Hachioji Digestive Disease Hospital

Hachiōji, Japan

Hachioji Digestive Disease Hospital

Hachiōji, Japan
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Sunaga T.,Hachioji Digestive Disease Hospital | Sunaga T.,Showa University | Suzuki S.,Hachioji Digestive Hospital | Kogo M.,Showa University | And 6 more authors.
European Journal of Cancer Care | Year: 2014

Neutropenia during chemotherapy has been reported to be a predictor of better survival in patients with several types of cancer, although there are no reports on stage III colorectal cancer (CRC). The purpose of this study was to examine the association between neutropenia and prognosis in stage III CRC patients receiving adjuvant chemotherapy consisting of oral uracil and tegafur (UFT) plus leucovorin (LV). We retrospectively analysed 123 patients with stage III CRC who received UFT/LV as adjuvant chemotherapy. The end-point was disease-free survival (DFS). Survival curves of the two categories (neutropenia absent vs. present) were estimated using the Kaplan-Meier method and compared by the log-rank test. We estimated the hazard ratio (HR) for DFS according to neutropenia after adjustment for covariates by multivariate analyses using Cox's regression analysis. A total of 33 (26.8%) patients experienced neutropenia. Patients without neutropenia showed a significantly lower DFS than those with neutropenia (3-year DFS 57.3% vs. 81.2%, P = 0.0213). By multivariate analysis, neutropenia and histological type were independent prognostic factors, with HR of 0.410 (neutropenia absent vs. present, P = 0.045) and 4.793 (well to moderately differentiated vs. poorly differentiated, P = 0.004) respectively. We demonstrated that neutropenia occurring during adjuvant chemotherapy consisting of UFT/LV may be a prognostic factor of recurrence in stage III CRC patients. © 2013 John Wiley & Sons Ltd.


Narita T.,Tokyo Women's Medical University | Seshimo A.,Tokyo Women's Medical University | Suzuki M.,Hachioji Digestive Disease Hospital | Murata J.,Asakadai Central General Hospital | Kameoka S.,Tokyo Women's Medical University
Hepato-Gastroenterology | Year: 2013

Background: The incidence of HER2 expression in gastric cancer varies among previous studies. Furthermore, serum HER2 levels have not been well studied in patients with gastric cancer. Methodology: Cancerous gastric tissue was analyzed by immunohistochemistry (IHC) to give an IHC score (IHCO, 1+, 2+ or 3) for HER2 expression. Fluorescence in situ hybridization (FISH) was performed to examine HER2 gene expression in IHC2+ cases. Levels of HER2 in serum collected before surgery were determined by chemiluminescent enzyme immunoassay. Results: Subjects were 105 gastric cancer patients who underwent surgical resection. Tissue expression of HER2 was positive (IHC3+, or IHC2+ plus FISH+) in 6.7% of patients (7/105). All HER2-positive tumors were highly differentiated. Mean serum HER2 level was 8.7±2.1 ng/dl in patients with primary gastric cancer. The mean serum HER2 level in the highly differentiated cancer group was 9.2±2.1 ng/dl, which was significantly higher than that (8.1±1.9 ng/dl) in the poorly differentiated group. Conclusion: Tissue expression of HER2 was found in 6.7% of examined Japanese gastric cancer patients, and all HER2-positive tumors were highly differentiated. Serum HER2 levels were significantly higher in patients with highly differentiated cancer, in good agreement with the higher tissue expression of HER2 in highly differentiated cancer. © H.G.E. Update Medical Publishing S.A.


Ohashi H.,Yamanashi Hospital of Social Insurance | Saida S.,Hachioji Digestive Disease Hospital | Ozawa T.,Yamanashi Hospital of Social Insurance
Journal of Japanese Society of Gastroenterology | Year: 2012

A health check up in a 31-year-old man revealed free air under the diaphragm by a chest X-ray. The CT showed marked cystic emphysema along the small intestinal wall, as well as thickening and stenosis of the pyloric wall of stomach. Therefore, we suspected pneumatosis cystoides intestinalis (PCI) with stenosis of the pylorus. Since no perforation of the intestinal tract was diagnosed, it was preserved. Upper G.I. endoscopy showed H2 stage gastric ulcer in the posterior wall of the antrum. Eventually, a diagnosis of PCI with gastric ulcer and stenosis of the pylorus was, which we preserved. We report this rare case here.


