorphism, indicating a diagnosis of MEC. Because the postoperative course was good and the tumor was low-grade, no adjuvant treatment was administered. The patient has had no signs of tumor recurrence for 9 months, to date, since resection of the tumor.

DOI： 10.1186/1749-8090-6-132

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Metastatic pulmonary tumors secondary to breast cancer detected either before or after surgery are predominantly multiple and bilateral. However, in cases detected to have a solitary pulmonary nodule (SPN), determining whether the lesion represents a primary cancer, metastasis, or a benign pulmonary lesion can be difficult. MATERIALS AND METHODS: Between January 2000 and December 2009, we performed breast cancer surgery on 1,226 patients, of which 49 cases (3.9%) were detected to have pulmonary lesions before or after the surgery. In 14 of these patients, video-assisted thoracoscopic surgery was performed to remove a SPN. RESULT: Pathological examination of the resected specimens in these 14 cases revealed metastatic pulmonary tumor in 8 cases, primary lung cancer in 3 cases, and benign disease in 3 cases. While lobectomy was performed in one of these patients with metastatic pulmonary tumor, the remaining 7 underwent partial resection of the lung. The primary lung cancer was an adenocarcinoma in all 3 patients, and lobectomy plus mediastinal lymph node dissection was performed in these patients. The tumor grading based on pathological diagnosis was T1N0M0, p-Stage 1A in all 3 patients. The prognosis was good in the breast cancer patients in whom the metastatic lung tumor was a SPN. CONCLUSION: Evaluating the immunohistochemical cytokeratin profile and levels of the TTF-1 and GCDFP-15 of the lesion was useful when distinguishing between pulmonary cancer and metastatic pulmonary tumor. In addition, some patients exhibited changes in the biological properties of the metastatic tumor, and delete tumor resection by video-assisted thoracoscopic surgery can be useful for deciding the drug treatment strategy in some cases.

DOI： 10.1186/1477-7819-9-124

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Intracystic carcinoma of the breast is a type of breast cancer with favorable prognosis where cancer arises from the cystic wall. However, it is a relatively rare disease, and no general consensus has been reached on its definition, including pathogenesis, extramural invasion, and lymph node metastasis. METHODS: Six patients who underwent surgery at the Department of Surgery at Asahikawa Medical University are presented. In each patient, background factors, diagnosis, surgery, pathological diagnosis, and prognosis were investigated. RESULTS: Fine needle aspiration showed class V disease in three patients and class III disease in the other three, and lumpectomy was performed for class III patients. Three patients underwent breast-conserving surgery While extramural invasion was seen in three patients, lymph node metastasis was absent in all patients. CONCLUSION: When it is difficult to diagnose intracystic carcinoma of the breast by fine needle aspiration, active lumpectomy is necessary. Because extramural invasion and lymph node metastasis have been reported, it is necessary to carefully determine the range of excision and rationally perform lymph node dissection, such as sentinel node biopsy.

DOI： 10.1186/1477-7819-9-116

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Ectopic thymoma rarely presents as an intrathoracic tumor. We report a case of ectopic thymoma presenting as a giant right intrathoracic tumor that was treated with resection. The patient was a 50-year-old Japanese woman who presented with the chief complaint of chest pain. Detailed examination revealed a solid tumor measuring 15 × 10 × 8 cm in diameter, with a clear border. The Imaging findings suggested a solitary fibrous tumor, and surgery was performed. At surgery, the tumor was found to be adherent to the diaphragm, mediastinal pleura, and lower lobe of the lung, although it could be dissected with relative ease and was removed. Pathological diagnosis indicated a type B1 tumor with no capsular invasion according to the World Health Organization classification, and a diagnosis of Masaoka stage I thymoma was made. No continuity with the normal thymus tissue was seen, and the thymoma was considered to be derived from ectopic thymic tissue in the pleura.

