2026/06/04 更新

お知らせ

 

写真a

カワゾエ　テツロウ
川副 徹郎
KAWAZOE TETSURO
所属
九州大学病院 先端医工学診療部 助教
医学部 医学科（併任）
職名
助教
プロフィール
消化器癌に関する基礎的、臨床的研究
外部リンク

研究分野

  • ライフサイエンス / 消化器外科学

学位

  • 博士(医学)

経歴

  •  九州大学病院 消化管外科(2)  助教 

    2024年10月 - 現在

  • 九州大学 九州大学病院　先端医工学診療部 助教 

    2026年4月 - 現在

学歴

  • 九州大学    

    2008年4月 - 2014年3月

受賞

  • 日本外科学会　第2回優秀論文賞

    2020年4月   日本外科学会  

  • 第57回日本癌治療学会　最優秀演題賞

    2019年10月   日本癌治療学会  

論文

  • Prediction of Tracheobronchial Invasion in ycT3 Esophageal Cancer Using Contact Angle on Preoperative CT Images: A Multicenter Analysis 査読

    Nakanoko, T; Kawazoe, T; Hirose, K; Hu, QJ; Tsuda, Y; Shin, Y; Natsugoe, K; Koga, N; Nambara, S; Kudou, K; Ando, K; Kimura, Y; Ninomiya, M; Oki, E; Yoshizumi, T

    ANNALS OF SURGICAL ONCOLOGY   33 ( 4 )   3076 - 3083   2026年4月   （ ISSN:1068-9265 eISSN:1534-4681 ）

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    記述言語：英語   出版者・発行元：Annals of Surgical Oncology  

    Background: If esophageal cancer extensively contacts the tracheobronchus (TB), a pathologic resection margin (pRM) cannot be reliably predicted. An objective diagnosis based on preoperative computed tomography (CT) is challenging because TB deformity is not necessarily caused by tumor invasion. It also may result from external compression by the tumor itself. Methods: Across three institutions, 100 esophageal cancer patients with a diagnosis of ycT3, characterized by contact with the TB without apparent invasion, were enrolled. This study evaluated the relationship between the degree of contact angle (CA) and the pathologic outcomes of curative resection. Results: Patients with positive resection margins (pRM1) had a significantly larger CA than those with negative margins (pRM0) (130° vs. 93°; P = 0.0002). Receiver operating characteristic (ROC) curve analysis identified an optimal CA cutoff of 125° for predicting pRM1 (sensitivity, 63%; specificity, 87%; area under the curve [AUC], 0.76). In all patients, CA ≥ 125° cases had a poorer prognosis (median survival time [MST]: CA ≥ 125° cases [11.0 months] vs CA < 125° cases [33.0 months]; hazard ratio [HR], 1.83; 95% confidence interval [CI], 1.05–3.20; P = 0.03). In neoadjuvant chemotherapy (NAC) cases, CA ≥ 125° had a poorer prognosis than < 125° cases (MST, 6.5 vs. 32.0 months; HR, 2.50; 95 % CI, 1.19–5.23; P = 0.02). Conclusion: The CA measured on preoperative CT may serve as a useful predictive indicator for curative pathologic resection in ycT3 esophageal cancer.

    DOI： 10.1245/s10434-025-18769-6

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  • Molecular analysis of tumor recurrence using established cancer stem cell-line and drug discovery 査読

    Nakano, K; Oki, E; Yamazaki, M; Suzuki, M; Kawai, S; Zaitsu, Y; Nishime, C; Ando, K; Nagae, G; Harimoto, N; Ota, M; Kawazoe, T; Nonaka, K; Natsugoe, K; Omori, S; Saeki, H; Aburatani, H; Yamazaki, T; Maehara, Y

    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY   31 ( 3 )   393 - 403   2026年3月   （ ISSN:1341-9625 eISSN:1437-7772 ）

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    記述言語：英語   出版者・発行元：International Journal of Clinical Oncology  

    Despite advances in adjuvant therapy for colorectal cancer, tumor relapses, often driven by minimal residual disease, remain a formidable clinical challenge. The cancer stem cell hypothesis provides a key framework for understanding this problem, positing that a small, therapy-resistant subpopulation of cells drives recurrence. To elucidate the role of these cells, we developed LGR5-specific monoclonal antibodies and a high-sensitivity immunofluorescence method to visualize the stem cell marker LGR5 in clinical tumors. Furthermore, we established a unique colorectal cancer cell line, PLR123, which maintains robust stem cell properties, and developed an in vitro model to study tumor recurrence. Through analyses including single-cell RNA sequencing and small molecule screening, we identified the RNA Polymerase I inhibitor BMH-21 as a compound that effectively suppresses recurrence both in vitro and in vivo. This article comprehensively reviews our series of studies on understanding the mechanisms of cancer stem cell-driven resistance and offers insights supporting the development of novel therapies aimed at preventing tumor relapses.

    DOI： 10.1007/s10147-025-02948-2

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  • A novel predictive scoring system for irreversible intestinal ischemia in patients with strangulated bowel obstruction 査読

    Kudou, K; Kawazoe, T; Nakanoko, T; Ando, K; Oki, E; Yoshizumi, T

    SURGERY TODAY   56 ( 2 )   115 - 122   2026年2月   （ ISSN:0941-1291 eISSN:1436-2813 ）

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    記述言語：英語   出版者・発行元：Surgery Today  

    Purpose: Strangulated bowel obstruction is a critical condition requiring emergency surgery. This study investigated the clinical parameters of patients undergoing emergency surgery for strangulated and non-strangulated bowel obstructions and identified the predictive factors for intestinal ischemia. Methods: This retrospective review included 270 patients who underwent surgery for bowel obstruction. The clinical and operative factors were analyzed to determine the predictive factors for intestinal ischemia. A novel predictive scoring system was developed based on significant parameters identified by a multivariate analysis. Results: Among patients with strangulated bowel obstruction, independent predictors for the need for intestinal resection were massive ascites, computed tomography value ≤ 50 Hounsfield units, lactate levels ≥ 30 mg/dL, and neutrophil–lymphocyte ratio ≥ 8.5. A novel predictive score was developed using these four parameters. Patients with a score of 0 did not require intestinal resection because of strangulation. Fifteen patients, with a score of 7, developed irreversible ischemia and required intestinal resection. Conclusions: A predictive score incorporating ascites, computed tomography values, lactate levels, and neutrophil–lymphocyte ratio effectively stratified patients with strangulated bowel obstruction, aiding early diagnosis and risk stratification.

    DOI： 10.1007/s00595-025-03121-y

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  • Appropriate Proximal Resection Margin Distance for Esophagogastric Junction Adenocarcinoma 査読

    Shin, Y; Yamamoto, M; Ota, M; Kawazoe, T; Zaitsu, Y; Kudo, K; Nakanishi, R; Nakanoko, T; Ando, K; Nakashima, Y; Oki, E; Kimura, Y; Taguchi, K; Morita, M; Yoshizumi, T

    ANNALS OF SURGICAL ONCOLOGY   2026年1月   （ ISSN:1068-9265 eISSN:1534-4681 ）

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    記述言語：英語   出版者・発行元：Annals of Surgical Oncology  

    Background: The purpose of this study was to clarify the appropriate proximal resection margin distance for esophagogastric junction (EGJ) adenocarcinoma and evaluate the impact on long-term outcomes. Proximal resection margin and lymph node dissection are critical factors in EGJ adenocarcinoma surgery. However, there is no clear consensus on the appropriate proximal resection margin distance to ensure negative margins, and the prognostic implications are unknown. Patients and Methods: This retrospective study included 116 patients with Siewert type II/III EGJ adenocarcinoma who underwent lower esophagectomy with proximal or total gastrectomy. The parameter, delta proximal margin (ΔPM), was used to analyze the discrepancy between gross and pathological proximal margins, while ΔPM′ accounted for shrinkage during formalin fixation. Margin recommendations were stratified by cancer stage and histological type, and long-term outcomes were analyzed using survival statistics. Results: Data for 109 patients were analyzed. Recommended gross resection margins ≥ 9 mm were necessary for early stage cancer, ≥ 15 mm for differentiated advanced cancer, and ≥ 21 mm for undifferentiated advanced cancer. Large tumor size (≥ 40 mm) was significantly associated with longer ΔPM′ (p = 0.028). In advanced cancers, patients with a gross resection margin < 15 mm had significantly worse relapse-free survival than those with a gross resection margin ≥ 15 mm (p = 0.038). This margin cutoff was a significant prognostic factor in the multivariate analysis (p = 0.017). Conclusions: A gross proximal margin of at least 15 mm appears to reduce positive margins and confer survival advantage for advanced EGJ adenocarcinoma.

