National Cancer Center East Hospital

Kashiwa, Japan

National Cancer Center East Hospital

Kashiwa, Japan
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PubMed | Red Cross, St Lukes International Hospital, Kobe University, Kawasaki Medical School and 5 more.
Type: Journal Article | Journal: Journal of pain and symptom management | Year: 2016

Symptom screening is important for appropriate symptom management. It remains uncertain as to which scores on the Edmonton Symptom Assessment System-Revised (ESAS-r) comprise the optimal cutoff points to determine symptom severity for Japanese cancer patients.To investigate optimal cutoff points for individual ESAS-r items for detecting symptom severity and to evaluate the screening performance of the ESAS-r depression item in Japanese cancer patients.We recruited cancer patients receiving palliative care from five tertiary acute hospitals in Japan. We asked participants to complete the ESAS-r Japanese version, Verbal Rating Symptom Severity Scale, and Quick Inventory of Depressive Symptomatology-Self-Report Japanese version. We calculated sensitivity and specificity for detecting severe and moderate/severe symptoms evaluated by the Verbal Rating Symptom Severity Scale at different cutoff points of the ESAS-r. We also calculated sensitivity and specificity for detecting both the presence of depression and moderate/severe depression evaluated by the Quick Inventory of Depressive Symptomatology-Self-Report at various cutoff points for the depression item of the ESAS-r Japanese version.A total of 292 participants completed the questionnaire. For most of the ESAS-r symptoms, cutoff points to achieve the best balance between sensitivity and specificity were 5-7 for determining severe intensity and 3-4 for determining moderate/severe intensity. For the ESAS-r depression item, a cutoff point of 2 achieved the best balance between sensitivity and specificity for detecting both the presence of depression and moderate/severe depression.The ESAS-r Japanese version can accurately represent the severity of many symptoms. The cutoff points established for determining the level of symptom severity using ESAS-r provides a guide for symptom management in Japanese cancer patients.


Uraoka T.,Okayama University | Saito Y.,National Cancer Center Hospital | Ikematsu H.,National Cancer Center East Hospital | Yamamoto K.,Okayama University of Science | Sano Y.,Sano Hospital
Digestive Endoscopy | Year: 2011

Narrow-band imaging enhances visualization of the mucosal surface structure and vascular network and helps to increase the visibility of neoplasia by improving contrast. Sano and his colleagues first reported its efficacy for endoscopic use in the gastrointestinal tract and later proposed a sequential classification of the mucosal vascular network patterns according to histopathological categories. Sano's 'capillary pattern classification' was established to facilitate diagnosis of early colorectal lesions on a step-by-step basis. This review focuses on the utility and effectiveness of Sano's capillary pattern classification when examining early colorectal lesions using narrow-band imaging. © 2011 The Authors Digestive Endoscopy © 2011 Japan Gastroenterological Endoscopy Society.


Kiyozuka M.,Tokyo Women's Medical University | Akimoto T.,Tokyo Women's Medical University | Akimoto T.,National Cancer Center East Hospital | Fukutome M.,Tokyo Women's Medical University | And 3 more authors.
Anticancer Research | Year: 2013

Aim: The purpose of this study was to investigate whether radiation induces ligand-independent dimerization of epidermal growth factor receptor (EGFR) and explore the possible role of radiation-induced receptor dimerization in the radiosensitizing effect of cetuximab. Materials and Methods: The human vulvar squamous cell carcinoma cell line A431 was used. The dimerization and activation of EGFR were quantified using immunoprecipitation, a western blotting analysis, and a chemical cross-linking analysis with dithiobissulfosuccinimidyl propionate. Results: Irradiation at a dose of 2 Gy induced the autophosphorylation of EGFR. Consistent with autophosphorylation, a 360-kDa polypeptide, corresponding to the size of the EGFR dimer, was detected in addition to an EGFR monomer. Radiation also induced hetero-dimerization between EGFR and HER2/neu. Cetuximab combined with radiation inhibited radiation-induced autophosphorylation of EGFR, and inhibited radiation-induced homo-dimerization of EGFR. However, cetuximab incompletely inhibited radiation-induced heterodimerization between EGFR and HER2. Conclusion: The results of this investigation suggest that radiation-induced homo- and/or hetero-dimerization between EGFR and/or HER2 might be involved in the radioresponse of cancer cells.


