Nagamata M.,Infectious Diseases Center Komagome Hospital |
Okuma Y.,Infectious Diseases Center Komagome Hospital |
Hosomi Y.,Infectious Diseases Center Komagome Hospital |
Hishima T.,Infectious Diseases Center Komagome Hospital
Journal of Bronchology and Interventional Pulmonology | Year: 2017
Thymic carcinoma is a rare cancer, accounting for only 1% to 4% of thymic epithelial tumors. Endobronchial metastasis is a rare presentation of these tumors. A 64-year-old man presented with a cough. Lung cancer was suspected because a chest radiograph showed a 7-cm mass in the left pulmonary hilum. Computed tomography showed a mass in the anterior mediastinum and an infiltrate in the upper lobe of the left lung. Bronchoscopy demonstrated bilateral polypoid tumors in the left B3 bronchus and the right B1 bronchus. Endobronchial biopsies of both lesions resulted in a diagnosis of squamous cell carcinoma that was positive for c-KIT by immunohistochemical staining. The patient was eventually found to have thymic squamous cell carcinoma with bilateral endobronchial metastases (stage IVb according to the Masaoka-Koga staging system) by diagnostic video-assisted thoracoscopic surgery. He was subsequently treated with platinum-doublet chemotherapy and achieved a partial response for 18.8 months. © 2017 Wolters Kluwer Health, Inc. All rights reserved.
Shimozuma K.,Ritsumeikan University |
Ohashi Y.,University of Tokyo |
Takeuchi A.,University of Tokyo |
Aranishi T.,University of Tokyo |
And 9 more authors.
Supportive Care in Cancer | Year: 2012
Purpose To elucidate whether adjuvant taxane monotherapy is a feasible and tolerable for postoperative breast cancer patients, we evaluated the severity of chemotherapy-induced peripheral neuropathy (CIPN) and the relative tolerability of regimens by health-related quality of life (HRQOL) assessment in node- positive breast cancer patients treated with taxane-containing regimens. Methods We evaluated CIPN and HRQOL in the first 300 patients enrolled in a larger (1,060 total) multicenter phase III trial randomized to one of four adjuvant regimens: (1) anthracycline-cyclophosphamide followed by paclitaxel (ACP), (2) AC followed by docetaxel (ACD), (3) paclitaxel alone (PTX), or (4) docetaxel alone (DTX). CIPN was assessed by the Patient Neurotoxicity Questionnaire (PNQ) and the National Cancer Institute Common Toxicity Criteria, and HRQOL by Functional Assessment of Cancer Therapy-General (FACT-G). CIPN and HRQOL scores were compared between ACP and ACD vs. PTX and DTX, and ACP and PTX vs. ACD and DTX. Results PNQ sensory scores were significantly higher in patients treated with taxane monotherapy compared to treatment with AC followed by taxane (P=.003). No significant differences in PNQ sensory scores were observed between the ACP and PTX vs. ACD and DTX regimens (P=.669). Regardless of taxane regimen, PNQ severity scores for CIPN appear to be largely reversible within 1 year of adjuvant treatment. No significant difference in FACT-G scores was observed between any regimens during the study treatments. Conclusions Patient-reported CIPN was significantly more severe with single-agent adjuvant taxane compared to AC followed by taxane treatment; however, the HRQOL findings support that single-agent taxane treatment is tolerable. © Springer-Verlag 2012.
Endo M.,Kumamoto University |
Nakano M.,Kumamoto University |
Kadomatsu T.,Kumamoto University |
Fukuhara S.,Japan National Cardiovascular Center Research Institute |
And 21 more authors.
Cancer Research | Year: 2012
Strategies to inhibit metastasis have been mainly unsuccessful in part due to insufficient mechanistic understanding. Here, we report evidence of critical role for the angiopoietin-like protein 2 (ANGPTL2) in metastatic progression. In mice, Angptl2 has been implicated in inflammatory carcinogenesis but it has not been studied in human tumors. In patients with lung cancer, elevated levels of ANGPTL2 expression in tumor cells within the primary tumor were associated with a reduction in the period of disease-free survival after surgical resection. Transcription factors NFATc, ATF2, and c-Jun upregulated in aggressive tumor cells promoted increased Angptl2 expression. Most notably, tumor cell-derived ANGPTL2 increased in vitro motility and invasion in an autocrine/paracrine manner, conferring an aggressive metastatic tumor phenotype. In xenograft mouse models, tumor cell-derived ANGPTL2 accelerated metastasis and shortened survival whereas attenuating ANGPTL2 expression in tumor cells-blunted metastasis and extended survival. Overall, our findings showed that tumor cell-derived ANGPTL2 drives metastasis and provided an initial proof of concept for blockade of its action as a strategy to antagonize the metastatic process. ©2012 AACR.