    DOI： 10.1245/s10434-025-18990-3

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  • Polo-like kinase 1 expression in colorectal cancer: association with RAS mutations 査読

    Tanaka, Y; Oki, E; Nakanishi, R; Kawazoe, T; Kudou, K; Zaitsu, Y; Hisamatsu, Y; Ando, K; Yoshizumi, T

    CANCER SCIENCE   117   584 - 584   2026年1月   （ ISSN:1347-9032 eISSN:1349-7006 ）

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  • Prognostic Significance of Platelet-Lymphocyte Ratio (PLR) and Prognostic Nutritional Index (PNI) in Remnant Gastric Cancer: A Multicenter Retrospective Study 査読

    Kudou, K; Ota, M; Ogaki, K; Kimura, Y; Kasagi, Y; Koga, N; Hasuda, H; Tajiri, H; Kawazoe, T; Tsuda, Y; Nakanoko, T; Ando, K; Oki, E; Yoshizumi, T

    WORLD JOURNAL OF SURGERY   49 ( 11 )   3195 - 3204   2025年11月   （ ISSN:0364-2313 eISSN:1432-2323 ）

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    記述言語：英語   出版者・発行元：World Journal of Surgery  

    Background: Remnant gastric cancer (RGC) is known to have a poorer prognosis compared to primary gastric cancer. Inflammation-based prognostic scores (IBPSs), which reflect systemic inflammation and nutritional status, have recently emerged as useful prognostic markers in various malignancies. However, their significance in RGC remains unclear due to the rarity of the disease and the limited number of cases available at single institutions. Methods: We conducted a retrospective multicenter study of 135 patients who underwent surgery for RGC between 2013 and 2024 at Kyushu University and four affiliated hospitals. After excluding nine patients with synchronous malignancies or noncurative resections, 126 patients were included in the final analysis. Associations between IBPSs—including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein-to-albumin ratio (CAR), and prognostic nutritional index (PNI)—and both short- and long-term outcomes were evaluated. Results: Receiver operating characteristic (ROC) analysis determined optimal cutoff values for each IBPS. Kaplan–Meier analysis revealed that PLR ≥ 195 and PNI < 43.5 were significantly associated with poorer overall survival (OS) (P = 0.008 and P < 0.001, respectively). Multivariate analysis identified PLR ≥ 195 and PNI < 43.5 as independent predictors of poor OS and recurrence-free survival (RFS). Additionally, PLR ≥ 260 was identified as an independent risk factor for postoperative complications (P = 0.047). Conclusion: PLR and PNI are independent prognostic markers for both OS and RFS in patients undergoing curative surgery for RGC. Elevated PLR also predicts postoperative complications, highlighting its potential role in perioperative risk stratification.

    DOI： 10.1002/wjs.70111

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  • Plasma Steroid Profiles in Individuals With Class II/III Obesity: Association With Weight Loss After Metabolic Surgery 査読

    Ibusuki, M; Nakatani, K; Matsuda, Y; Umakoshi, H; Yokomoto-Umakoshi, M; Takayanagi, H; Sakamoto, R; Kawazoe, T; Oki, E; Yoshizumi, T; Izumi, Y; Bamba, T; Ogawa, Y

    JOURNAL OF THE ENDOCRINE SOCIETY   9 ( 11 )   bvaf151   2025年11月   （ eISSN:2472-1972 ）

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    記述言語：英語   出版者・発行元：Journal of the Endocrine Society  

    Context: Although steroid metabolism is altered in individuals with obesity, comprehensive profiles of steroid metabolites remain unexplored, some of which may be related to weight loss after metabolic surgery. Objective: We aimed to characterize comprehensive steroid profiles in individuals with class II/III obesity (body mass index ≥35 kg/m<sup>2</sup> ) and identify metabolite(s) related to weight loss outcomes after laparoscopic sleeve gastrectomy (LSG). Methods: Using liquid chromatography–tandem mass spectrometry, we measured 27 plasma steroid metabolites in individuals with class II/III obesity (n = 93), healthy controls (n = 15), and those after LSG (n = 20). Results: Discriminant analysis revealed distinct steroid profiles between individuals with class II/III obesity and healthy controls, with statistical significance for 9 metabolites in men (n = 53) and 11 in premenopausal women (n = 44). One year after LSG, the insufficient and sufficient weight loss groups (percent total weight loss (%TWL) < 20%; n = 10 and %TWL ≥ 20%; n = 26) showed distinct preoperative steroid profiles. Preoperative 17α-hydroxypregnenolone (17α-OHPreg) levels, which were lower in individuals with class II/III obesity, were the most significant factor contributing to this distinction, and remained significantly lower in the insufficient weight loss group even after adjusting for confounders (P = .012). The 17α-OHPreg levels significantly increased postoperatively in men (n = 9, P = .024). Conclusion: This study is the first detailed analysis of comprehensive steroid profiles in individuals with class II/III obesity and suggests that lower preoperative 17α-OHPreg levels are associated with insufficient weight loss after LSG.

    DOI： 10.1210/jendso/bvaf151

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  • A 14-Gene Panel for Predicting Colorectal Cancer Recurrence Using Circulating Tumor DNA in Different Testing Conditions(タイトル和訳中) 査読

    Hisamatsu Yuichi, Ando Koji, Kudo Kensuke, Nakanishi Ryota, Kawazoe Tetsuro, Zaitsu Yoko, Kusumoto Tetsuya, Hata Taishi, Kagawa Yoshinori, Yoshizumi Tomoharu, Ashida Naoko, Niiro Hayato, Hirose Takashi, Oki Eiji

    Cancer Science   116 ( 9 )   2499 - 2506   2025年9月   （ ISSN:1347-9032 ）

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    記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

  • 大腸癌におけるポロ様キナーゼ1の発現　RAS変異との関連性(Polo-Like Kinase 1 Expression in Colorectal Cancer: Association With RAS Mutations) 査読

    Tanaka Yasushi, Oki Eiji, Nakanishi Ryota, Kawazoe Tetsuro, Kudo Kensuke, Zaitsu Yoko, Hisamatsu Yuichi, Ando Koji, Oda Yoshinao, Yoshizumi Tomoharu

    Cancer Science   116 ( 7 )   2032 - 2039   2025年7月   （ ISSN:1347-9032 ）

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    記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

    補助化学療法を受けた大腸癌患者において、正常な細胞分裂の進行に必要な酵素の一つであるポロ様キナーゼ1(PLK1)発現と生存転帰との関連性を後ろ向きに検討した。大腸癌手術を受けた患者225例の患者を対象とし、PLK1高発現群103例(平均65.7±12.2歳)とPLK1低発現群122例(平均68.4±14.2歳)に分類した。PLK1発現は組織病理学的所見および神経周囲の浸潤と有意に関連していた。無再発生存率の観点から、PLK1高発現群は、患者全体およびステージIII患者において、PLK1低発現群より予後が悪い傾向を示した。ステージIII大腸癌で補助化学療法を受けた患者では、PLK1高発現が無再発生存率における唯一の不良予後因子であった。RAS変異を有する患者は野生型RAS患者に比べて有意に予後が悪かった。以上より、大腸癌患者において、PLK1高発現は補助化学療法後の生存率の不良と関連し、RAS変異の関与が示唆された。

  • A 14-Gene Panel for Predicting Colorectal Cancer Recurrence Using Circulating Tumor DNA in Different Testing Conditions 査読

    Hisamatsu, Y; Ando, K; Kudo, K; Nakanishi, R; Kawazoe, T; Zaitsu, Y; Kusumoto, T; Hata, T; Kagawa, Y; Yoshizumi, T; Ashida, N; Niiro, H; Hirose, T; Oki, E

    CANCER SCIENCE   116 ( 9 )   2499 - 2506   2025年6月   （ ISSN:1347-9032 eISSN:1349-7006 ）

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    記述言語：英語   出版者・発行元：Cancer Science  

    Detecting minimal residual disease after surgery is critical for assessing colorectal cancer recurrence risk. Traditional methods, including histology and carcinoembryonic antigen testing, have limited sensitivity. As circulating tumor DNA has emerged as a promising minimal residual disease biomarker, we evaluated circulating tumor DNA detection using a sensitive, targeted 14-gene panel, the Sysmex Plasma-Safe-SeqS colorectal cancer assay, in resectable colorectal cancer cases. We enrolled 46 Japanese patients with preoperatively diagnosed stage II colorectal cancer who underwent surgery at three institutions. Plasma samples were collected pre- and postoperatively. Tumor-informed, plasma-informed, and tumor-naive Plasma-Safe-SeqS colorectal cancer assays were performed. Patients were followed for a median of 1169 (range 148–1476) days using clinical assessments and computed tomography scans. Variants in tumor tissue were detected in 45 of 46 cases (98%). Preoperative circulating tumor DNA was detected in 32 (70%) and postoperative circulating tumor DNA in 16 (35%) patients. Postoperative circulating tumor DNA predicted recurrence with 33%, 38%, and 25% of positive percent agreement for tumor-informed, plasma-informed, and tumor-naive assays, respectively. The tumor-naive assay detected more postoperative circulating tumor DNA-positive cases than the others. As the tumor-naive approach does not require preoperative genetic profiling, it offers significant advantages in cost and ease of implementation in routine clinical practice. Further large-scale studies are warranted to optimize detection strategies.

