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Saku, Japan

Umemura T.,Shinshu University | Ota M.,Shinshu University | Katsuyama Y.,Shinshu University | Wada S.,Red Cross | And 18 more authors.
Human Immunology | Year: 2014

Natural killer cells play a key role in the immune control of viral infections. Killer immunoglobulin-like receptors (KIRs) regulate natural killer cell activation and inhibition through the recognition of their cognate HLA class I ligands. We assessed the predictive factors of a sustained virological response (SVR) in 200 Japanese patients with chronic genotype 1b hepatitis C who were treated with telaprevir (TVR), pegylated-interferon-α2b (PEG-IFN), and ribavirin (RBV) triple therapy (92 patients) or PEG-IFN/RBV therapy alone (108 patients). Sixteen KIR genotypes, HLA-A, -B and -C ligands, and an interleukin (IL) 28B polymorphism (rs8099917) were analyzed. We observed that triple therapy, white blood cell count, hemoglobin value, hepatitis C viral load, a rapid virological response (RVR), IL28B TT genotype, and KIR3DL1-HLA-Bw4 genotype were associated with an SVR. In multivariate regression analysis, we identified an RVR (P<. 0.000001; odds ratio [OR]. = 20.95), the IL28B TT genotype (P= 0.00014; OR. = 5.53), and KIR3DL1-HLA-Bw4 (P= 0.004, OR. = 3.42) as significant independent predictive factors of an SVR. In conclusion, IL28B and KIR3DL1/HLA-Bw4 are independent predictors of an SVR in Japanese patients infected with genotype 1b HCV receiving TVR/PEG-IFN/RBV or PEG-IFN/RBV therapy. © 2014 American Society for Histocompatibility and Immunogenetics. Source


Lutz M.P.,CaritasKlinikum St. Theresia | Zalcberg J.R.,University of Melbourne | Ducreux M.,Institute Gustave Roussy | Ajani J.A.,University of Houston | And 22 more authors.
European Journal of Cancer | Year: 2012

The 1st St. Gallen EORTC Gastrointestinal Cancer Conference 2012 Expert Panel clearly differentiated treatment and staging recommendations for the various gastroesophageal cancers. For locally advanced gastric cancer (≥T3N+), the preferred treatment modality was pre- and postoperative chemotherapy. The majority of panel members would also treat T2N+ or even T2N0 tumours with a similar approach mainly because pretherapeutic staging was considered highly unreliable. It was agreed that adenocarcinoma of the gastroesophageal junction (AEG) is classified best according to Siewert et al. Preoperative radiochemotherapy (RCT) is the preferred treatment for AEG type I and II tumours. For AEG type III, i.e. tumours which may be considered as gastric cancer, perioperative chemotherapy is the majority approach. For resectable squamous cell cancer of the oesophagus a clear majority recommended radiochemotherapy followed by surgery as optimal approach, irrespective of tumour size. In contrast, definitive RCT was judged appropriate for advanced tumours with extended lymph node involvement (N2) or for cancers of the upper oesophagus. Additional recommendations are presented on the use of endosonography, PET-CT scan and laparoscopy for staging and on the preferred approach to surgery. © 2012 Elsevier Ltd. All rights reserved. Source


Endoh H.,Saku General Hospital
Surgery today | Year: 2013

The indications for pulmonary resection in elderly patients with lung cancer concomitant with another disease are unclear. We conducted this retrospective study to establish the risk factors of complications and survival to improve patient selection. The subjects were 295 patients aged ≥ 75 years, who underwent pulmonary resection for lung cancer. We assessed comorbidity according to the Charlson comorbidity index (CCI) and examined risk factors for morbidity and the prognostic factors. Postoperative complications developed in 55 patients (morbidity 18.6 %). The median survival time was 59.3 months and the 5-year survival rate was 69.7 %. Multivariate logistic regression analyses selected smoking and thoracotomy as risk factors for complications, and a history of cerebrovascular disease, cancer stage, and thoracotomy as risk factors for a prolonged hospital stay (PHS). Video-assisted thoracic surgery (VATS) decreased the risk of morbidity and PHS, and influenced survival. Multivariate analysis with the Cox proportional hazard model identified CCI ≥ 2, morbidity, and PHS as unfavorable survival factors, in addition to age ≥ 80 and cancers that were non-adenocarcinoma or advanced. Although CCI ≥ 2 was associated with poorer survival, it was not necessarily a risk factor of postoperative complications or PHS. Performing VATS when possible could reduce the incidence of postoperative complications and PHS in elderly patients. Source


