Time filter

Source Type

Yamamoto K.,National Hospital Organization Osaka National Hospital | Tsujinaka T.,Kaizuka City Hospital | Takahashi T.,Osaka University | Sato S.,Shizuoka General Hospital | And 5 more authors.
Annals of Surgical Oncology | Year: 2015

Background: Gastrointestinal stromal tumors (GISTs) of the stomach are found incidentally during gastric cancer screening in Japan. This study investigated whether the Japanese gastric cancer screening system helps to improve treatment outcomes in gastric GIST based on an analysis of the GIST registry conducted by the Kinki GIST Study Group.Methods: The registry was designed to collect data on background characteristics, treatment methods, pathologic characteristics, and prognosis of GIST from January 2003 through December 2007 at 40 participating institutions.Results: The study enrolled 672 GIST patients, 482 of whom had gastric GIST. According to the modified National Institutes of Health consensus criteria, 22.6 % of the patients were classified as high risk for recurrence, 18.5 % as intermediate risk, 35.9 % as low risk, and 13.9 % as very low risk. After exclusion of the patients inevaluable for treatment outcome, the study included 137 symptomatic patients (symptomatic group) and 147 asymptomatic patients (asymptomatic group). The diagnosis of the asymptomatic patients was determined through gastric cancer screening. The median tumor size in the asymptomatic group was significantly smaller than in the symptomatic group (3.5 vs. 5.3 cm; P < 0.0001). The 5-year recurrence-free survival rate in the asymptomatic high-risk patients (72.4 %) was lower than in their symptomatic counterparts (46.3 %) (P = 0.017). More patients in the asymptomatic group underwent laparoscopic surgery (42.2 vs. 27.2 %; P = 0.0081).Conclusions: By identifying asymptomatic patients, the Japanese gastric cancer screening system contributes to early detection of gastric GIST and favorable treatment outcomes. © 2014, Society of Surgical Oncology. Source

Tsujinaka T.,Kaizuka City Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2016

Osaka Gastrointestinal Cancer Chemotherapy Study Group (OGSG) was established in 2000 and has been conducting investigator initiated multi-institutional collaboration trials regarding the treatment of gastrointestinal cancer, especially using chemotherapeutic agents. Although organization of OGSG has been renovated to perform post-marketing clinical trials with high quality, OGSG is now facing severe financial crisis because of shortage of donation from pharmaceutical companies. Here, present problems and future perspectives are discussed. Source

Kohjimoto Y.,Wakayama Medical University | Sasaki Y.,Wakayama Medical University | Iguchi M.,Kaizuka City Hospital | Matsumura N.,Wakayama Medical University | And 2 more authors.
American Journal of Kidney Diseases | Year: 2013

Background: Although metabolic syndrome and its individual components have been associated with kidney stone disease, whether the clustering of metabolic syndrome traits increases the severity of kidney stone disease has not been examined in a large-scale study. Study Design: Cross-sectional analysis. Setting & Participants: Data were obtained from 30,448 patients enrolled in the 6th Nationwide Survey on Urolithiasis in Japan conducted in 2005. Patients with lower urinary tract stones, struvite stones, cystine stones, or hyperparathyroidism and those younger than 15 years were excluded. Predictor: Number of metabolic syndrome traits (obesity [body mass index ≥25 kg/m 2], diabetes, hypertension, and dyslipidemia). Outcomes: Severe form of kidney stone disease, defined as recurrent and/or multiple stones, and abnormalities in urine constituents (hypercalciuria, hyperuricosuria, hyperoxaluria, and hypocitraturia). Results: 11,555 patients were included in the final analyses. Proportions of patients with recurrent and/or multiple stones were 57.7%, 61.7%, 65.2%, 69.3%, and 73.3% with 0, 1, 2, 3, and 4 metabolic syndrome traits, respectively (P < 0.001). There was a significant and stepwise increase in the odds of recurrent and/or multiple stones after adjustment for age and sex. In patients with 4 metabolic syndrome traits, the odds was 1.8-fold greater compared with patients with 0 traits (OR, 1.78; 95% CI, 1.22-2.66). In addition, the presence of metabolic syndrome traits was associated with significantly increased odds of having hypercalciuria, hyperuricosuria, hyperoxaluria, and hypocitraturia after adjustment for age and sex. Limitations: Cross-sectional design, absence of dietary data, ill-defined diagnostic criteria for metabolic syndrome traits, and missing data for the majority of participants. Conclusions: Metabolic syndrome trait clustering is associated with greater severity of kidney stone disease; increased urinary calcium, uric acid, and oxalate excretion; and decreased urinary citrate excretion. These results suggest that kidney stone disease should be regarded as a systemic disorder linked to metabolic syndrome. © 2013 National Kidney Foundation, Inc. Source

Inoue T.,Kaizuka City Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2011

We report two cases of primary advanced breast cancer that was locally controlled by using Mohs'paste. CASE 1: A 70- year-old woman was suffering massive exudates and offensive smell from her right giant breast tumor. Histopathological examination showed an invasive ductal carcinoma. However, she didn't have distant metastases. The patient received chemotherapy and the breast tumor has been fixed using Mohs'paste, and dissected. The giant tumor became flat and dry, so we could perform a radical operation. Then, she had contra-lateral axillary lymph node metastases. We performed a resection of left axillary lymph node and radiation therapy. After two years, we have not found a new lesion. CASE 2: A 54-year- old woman with right local advanced breast cancer discharged massive exudates and oozed blood. Histopathologically, she had an invasive ductal carcinoma. Moreover, she had lung and contra-lateral axillary lymph node metastases. She received chemotherapy and the breast tumor has been fixed using Mohs'paste, and dissected. The bleeding and exudates stopped almost completely, and the breast tumor became flat and dry. Both patients had experienced a mild pain, but their QOL improved remarkably. It is suggested that the patient with local advanced breast cancer may be controlled by using Mohs' paste. Source

Yamaoka Y.,National Hospital Organization Osaka National Hospital | Fujitani K.,Osaka Prefectural General Medical Center | Tsujinaka T.,Kaizuka City Hospital | Yamamoto K.,National Hospital Organization Osaka National Hospital | And 2 more authors.
Gastric Cancer | Year: 2014

Background Skeletal muscle loss is associated with physical disability, nosocomial infections, postoperative complications, and decreased survival. Preventing the loss of skeletal muscle mass after gastrectomy may lead to improved outcomes. The aims of this study were to assess changes in skeletal muscle mass after total gastrectomy (TG) and to clarify the clinical factors affecting significant loss of skeletal muscle after TG. Patients and methods One hundred and two patients undergoing TG for primary gastric cancer underwent abdominal computed tomography before and 1 year after TG to precisely quantify postoperative changes in skeletal muscle and adipose tissue. Univariate and multivariate logistic regression analyses identified clinical factors contributing to significant loss of skeletal muscle after TG. Results At 1 year after TG, the mass of both skeletal muscle and adipose tissue was reduced by 6.20 ± 6.80 and 65.8 ± 36.1 % of the preoperative values, respectively, and 26 patients (25.5 %) showed a significant loss of skeletal muscle of more than 10 %. Adjuvant chemotherapy with S-1 for ≥6 months (hazard ratio 26.61, 95 % confidence interval, 3.487-203.1) was identified as the single independent risk factor for a significant loss of skeletal muscle. Conclusions Skeletal muscle loss was exacerbated by extended adjuvant chemotherapy after TG. Further research should identify appropriate nutritional interventions for maintaining skeletal muscle mass and leading to improved outcomes. © 2014 The International Gastric Cancer Association and The Japanese Gastric Cancer Association. Source

Discover hidden collaborations