    DOI： 10.1111/cas.70114

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  • Squamous cell carcinoma arising in sacrococcygeal teratoma in an adult: A case report 査読

    Tanaka, Y; Nakanishi, R; Hazama, H; Mori, T; Kawazoe, T; Kudou, K; Zaitsu, Y; Hisamatsu, Y; Ando, K; Oki, E; Aishima, S; Oda, Y; Yoshizumi, T

    HUMAN PATHOLOGY REPORTS   40   2025年6月   （ eISSN:2772-736X ）

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    記述言語：英語   出版者・発行元：Human Pathology Reports  

    Sacrococcygeal teratomas (SCT) with malignant transformation to squamous cell carcinoma are extremely rare, with only few cases reported in the literature. Herein, we report on a case of a primary sacrococcygeal mature cystic teratoma with malignant transformation into a squamous cell carcinoma. A 53-year-old woman presented with dysuria and lower abdominal pain caused by a huge SCT. Computed tomography (CT), magnetic resonance imaging, and positron emission tomography/CT findings were suggestive of SCT with malignant transformation. The treatment involved robotic-assisted laparoscopic abdominoperineal resection and bilateral lymph node dissection. Histopathology revealed squamous cell carcinoma within the teratoma. Postoperatively, the patient underwent six cycles of paclitaxel-carboplatin chemotherapy and showed no signs of recurrence during the 1-year follow-up.

    DOI： 10.1016/j.hpr.2025.300773

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  • ICI併用療法後にConbversion手術として食道切除術を施行し、術後早期にirAEを発症した1例 査読

    進 勇輝, 川副 徹郎, 夏越 啓太, 財津 瑛子, 工藤 健介, 中ノ子 智徳, 安藤 幸滋, 沖 英次, 大内田 研宙, 吉住 朋晴

    日本食道学会学術集会プログラム・抄録集   79回   331 - 331   2025年6月

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    記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

  • Polo-Like Kinase 1 Expression in Colorectal Cancer: Association With RAS Mutations. 査読

    Tanaka Y, Oki E, Nakanishi R, Kawazoe T, Kudo K, Zaitsu Y, Hisamatsu Y, Ando K, Oda Y, Yoshizumi T

    Cancer science   116 ( 7 )   2032 - 2039   2025年5月   （ ISSN:1347-9032 eISSN:1349-7006 ）

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    記述言語：英語   出版者・発行元：Cancer Science  

    Polo-like kinase 1 (PLK1) controls mitotic spindle formation and cytokinesis. However, its role as a predictive biomarker for treatment outcomes in colorectal cancer (CRC) remains underexplored, particularly in the context of RAS mutations. We retrospectively analyzed the relationships among PLK1 expression, clinicopathological factors, and survival in 225 patients who underwent CRC surgery. We also analyzed the relationship between PLK1 expression and survival after adjuvant chemotherapy and how RAS mutation influenced the prognosis. We found that PLK1 expression was significantly correlated with histopathology (p < 0.0001) and perineural invasion (p = 0.005). The high PLK1 expression group tended to have a worse prognosis in terms of relapse-free survival than the low expression group for all patients (p = 0.060) and patients with stage III disease (p = 0.055). In patients who received adjuvant chemotherapy for stage III CRC, high PLK1 expression was the only poor prognostic factor for relapse-free survival (p = 0.01), and those with mutated RAS had a significantly poorer prognosis than those with wild-type RAS (p = 0.027). In patients with CRC, high PLK1 expression was associated with poor survival after adjuvant chemotherapy, and there was potential involvement of the RAS mutation.

    DOI： 10.1111/cas.70088

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  • 重症心身障害者の大腸癌に対する3例の手術経験 査読

    江端 由穂, 中西 良太, 川副 徹郎, 工藤 健介, 財津 瑛子, 中島 雄一郎, 安藤 幸滋, 沖 英次, 石神 康生, 相島 慎一, 吉住 朋晴

    日本消化器外科学会雑誌   58 ( 5 )   295 - 303   2025年5月   （ ISSN:03869768 eISSN:13489372 ）

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    記述言語：日本語   出版者・発行元：一般社団法人 日本消化器外科学会  

    <p>症例1は44歳の女性で，レット症候群，慢性呼吸不全で人工呼吸器下であった．便潜血の精査で上行結腸癌を指摘され，腹腔鏡下結腸右半切除術を施行した．術後経過は良好で術後7日目に施設転院となった．症例2は61歳の男性で，脳性麻痺，てんかんがあり，便潜血の精査で横行結腸癌を指摘された．腹腔鏡下横行結腸切除術・胃瘻造設術を施行し，術後に尿路感染症を認めたが術後8日目に施設転院となった．症例3は47歳の女性で，染色体異常，てんかんがあり，下血の精査でS状結腸癌を指摘された．腹腔鏡下ハルトマン術を施行し，術後に麻痺性イレウス，てんかん発作，肺炎を認め術後30日目に施設転院となった．重症心身障害者に対する便潜血検査の普及に伴い，根治切除可能な大腸癌と診断された症例を経験した．重症心身障害のある症例では環境の変化で容易に重度の合併症を併発することが多く，周術期管理においては施設との連携が極めて重要である．</p>

    DOI： 10.5833/jjgs.2024.0065

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  • 重症心身障害者の大腸癌に対する3例の手術経験 査読

    江端 由穂, 中西 良太, 川副 徹郎, 工藤 健介, 財津 瑛子, 中島 雄一郎, 安藤 幸滋, 沖 英次, 石神 康生, 相島 慎一, 吉住 朋晴

    日本消化器外科学会雑誌   58 ( 5 )   295 - 303   2025年5月   （ ISSN:0386-9768 ）

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    記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

    症例1は44歳の女性で,レット症候群,慢性呼吸不全で人工呼吸器下であった.便潜血の精査で上行結腸癌を指摘され,腹腔鏡下結腸右半切除術を施行した.術後経過は良好で術後7日目に施設転院となった.症例2は61歳の男性で,脳性麻痺,てんかんがあり,便潜血の精査で横行結腸癌を指摘された.腹腔鏡下横行結腸切除術・胃瘻造設術を施行し,術後に尿路感染症を認めたが術後8日目に施設転院となった.症例3は47歳の女性で,染色体異常,てんかんがあり,下血の精査でS状結腸癌を指摘された.腹腔鏡下ハルトマン術を施行し,術後に麻痺性イレウス,てんかん発作,肺炎を認め術後30日目に施設転院となった.重症心身障害者に対する便潜血検査の普及に伴い,根治切除可能な大腸癌と診断された症例を経験した.重症心身障害のある症例では環境の変化で容易に重度の合併症を併発することが多く,周術期管理においては施設との連携が極めて重要である.(著者抄録)

  • The clinical significance of signal regulatory protein alpha expression in the immune environment of gastric cancer(タイトル和訳中) 査読

    Tanaka Yasushi, Hu Qingjiang, Kawazoe Tetsuro, Tajiri Hirotada, Nakanishi Ryota, Zaitsu Yoko, Nakashima Yuichiro, Ota Mitsuhiko, Oki Eiji, Oda Yoshinao, Yoshizumi Tomoharu

    International Journal of Clinical Oncology   30 ( 2 )   330 - 339   2025年2月   （ ISSN:1341-9625 ）

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    記述言語：英語   出版者・発行元：シュプリンガー・ジャパン(株)  

    マクロファージに発現する抑制性受容体であるシグナル調節タンパク質α(SIRPα)の発現が胃癌に及ぼす影響と、免疫チェックポイント阻害薬(ICI)の効果との関連を後ろ向きに検討した。2012年1月から2015年12月までに当院で原発性胃癌に対して外科的切除を受けた患者137例と、2017年から2020年までに切除不能な進行性胃癌に対してニボルマブ治療を受けた患者19例を対象とした。胃切除群137例をSIRPα高発現群(平均68.9±11.8歳)とSIRPα低発現群(平均67.0±11.6歳)で比較した。その結果、SIRPα高発現は、進行した腫瘍浸潤、遠隔転移、無再発生存期間および全生存期間の不良と相関していた。SIRPαの発現はマクロファージやCD8+T細胞の浸潤、PD-L1の発現とも有意に関連していた。ICI治療を受けた患者では、SIRPαの高発現はニボルマブ導入後の全生存期間の延長と関連していた。さらに、末梢血単核球およびTHP-1細胞をin vitroでIFN-γ刺激した。その結果、細胞表面でのSIRPα発現が上昇したことから、SIRPαの高発現は活発な免疫微小環境を反映している可能性が示唆された。以上より、SIRPα発現は、CD47-SIRPα経路の阻害を介した胃癌の予後不良因子であるだけでなく、胃癌におけるICI療法の有効性にも関与している可能性があった。

