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Nakashima H.,Foundation for Detection of Early Gastric Carcinoma.
Nihon rinsho. Japanese journal of clinical medicine | Year: 2012

This article describes a method of gastrographic examination and its use in diagnosis of gastric cancer. Gastrography includes four examination methods: barium filled, mucosal relief, compression, and double contrast studies. Diagnosis by gastrography is based on the histogenesis of gastric cancer. Depressive undifferentiated type cancer, which arises from the fundic gland mucosa, shows a clear depressed border between the carcinoma and normal mucosa. The surface of the cancer also shows granular changes in regenerative mucosa. Depressive differentiated type cancer, which develops from intestinal metaplastic mucosa, has a smooth mucosal surface and shows depression of the cancer accompanied with slightly elevated margins. Most elevated type gastric cancers are intramucosal cancers of differentiated type carcinoma. However, cancers showing elevation of more than 3cm would be predicted to show invasive potential by conventional statistical gastric cancer studies. Source

Miura A.,Tokyo Metropolitan Cancer and Infectious Diseases Center | Honda M.,Tokyo Metropolitan Cancer and Infectious Diseases Center | Izumi Y.,Tokyo Metropolitan Cancer and Infectious Diseases Center | Kato T.,Tokyo Metropolitan Cancer and Infectious Diseases Center | And 7 more authors.
Esophagus | Year: 2011

Purpose: In Japan, chemoradiotherapy (CRT) is primarily indicated for T4 esophageal cancer for curative intent or when aiming for downstaging. However, CRT yields a low rate of complete response, is associated with a high incidence of complications such as fistula, and often results in the emergence of severe lymph node metastasis or distant organ metastasis after the therapy. A safer and more effective treatment strategy is needed. The aim of this study is to evaluate the efficacy of the combination of induction chemotherapy and subsequent CRT for T4M0 esophageal squamous cell carcinoma. Patients and methods: In our institute, 97 consecutive patients with T4M0 esophageal cancer underwent CRT between 2000 and 2007. Of these, 47 patients who received induction chemotherapy before CRT were eligible for the present retrospective analysis. The regimen of induction chemotherapy was FAP therapy (fluorouracil 700 mg/m2/day, cisplatin 14 mg/m2/day on days 1-5, doxorubicin 30 mg/m2/day on day 1) administered every 4 weeks. After one to five courses of FAP therapy, concurrent CRT at a dose of 60-66 Gy in 30-33 fractions was undergone. Results: Induction chemotherapy, which preceded CRT, was effective in 21 patients (47%; responder) and ineffective in the remaining 26 patients (47%; non-responder). Better survival was achieved in the responder than in the non-responder group: the mean survival time (MST) and 1-year survival rate were 14.3 months and 66.7%, respectively, in the former, and 9.1 months and 33.6%, respectively, in the latter group. Treatment-related death occurred in 3 (6%) of the 47 patients receiving induction chemotherapy because of the progression of the radiation pneumonitis. Conclusion: Induction chemotherapy followed by CRT is expected to improve the survival rate without increasing severe therapy-associated complications in patients with T4M0 esophageal cancer. © 2011 The Japan Esophageal Society and Springer. Source

Sakaki N.,Foundation for Detection of Early Gastric Carcinoma. | Ashida K.,Osaka Saiseikai Nakatsu Hospital | Mizokami Y.,University of Tsukuba | Chiba T.,Kyoto University | And 5 more authors.
Hepato-Gastroenterology | Year: 2013

Background/Aims: To compare the endoscopic features of LDA-induced ulcers developing during secondary prophylaxis with lansoprazole (LPZ) and gefarnate (GFN). Methodology: All ulcers that had developed during prophylaxis with LPZ (15mg once daily) and GFN (50mg twice daily) in a prospective, randomized, double-blind trial, were reviewed and compared by a panel of expert endoscopists, based on endoscopic images available from the trial, to provide evidence for efficacy of LPZ versus GFN in secondary prophylaxis in patients with endoscopically confirmed ulcer scars. Results: A total of 6 and 53 patients had developed gastric or duodenal ulcers during prophylaxis with LPZ and GFN, respectively. Six gastric ulcers seen in those given LPZ were "small" and "shallow", while, of the 38 gastric ulcers seen those given GFN, 44.7% and 55.3% were "medium" or "large" and "small", respectively. Ulcers associated with blood coagula were seen only in those given GFN. Duodenal ulcers developed in 15 and 0 patients given GFN and LPZ, respectively. Conclusions: The ulcers developing during prophylaxis with GFN and LPZ varied in their features. The study findings may be useful when devising a strategy for prophylaxis of ulcers in high-risk patients receiving LDA therapy in a routine clinical setting. © H.G.E. Update Medical Publishing S.A. Source

Nishigori T.,Tokyo Metropolitan Cancer and Infectious Diseases Center | Miura A.,Tokyo Metropolitan Cancer and Infectious Diseases Center | Kato T.,Tokyo Metropolitan Cancer and Infectious Diseases Center | Ryotokuji T.,Tokyo Metropolitan Cancer and Infectious Diseases Center | And 7 more authors.
Esophagus | Year: 2013

A 70-year-old man was diagnosed with a thoracic esophageal squamous cell carcinoma invading the muscularis mucosa without lymph node or distant metastases in June 2003. Endoscopic mucosal resection was conducted. Histological examination showed squamous cell carcinoma invading the deep mucosal layer without lymphatic permeation. In April 2006, a chest CT scan revealed a metastasis to the right recurrent laryngeal nerve chain (106recR) lymph node, and chemoradiotherapy and chemotherapies were performed but were not very effective. He died of esophagobronchial fistula in October 2007. We reexamined this case in detail, and a deeper cut of the block revealed positive lymph vessel invasion and droplet infiltrations. We were initially unable to identify lymphatic permeation but specific findings were determined, such as high degrees of cellular atypia, downward extension of irregular epithelial processes, and irregular margins of cancer alveoli. Extreme caution is required for treating patients with these morphological changes. © 2012 The Japan Esophageal Society and Springer Japan. Source

Ichikawa K.,Dokkyo Medical University | Fujimori T.,Dokkyo Medical University | Moriya T.,Kawasaki Medical School | Ochiai A.,Research Center for Innovative Oncology | And 25 more authors.
Digestion | Year: 2013

The 6th Diagnostic Pathology Summer Fest, held in Tokyo on August 25-26, 2012, opened its gates for everyone in the medical profession. Basic pathology training can contribute to the improvement of algorithms for diagnosis and treatment. The 6th Summer Fest with the theme 'Pathology and Clinical Treatment of Gastrointestinal Diseases' was held at the Ito International Research Center, The University of Tokyo. On August 25, 'Treatment of Early Gastrointestinal Cancer and New Guidelines' was discussed in the first session, followed by 'Biopsy Diagnosis of Digestive Tract: Key Points of Pathological Diagnosis for Inflammation and Their Clinical Significance' in the second session. On August 26, cases were discussed in the third session, and issues on pathological diagnosis and classification of neuroendorcrine tumor in the fourth session. The summaries of speeches and discussions are introduced along with the statements of each speaker. This meeting was not a formal evidence-based consensus conference, and 20 experts gave talks on their areas of specialty. Discussion was focused on how the management strategy should be standardized on the algorithm of patient care. © 2013 S. Karger AG, Basel. Source

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