PubMed | National Hospital Organization Osaka National Hospital, Aichi Cancer Center Hospital, Prefectural Aichi Hospital, Japan National Cardiovascular Center Research Institute and 7 more.
Type: Journal Article | Journal: Cancer science | Year: 2016
The prognostic and predictive value of KRAS gene mutations in stage III colorectal cancer is controversial because many recent clinical trials have not involved a surgery-alone arm. Additionally, data on the significance of extended RAS (KRAS/NRAS) mutations in stage III cancer are not available. Hence, we undertook a combined analysis of two phase III randomized trials, in which the usefulness of adjuvant chemotherapy with tegafur-uracil (UFT) was evaluated, as compared with surgery alone. We determined the association of extended RAS and mismatch repair (MMR) status with the effectiveness of adjuvant chemotherapy. Mutations in KRAS exons 2, 3, and 4 and NRAS exons 2 and 3 were detected by direct DNA sequencing. Tumor MMR status was determined by immunohistochemistry. Total RAS mutations were detected in 134/304 (44%) patients. In patients with RAS mutations, a significant benefit was associated with adjuvant UFT in relapse-free survival (RFS) (hazard ratio = 0.49; P = 0.02) and overall survival (hazard ratio = 0.51; P = 0.03). In contrast, among patients without RAS mutations, there was no difference in RFS or overall survival between the adjuvant UFT group and surgery-alone group. We detected deficient DNA MMR in 23/304 (8%) patients. The MMR status was neither prognostic nor predictive for adjuvant chemotherapy. An interaction analysis showed that there was better RFS among patients treated with UFT with RAS mutations, but not for those without RAS mutations. Extended RAS (KRAS/NRAS) mutations are proposed as predictive indicators with respect to the efficacy of adjuvant UFT chemotherapy in patients with resected stage III colorectal cancer.
Ishibashi K.,Tokyo Metropolitan University |
Ishibashi K.,Infectious Diseases Center Komagome Hospital |
Miura Y.,Infectious Diseases Center Komagome Hospital |
Oda K.,Tokyo Metropolitan University |
And 2 more authors.
Journal of Alzheimer's Disease | Year: 2014
Increased plasma glucose levels can cause the regional reduction of fluorine-18-labeled fluorodeoxyglucose (18F-FDG) uptake in the posterior cingulate, precuneus, and/or temporoparietal cortices as an Alzheimer's disease (AD)-like pattern. However, the association of such an AD-like pattern of cerebral 18F-FDG uptake with AD pathophysiology is unknown. We report a case of a 70-year-old patient with mild cognitive impairment, and show that the AD-like pattern of cerebral 18F-FDG uptake during a hyperglycemic state could be reversible and is not associated with amyloid-β accumulation. Our case concludes that the AD-like pattern is dependent on the plasma glucose level and independent of AD pathophysiology. © 2014 - IOS Press and the authors. All rights reserved.
Randomized phase II study of weekly paclitaxel with and without carboplatin followed by cyclophosphamide/epirubicin/5-fluorouracil as neoadjuvant chemotherapy for stage II/IIIA breast cancer without HER2 overexpression
Ando M.,Aichi Cancer Center Hospital |
Yamauchi H.,St Lukes International Hospital |
Aogi K.,National Hospital Organization |
Shimizu S.,Kanagawa Cancer Center |
And 9 more authors.