  • The clinical significance of signal regulatory protein alpha expression in the immune environment of gastric cancer 査読

    Tanaka, Y; Hu, QJ; Kawazoe, T; Tajiri, H; Nakanishi, R; Zaitsu, Y; Nakashima, Y; Ota, M; Oki, E; Oda, Y; Yoshizumi, T

    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY   30 ( 2 )   330 - 339   2025年2月   （ ISSN:1341-9625 eISSN:1437-7772 ）

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    記述言語：英語   出版者・発行元：International Journal of Clinical Oncology  

    Background: Signal regulatory protein alpha (SIRPα) inhibits phagocytosis by macrophages by interacting with CD47. Despite its known role in various cancers, the clinical significance of SIRPα in gastric cancer (GC) remains unclear. This study aimed to elucidate the clinical implications of SIRPα in GC, exploring its relevance to immunotherapy efficacy and the tumor microenvironment. Methods: Two cohorts were studied: a gastrectomy cohort (137 patients) and an immune checkpoint inhibitor (ICI)-treated cohort (19 patients with unresectable advanced GC who received nivolumab). Immunohistochemistry was used to assess SIRPα, CD80, CD163, CD8, and PD-L1 expressions. Kaplan–Meier curves and Cox models were used to analyze the clinical outcomes. In vitro experiments used peripheral blood mononuclear cells and THP-1 macrophage cell lines to examine SIRPα responses to interferon-γ (IFN-γ). Results: In the gastrectomy cohort, high SIRPα expression correlated with advanced tumor invasion, distant metastasis, and poor recurrence-free and overall survival. SIRPα expression was also significantly associated with macrophage and CD8 + T cells infiltration and PD-L1 expression. In the ICI-treated cohort, high SIRPα expression was associated with better overall survival after nivolumab induced. Moreover, in vitro IFN-γ stimulation upregulated SIRPα expression on monocytes in peripheral blood mononuclear cells and THP-1 cells, suggesting high SIRPα expression may reflect an active immune microenvironment. Conclusion: SIRPα expression is not only a poor prognostic factor for GC, possibly through inhibition of the CD47-SIRP⍺ pathway, but may also be involved in the efficacy of ICI therapy in GC.

    DOI： 10.1007/s10147-024-02666-1

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  • Preoperative CT lymph node size as a predictor of nodal metastasis in resectable Colon cancer: a retrospective study of 694 patients 査読

    Kawazoe, T; Nakanishi, R; Ando, K; Zaitsu, Y; Kudou, K; Nakashima, Y; Oki, E; Yoshizumi, T

    BMC GASTROENTEROLOGY   25 ( 1 )   18   2025年1月   （ eISSN:1471-230X ）

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    記述言語：英語   出版者・発行元：BMC Gastroenterology  

    Purpose: This study aimed to investigate the efficacy of measuring lymph node size on preoperative CT imaging to predict pathological lymph node metastasis in patients with colon cancer to enhance diagnostic accuracy and improve treatment planning by establishing more reliable assessment methods for lymph node metastasis. Methods: We retrospectively analyzed 1,056 patients who underwent colorectal resection at our institution between January 2004 and March 2020. From this cohort, 694 patients with resectable colon cancer were included in the study. We analyzed the relationship between lymph node size on preoperative CT imaging and lymph node metastasis identified on postoperative pathological examination. Results: The optimal cutoff values for the maximum long diameter and short diameter of regional lymph nodes on preoperative CT were identified as 6.5 mm and 5.5 mm, respectively, with an AUC of 0.7794 and 0.7755, respectively. Notably, the predictive accuracy varied by tumor location. Higher cutoff values were observed in the right-sided colon (maximum long diameter: 7.7 mm, maximum short diameter: 5.9 mm) compared to the left-sided colon (maximum long diameter: 5.8 mm, maximum short diameter: 5.2 mm). Conclusion: Lymph node size on preoperative CT is a significant predictor of pathological lymph node metastasis in colon cancer. Notably, the optimal cutoff values for predicting lymph node metastasis vary depending on the specific region within the colon.

    DOI： 10.1186/s12876-025-03602-x

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  • Long-Term Survival after Choroidal Metastasis Following Colorectal Cancer Surgery: A Case Report 査読

    Ryujin, K; Kawazoe, T; Sato, S; Otake, A; Shin, Y; Tajiri, H; Zaitsu, Y; Ando, K; Oki, E; Yoshizumi, T

    Surgical Case Reports   11 ( 1 )   n/a   2025年   （ ISSN:2198-7793 eISSN:21987793 ）

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    担当区分：責任著者   記述言語：英語   出版者・発行元：一般社団法人 日本外科学会  

    <p><b>INTRODUCTION:</b> Choroidal metastasis from colorectal cancer is extremely rare, accounting for approximately only 4% of all choroidal metastases. However, with the increasing incidence and improved survival rates of colorectal cancer, the importance of diagnosing and treating ocular metastases is growing. We report a case of choroidal metastasis from colorectal cancer and review the relevant literature.</p><p><b>CASE PRESENTATION:</b> A 67-year-old man underwent curative surgery and adjuvant chemotherapy for ascending colon cancer. Two years later, pulmonary recurrence was detected and surgically resected. At 2 years and 5 months postoperatively, he developed visual impairment in the left eye, which led to the diagnosis of choroidal metastasis. A combination of systemic chemotherapy and local radiotherapy resulted in tumor shrinkage and relief of ocular pain. With additional local treatments administered in response to subsequent recurrences, the patient achieved long-term survival—5 years and 6 months after surgery and 3 years after the diagnosis of choroidal metastasis. A review of 22 reported cases of choroidal metastasis from colorectal cancer published since 2000 revealed that most patients had multi-organ metastases at the time of diagnosis. The average survival following the diagnosis of ocular metastasis was 10.4 months, indicating a poor prognosis. By contrast, local treatments—such as radiotherapy and intravitreal injections—contributed to symptom relief and the maintenance of quality of life. This case represents a valuable example of long-term survival achieved through combined local therapies.</p><p><b>CONCLUSIONS:</b> Although choroidal metastasis from colorectal cancer is rare, clinical management should consider the possibility of ocular involvement. A multidisciplinary approach combining systemic therapy with local treatments is essential for maintaining quality of life and prolonging survival.</p>

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  • Dual-Outlet Stomach-Partitioning Gastrojejunostomy for Malignant Duodenal Obstruction: A Novel Palliative Bypass Technique

    Kudou, K; Oki, E; Kawazoe, T; Nambara, S; Tsuda, Y; Nakanoko, T; Ando, K; Yoshizumi, T

    Surgical Case Reports   11 ( 1 )   n/a   2025年   （ ISSN:2198-7793 eISSN:21987793 ）

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    記述言語：英語   出版者・発行元：一般社団法人 日本外科学会  

    <p><b>INTRODUCTION:</b> Stomach-partitioning gastrojejunostomy (SPGJ) is widely performed for malignant gastric outlet obstruction; however, its utility may be limited when the obstruction is located in the distal duodenum, where digestive fluid stasis can become problematic. We devised a novel modification, termed dual-outlet stomach-partitioning gastrojejunostomy (DO-SPGJ), to address this limitation by adding a 2nd gastrojejunostomy distal to the gastric partition.</p><p><b>CASE PRESENTATION:</b> A 67-year-old man with a tumor in the 3rd portion of the duodenum was diagnosed with squamous cell carcinoma without distant metastasis. The tumor was deemed unresectable due to invasion of the superior mesenteric artery. After 2 months of systemic chemotherapy, the patient developed symptoms of gastric outlet obstruction. A laparoscopic modified SPGJ was performed, involving a standard proximal gastrojejunostomy and an additional distal anastomosis between the gastric antrum and jejunum. The postoperative course was uneventful, and oral intake was successfully resumed.</p><p><b>CONCLUSIONS:</b> This dual-anastomosis approach allows for both food bypass and drainage of digestive secretions, addressing the limitation of conventional SPGJ in cases of distal duodenal obstruction. The technique may also mitigate complications related to fluid stagnation, such as cholangitis or pancreatitis. This novel technique may represent a viable surgical option for select patients with unresectable malignant obstruction of the distal duodenum, especially when fluid stasis is a concern.</p>

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  • Immune Checkpoint Inhibition as a Novel Strategy for Microsatellite Instability-High Duodenal Adenocarcinoma: A Report of Three Cases

    Shirabe, K; Kawazoe, T; Harima, T; Nambara, S; Tsuda, Y; Nakanoko, T; Ando, K; Oki, E; Yoshizumi, T