Matsuda T.,National Cancer Center Hospital | Saito Y.,National Cancer Center Hospital | Nakajima T.,National Cancer Center Hospital | Sakamoto T.,National Cancer Center Hospital | And 4 more authors.
Techniques in Gastrointestinal Endoscopy | Year: 2011

Colorectal cancer is the third most prevalent cause of cancer-related mortality in Japan, and the incidence of submucosal colorectal cancer is increasing. To reduce colorectal cancer mortality, however, early detection of colorectal cancer is required and adequate diagnosis of depth is needed. Current endoscopes provide high-resolution imaging that result in clear, vivid features of the detected lesions. In particular, when combined with image enhancement, high-magnification endoscopy can provide a detailed analysis of the morphologic architecture of the pit pattern and the capillary pattern in a simple and quick manner. Characteristic colonoscopic findings obtained by a combination of conventional colonoscopy, magnifying chromoendoscopy, and narrow-band imaging are useful for determining the depth of invasion of early-stage colorectal cancers, an essential factor in selecting a treatment modality. © 2011 Elsevier Inc.


Yamagishi A.,University of Tokyo | Yamagishi A.,Keio University | Yamagishi A.,National Cancer Center East Hospital | Morita T.,Seirei Mikatahara Hospital | And 5 more authors.
Journal of Pain and Symptom Management | Year: 2010

Context: Anorexia is one of the most common symptoms in terminally ill cancer patients and causes considerable distress for both patients and their families. Objectives: The primary aims of the present study were to clarify the level of the family-perceived emotional distress and necessity for improvement in professional practice when a relative becomes unable to take nourishment orally and explore the determinants of these outcomes. The ultimate aim was to develop an effective care strategy for family members of terminally ill cancer patients who become unable to take nourishment orally. Methods: A cross-sectional anonymous nationwide survey was conducted involving 662 bereaved family members of cancer patients who had been admitted to 95 palliative care units throughout Japan. Results: A total of 452 bereaved family members returned the questionnaires (effective response rate, 68%). Overall, 80% of family members experienced the situation where a terminally ill relative became unable to take nourishment orally. The reported level of family-perceived emotional distress was very distressing (38%) and distressing (33%). Responses to the family-perceived necessity for improvement in professional practice they received were much improvement needed (4%), considerable improvement needed (10%), and some improvement needed (46%). The independent determinants of a high level of family perceived emotional distress were a sense of helplessness and guilt, and belief that dehydration causes profound distress for dying patients. Independent determinants of a high level of family-perceived necessity for improvement in professional practice were a sense of helplessness and guilt, experience that health care providers did not pay enough attention to family members' concerns, and insufficient relief of the patient's symptoms. Conclusion: A considerable number of family members experienced high levels of emotional distress when a terminally ill cancer patient became unable to take nourishment orally, and many perceived a necessity for improvement in professional practice they received. A recommended care strategy includes the following four major domains: 1) relieving the family members' sense of helplessness and guilt, 2) providing up-to-date information about hydration and nutrition at the end of life, 3) understanding family members' concerns and providing emotional support, and 4) relieving the patient's symptoms. Further research is needed to evaluate the effects of this care strategy on family members' outcomes, including clinical studies to obtain more accurate understanding of the symptomatic effects of hydration and nutrition in terminally ill cancer patients. © 2010 U.S. Cancer Pain Relief Committee Published by Elsevier Inc. All rights reserved.


Okusaka T.,National Cancer Center Hospital | Ueno H.,National Cancer Center Hospital | Ikeda M.,National Cancer Center East Hospital | Morizane C.,National Cancer Center Hospital
Hepatology Research | Year: 2011

Aim: NIK-333 (an acyclic retinoid) has been reported to prevent recurrence of hepatocellular carcinoma (HCC) in patients after curative treatment. This study was conducted to determine the maximum tolerated dose, dose-limiting toxicities (DLT) and pharmacokinetics of NIK-333 administrated p.o. at doses ranging 300-900mg/day. Methods: Patients who were cancer-free after percutaneous local ablation or surgical resection of HCC were enrolled. The total daily dose was administrated as a single dose (single-dose stage) followed by a week of rest, and then in two equally divided doses administrated after breakfast and supper for 48 consecutive weeks (repeated-dose stage). Results: No patients at the dose levels of 300mg/day and 600mg/day developed any DLT. At the final dose level of 900mg/day, three of the nine patients developed grade 3 hypertension as a DLT. There were no significant difference values of maximum drug concentration (Cmax) and log(Cmax) between fasting and postprandial condition. In the repeated-dose stage, there was no significant difference between the start and week 24 of NIK-333 administration within any dose cohort in either the mean area under the blood concentration time curve (0-6h) or the Cmax. NIK-333 was well-tolerated when administrated p.o. at doses of up to 600mg/day for 48weeks. Conclusion: Hypertension was noted as a DLT at the dose level of 900mg/day, and this dose was considered to be inappropriate. The recommended dose for the phase II/III clinical trial is thought to be 300mg/day and 600mg/day. © 2011 The Japan Society of Hepatology.


