基本情報
受賞
1論文
55-
World Journal of Surgery 2024年6月24日Abstract Background Osteopenia reflects frailty and has been shown to be associated with outcomes in cancer patients. This study was undertaken to examine whether osteopenia is an independent prognostic factor in patients with esophageal cancer after resection. Methods A total of 214 patients who underwent surgery for esophageal cancer were analyzed retrospectively. Bone mineral density (BMD) of the 11th thoracic vertebra was measured by computed tomography scan, and patients classified into osteopenia and normal BMD groups with BMD <160 Hounsfield units as the cutoff. Clinicopathological data and prognosis were analyzed. Results The 5‐year survival rate was 55.4% for the osteopenia group and 74.7% for the normal BMD group with a significantly worse prognosis in the osteopenia group (p = 0.0080). In multivariable analysis, osteopenia was a significant independent risk factor associated with overall survival (hazard ratio [HR] 1.90, 95% confidence interval [CI] 1.27–3.34, and p = 0.0151) along with R1/2 resection (HR 3.02, 95% CI 1.71–5.18, and p = 0.0002). Conclusion In patients with esophageal cancer undergoing resection, osteopenia may be a surrogate marker for frailty and an independent predictor of prognosis.
-
Journal of thoracic disease 16(1) 391-400 2024年1月30日BACKGROUND: Adjuvant nivolumab therapy has become the standard therapy for patients with localized advanced esophageal cancer with non-pathological complete response after neoadjuvant chemoradiotherapy followed by curative surgery. However, the necessity of this therapy for patients after neoadjuvant chemotherapy (NAC) with docetaxel, cisplatin, and 5-fluorouracil (DCF) regimen followed by surgery is unclear, and the prognosis of grouping based on the presence or absence of pathological tumor and lymph node findings has not been analyzed. Therefore, our study aimed to address these questions. METHODS: This retrospective cohort study included patients with cT1N1-3M0 and cT2-3N0-3M0 esophageal cancer according to the Japanese Classification of Esophageal Cancer, 11th edition, who received NAC with DCF followed by curative surgery between 2008 and 2020 at Jichi Medical University Hospital. We divided patients with ypT0-3N0-3M0 into four histological groups, namely ypT0N0, ypT+N0, ypT0N+, and ypT+N+, and we evaluated overall survival as the primary outcome and the prognostic relationship of lymph node metastasis as the secondary outcome. RESULTS: A total of 101 patients were included in this study. Kaplan-Meier analysis showed that the curves of the ypT0N0 and ypT+N0 groups were almost identical, while they differed from the other two groups. The hazard ratio of ypN+ was 4.44 (95% confidence interval: 2.03-9.71; P<0.001). CONCLUSIONS: The prognosis of the ypT+N0 group after NAC with DCF followed by surgery was similar to that of pathological complete remission. Grouping patients according to pathological lymph node status is a reasonable predictor of prognosis.
MISC
14書籍等出版物
1講演・口頭発表等
119-
Gastroenterological Endoscopy 2004年8月 (一社)日本消化器内視鏡学会症例1は28歳男性で,針を飲み込んだ.症例2は53歳男で,釘を誤嚥した.両症例に内視鏡的摘出術を施行した.ロングオーバーチューブを内視鏡に装着し,透視ガイド下に鰐口把持鉗子を用いて異物を把持して,胃内まで進めたロングオーバーチューブ内に異物を収納し摘出した.ロングオーバーチューブ法は鋭利端のある異物や大きな異物を摘出する際に粘膜損傷なく容易に摘出することができ,極めて有用であると考えられた
-
腎と透析 2004年5月 (株)東京医学社73歳女.胃癌で幽門側胃切除術,乳癌で乳房切断術の既往がある.慢性腎不全で血液透析導入となった.定期検査の胸部X線写真で右肺異常陰影を指摘された.胸部X線写真で右下肺野に結節影を認め,CT検査で右肺下葉S9の末梢に1.5cm大の結節影を認め,ノッチを伴った.経気管支的擦過細胞診と気管支洗浄液細胞診はClassIIであった.画像上肺癌を疑い,手術を施行した.右肺下葉S9に結節を認め,穿刺吸引細胞診を行いClass Vで肺癌と診断した.左肺下葉切除術,リンパ節郭清を胸腔鏡補助下に施行した.術後5日目に胸水貯留を認めたが,透析を行うことで改善した.食事摂取が不良で,9日間カリウムフリーの高カロリー輸液を行い術後22日目に退院となった.現在術後10ヵ月であるが,再発なく生存中である