DOI： 10.1186/1477-7819-9-66

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

The incidence of male breast cancer is low, and treatment strategies similar to those used for female breast cancer patients are frequently used for male patients. However, the safety and utility of sentinel lymph node biopsies (SLNBs) for male breast cancer have not been proven. Among the five cases of male breast cancer who received surgery at our hospital, mastectomy with SLNB was performed in two of the cases. The first patient was 77 years old and the second was 74 years old, and both presented as outpatients with chief complaints of a mammary mass. Clinical diagnoses were T1N0 in both cases, and mastectomies with SLNB were performed. The sentinel lymph node was identified using the dye method. Postoperatively, the patients were hormone receptor-positive, and they are now being followed while continuing to take oral tamoxifen.

DOI： 10.1007/s00595-010-4366-1

PubMed

researchmap

Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: Aluminum potassium sulfate and tannic acid (ALTA) induce noninvasive sclerosis and the involution of hemorrhoids by initiating an inflammatory reaction. We assessed the mid-term outcome after ALTA sclerotherapy for symptomatic hemorrhoids. METHODS: Between May 2006 and July 2009, 1210 patients with grade III or IV hemorrhoids underwent surgery at Kunimoto Hospital. Our treatment strategy for internal hemorrhoids is first establishing whether ALTA therapy is possible for the type of hemorrhoid, and then performing either ALTA therapy or alternatively, ligation and excision (LE) for those types unsuitable for ALTA therapy. RESULTS: A total of 448 patients were treated with ALTA therapy alone (Group A), 706 patients were treated with a combination of ALTA and LE therapy (Group B), and 56 patients were treated with LE alone (Group C). The overall recurrence rates were 3.6% (16/448) and 0.3% (2/706) in Groups A and B, respectively. There was no recurrence in Group C. Rectal ulcers developed at the injection site in four (0.9%) patients from Group A, but they healed within a few months with conservative therapy. CONCLUSION: ALTA sclerotherapy is a simple and safe treatment for symptomatic hemorrhoids, with few complications.

DOI： 10.1007/s00595-010-4386-x

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Alpha-fetoprotein (AFP)-producing lung adenocarcinoma is a rare type of lung cancer, with its characteristics not yet fully clarified. We recently encountered a case of this type of lung cancer. The patient was a 69-year-old man who consulted an internist with the chief complaint of epigastric pain. Chest X-ray and CT revealed a lobulated mass measuring 70 mm in diameter in the right lower lung field and a metastasis in the right hilar lymph nodes. Of the tumor markers, the serum AFP was elevated (4620 ng/ml), and the serum carcinoembryonic antigen and carbohydrate antigen 19-9 were also slightly elevated. Transbronchial lung biopsy revealed the diagnosis of lung cancer. Under thoracoscopic assistance, right lower lobectomy + mediastinal lymph node dissection was carried out. Immunostaining showed the tumor cells to be AFP-positive. The tumor was thus diagnosed as an AFP-producing lung adenocarcinoma. The patient followed an uneventful clinical course after the surgery, with serum AFP decreasing to the normal range by about 2 weeks after the surgery. As of this writing, no sign of tumor recurrence has been noted. This case is presented here with a review of the literature.

DOI： 10.1186/1477-7819-9-47

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Adenoid cystic carcinoma of the peripheral lung is a rare entity. We recently encountered a patient with adenoid cystic carcinoma. A 75-year-old woman showed a nodular lesion with 10 mm in diameter in the right upper lung field on chest radiography. The diagnosis was unclear, but lung cancer could not be ruled out. Thoracoscopic biopsy was performed, and intraoperative pathological diagnosis revealed the carcinoma of the lung. We enforced upper lobectomy and mediastinal lymph node dissection to the patient. Histopathological examination revealed adenoid cystic carcinoma with a characteristic cribriform structure. Immunohistochemical examination revealed that the tumor cells were positive for thyroid transcription factor 1 (TTF-1), this tumor was diagnosed primary ACC of the lung.