PubMed | Tokyo Medical and Dental University, Toride Kyodo General Hospital and National Cancer Center East Hospital
Type: Journal Article | Journal: Journal of rural medicine : JRM | Year: 2015

Here, we present the case of a 78-year-old man with a deep neck infection that caused descending necrotizing mediastinitis that extended from the pharynx to the stomach and was accompanied by two large esophageal fistulas and multiple gastric ulcers. We believe that the series of lesions were the signs of a hidden carcinoma.


Kobayashi S.,National Cancer Center East Hospital | Takahashi S.,National Cancer Center East Hospital | Kato Y.,National Cancer Center East Hospital | Gotohda N.,National Cancer Center East Hospital | And 3 more authors.
Journal of Hepato-Biliary-Pancreatic Sciences | Year: 2011

Background No consensus has been reached on the feasibility and efficacy of surgery for lymph node metastases (LNM) from hepatocellular carcinoma (HCC). Methods Of 2189 patients with HCC treated at our hospital between July 1992 and March 2008, we retrospectively reviewed the medical dossiers of the 18 patients (0.8%) who underwent lymph node resection and were pathologically diagnosed to have LNM from HCC. The surgical procedure for LNM was selective lymphadenectomy of those lymph nodes suspected to harbor metastasis. The feasibility and efficacy of selective lymphadenectomy was examined, and clinicopathological factors were analyzed with the aim of determining which patients would most benefit from surgery. Results Eighteen patients underwent surgery without mortality or liver failure. Morbidities were found in four patients (22.2%). The median survival time (MST) after surgery was 29 months [95% confidence interval (CI) 21-38 months). The 1-, 3-, and 5-year overall survival rates were 85, 42, 21%. The median progression-free survival (PFS) after surgery was 6 months (95% CI 1-11 months), and the median extrahepatic PFS was 16 months (95% CI 13-18 months). Single LNM was the only favorable prognostic factor after surgery (Hazard ratio 0.082, 95% CI 0.008-0.83). Conclusion Selective lymphadenectomy of LNM from HCC was a feasible and efficacious procedure. Survival rates can be expected to improve after selective lymphadenectomy of single LNM. © Japanese Society of Hepato-Biliary-Pancreatic Surgery and Springer 2011.


Nakanotani T.,National Cancer Center East Hospital
Japanese journal of clinical oncology | Year: 2014

Cancer incidence and the number of cancer patients are increasing in today's aging society. The purpose of this study was to investigate the characteristics of elderly cancer patients' concerns and examine the association between their concerns and quality of life. This was a cross-sectional web-based survey completed by ambulatory cancer patients aged 20 years or older. The questionnaire on cancer patients' concerns, comprehensive concerns assessment tool and the European Organization for Research and Treatment of Cancer QLQ-C30 were distributed to the subjects. Multiple regression analysis was conducted to determine which patients' concerns significantly contributed to their quality of life. The final study population consisted of 807 cancer patients, among whom 243 (30%) were elderly (65 years or older). Elderly cancer patients had particular difficulty with self-management, psychological symptoms and medical information, and the prevalence of their concerns was generally lower than that of younger patients, with the exception of physical symptoms. Multiple types of elderly patients' concerns were independently associated with quality of life. We found that elderly cancer patients suffered from various concerns, thus multidisciplinary intervention is important for providing them with optimal care. The results of this study suggest that elderly cancer patients' quality of life will improve if their concerns are properly handled.


Yoshikawa K.,National Cancer Center East Hospital | Konishi M.,National Cancer Center East Hospital | Takahashi S.,National Cancer Center East Hospital | Gotohda N.,National Cancer Center East Hospital | And 2 more authors.
Hepato-Gastroenterology | Year: 2011

Background/Aims: Pancreatic fistula remains a major cause of postoperative morbidity in patients undergoing pancreatectomy and is generally difficult to cure. None of the several surgical techniques and devices available for managing pancreatic remnant have been clinically evaluated. Methodology: We retrospectively reviewed medical records of 120 consecutive patients who underwent distal pancreatectomy at our institution between October 1992 and September 2009. Furthermore, we divided these cases into 3 periods based on 2 points at which we changed our surgical strategy. One was September 2004, when we introduced a stapling technique for managing remnant pancreas. The other was November 2006, when we started using a closed active drain. We evaluated the incidence of pancreatic fistula, risk factors for its development, and our strategy in the perioperative period. Results: The overall and clinical pancreatic fistula rates gradually decreased but were not significant. The persistent drainage period gradually reduced from 19 days to 8 days (p=0.071) over a time period. Postoperative hospital stay was significantly reduced from 24 days to 14 days (p=0.026). Conclusions: Utilization of a stapling technique and closed active drain significantly reduces post-operative hospital stay. © H.G.E. Update Medical Publishing S.A.

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