    Surgical Case Reports   11 ( 1 )   n/a   2025年   （ ISSN:2198-7793 eISSN:21987793 ）

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    記述言語：英語   出版者・発行元：一般社団法人 日本外科学会  

    <p><b>INTRODUCTION:</b> Duodenal adenocarcinoma (DA) is an extremely rare malignancy, accounting for less than 1% of all gastrointestinal cancers. Most cases are diagnosed at an advanced stage, making curative resection difficult and leading to a poor prognosis. Recent advances in tumor immunology have identified microsatellite instability-high (MSI-H) and deficient mismatch repair (dMMR) as predictive biomarkers for immune checkpoint inhibitors (ICIs). However, clinical evidence regarding their efficacy in DA remains limited. We report 3 cases of MSI-H/dMMR DA.</p><p><b>CASE PRESENTATION:</b> (a) Case 1: A 55-year-old woman underwent pancreaticoduodenectomy for DA and was subsequently diagnosed with Lynch syndrome. She has remained recurrence-free for 5 years and 2 months postoperatively. (b) Case 2: A 75-year-old man with locally advanced DA and impaired oral intake declined pancreaticoduodenectomy. After gastrojejunostomy, pembrolizumab was administered, achieving durable disease control for 1 year and 10 months. (c) Case 3: A 65-year-old woman with DA invading adjacent organs received neoadjuvant pembrolizumab. Following bowel obstruction, she underwent partial small intestine resection, and pathological examination revealed a complete response. She has remained recurrence-free for 3 years and 2 months.</p><p><b>CONCLUSIONS:</b> Surgical resection remains the standard treatment for DA. However, in MSI-H/dMMR cases, ICIs are expected to be effective, as observed in other gastrointestinal cancers. Pembrolizumab may represent a useful neoadjuvant option, and in patients who achieve a pathological response, nonsurgical management could also be considered.</p>

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  • Dual-Outlet Stomach-Partitioning Gastrojejunostomy for Malignant Duodenal Obstruction: A Novel Palliative Bypass Technique(タイトル和訳中) 査読

    Kudou Kensuke, Oki Eiji, Kawazoe Tetsuro, Nambara Sho, Tsuda Yasuo, Nakanoko Tomonori, Ando Koji, Yoshizumi Tomoharu

    Surgical Case Reports   11 ( 1 )   scrj.cr.25 - 0483   2025年

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    記述言語：英語   出版者・発行元：(一社)日本外科学会  

  • Immune Checkpoint Inhibition as a Novel Strategy for Microsatellite Instability-High Duodenal Adenocarcinoma: A Report of Three Cases(タイトル和訳中) 査読

    Shirabe Kojiro, Kawazoe Tetsuro, Harima Tomoya, Nambara Sho, Tsuda Yasuo, Nakanoko Tomonori, Ando Koji, Oki Eiji, Yoshizumi Tomoharu

    Surgical Case Reports   11 ( 1 )   scrj.cr.25 - 0645   2025年

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    記述言語：英語   出版者・発行元：(一社)日本外科学会  

  • 大腸癌手術後に脈絡膜転移が判明し長期生存を得た症例　1症例報告(Long-Term Survival after Choroidal Metastasis Following Colorectal Cancer Surgery: A Case Report) 査読

    Ryujin Keiichiro, Kawazoe Tetsuro, Sato Shota, Otake Akihiko, Shin Yuki, Tajiri Hirotada, Zaitsu Yoko, Ando Koji, Oki Eiji, Yoshizumi Tomoharu

    Surgical Case Reports   11 ( 1 )   scrj.cr.25 - 0317   2025年

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    記述言語：英語   出版者・発行元：(一社)日本外科学会  

    症例は67歳男性で、上行結腸癌(T3N0M0,Stage IIA)と診断され、腹腔鏡下右半結腸切除術と完全結腸間膜切除術によりR0切除が得られた。病理学的には高～中分化腺癌であり、脈管侵襲はなく、RAS/BRAF野生型、マイクロサテライト安定性であった。補助化学療法としてカペシタビン+オキサリプラチン投与を4コース施行後、経過観察となった。術後1年10ヵ月で右上葉肺転移が出現し、部分切除を行った。術後2年5ヵ月にはさらに二つの肺転移が認められ、同時期に左眼の視力低下・視野障害・軽度眼痛も出現した。眼検査で脈絡膜腫瘍が確認され、PET/CTでも同部に異常集積を認め、脈絡膜転移と診断した。カペシタビン+ベバシズマブ投与を開始し、2ヵ月目からイリノテカンを併用した。治療5ヵ月後には腫瘍は縮小し眼痛も改善したが、11ヵ月後に悪心のためイリノテカンを中止した。その後腫瘍は増大し眼窩外や視神経への浸潤が進行したため、局所放射線治療を施行し一時縮小した。しかし、その後も放射線合併症や頭蓋・眼窩への進展、基底核転移が出現し、定位放射線治療を追加した。全身療法をレゴラフェニブに変更したが、病勢は進行し、最終的に多臓器転移を認め緩和ケアへ移行した。初回手術から5年6ヵ月、脈絡膜転移診断から3年で死亡した。

  • Duodenal Brunner's gland hamartoma resected using laparoscopic and endoscopic cooperative surgery: A case report 査読

    Sato, S; Kawazoe, T; Tanaka, Y; Ota, M; Oki, E; Yoshizumi, T

    INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS   125   110617   2024年12月   （ ISSN:2210-2612 ）

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    担当区分：責任著者   記述言語：英語   出版者・発行元：International Journal of Surgery Case Reports  

    Introduction and importance: Brunner's gland hamartoma is a rare benign duodenal tumor. Resection is recommended for large or symptomatic lesions, but conventional pancreaticoduodenectomy and other procedures can be overly invasive for the lesion. We report a case of Brunner's gland hamartoma resected using laparoscopic and endoscopic cooperative surgery (LECS). Case presentation: A 51-year-old woman was referred to our hospital with an asymptomatic duodenal tumor that had increased in size. A submucosal tumor was found on the anterior wall of the duodenal bulb during a detailed examination, and surgery was performed because the tumor was large (2 cm). In order to optimally resect the tumor, duodenal LECS (D-LECS) was selected. The resection line was determined while checking the base of the lesion with an intraoperative endoscope, and after the lesion was resected, the mucosal defect was closed using laparoscopic manipulation. Histopathological evaluation revealed Brunner's gland hyperplasia and mixed smooth muscle bundles, and the lesion was diagnosed as a Brunner's gland hamartoma. The surgery was completed without any problems, and the patient made a full recovery after the surgery with no complications such as stenosis, and no recurrence was observed. Clinical discussion: With D-LECS, the lesion can be resected without excess or deficiency, and the incision can be sutured with minimal invasiveness. D-LECS is an effective method as a treatment option for Brunner's gland hamartoma. Conclusion: We herein report a case of Brunner's gland hamartoma treated safely with a minimally invasive surgical technique: D-LECS.

    DOI： 10.1016/j.ijscr.2024.110617

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  • RAS mutant transverse colon cancer with multiple liver metastases achieving long-term disease-free survival with postoperative maintenance therapy with aflibercept plus FOLFIRI and four repeated radical resections: a case report 査読

    Tanaka, Y; Nakanishi, R; Sato, S; Otake, A; Ryujin, K; Ikeda, S; Ebata, Y; Harima, T; Natsugoe, K; Yoshiyama, T; Shin, Y; Kawazoe, T; Kudo, K; Zaitsu, Y; Hisamatsu, Y; Ando, K; Nakashima, Y; Itoh, S; Oki, E; Oda, Y; Yoshizumi, T

    SURGICAL CASE REPORTS   10 ( 1 )   231   2024年10月   （ ISSN:2198-7793 ）

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  • Impact of surgical proximal and distal margins on the recurrence of resectable colon cancer: a single-center observational cohort study 査読

    Kawazoe, T; Toyota, S; Nakanishi, R; Tajiri, H; Zaitsu, Y; Nakashima, Y; Ota, M; Oki, E; Yoshizumi, T

    SURGERY TODAY   54 ( 10 )   1248 - 1254   2024年10月   （ ISSN:0941-1291 eISSN:1436-2813 ）

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    記述言語：英語   出版者・発行元：Surgery Today  

    Purpose: Few studies have investigated the impact of the surgical proximal and distal margins on colon cancer recurrence. We conducted this study to investigate the effect of resection margins on the prognosis of resectable colon cancer. Methods: We analyzed data on 1458 patients who underwent colorectal resection in our institute between January, 2004 and March, 2020, including 579 patients with resectable colon cancer. The association between the resection margin and recurrence for each oncological status was assessed and the value of the resection length that influenced recurrence was analyzed. Results: Patients who had pT4 colon cancer with margins of more than 7 cm had a trend of fewer recurrences and longer relapse-free survival (RFS) than those with colon cancer of other stages (P = 0.033; hazard ratio [HR], 0.42; 95% confidence interval [CI], 0.20–0.89). Multivariate analysis identified a margin of < 7 cm as an independent risk factor for RFS in patients with pT4 colon cancer (P = 0.023; HR, 2.65; 95% CI 1.013–6.17). No correlation was found between resection margins and recurrence, depending on the extent of lymph node metastasis and tumor location. Conclusion: A resection margin of at least 7 cm should be maintained for patients with pT4 colon cancer.