Suzuki S.,Hachioji Digestive Disease Hospital | Kaji S.,Hachioji Digestive Disease Hospital | Koike N.,Hachioji Digestive Disease Hospital | Harada N.,Hachioji Digestive Disease Hospital | And 4 more authors.
Journal of the Pancreas | Year: 2010

Context: We report the imaging features of pancreatic schwannomas, a rare benign type of pancreatic tumor. Case report: A 66-year-old woman was admitted to our hospital with a pancreatic tumor indicated in medical examinations. Computed tomography (CT), magnetic resonance imaging (MRI) and endoscopic ultrasonography (EUS) revealed a solid and cystic tumor, 3 cm in diameter, within the body of the pancreas. Contrast-enhanced CT, MRI and ultrasonography showed partial enhancement in the solid component. Endoscopic retrograde cholangiopancreatography (ERCP) and angiography showed no abnormal findings. A distal pancreatectomy together with a splenectomy and lymph node dissection were performed with a tentative diagnosis of mucinous cystic neoplasm of the pancreas. The cut surface of the resected pancreas showed a well-demarcated, pale yellow, solid tumor within the pancreas parenchyma. Histopathological examination of the tumor revealed proliferation of the spindle cells showing interlacing and palisading patterns. Immunohistochemically, these spindle cells were positive for S-100 protein and vimentin, and negative for alpha-smooth muscle actin, CD34, and cytokeratin. Thus the tumor was diagnosed as a pancreatic schwannoma. Conclusion: CT and US can detect pancreatic schwannomas as solid and cystic masses, and MRI shows a relatively characteristic feature. Imaging procedures such as CT, MRI and US are able to differentiate a pancreatic tumor, such as a pancreatic schwannoma.


Suzuki S.,Hachioji Digestive Disease Hospital | Kaji S.,Hachioji Digestive Disease Hospital | Koike N.,Hachioji Digestive Disease Hospital | Harada N.,Hachioji Digestive Disease Hospital | And 4 more authors.
Journal of Hepato-Biliary-Pancreatic Sciences | Year: 2011

Background/purpose: The aim of this study was to evaluate the long-term complications of pancreaticoduodenectomy with a duct-to-mucosa pancreaticojejunostomy anastomosis without a stenting tube. Methods: Patients were followed for at least 3 years after pancreaticoduodenectomy. They were classified into two groups: duct-to-mucosa pancreaticojejunostomy anastomosis with a stenting tube (group A: 24) and without a stenting tube (group B: 21). Outcomes, including complications and dilatation of the pancreatic duct, were reported retrospectively. Results: The following complication rates were found for group A: morbidity 29.1%, cholangitis 12.5%, nonalcoholic steatohepatitis 4.2%, liver abscess 4.2%, intrahepatic stones 4.2%, abnormal glucose tolerance (progression of diabetes) 20.8%, and dilatation of the pancreatic duct 20.8%. In group B, the rates for morbidity (14.3%) and abnormal glucose tolerance (19%), and dilatation of the pancreatic duct (4.8%) were lower than those in group A, but all results lacked statistical significance. Conclusions: Pancreaticoduodenectomy with a duct-tomucosa anastomosis of pancreaticojejunostomy with or without a stenting tube showed no difference in long-term follow-up. © Japanese Society of Hepato-Biliary-Pancreatic Surgery and Springer 2010.


Suzuki S.,Hachioji Digestive Disease Hospital | Ozaki Y.,Hachioji Digestive Disease Hospital | Saida S.,Hachioji Digestive Disease Hospital | Kaji S.,Hachioji Digestive Disease Hospital | And 4 more authors.
Hepato-Gastroenterology | Year: 2013

Background/Aims: The aim of this study was to compare gemcitabine plus S-1 (GS) combination chemotherapy to gemcitabine (GEM) monotherapy in cases with unresectable advanced pancreatic cancer. Methodology: We retrospectively reviewed 107 consecutive patients with unresectable advanced pancreatic cancer who received GEM monotherapy or GS combination chemotherapy between 2004 and 2010. In 73 patients, GEM (1,000mg/m2) was administered intravenously on days 1, 8 and 15, repeated every four weeks. The GS regimen received by 34 patients consisted of intravenous GEM (1,000mg/m2) on days 1 and 8, combined with oral S-1 (40mg/m2) twice daily on days 1-14, repeated every four weeks. Results: Response rates in the GEM and GS groups (6.8% vs. 32.4%) varied significantly, as did disease control rates (28.8% vs. 61.8%, respectively). There was a significant difference in median overall survival (206 vs. 258 days) and median progression-free survival (86 vs. 123 days) between the GEM and GS groups. Grade 3/4 toxicities in both groups were neutropenia (16.4% in GEM, 17.6% in GS), thrombocytopenia (1.3%, 2.9%), anorexia (1.3%, 0%), and diarrhea (1.3%, 0%). Conclusions: Retrospectively, GS combination therapy is more effective than GEM monotherapy, and therefore should be considered in cases with unresectable advanced pancreatic cancer. © H.G.E. Update Medical Publishing S.A.