DOI： 10.1186/1477-7819-8-74

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

We report herein a technique for the repair of recurrent diaphragmatic hernia after repair of diaphragmatic rupture. Although chest roentgenography and computed tomography in a patient who presented with postprandial abdominal pain demonstrated a left intrathoracic intestinal shadow, the hernia was disregarded. To repair a diaphragmatic rupture along with intrathoracic adhesions, we performed adjunctive thoracotomy coupled with laparotomy. This report demonstrates the need for consideration of previous injuries, the value of combined thoracotomy and laparotomy, and the utility of repair using nonabsorbable sutures in the management of diaphragmatic hernia.

PubMed

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

We report a case of functional mediastinal parathyroid adenoma with cystic change. A 72-year-old woman was admitted to our hospital because of general fatigue. Laboratory examinations suggested a diagnosis of hyperparathyroidism (HPT) based on high levels of serum calcium and intact parathyroid hormone (PTH). Computed tomography (CT) revealed the shape of a cystic tumor with a diameter of 4 cm in the anterior mediastinum. 99mTc-MIBI scintigraphy showed accumulation of the radioisotope in the tumor. The patient was diagnosed as primary HPT caused by the cystic parathyroid adenoma. The tumor was resected through a median sternotomy. The patient had an uneventful postoperative course, and her serum calcium and intact PTH levels rapidly returned to normal. Careful dissection is essential in order not to occur implantation of parathyroid tissue.

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Mediastinal teratomas are typically benign and asymptomatic, but they undergo sudden enlargement or rupture into neighboring organs in some patients owing to intratumoral hemorrhage, leading to serious complications. We report the case of a mediastinal mature teratoma that was discovered because of the sudden onset of chest pain accompanied by elevated preoperative serum CA19-9 levels. The patient was a 43-year-old man who experienced sudden chest pain and was brought to hospital in an ambulance. Chest radiography and computed tomography revealed a mediastinal tumor and a serum CA19-9 level that was elevated to 4377 U/ml. The tumor comprised soft tissue, fluid, and cystic components. The histological diagnosis was mature teratoma with peritumoral bleeding. Most epithelial components, including squamous epithelium and similar components in the bronchi, showed positive results for CA19-9 on immunohistological examination. The postoperative course was uneventful, and serum CA19-9 levels normalized.

DOI： 10.1007/s11748-009-0523-0

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Primary chest wall tumors are relatively rare, and in individual cases the biological properties and onset site of the tumor must be considered before surgery, and the chest wall defect must be reconstructed. The case of a patient with a chondrosarcoma arising in the right first rib who underwent resection and reconstruction is reported. The patient was a 56-year-old man with a 6 × 7 cm tumor in the anterior chest wall side of the right first rib; biopsy confirmed a grade I chondrosarcoma. During surgery, a safe surgical field was prepared by severing the clavicle inside the periosteum and resecting the tumor with the anterior side of the first and second ribs. The chest wall defect measured about 10 cm, and reconstruction was performed, using the greater pectoral muscle and a polypropylene mesh as covers. In the treatment of chondrosarcoma, chemotherapy and radiotherapy are less effective, and appropriate surgery is needed. In the present patient it was useful to prepare a safe surgical field for resecting the first rib tumor by severing the clavicle and then reconstructing the chest wall, using the greater pectoral muscle and a polypropylene mesh.

PubMed

researchmap

Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

We present here in the case of a patient who underwent resection of clear cell carcinoma of the lung, a rare histological type. A screening test of the 71-year-old woman revealed a 2.0-cm lesion in S4 of the right lung with a diagnosis of bronchioloalveolar carcinoma before resection. Under the guidance of video-assisted thoracoscopy, right middle lobe resection and mediastinal lymph node dissection were performed. The histopathological examination showed clear, slightly acidophilic tumor cells rich in fine granular components proliferating in an alveolar fashion. Immunostaining was diagnostically useful, distinguishing clear cell carcinoma from lung metastasis of renal clear cell carcinoma or clear cell squamous cell carcinoma.

