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KODAMA KEISUKE Last modified date：2024.04.10

Assistant Professor / Gynecology & Obstetrics
Kyushu University Hospital




Homepage
https://kyushu-u.elsevierpure.com/en/persons/keisuke-kodama
　Reseacher Profiling Tool　Kyushu University Pure
Academic Degree
with degree
Country of degree conferring institution (Overseas)
Yes　Doctor
Field of Specialization
gynecology
Total Priod of education and research career in the foreign country
00years00months
Research
Research Interests
  • Development of novel tracers for sentinel node identification in uterine cancer
    keyword : SLN　SNNS　ICG　Liposome　
    2019.04～2023.03.
Academic Activities
Papers
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1. Keisuke Kodama, Chuya Tateishi, Tsuyoshi Oda, Cui Lin, Kazutaka Kuramoto, Hideaki Yahata, Kaoru Okugawa, Shoji Maenohara, Hiroshi Yagi, Masafumi Yasunaga, Ichiro Onoyama, Kazuo Asanoma, Takeshi Mori, Yoshiki Katayama, Kiyoko Kato, Development of novel tracers for sentinel node identification in cervical cancer, Cancer Science. 2023;00:1–9.  , DOI: 10.1111/cas.15927, 2023.09, Indocyanine green (ICG) with near-infrared (NIR) fluorescence imaging is used for lymphatic mapping. However, binding of ICG to blood proteins like serum albumin can shorten its retention time in sentinel lymph nodes (SLNs). Here we investigated the efficacy and safety of a new fluorescence tracer comprising phytate and liposome-encapsulated ICG (LP). Coadministration of phytate with LP containing phosphatidic acid promotes chelation mediated by Ca2+ in bodily fluids to enhance SLN retention. Uniformly-sized LPs (100 nm) encapsulating ICG under conditions that minimized fluorescence self-quenching during storage were produced. We analyzed the behavior of the new tracer (ICG-phytate-LP) and control tracers (ICG and ICG-LP) in the lymphatic flow of mice in terms of lymph node retention time. We also tested lymphatic flow and safety in pigs that have a more human-like lymphatic system. LPs encapsulating stabilized ICG were successfully prepared. Mixing LP with phytate in the presence of Ca2+ increased both the particle size and negative surface charge. In mice, ICG-phytate-LP had the best lymph node retention, with a fluorescence intensity ratio that increased over 6 hours and then decreased slowly over the next 24 hours. In pigs, administration of ICG and ICG-phytate-LP resulted in no death or weight loss. There were no obvious differences between blood test results for the ICG and ICG-phytate-LP groups, and overall safety was good. ICG-phytate-LP may be a useful new tracer for gynecological cancers that require time for lymph node identification due to a retroperitoneal approach..
Presentations
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1. Keisuke Kodama, Hideaki Yahata, Masako Kijima, Nobuko Yasutake, Hiroshi Yagi, Masafumi Yasunaga, Tatsuhiro Ohgami, Ichiro Onoyama, Eisuke Kaneki, Kaoru Okugawa, Kazuo Asanoma, and Kiyoko Kato, Long-term follow-up after sentinel node navigation surgery for early-stage cervical cancer, 第72回日本産科婦人科学術講演会, 2020.04, (Objective) To evaluate the long-term prognostic outcome and complications in patients with early-stage cervical cancer after sentinel node navigation surgery (SNNS) for hysterectomy or trachelectomy.
(Methods) We performed SNNS in 133 patients with cervical cancer using a radioisotope method between 2009 and 2015 under informed consent. If the intraoperative sentinel lymph node evaluation was negative for metastasis, no further lymph nodes were removed. This study was approved by the institutional review board.
(Results) The median age of the 133 patients was 33 (range, 21–73) years. The International Federation of Gynecology and Obstetrics stage was IA1 in 4 patients, IA2 in 12, IB1 in 114, and IIA1 in 3. The histological subtype was squamous cell carcinoma in 88 patients, endocervical adenocarcinoma in 34, and adenosquamous carcinoma in 11. The mean number of sentinel lymph nodes detected per patient was 3.2. Among the 133 patients, 8 did not undergo pelvic lymphadenectomy because of a false-negative intraoperative diagnosis, and 19 received adjuvant therapy after surgery (chemotherapy in 16, radiation in 3). Over a median follow-up of 69 (range, 20–127) months, two patients (2%) experienced recurrence after 44 and 100 months, one in the lung as metastasis and one in the pelvic lymph node, respectively. After multidisciplinary therapy, these two patients are alive without disease at the time of writing. Regarding postoperative complications, lymphedema, lymphocele, and ileus were identified in one case each.
(Conclusion) SNNS for early-stage cervical cancer is safe and effective with low rates of recurrence and postoperative complications..


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