Suzuki S.,Hachioji Digestive Disease Hospital | Kaji S.,Hachioji Digestive Disease Hospital | Koike N.,Hachioji Digestive Disease Hospital | Harada N.,Hachioji Digestive Disease Hospital | Suzuki M.,Hachioji Digestive Disease Hospital
Surgery Today | Year: 2013

Background: Although pancreaticoduodenectomy has been recognized in the past for its severe complications, improvements in operative methods and perioperative management have made it a safe procedure. Therefore, pancreaticoduodenectomy can be performed in elderly patients, and our experience and outcomes are described in this report. Methods: We retrospectively investigated 142 patients in whom pancreaticoduodenectomy was performed without stenting tubes during pancreaticojejunostomy. The patients were classified into two groups: (A) those older and (B) younger than 75 years. The outcomes, including preoperative characteristics, intraoperative characteristics, postoperative complications and mortality, are herein reported. Continuous variables were compared using Student's t test and the Chi-square test. Results: There were no differences between groups A and B in terms of sex, operative time, amount of blood loss, performance status, soft pancreas rate, disease distribution and operative procedure. Comorbidities in groups A and B were statistically different. Regarding the preoperative status, the elderly patients exhibited lower serum albumin and hemoglobin levels than the younger patients. There were no differences in mortality (0 vs. 0 %), morbidity (24.3 vs. 29.5 %, p = 0.362), postoperative hospital days or major complications such as pancreatic fistula development, delayed gastric emptying, intra-abdominal abscess development, biliary fistula formation and postpancreatectomy hemorrhage. Conclusions: Pancreaticoduodenectomy can be safely performed in elderly as well as younger patients. © 2012 Springer Japan.


PubMed | Hachioji Digestive Disease Hospital
Type: Comparative Study | Journal: Journal of hepato-biliary-pancreatic sciences | Year: 2011

The aim of this study was to evaluate the long-term complications of pancreaticoduodenectomy with a duct-to-mucosa pancreaticojejunostomy anastomosis without a stenting tube.Patients were followed for at least 3 years after pancreaticoduodenectomy. They were classified into two groups: duct-to-mucosa pancreaticojejunostomy anastomosis with a stenting tube (group A: 24) and without a stenting tube (group B: 21). Outcomes, including complications and dilatation of the pancreatic duct, were reported retrospectively.The following complication rates were found for group A: morbidity 29.1%, cholangitis 12.5%, nonalcoholic steatohepatitis 4.2%, liver abscess 4.2%, intrahepatic stones 4.2%, abnormal glucose tolerance (progression of diabetes) 20.8%, and dilatation of the pancreatic duct 20.8%. In group B, the rates for morbidity (14.3%) and abnormal glucose tolerance (19%), and dilatation of the pancreatic duct (4.8%) were lower than those in group A, but all results lacked statistical significance.Pancreaticoduodenectomy with a duct-to-mucosa anastomosis of pancreaticojejunostomy with or without a stenting tube showed no difference in long-term follow-up.


PubMed | Hachioji Digestive Disease Hospital
Type: Case Reports | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2012

We report a case of bile duct cancer with a positive surgical margin obtaining long-term survival after S-1 monotherapy. A 79-year-old male with fever and liver dysfunction was admitted to our hospital. After a series of examinations he was diagnosed as hilar cholangiocarcinoma, which was treated with bile duct resection and biliary reconstruction for adhesion and pulmonary dysfunction of tuberculosis. Histopathological findings revealed that both surgical margins of the bile duct were positive. After operation, the patient received S-1 oral monotherapy(100mg/day for 28 days, followed by 14 days of rest)for 3 years. The patient has been alive for 5 years without recurrence.


PubMed | Hachioji Digestive Disease Hospital
Type: Journal Article | Journal: Surgery today | Year: 2013

Although pancreaticoduodenectomy has been recognized in the past for its severe complications, improvements in operative methods and perioperative management have made it a safe procedure. Therefore, pancreaticoduodenectomy can be performed in elderly patients, and our experience and outcomes are described in this report.We retrospectively investigated 142 patients in whom pancreaticoduodenectomy was performed without stenting tubes during pancreaticojejunostomy. The patients were classified into two groups: (A) those older and (B) younger than 75 years. The outcomes, including preoperative characteristics, intraoperative characteristics, postoperative complications and mortality, are herein reported. Continuous variables were compared using Students t test and the Chi-square test.There were no differences between groups A and B in terms of sex, operative time, amount of blood loss, performance status, soft pancreas rate, disease distribution and operative procedure. Comorbidities in groups A and B were statistically different. Regarding the preoperative status, the elderly patients exhibited lower serum albumin and hemoglobin levels than the younger patients. There were no differences in mortality (0 vs. 0 %), morbidity (24.3 vs. 29.5 %, p = 0.362), postoperative hospital days or major complications such as pancreatic fistula development, delayed gastric emptying, intra-abdominal abscess development, biliary fistula formation and postpancreatectomy hemorrhage.Pancreaticoduodenectomy can be safely performed in elderly as well as younger patients.

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