DOI： 10.1007/s11748-009-0471-8

PubMed

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: No surgical method for repair of total rectal prolapse has been established as optimal. We describe a new technique that uses ALTA (aluminum potassium sulfate and tannic acid) injection as a simple perianal procedure for total rectal prolapse. METHODS: Fourteen patients with total rectal prolapse were treated with sclerosing therapy by using ALTA injection. Via a perianal approach, 0.5 to 1 ml of ALTA solution was injected along a linear track into the submucosa at 30 to 80 different sites, totaling 20 to 60 ml. RESULTS: All 14 patients treated with injection sclerotherapy were cured, with no intraoperative or postoperative complications. One patient required a repeat injection after two months to be cured. No exacerbation of constipation has resulted, and no stenosis has been evident on rectal examination. In seven of ten patients presenting with fecal incontinence, this complaint resolved after therapy. CONCLUSIONS: ALTA sclerotherapy yielded satisfactory results in total rectal prolapse, causing no alteration in neurophysiology of bowel function. Injection sclerotherapy should be recommended as the first procedure for treatment of total rectal prolapse.

PubMed

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Authorship：Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Language：Japanese   Publishing type：Research paper (scientific journal)  

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

A 46-year-old woman presented to our hospital with a rapidly growing lump in her right breast. Fine-needle aspiration (FNA) cytology and core needle biopsy of the mass revealed many epithelioid cells admixed with multinucleated Langhans-type giant cells, neutrophils, lymphocytes, and stromal cells, leading to a diagnosis of granulomatous mastitis. Mammography and ultrasonography provided little information for differentiating between granulomatous mastitis and carcinoma. This patient was successfully treated with low dose and short period of corticosteroid therapy.

PubMed

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：Japanese   Publisher：東京 : 南江堂  

CiNii Research

researchmap

Other Link： https://ndlsearch.ndl.go.jp/books/R000000004-I032779229

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：Japanese   Publisher：[札幌] : 北海道外科学会  

CiNii Books

CiNii Research

researchmap

Other Link： https://ndlsearch.ndl.go.jp/books/R000000004-I031228162

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Authorship：Lead author   Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Publisher：北海道外科学会  

乳癌治療にあたっては、局所治療である手術療法や放射線療法と、全身療法である薬物療法を組み合わせ、癌の腫瘍学的特性(腫瘍径、リンパ節転移の有無、脈管侵襲因子、Ki-67等)と生物学的特性(ホルモンレセプター、HER2タンパク、等)を検討し、的確な治療計画を立てる事が重要である。手術は、乳房およびリンパ節を広範囲に除去した時代から、整容性、QOLの維持を求める機能温存手術を考慮する時代となった。乳房温存療法は、乳房切除術に比べ生存率に差は無く、Stage I、IIの局所療法として推奨されている。また、腋窩リンパ節郭清に伴う合併症(上肢のリンパ浮腫、等)発症予防の目的でセンチネルリンパ節生検の概念が生まれた。センチネルリンパ節転移陰性例に対する郭清省略群と郭清群との比較試験では、全生存率、再発率に差を認めず、現在多くの施設で施行している。以上を中心に、乳癌に対する乳房温存療法の現状について報告する。(著者抄録)

researchmap

Authorship：Lead author   Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

CiNii Books

researchmap

Other Link： http://amcor.asahikawa-med.ac.jp/modules/xoonips/detail.php?id=2011325942