    DOI： 10.1007/s00595-024-02836-8

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  • 多発性肝転移を伴うRAS遺伝子変異型横行結腸癌に対し、アフリベルセプト+FOLFIRIによる術後維持療法と4回の根治的切除を繰り返すことで長期無病生存を達成した症例　症例報告(RAS mutant transverse colon cancer with multiple liver metastases achieving long-term disease-free survival with postoperative maintenance therapy with aflibercept+FOLFIRI and four repeated radical resections: a case report) 査読

    Tanaka Yasushi, Nakanishi Ryota, Sato Shota, Otake Akihiko, Ryujin Keiichiro, Ikeda Shinichiro, Ebata Yuho, Harima Tomoya, Natsugoe Keita, Yoshiyama Takayuki, Shin Yuki, Kawazoe Tetsuro, Kudo Kensuke, Zaitsu Yoko, Hisamatsu Yuichi, Ando Koji, Nakashima Yuichiro, Itoh Shinji, Oki Eiji, Oda Yoshinao, Yoshizumi Tomoharu

    Surgical Case Reports   10   s40792 - 024   2024年10月

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    記述言語：英語   出版者・発行元：(一社)日本外科学会  

    症例は37歳女性で、妊娠17週であり、3週間前から腹痛と下痢が続いていた。大腸内視鏡検査で、脾彎曲部にて腫瘍による高度狭窄を認め、組織学的検査と遺伝子型からRAS遺伝子変異型横行結腸癌と診断した。腹部造影CTでは、脾彎曲部の横行結腸の壁肥厚、腫瘍近傍の中結腸リンパ節の腫大が3個、肝臓に多発性の低密度充実性腫瘤が19個認められた。転移は肝臓に限局していたため、縮小手術を目的として全身化学療法を導入した。ベバシズマブ(BEV)+FOLFOXIRIを6サイクル行った後、全肝転移巣に対して部分肝切除術を施行した。原発巣に対しては、BEV+FOLFIRIをさらに4サイクル行った後に左結腸切除術を施行した。術後3ヵ月目に癌性腹水貯留を伴う巨大な卵巣転移を認めたため、両側卵巣摘出術を行い、BEV抵抗性の可能性を考慮してアフリベルセプト+FOLFIRI療法を開始した。アフリベルセプト+FOLFIRI療法中の2年間は再発を認めなかったが、投与中止後に遠隔転移が2ヶ所出現した。いずれも切除可能であり、追加の化学療法を行わずに、最後の手術から2年3ヵ月の無再発生存期間を達成した。

  • 切除可能結腸癌における手術の近位側および遠位側切除断端長が再発に与える影響　単独施設観察コホート研究(Impact of surgical proximal and distal margins on the recurrence of resectable colon cancer: a single-center observational cohort study)

    Kawazoe Tetsuro, Toyota Satoshi, Nakanishi Ryota, Tajiri Hirotada, Zaitsu Yoko, Nakashima Yuichiro, Ota Mitsuhiko, Oki Eiji, Yoshizumi Tomoharu

    Surgery Today   54 ( 10 )   1248 - 1254   2024年10月   （ ISSN:0941-1291 ）

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    記述言語：英語   出版者・発行元：シュプリンガー・ジャパン(株)  

    結腸癌手術における切除断端長が予後に与える影響を調査した。2004年1月から2020年3月までに当院にて大腸切除術を受けた1458例のうち、切除可能結腸癌579例を対象とした。腫瘍学的ステージ別に再発に影響を与える断端長を分析した。その結果、pT4結腸癌患者において、断端長≧7cmと<7cmを比較したところ、≧7cm群は再発が少なく、無再発生存期間(RFS)および全生存期間が長い傾向を示した。多変量解析により、年齢、リンパ節転移、断端長<7cmがpT4結腸癌患者のRFSの独立危険因子であった。切除断端長と再発箇所の相関は認めなかった。以上より、pT4結腸癌患者では少なくとも≧7cmの断端長を確保すべきことが示された。

  • Neoadjuvant Chemotherapy in Patients With T4b or Obstructive Colon Cancer: A Single Center Retrospective Cohort Study 査読

    Ebata, Y; Nakanishi, R; Tanaka, Y; Kawazoe, T; Tajiri, H; Zaitsu, Y; Nakashima, Y; Ota, M; Oki, E; Yoshizumi, T

    ANTICANCER RESEARCH   44 ( 3 )   1281 - 1287   2024年3月   （ ISSN:0250-7005 eISSN:1791-7530 ）

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    記述言語：英語   出版者・発行元：Anticancer Research  

    Background/Aim: The efficacy of neoadjuvant chemotherapy (NAC) for colon cancer remains unestablished. This study aimed to investigate the outcomes of NAC in patients with locally advanced T4b or obstructive T4a colon cancers (LACC). Patients and Methods: Data of patients with LACC who underwent colon surgery between 2010 and 2022 after NAC at our institution were retrospectively reviewed. Patient characteristics, surgical outcomes, tumor features, and prognosis were analyzed. Results: Among 800 patients with LACC who underwent radical resection, 11 received NAC because of cT4b or cT4a with mechanical obstruction. NAC, administered as a doublet regimen, had a median duration of three months, without grade ≥3 adverse events. R0 resection was achieved in all patients and downstaging was observed in eight patients. One patient developed a postoperative abdominal abscess, and adjuvant chemotherapy was administered to eight patients. Four patients experienced recurrence: liver metastasis in two, and local recurrence in two. Among these, three patients underwent resection of recurrent tumors. Median follow-up was 30 months. Conclusion: NAC is feasible for T4b or obstructive T4a colon cancer and may be a treatment option for LACC. Further large-scale studies are required to confirm the efficacy of NAC in these patients.

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  • Preoperative Hemoglobin Level as Predictor of the Development of High-output Stoma in Rectal Cancer Surgery 査読 国際誌

    Tetsuro Kawazoe, Kippei Ohgaki, Yoshihiko Fujinaka, Huanlin Wang, Kazutoyo Morita, Ryota Nakanishi, Yoichi Ikeda

    Cancer Diagnosis and Prognosis   3 ( 6 )   667 - 672   2023年11月

    　詳細を見る

    記述言語：日本語   掲載種別：研究論文（学術雑誌）  

    DOI： doi: 10.21873/cdp.10270.

  • Successful Treatment of Refractory Enterocutaneous Fistula After Esophagectomy Using Soft Coagulation by an Endoscopic and Percutaneous Approach: A Case Report 査読

    Ito S., Ohgaki K., Kawazoe T., Wang H., Okamoto Y., Adachi E., Ikeda Y.

    Anticancer Research   43 ( 6 )   2873 - 2877   2023年6月   （ ISSN:02507005 ）

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    出版者・発行元：Anticancer Research  

    Background/Aim: Anastomotic leakage (AL) is a serious complication after esophagectomy, and the refractory fistula (RF) following AL is therapeutically challenging with no optimal management strategies known. Thus, new therapeutic options are required for treating RF. Case Report: A 67-year-old man who underwent endoscopic mucosal dissection was subjected to subtotal esophagectomy and reconstruction with a gastric tube through the retrosternal route with cervical anastomosis as additional therapy. On postoperative day 5, leakage from the esophagogastric anastomosis was detected. A refractory enterocutaneous fistula (4 cm in length) developed between the esophagogastric anastomosis (the fistula opening was 1 cm approximately) and cervical skin. The RF did not heal despite the drainage of saliva, enteral nutrition, oral administration of biperiden hydrochloride for orofacial dyskinesia to rest the esophagogastric anastomosis, coagulation factor XIII transvenously, and fibrin glue injection from the opening of the fistula, probably due to difficulty in maintaining the rest of the esophagogastric anastomosis caused by orofacial dyskinesia. On postoperative day 76, soft coagulation to the fistula opening at the esophagogastric anastomosis by an endoscopic approach and to the fistula via the fistula opening at the cervical site by a percutaneous approach was performed. The post-treatment course was uneventful. The RF completely closed immediately after soft coagulation. Conclusion: Soft coagulation using endoscopic and percutaneous approaches to RF is a minimally invasive procedure and may be a useful option if the fistula opening of the anastomotic site is small and accessible endoscopically, and there are no vital organs around the fistula.