Endoh H.,Saku General Hospital | Endoh H.,Gunma University | Yamamoto R.,Saku General Hospital | Satoh Y.,Kitasato University | And 2 more authors.
Surgery Today | Year: 2012

Purpose: The indications for pulmonary resection in elderly patients with lung cancer concomitant with another disease are unclear. We conducted this retrospective study to establish the risk factors of complications and survival to improve patient selection. Methods: The subjects were 295 patients aged ≥75 years, who underwent pulmonary resection for lung cancer. We assessed comorbidity according to the Charlson comorbidity index (CCI) and examined risk factors for morbidity and the prognostic factors. Results: Postoperative complications developed in 55 patients (morbidity 18.6 %). The median survival time was 59.3 months and the 5-year survival rate was 69.7 %. Multivariate logistic regression analyses selected smoking and thoracotomy as risk factors for complications, and a history of cerebrovascular disease, cancer stage, and thoracotomy as risk factors for a prolonged hospital stay (PHS). Video-assisted thoracic surgery (VATS) decreased the risk of morbidity and PHS, and influenced survival. Multivariate analysis with the Cox proportional hazard model identified CCI ≥ 2, morbidity, and PHS as unfavorable survival factors, in addition to age ≥80 and cancers that were non-adenocarcinoma or advanced. Conclusions: Although CCI ≥ 2 was associated with poorer survival, it was not necessarily a risk factor of postoperative complications or PHS. Performing VATS when possible could reduce the incidence of postoperative complications and PHS in elderly patients. © 2012 Springer Japan. Source


Suzuki R.,Research Center for Cancer Prevention and Screening | Iwasaki M.,Research Center for Cancer Prevention and Screening | Inoue M.,Research Center for Cancer Prevention and Screening | Inoue M.,National Cancer Center | And 105 more authors.
International Journal of Cancer | Year: 2010

Epidemiological studies have evaluated whether the impact of alcohol intake on breast cancer risk is modified by use of exogenous estrogens, folate intake, body weight and smoking status, but results have been inconsistent. Further, effect modification by intake of isoflavones and alcohol-induced facial flushing, which are prevalent in Asian populations, have not been investigated. We investigated the association between alcohol intake and breast cancer risk and whether the association is modified by these factors among 50,757 premenopausal and postmenopausal women (aged 40-69 years) in the population-based Japan Public Health Center-based Prospective Study. Alcohol consumption and other related factors were assessed using self-reported questionnaires. Through to the end of 2006, 572 patients were identified. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated by hazard ratios derived from Cox proportional hazards regression models. Compared with never-drinkers, regular alcohol drinkers (>150 g of ethanol/week) had a higher risk of the development of breast cancer; the multivariable-adjusted RRs were 1.75 (95% CI = 1.16-2.65; ptrend 5 0.035) for overall, 1.78 (95% CI = 1.09-2.90) for premenopausal and 1.21 (95% CI = 0.53-2.75) for postmenopausal women. There was no statistical evidence for effect modification by menopausal status, use of exogenous estrogens, intakes of isoflavone and folate, body weight, alcohol-induced facial flushing or smoking (All p interactions ≥ 0.15). Excessive alcohol intake was associated with an increase in the risk of breast cancer in this population. There was no statistical evidence for effect modification. © 2009 UICC. Source

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