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2008&ichushi_jid=J01244&link_issn=&doc_id=20081016270406&doc_link_id=%2Fec7jaluc%2F2008%2F004805%2F196%2F0508-0508%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fec7jaluc%2F2008%2F004805%2F196%2F0508-0508%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(NPO)日本肺癌学会  

researchmap

researchmap

researchmap

researchmap

researchmap

Language：Japanese  

DOI： 10.3919/ringe1963.58.1456

CiNii Books

researchmap

Other Link： http://search.jamas.or.jp/link/ui/1998010117

DOI： 10.3919/ringe1963.58.1456

researchmap

DOI： 10.11389/jjrs1963.34.755

PubMed

researchmap

researchmap

researchmap

researchmap

Language：Japanese  

CiNii Books

researchmap

Language：Japanese  

Between 1980 and 1995, 10 patients underwent thoracotomy for pulmonary aspergillosis. In six patients, hemoptysis and bloody sputum were the chief complaints. The other complaints were non-specific. Six patients had a history of pulmonary tuberculosis, and two of those patients underwent upper lobectomy. Aspergillosis had developed in the residual space. A fungus ball was observed on the preoperative chest X-ray and CT scan films in seven patients. Lobectomy was done in three patients, segmentectomy in two, and partial pulmonary resection in four. The patients with lesions that had grown in the residual space underwent curettage with muscle plombage. Three patients underwent thoracoplasty. An additional operation was done in two patients because of poor residual lung expansion. No patient had recurrence. We conclude that surgical treatment should be based on symptoms and on pathological findings.