    DOI： 10.21873/anticanres.16457

    Scopus

  • Survival Benefits of Laparoscopic Gastrectomy in Elderly Patients With Gastric Cancer: Focusing on Preoperative Nutritional and Inflammatory Status 査読

    Ito S., Ohgaki K., Kawazoe T., Sato S., Ikeda S., Kakizoe K., Wang H., Nakamura T., Maehara S., Adachi E., Ikeda Y., Maehara Y.

    Anticancer Research   43 ( 5 )   2055 - 2067   2023年5月   （ ISSN:02507005 ）

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    出版者・発行元：Anticancer Research  

    Background/Aim: Laparoscopic gastrectomy (LG) may have greater clinical benefits as a less invasive surgery for elderly patients with gastric cancer (GC). Therefore, we aimed to evaluate the survival benefit of LG in elderly patients with GC, especially focusing on preoperative comorbidities, and nutritional and inflammatory status. Patients and Methods: Data collected from 115 patients aged ≥75 years with primary GC who underwent curative gastrectomy, comprising 58 patients who underwent open gastrectomy (OG) and 57 patients who underwent LG, were retrospectively reviewed (total cohort), and 72 propensity-matched patients (matched cohort) were selected for survival analysis. The aim of the study was to determine short- and long-term outcomes, and the clinical markers to identify a population who may benefit from LG in elderly patients. Results: The complication and mortality rates as a short-term outcome in the total cohort and overall survival (OS) as a long-term outcome in the matched cohort did not differ significantly between the groups. In the total cohort, advanced tumor stage and ≥3 comorbidities were independent factors for poor prognosis in terms of OS [hazard ratio (HR)=3.73, 95% confidence interval (CI)=1.78-7.78, p<0.001 and HR=2.50, 95% CI=1.35-4.61, p<0.01, respectively]. The surgical approach was not an independent risk factor for postoperative complications (grade ≥III) and OS. In subgroup analysis of the total cohort, patients with a neutrophil-lymphocyte ratio (NLR) ≥3 in the LG group demonstrated a trend toward greater OS (HR=0.26, 95% CI=0.10-0.64, interaction p<0.05). Conclusion: LG might offer greater survival benefits than OG in frail patients such as those with high NLR.

    DOI： 10.21873/anticanres.16366

    Scopus

  • Lineage of drug discovery research on fluorinated pyrimidines: chronicle of the achievements accomplished by Professor Setsuro Fujii 査読

    Maehara, Y; Oki, E; Ota, M; Harimoto, N; Ando, K; Nakanishi, R; Kawazoe, T; Fujimoto, Y; Nonaka, K; Kitao, H; Iimori, M; Makino, K; Takechi, T; Sagara, T; Miyadera, K; Matsuoka, K; Tsukihara, H; Kataoka, Y; Wakasa, T; Ochiiwa, H; Kamahori, Y; Tokunaga, E; Saeki, H; Yoshizumi, T; Kakeji, Y; Shirabe, K; Baba, H; Shimada, M

    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY   28 ( 5 )   613 - 624   2023年5月   （ ISSN:1341-9625 eISSN:1437-7772 ）

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    記述言語：英語   出版者・発行元：International Journal of Clinical Oncology  

    Prof. Setsuro Fujii achieved significant results in the field of drug discovery research in Japan. He developed nine well-known drugs: FT, UFT, S-1 and FTD/TPI are anticancer drugs, while cetraxate hydrochloride, camostat mesilate, nafamostat mesilate, gabexate mesilate and pravastatin sodium are therapeutic drugs for various other diseases. He delivered hope to patients with various diseases across the world to improve their condition. Even now, drug discovery research based on Dr. Fujii’s ideas is continuing.

    DOI： 10.1007/s10147-023-02326-w

    Web of Science

    Scopus

    PubMed

  • 高齢のステージIVB期食道扁平上皮癌患者における免疫チェックポイント阻害薬による化学療法後のコンバージョン手術の奏効　症例報告(Successful conversion surgery following chemotherapy with an immune checkpoint inhibitor in an older adult patient with stage IVB esophageal squamous cell carcinoma: a case report) 査読

    Kawazoe Tetsuro, Ito Shuhei, Ohgaki Kippei, Fujinaka Yoshihiko, Funakoshi Hiroki, Otake Akihiko, Wang Huanlin, Morita Kazutoyo, Fushimi Fumiyoshi, Ikeda Yoichi

    Surgical Case Reports   9   1 of 7 - 7 of 7   2023年3月

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    記述言語：英語   出版者・発行元：Springer Berlin Heidelberg  

    症例は80歳女性。嚥下困難を主訴に来院した。上部消化管内視鏡検査で胸部下部食道に潰瘍性病変を認め、生検で中分化型扁平上皮癌と診断した。CTで胃周囲リンパ節に加え、鎖骨上リンパ節と傍下大静脈リンパ節の腫大を認めた。PET-CTで上記のリンパ節でFDGの異常集積を認めた。以上の所見から、ステージIVB期食道扁平上皮癌(cT3N2M1 cStageIVB)と診断し、ペムブロリズマブと標準化学療法の併用療法を開始した。レジメンは3週ごとのコースで、5-FU(800mg/m2)、シスプラチン(80mg/m2)、ペムブロリズマブ(200mg)を静注した。2コース終了後に好中球減少症が発現したため、5-FUとシスプラチンの投与量を減量した。4コース終了後に原発巣と転移巣の縮小を認め、PET-CTでFDGの異常集積は見られなかった。診断をycT2N0M0 ycStageIIに変更し、コンバージョン手術の方針となった。胸腔鏡下食道亜全摘術、リンパ節郭清術、胃管再建術を施行した。術後に腫瘍細胞の遺残を認めず、組織学的完全奏効と判定した。16日後に無事退院となった。10ヵ月後の再診で再発は見られなかった。

  • Preoperative hemoglobin level as predictor of the development of high-output stoma in rectal cancer surgery 査読

    Kawazoe T., Ohgaki K., Fujinaka Y., Wang H., Morita K., Nakanishi R., Ikeda Y.

    Cancer Diagnosis and Prognosis   3 ( 6 )   667 - 672   2023年

    　詳細を見る

    記述言語：英語   出版者・発行元：Cancer Diagnosis and Prognosis  

    Background/Aim: High-output stomas (HOSs) are a complication that can cause dehydration or renal dysfunction and affect the quality of life of patients, causing water, sodium, and magnesium depletion with malnutrition. Preoperative factors that are useful for predicting HOS are not well defined. Patients and Methods: A total of nine patients developed HOS among 31 patients who underwent rectal cancer surgery with ileostomies during 2014-2021. Clinicopathological and surgical parameters were also analyzed. HOS was defined as maximum output of 2,000 ml/day. Results: The clinicopathological features did not differ between the HOS and non-HOS groups. Lower Hemoglobin (Hb) levels (<12 mg/dl) and longer operation times (300 min) were shown to be risk factors in the development of HOS. Conclusion: Low Hb levels on preoperative blood tests were predictors of HOS development in patients who underwent rectal cancer surgery and ileostomies simultaneously in our data set. Further studies are required to improve the robustness of these findings.

    DOI： 10.21873/cdp.10270

    Scopus

    PubMed

  • Refractory splenic bleeding from splenic angiosarcoma: A case report and literature review 査読

    Kawazoe T., Ohgaki K., Adachi E., Ikeda Y., Fushimi F., Kakihara D.

    International Journal of Surgery Case Reports   99   2022年10月   （ ISSN:22102612 ）

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    出版者・発行元：International Journal of Surgery Case Reports  

    Introduction and importance: Atraumatic splenic rupture (ASR) is a rare state that accounts for only <1 % of splenic ruptures. One of the causes of ASR is splenic neoplasm such as angiosarcoma. The treatment strategy for ASR is still unclear given the small number of cases reported in detail. Case presentation: A 75-year-old woman presenting with abdominal pain with shock was referred to our hospital. Emergency computed tomography revealed splenic rupture, and hemodynamic stabilization was obtained by emergent vascular embolization. Rebleeding occurred 27 days after the initial treatment, and splenectomy was performed. Pathologically, ASR was diagnosed as caused by splenic angiosarcoma. Clinical discussion: ASR is a very rare disease. The etiology of ASR has been reported as neoplastic, infectious, and so on. The treatment for ASR should be decided considering the etiology of ASR, hemodynamic stability, volume of blood transfusion, patient status, severity of the splenic injury, and volume of intraperitoneal bleeding. Conclusions: We experienced a very rare case of ASR, in which diagnosis was challenging and the timing of surgery was difficult to determine. When splenic rupture has an atraumatic cause, splenectomy should be considered because of the possibility of malignancy.

    DOI： 10.1016/j.ijscr.2022.107708

    Scopus

  • Survival benefits of gastrectomy compared to conservative observation for older patients with resectable gastric cancer: a propensity score matched analysis 査読

    Ito S., Ohgaki K., Kawazoe T., Wang H., Nakamura T., Maehara S., Adachi E., Ikeda Y., Maehara Y.

