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Nishi-Tokyo-shi, Japan

Sakuraba M.,National Cancer Center Hospital East | Miyamoto S.,National Cancer Center Hospital Tokyo | Nagamatsu S.,National Cancer Center Hospital East
Japanese Journal of Plastic Surgery

The most important purpose of reconstructive surgery for patients with advanced hypopharynge-al cancer is to reconstruct the upper digestive tract. Free jejunum transfer is the most common procedure for reconstruction of defect of the hypopharynx and cervical esophagus. However, postoperative results, such as postoperative complications and functions differ among institutions in Japan. A standardized surgical procedure should be established to provide a safe and reliable method for cancer patients. In this report, our latest free jejunum transfer procedure and postoperative management are described. Furthermore, the key points for a further prospective study are discussed. Source

Kondo S.,National Cancer Center Hospital Tokyo | Kondo M.,Kondo Hospital | Kondo A.,Kondo Hospital
Journal of Palliative Medicine

Background: No method is available for evidence-based glycemic-control management in the context of advanced cancer. Objective: This study aimed to analyze, by investigating A1C levels, the necessity of glycemic control in terminal cancer patients with preexisting type 2 diabetes. Design: This was a retrospective study. Subjects: We analyzed 53 terminal cancer patients who had preexisting type 2 diabetes. All patients first visited Kondo Hospital between April 2002 and December 2006. Measurements: We assessed the necessity of glycemic control based on the length of hospitalization and the length of the end-of-life period by using the Kaplan-Meier method and Cox hazard model. Length of the end-of-life period was calculated from the completion of palliative chemotherapy until death. Length of hospitalization was calculated from last admission until death. Results: The median length of hospitalization was significantly longer in relatively well controlled patients - with A1C levels <7.5% (49 days; 95% confidence interval [CI] 34.9-63.1) - than in poorly controlled patients, with A1C levels ≥7.5% (23 days; 95% CI 14.6-31.4, P=0.05). The median length of end of life was significantly longer in the relatively well controlled patients (144 days; 95% CI 115.9-172.1) than in poorly controlled patients (45 days; 95% CI 13.8-76.2, P=0.02). Cox multivariate analysis indicated that performance status (PS) at the initial visit to the hospice (hazard ratio [HR] 2.79; 95% CI 1.46-5.32, P=0.002) and glycemic control (HR 2.10; 95% CI 1.18-3.75, P=0.01) were independent, positive prognostic factors. Conclusion: Good glycemic control, that is, maintenance of A1C levels at <7.5% during the terminal phase of cancer, conferred a significant survival benefit in cancer patients who had preexisting type 2 diabetes. © Mary Ann Liebert, Inc. Source

Tanioka M.,National Cancer Center Hospital Tokyo | Tanioka M.,Hyogo Cancer Center | Katsumata N.,National Cancer Center Hospital Tokyo | Yonemori K.,National Cancer Center Hospital Tokyo | And 5 more authors.
Cancer Chemotherapy and Pharmacology

Background: After the front-line platinum-based regimens including concurrent chemoradiotherapy (CCRT) in patients with advanced or recurrent cervical cancer, platinum-based regimens are often used again. Patients and methods: We retrospectively studied the predictors of response to second platinum therapy and prognostic factors of survival of 65 women who had received ≥2 platinum-based regimens in order to evaluate the effects of platinum-free interval (PFI), i.e., the interval between the platinum therapies. Results: The median survival and PFI were 11.0 and 11.1 months, respectively. The response rate was 42% overall and 36% in the 36 patients who had received CCRT. The response rate increased in parallel with the length of the PFI. Multivariate analyses showed a PFI for ≥12 months (odds ratio [OR] = 0.20), a PS of 0 (OR = 0.16) and a maximum tumor diameter ≤30 mm (OR = 0.18) were predictive of response. Multivariate analyses also revealed a PFI for ≥6 months (hazard ratio [HR] = 0.44) and a PS of 0 (HR = 0.30) were prognostic of survival. Conclusion: Our exploratory study demonstrated that PFI has both predictive and prognostic value for second platinum therapy in patients with advanced or recurrent cervical cancer. © 2010 Springer-Verlag. Source

Mizuta S.,Fujita Health University Hospital | Matsuo K.,Kyushu University | Nishiwaki S.,Nagoya University | Imai K.,Sapporo Hokuyu Hospital | And 13 more authors.

We aimed to evaluate the impact of pretransplant imatinib administration on the outcome of allogeneic hematopoietic stem cell transplantation(allo-HSCT) in adults with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). We retrospectively analyzed 738 patients with Ph+ ALL that underwent allo-HSCT between 1990 and 2010 using data from the Transplant Registry Unified Management Program of the Japan Society of Hematopoietic Cell Transplantation. We compared the allo-HSCT outcomes between 542 patients who received imatinib before allo-HSCT during the initial complete remission period (imatinib cohort) and 196 patients who did not receive imatinib (non-imatinib cohort). The 5-year overall survival after allo-HSCT was significantly higher in the imatinib cohort than in the non-imatinib cohort (59% vs 38%; 95% confidence interval [CI], 31-45%; P < .001). Multivariate analysis indicated that pretransplant imatinib administration had beneficial effects on overall survival (hazardratio [HR], 0.57; 95%CI, 0.42-0.77; P < .001), relapse (HR, 0.66; 95% CI, 0.43-0.99; P = .048), and nonrelapse mortality (HR, 0.55; 95% CI, 0.37-0.83; P = .005). In conclusion, our study showed that imatinib administration before allo-HSCT had advantageous effects on the clinical outcomes of allo-HSCT in patients with Ph+ ALL. © 2014 by The American Society of Hematology. Source

Ando N.,Tokyo Dental College | Kato H.,National Cancer Center Hospital Tokyo | Igaki H.,National Cancer Center Hospital Tokyo | Shinoda M.,Aichi Cancer Center Hospital | And 11 more authors.
Annals of Surgical Oncology

Background: Patients with esophageal carcinoma receiving postoperative chemotherapy showed superior disease-free survival than those receiving surgery alone in a Japan Clinical Oncology Group trial (JCOG9204). The purpose of this study was to evaluate optimal perioperative timing-that is, before or after surgery-for providing chemotherapy in patients with locally advanced esophageal squamous cell carcinoma. Methods: Eligible patients with clinical stage II or III, excluding T4, squamous cell carcinoma were randomized to undergo surgery followed (group 1) or preceded (group 2) by chemotherapy consisting of two courses of cisplatin plus 5-fluorouracil. The primary end point was progression-free survival. Results: We randomized 330 patients, with 166 assigned to group 1 and 164 to group 2, between May 2000 and May 2006. The planned interim analysis was conducted after completion of patient accrual. Progression-free survival did not reach the stopping boundary, but overall survival in group 2 was superior to that of group 1 (P = 0.01). Therefore, the Data and Safety Monitoring Committee recommended early publication. Updated analyses showed the 5-year overall survival to be 43% in group 1 and 55% in group 2 (hazard ratio 0.73, 95% confidence interval 0.54-0.99, P = 0.04), where the median follow-up of censored patients was 61.6 months. Concerning operative morbidity, renal dysfunction after surgery in group 2 was slightly higher than in group 1. Conclusions: Preoperative chemotherapy with cisplatin plus 5-fluorouracil can be regarded as standard treatment for patients with stage II/III squamous cell carcinoma. © 2011 Society of Surgical Oncology. Source

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