Breast Cancer Research and Treatment | Year: 2014
Addition of carboplatin to neoadjuvant chemotherapy in HER2-negative breast cancer may improve pathological complete response (pCR) rates. We evaluated the efficacy and safety of carboplatin and weekly paclitaxel (wPTX) followed by cyclophosphamide, epirubicin, and 5-fluorouracil (CEF) as neoadjuvant chemotherapy for HER2-negative breast cancer. Patients with stage II/IIIA HER2-negative breast cancer were randomly assigned to preoperatively receive CP-CEF (four 3-week cycles of carboplatin [area under the curve 5 mg/mL/min, day 1] and wPTX [80 mg/m2, day 1, 8, 15] followed by four 3-week cycles of CEF [500/100/500 mg/m2] or P-CEF (four cycles of wPTX followed by four cycles of CEF). The primary objective was pCR rate. Of 181 eligible patients, 89 were randomly assigned to the CP-CEF and 92 to the P-CEF. Two patients in each arm refused to receive neoadjuvant chemotherapy. Overall 88 patients in the CP-CEF and 91 patients in the P-CEF were assessable for efficacy and safety. The pCR rate in the CP-CEF was significantly higher than that in the P-CEF (31.8 vs. 17.6 %, one-sided P = 0.01). Among patients with triple-negative breast cancer, the pCR rate in the CP-CEF was significantly higher than that in the P-CEF [61.2 (23/37) vs. 26.3 % (10/38), P = 0.003]. Grade 3-4 neutropenia was observed in the CP-CEF more frequently than in the P-CEF (65.9 vs. 38.5 %). Adding carboplatin to neoadjuvant wPTX followed by CEF for HER2-negative breast cancer improved the pCR rate and exacerbated hematotoxicity. © 2014 Springer Science+Business Media New York.
Fukushima H.,Infectious Diseases Center Komagome Hospital |
Nakanishi Y.,Infectious Diseases Center Komagome Hospital |
Kataoka M.,Infectious Diseases Center Komagome Hospital |
Tobisu K.-I.,Infectious Diseases Center Komagome Hospital |
Koga F.,Infectious Diseases Center Komagome Hospital
Journal of Urology | Year: 2016
Purpose Sarcopenia, a novel concept reflecting the degenerative loss of skeletal muscle mass, is a critical physiological change during the development of cancer cachexia. We retrospectively investigated the prognostic role of sarcopenia in patients with metastatic renal cell carcinoma. Materials and Methods Skeletal muscle index was calculated using computerized tomography performed at the diagnosis of metastatic renal cell carcinoma. Sarcopenia was defined as skeletal muscle index less than 43 cm2/m2 for males with a body mass index less than 25 kg/m2, less than 53 cm2/m2 for males with a body mass index 25 kg/m2 or greater, and less than 41 cm2/m2 for females. The relationship between sarcopenia and overall survival was assessed in 92 patients with metastatic renal cell carcinoma using Cox proportional hazards models. The predictive accuracy of these models was evaluated using the c-index. Results A total of 63 (68%) patients were classified as having sarcopenia and 52 (57%) died (median overall survival 27 months) during followup (median 19 months). A multivariate analysis identified sarcopenia as a significant and independent predictor of overall survival (HR 2.58, p = 0.015), along with prior nephrectomy (p <0.001), number of metastatic sites (p = 0.017), corrected calcium (p = 0.026) and lactate dehydrogenase (p = 0.006). The 3-year overall survival rates were 31% and 73% for sarcopenic and nonsarcopenic cases, respectively (p <0.001). The integration of sarcopenia into the Memorial Sloan Kettering Cancer Center risk model improved the c-index from 0.726 to 0.758 (addition of sarcopenia to the original model) and 0.755 (substitution of sarcopenia for Karnofsky performance status). Conclusions Sarcopenia is a significant prognostic factor in metastatic renal cell carcinoma. © 2016 American Urological Association Education and Research, Inc.
Okuma Y.,Infectious diseases Center Komagome Hospital |
Okuma Y.,Jikei University School of Medicine |
Hosomi Y.,Infectious diseases Center Komagome Hospital |
Watanabe K.,Infectious diseases Center Komagome Hospital |
And 5 more authors.