    Langenbeck's Archives of Surgery   407 ( 6 )   2281 - 2292   2022年9月   （ ISSN:14352443 ）

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    出版者・発行元：Langenbeck's Archives of Surgery  

    Purpose: Radical gastrectomy is considered the first choice of curative treatment for older patients with gastric cancer (GC). However, there is limited data on the survival benefits of gastrectomy for older patients with GC. Methods: This was a retrospective observational study where medical records of patients aged ≥ 75 years with clinically resectable primary GC, comprising 115 patients who underwent radical surgery (S group) and 33 patients who received conservative therapy (non-S group) (total cohort) and 44 propensity-matched patients (matched cohort), were reviewed. Survival and independent risk factors, including comorbidities and systemic nutritional and inflammatory statuses, were evaluated. Results: In the total cohort, the 5-year overall survival (OS) in the S group was significantly higher than that in the non-S group (53.7% vs 19.7%, P < 0.0001). In the matched cohort, the 3-year OS in the S group was significantly higher than that in the non-S group (59.4% vs 15.9%, P < 0.01). Multivariate analysis of the total cohort showed that no surgery was an independent prognostic factor for poor OS (hazard ratio (HR) 3.70, 95% confidence interval (CI) 1.91–7.20, P = 0.0001). In the S group in the total cohort, the multivariate analysis showed that renal disease (HR 2.51, 95% CI 1.23–5.12, P < 0.05) was an independent prognostic factor for poor OS. Conclusions: Gastrectomy for older patients improved the prognosis; however, careful patient selection is essential, especially among those with renal disease.

    DOI： 10.1007/s00423-022-02511-x

    Scopus

  • RAD51 Expression as a Biomarker to Predict Efficacy of Preoperative Therapy and Survival for Esophageal Squamous Cell Carcinoma A Large-cohort Observational Study (KSCC1307) 査読

    Saeki, H; Jogo, T; Kawazoe, T; Kamori, T; Nakaji, Y; Zaitsu, Y; Fujiwara, M; Baba, Y; Nakamura, T; Iwata, N; Egashira, A; Nakanoko, T; Morita, M; Tanaka, Y; Kimura, Y; Shibata, T; Nakashima, Y; Emi, Y; Makiyama, A; Oki, E; Tokunaga, S; Shimokawa, M; Mori, M

    ANNALS OF SURGERY   275 ( 4 )   692 - 699   2022年4月   （ ISSN:0003-4932 eISSN:1528-1140 ）

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    記述言語：英語   出版者・発行元：Annals of Surgery  

    Objective:The aim of this study is to identify biomarkers that predict efficacy of preoperative therapy and survival for esophageal squamous cell carcinoma (ESCC).Background:It is essential to improve the accuracy of preoperative molecular diagnostics to identify specific patients who will benefit from the treatment; thus, this issue should be resolved with a large-cohort, retrospective observational study.Methods:A total of 656 patients with ESCC who received surgery after preoperative CDDP + 5-FU therapy, docetaxel + CDDP + 5-FU therapy or chemoradiotherapy (CRT) were enrolled. Immunohistochemical analysis of TP53, CDKN1A, RAD51, MutT-homolog 1, and programmed death-ligand 1 was performed with biopsy samples obtained before preoperative therapy, and expression was measured by immunohistochemistry.Results:In all therapy groups, overall survival was statistically separated by pathological effect (grade 3 > grade 2 > grade 0, 1, P < 0.0001). There was no correlation between TP53, CDKN1A, MutT-homolog 1, programmed death-ligand 1 expression, and pathological effect, whereas the proportion of positive RAD51 expression (≥50%) in cases with grade 3 was lower than that with grade 0, 1, and 2 (P = 0.022). In the CRT group, the survival of patients with RAD51-positive tumor was significantly worse than RAD51-negative expressors (P = 0.0119). Subgroup analysis of overall survival with respect to positive RAD51 expression indicated preoperative chemotherapy (CDDP + 5-FU or docetaxel + CDDP + 5-FU) was superior to CRT.Conclusions:In ESCC, positive RAD51 expression was identified as a useful biomarker to predict resistance to preoperative therapy and poor prognosis in patients who received preoperative CRT. Administration of preoperative chemotherapy may be warranted for patients with positive RAD51 expression.

    DOI： 10.1097/SLA.0000000000003975

    Web of Science

    Scopus

    PubMed

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講演・口頭発表等

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MISC

所属学協会

  • 日本外科学会

  • 日本消化器外科学会

  • 日本癌治療学会

  • 日本胃癌学会

  • 日本胸部外科学会

  • 日本食道学会

  • 日本内視鏡外科学会

  • 日本癌学会

  • 日本大腸肛門病学会

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共同研究・競争的資金等の研究課題

  • 食道癌における間質細胞が関与する炎症関連シグナル伝達の解明と新規治療法の開発

    研究課題/領域番号：25K19737  2025年4月 - 2028年3月

    科学研究費助成事業  若手研究

    川副 徹郎

    　 詳細を見る

    資金種別：科研費

    LIF (Leukemia inhibitory factor)はIL-6ファミリーサイトカインの一つであり、胚細胞、成体細胞で細胞の分化・増殖を調節することが知られている。我々はこれまで、食道扁平上皮癌においてLIFのノックダウンにより食道扁平上皮癌進展が抑制されることを報告した。
    本研究ではLIFやIL-6を標的とした治療を開発し、食道扁平上皮癌の予後改善に取り組むことを目的とする。食堂扁平上皮癌において、LIFが周囲の間質にどのような影響を及ぼすかは明らかではない。これらのクロストークを明らかにすることで、LIFを標的とした治療を臨床応用できると考える。

    CiNii Research

  • 質量分析イメージングを応用した革新的ながん診断システムの開発

    研究課題/領域番号：25K11867  2025年4月 - 2028年3月

    科学研究費助成事業  基盤研究(C)

    財津 瑛子, 安藤 幸滋, 川副 徹郎, 沖 英次, 吉住 朋晴, 工藤 健介

    　 詳細を見る

    資金種別：科研費

    本研究は質量分析イメージングを応用したがんの迅速診断の手法を開発することが目的である。研究は２つのプロセスからなっている。一つ目は実際のがん組織を用いた検証である。すでに癌の診断がついている組織に対し、実際の迅速診断と同じ環境下で検証し、所要時間、誤判定の頻度、転写基板の特性が実際に迅速診断の環境下で汎用性をもって使用できるかを検討する。次に新規検体で同様の検討を行い再現性の確認を行う。
    二つ目のプロセスは検出されたがん由来分子について解析することである。複数のがん由来分子が検出されることを想定しており、高次元解析等を行うことで臨床応用ができる特異度の高い指標がないかを検証する。

    CiNii Research

  • 食道扁平上皮癌における炎症関連シグナル活性化の分子機序とその制御

    研究課題/領域番号：2 2 K 1 6 5 2 6  2022年 - 2024年

    日本学術振興会  科学研究費助成事業  若手研究

    川副 徹郎

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    担当区分：研究代表者  資金種別：科研費

    LIF (Leukemia inhibitory factor)はIL-6ファミリーサイトカインの一つであり、胚細胞、成体細胞で細胞の分化・増殖を調節することが知られている。我々はこれまで、食道扁平上皮癌においてLIFがその下流のシグナルであるSFK-YAP経路、JAK-STAT3経路を介して癌進展に寄与すること、またLIFのノックダウンにより食道扁平上皮癌進展が抑制されることを報告した。
    本研究ではLIFやIL-6を標的とした治療を開発し、食道扁平上皮癌の予後改善に取り組むことを目的とする。

    CiNii Research

  • 食道扁平上皮癌における炎症関連シグナル伝達を標的とした新規治療法の開発

    2022年 - 2023年

    第 5 6 回 がん研究助成金

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    資金種別：受託研究

  • 食道扁平上皮癌における慢性炎症シグナルを標的とした新規治療法の開発

    研究課題/領域番号：19J11357  2019年 - 2020年

    日本学術振興会  科学研究費助成事業  特別研究員奨励費

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    担当区分：研究代表者  資金種別：科研費

  • 食道扁平上皮癌における慢性炎症シグナルを標的とした新規治療法の開発

    2019年 - 2020年

    日本学術振興会  特別研究員

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    資金種別：共同研究

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担当授業科目

  • 医工学

    2024年4月 - 2024年9月   前期

  • 消化管・腹膜

    2024年4月 - 2024年9月   前期

専門診療領域

  • 生物系／医歯薬学／外科系臨床医学／消化管外科学

臨床医資格

  • 専門医

    日本外科学会

  • 専門医

    日本消化器外科学会

医師免許取得年

  • 2014年