DOI： 10.11389/jjrs1963.34.755

Scopus

PubMed

researchmap

researchmap

researchmap

researchmap

researchmap

researchmap

researchmap

Event date： 2015.12

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2015.11

Language：Japanese  

Venue：横浜市  

researchmap

Event date： 2015.10

Language：Japanese  

Venue：京都市  

researchmap

Event date： 2015.10

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2015.10

Language：Japanese  

Venue：神戸市  

researchmap

Event date： 2015.9

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2015.9

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2015.9

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2015.7

Language：Japanese  

Venue：東京都  

researchmap

Event date： 2015.7

Language：Japanese  

Venue：東京都  

researchmap

Event date： 2015.7

Language：Japanese  

Venue：東京都  

researchmap

Event date： 2015.6

Language：Japanese  

Venue：東京都  

researchmap

Event date： 2015.6

Language：Japanese  

Venue：埼玉  

researchmap

Event date： 2015.4

Language：Japanese  

Venue：名古屋市  

researchmap

Event date： 2015.2

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2015.2

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2015.2

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2014.11

Language：Japanese  

Venue：郡山市  

researchmap

Event date： 2014.11

Language：Japanese  

Venue：郡山市  

researchmap

Event date： 2014.11

Language：Japanese  

Venue：京都市  

researchmap

Event date： 2014.10

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：神戸市  

researchmap

Event date： 2014.9 - 2014.10

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡市  

researchmap

Event date： 2014.9

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：札幌市  

researchmap

Event date： 2014.9

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2014.9

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2014.9

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2014.8

Language：Japanese  

Venue：横浜市  

researchmap

Event date： 2014.7

Language：Japanese   Presentation type：Poster presentation  

Venue：大阪市  

researchmap

Event date： 2014.7

Language：Japanese   Presentation type：Poster presentation  

Venue：大阪市  

researchmap

Event date： 2014.7

Language：Japanese   Presentation type：Poster presentation  

Venue：大阪市  

researchmap

Event date： 2014.7

Language：Japanese   Presentation type：Poster presentation  

Venue：大阪市  

researchmap

Event date： 2014.7

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：函館市  

researchmap

Event date： 2014.6

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：浜松市  

researchmap

Event date： 2014.5

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：東京都  

researchmap

Event date： 2014.5

Language：Japanese   Presentation type：Poster presentation  

Venue：東京都  

researchmap

Event date： 2014.5

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：東京都  

researchmap

Event date： 2014.5

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：東京都  

researchmap

Event date： 2014.4

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：京都市  

researchmap

Event date： 2014.4

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：京都市  

researchmap

Event date： 2014.4

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：京都市  

researchmap

Event date： 2014.2

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2014.2

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2014.2

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2013.12

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：札幌市  

researchmap

Event date： 2013.12

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：札幌市  

researchmap

Event date： 2013.11

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡市  

researchmap

Event date： 2013.11

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：名古屋市  

researchmap

Event date： 2013.11

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：名古屋市  

researchmap

Event date： 2013.11

Language：Japanese   Presentation type：Poster presentation  

Venue：東京都  

researchmap

Event date： 2013.10

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：京都市  

researchmap

Event date： 2013.10

Language：Japanese  

Venue：京都市  

researchmap

Event date： 2013.10

Language：Japanese   Presentation type：Poster presentation  

Venue：仙台市  

researchmap

Event date： 2013.9

Language：Japanese   Presentation type：Poster presentation  

Venue：京都市  

researchmap

Event date： 2013.9

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：札幌市  

researchmap

Event date： 2013.9

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：札幌市  

researchmap

Event date： 2013.6

Language：Japanese   Presentation type：Poster presentation  

Venue：浜松市  

researchmap

Event date： 2013.6

Language：Japanese   Presentation type：Poster presentation  

Venue：浜松市  

researchmap

Event date： 2013.6

Language：Japanese   Presentation type：Poster presentation  

Venue：浜松市  

researchmap

Event date： 2013.6

Language：Japanese   Presentation type：Poster presentation  

Venue：浜松市  

researchmap

Event date： 2013.6

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：大阪市  

researchmap

Event date： 2013.2

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2013.2

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2012.11 - 2012.12

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：東京都  

researchmap

Event date： 2012.11 - 2012.12

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：東京都  

researchmap

Event date： 2012.9

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2012.9

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2012.9

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2012.6

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：熊本市  

researchmap

Event date： 2012.6

Language：Japanese  

Venue：熊本市  

researchmap

Event date： 2012.6

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：熊本市  

researchmap

Event date： 2012.3

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2012.3

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2012.2

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2011.10

Language：Japanese  

Venue：名古屋市  

researchmap

Event date： 2011.10

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：名古屋市  

researchmap

Event date： 2011.10

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2011.9

Language：Japanese  

Venue：仙台市  

researchmap

Event date： 2011.9

Language：Japanese  

Venue：仙台市  

researchmap

Event date： 2011.9

Language：Japanese  

Venue：仙台市  

researchmap

Event date： 2011.7

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：名寄市  

researchmap

Event date： 2011.5

Language：Japanese   Presentation type：Poster presentation  

Venue：震災のため紙上開催  

researchmap

Event date： 2011.3

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：札幌  

researchmap

Event date： 2011.3

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：札幌  

researchmap

Event date： 2011.3

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：札幌  

researchmap

Event date： 2011.2

Language：Japanese  

Venue：札幌市  

researchmap

Event date： 2011.2

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：札幌  

researchmap

Event date： 2011.2

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：札幌  

researchmap

Event date： 2011.2

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：東京  

researchmap

Event date： 2011.2

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：東京  

researchmap

Event date： 2010.11

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：パシフィコ横浜  

researchmap

Event date： 2010.11

Language：English   Presentation type：Poster presentation  

Venue：Pacifico Yokohama, Japan  

researchmap

Event date： 2010.11

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：パシフィコ横浜  

researchmap

Event date： 2010.11

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：広島  

researchmap

Event date： 2010.11

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：広島  

researchmap

Event date： 2010.10

Language：Japanese   Presentation type：Poster presentation  

Venue：京都  

researchmap

Event date： 2010.9

Language：English   Presentation type：Poster presentation  

Venue：Kagoshima, Japan  

researchmap

Event date： 2010.8 - 2010.9

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：久留米  

researchmap

Event date： 2010.7

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：下関  

researchmap

Event date： 2010.6

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：札幌  

researchmap

Event date： 2010.6

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：札幌  

researchmap

Event date： 2010.6

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：札幌  

researchmap

Event date： 2010.5

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：仙台  

researchmap

Event date： 2010.5

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：仙台  

researchmap

Event date： 2010.5

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：仙台  

researchmap