BMC Cancer | Year: 2014
Background: Thymic epithelial tumors (TETs), which comprise thymoma and thymic carcinoma, are rare cancers with specific morphological and clinical features. Their clinical characteristics and outcomes have gradually been clarified by assessing large-scale, retrospective data obtained with international cooperation.Methods: The study is a retrospective review of 187 Japanese patients with TETs who attended our institution from 1976 to 2012. Relevant clinical features of patients with TETs and their tumors, including histology, staging, treatment strategies, and overall survival, were investigated. Differences in survival were assessed by the Kaplan-Meier method and uni- and multi-variate Cox proportional hazards regression analyses.Results: The 187 patients included 52 patients with stage I, 37 with stage II, 22 with stage III, and 76 with stage IVa/IVb tumors according to the Masaoka-Koga Staging System. As to histological type, five patients had type A, 33 type AB, 19 type B1, 39 type B2, and 15 type B3 thymomas, whereas 68 patients had thymic carcinoma, including 11 with neuroendocrine carcinomas according to the 2004 WHO classification. Either insufficient data were available to classify the tumors of the remaining eight patients or they had rare types. Immunological abnormalities were present in 26 patients, most of whom had thymomas (21.8% of the thymoma group). Most of the patients who presented with symptoms had myasthenia gravis or extensive thymic carcinoma. Secondary cancers were present in 25 patients (13.3%). The overall 5- and 10-year survival rates for thymoma were 85.4 and 71.5%, respectively, and those for thymic carcinoma were 33.8 and 2.3%, respectively. OS differed significantly between stage IVa thymomas and thymic carcinomas. The stage and whether the tumors were thymomas or thymic carcinomas were significant determinants of survival according to multivariate analysis.Conclusion: The efficacy of treatments for thymoma and thymic carcinoma should be investigated separately because these tumors differ in their clinical features and prognosis. © 2014 Okuma et al.; licensee BioMed Central Ltd.
Kageyama S.,Infectious Diseases Center Komagome Hospital
Japanese Journal of Clinical Radiology | Year: 2015
In late years efficacy of the cetuximab combination radiation therapy is established and it became the insurance adaptation in Japan from December, 2012. Because there are not cisplatin and the result of the direct comparison, cetuximab combination radiation therapy tend to use for the case that it is hard to give of cisplatin in our hospital. However, the validity for the case having complications is unidentified. We report cetuximab combination radiation therapy for the head and neck squamous carcinoma having the complications e in our hospital and consider its validity.
Kato H.,Infectious Diseases Center Komagome Hospital |
Sasaki S.,Infectious Diseases Center Komagome Hospital |
Sekiya N.,Infectious Diseases Center Komagome Hospital
Medicine (United States) | Year: 2016
Primary extraintestinal complications caused by Yersinia enterocolitica are extremely rare, especially in the form of skin and soft-tissue manifestations, and little is known about their clinical characteristics and treatments. We presented our case and reviewed past cases of primary skin and soft-tissue infections caused by Y enterocolitica. We report a case of primary cellulitis and cutaneous abscess caused by Y enterocolitica in an immunocompetent 70-year-old woman with keratodermia tylodes palmaris progressiva. She presented to an outpatient clinic with redness, swelling, and pain of the left ring finger and left upper arm without fever or gastrointestinal symptoms 3 days before admission. One day later, ulceration of the skin with exposed bone of the proximal interphalangeal joint of the left ring finger developed, and cefditoren pivoxil was described. However, she was admitted to our hospital due to deterioration of symptoms involving the left finger and upper arm. Cefazolin was initiated on admission, then changed to sulbactam/ampicillin and vancomycin with debridement of the left ring finger and drainage of the left upper arm abscess. Wound culture grew Y enterocolitica serotype O:8 and methicillin-sensitive Staphylococcus aureus. Blood cultures were negative and osteomyelitis was ruled out. Vancomycin was switched to ciprofloxacin, then skin and soft-tissue manifestations showed clear improvement within a few days. The patient received 14 days of ciprofloxacin and oral amoxicillin/clavulanate and has since shown no recurrence. We reviewed 12 cases of primary skin and soft-tissue infections caused by Y enterocolitica from the literature. In several past cases, portal entry involved failure of the skin barrier on distal body parts. Thereafter, infection might have spread to the regional lymph nodes from the ruptured skin. Y enterocolitica is typically resistant to aminopenicillins and narrow-spectrum cephalosporins. In most cases, these inefficient antibiotic agents were initially prescribed, but patient conditions rapidly improved after implementing appropriate therapy and drainage. In addition, primary skin and soft-tissue infections occurred even in patients lacking risk factors. Physicians should consider the rare differential diagnosis of Y enterocolitica infection when seeing patients with deteriorating skin lesions under standard treatment, even if the patient is immunocompetent. © 2016 Wolters Kluwer Health, Inc. All rights reserved.