Biomedical subjects

M Saku

Publications and source records attributed to M Saku.

79 records · Page 5Linked to original sources

PubMedDate not supplied

Evaluation of surgical treatment for patients with gastric cancer who are over 80 years of age.

BACKGROUND/AIMS: The aim of this study is to evaluate whether super-elderly patients (> or = 80) with gastric cancer may be appropriate candidates for an R2/R3 (extended) gastrectomy. METHODOLOGY: The study evaluated 1334 patients with gastric cancer treated over the past 15 years, who were over 40 years of age. They were divided into three groups according to age: Super-elderly patients who were over 80 (group A; n=60), those aged 60-79 (group B; n=703) and those aged 40-59 (group C; n=571). RESULTS: The incidence of concomitant systemic disorders was higher in group A than in either group B or group C (65% vs. 53.2% vs. 34%) (p<0.0001). The resection rates were similar (88.3% vs. 93.7% vs. 96.1%), however, the incidence of a total gastrectomy, an R2/R3 dissection, or a combined resection of other organs was much lower in group A than those in the other groups (p<0.005). The survival curves of patients after a curative resection were not significant, however, 34.4% of the super-elderly patients died of other causes and the 5-year survival rates including other cause of death were poorer in groups A and B than those in group C (p<0.01). In group A, patients receiving an R2/R3 dissection had a two-fold higher incidence of post-operative complications over those receiving an R0/R1 (regional) dissection, however, they also had a better prognosis whether or not other causes of death were considered. CONCLUSIONS: We, therefore, conclude that an R2/R3 gastrectomy is basically appropriate for super-elderly patients, as long as they demonstrate a good risk. However, the short-term results should also be considered.

Adult↗

PubMedDate not supplied

A resected case of combined hepatocellular carcinoma and cholangiocarcinoma associated with cystic formation.

Combined hepatocellular carcinoma and cholangiocarcinoma is a rare tumor. In addition, both hepatocellular carcinoma and cholangiocarcinoma are rarely associated with cystic lesions. We herein present a 62-year-old Japanese woman with combined hepatocellular carcinoma and cholangiocarcinoma which was associated with a rapidly enlarging cystic lesion. Both abdominal ultrasonography and computed tomography revealed a cyst with a solid portion in the left hepatic lobe. A partial hepatectomy was performed on the basis of a tentative diagnosis of a cystadenocarcinoma of the liver, while the diagnosis based on immunohistochemical studies was combined hepatocellular carcinoma and cholangiocarcinoma with cystic formation. The patient died of tumor recurrence, such as intrahepatic metastases and extensive lymph node metastases, 6 months after the operation. The prognosis of this entity, which has never been reported in the English medical literature and is difficult to preoperatively differentiate from hepatic cystadenocarcinoma, therefore seems to be extremely poor.

Bile Duct Neoplasms↗

PubMedDate not supplied

Retrospective study on the effects of lipiodolization before a potentially curative hepatectomy for colorectal liver metastases: long-term results of a pilot study.

BACKGROUND/AIMS: Lipiodolization, a selective regional cancer chemotherapeutic modality using lipiodol plus anticancer drugs, can prolong the survival time of patients with unresectable liver cancer. A preliminary study was conducted with adjuvant lipiodolization before a potentially curative hepatectomy for patients with metachronous colorectal liver metastases. The ultimate aim of this study was to improve the long-term survival after hepatectomy. METHODOLOGY: Twenty-one consecutive patients with colorectal hepatic metastases were included in this study. Seven patients underwent preoperative lipiodolization, while the remaining 14 patients did not receive any preoperative adjuvant therapy. The clinicopathological features and prognoses of these patients were investigated. The median follow-up period after a curative hepatectomy was 56 months. RESULTS: The clinicopathological factors did not differ markedly between the 2 groups. However, the cumulative survival rate of the 7 patients receiving preoperative lipiodolization was significantly (P < 0.05) better than that in those not receiving any preoperative treatment. CONCLUSIONS: Based on the above encouraging findings, we therefore propose that a prospective randomized trial should be carried out to confirm the beneficial effects of our adjuvant chemotherapeutic modality on patient survival following a curative hepatectomy for the patients with colorectal liver metastases.

Aged↗

PubMedDate not supplied

Intrarectal hyperthermia of circumferential rectal cancer. Report of 2 cases.

An intrarectal microwave (2,450 MHz) applicator was designed for hyperthermia of rectal cancer. Combined treatment of hyperthermia and irradiation was applied in two selected cases. The lesions of case 1 regressed completely, but cancer cells were still present after treatment in case 2. Such hyperthermia is useful for other circumferential cancers such as those of the esophagus and biliary tract. Combined hyperthermia and irradiation are an effective means of achieving therapeutic gains.

Adult↗

PubMedDate not supplied

Surgical treatment for advanced gastric cancer.

BACKGROUND/AIMS: We herein report on the clinicopathological factors related to the unresectability of far advanced gastric cancer and the prognostic effect of gastrectomy on these cases. MATERIAL AND METHODS: There are four main prognostic factors for advanced gastric cancer including 1) peritoneal dissemination, 2) hepatic metastasis, 3) lymph node involvement and 4) invasion to adjacent organs. RESULTS: The rate of unresectability was high in the cases demonstrating both histologically undifferentiated type cancer and cancers located in the lower third of the stomach. It was difficult to resect the main tumor based on an increase in the factors regulating the macroscopical stage. The rate of unresectability tended to be higher in cancers with peritoneal dissemination or invasion to adjacent organs. The pancreas was the most frequently invaded organ. accounting for the unresectability of the disease. The prognosis for cases with unresected gastric cancers was poor and all died within 2 years of the operation. In addition, the prognosis for cases with Stage IV gastric cancer, demonstrating either 1 or 2 factors, improved after gastrectomy while no such improvement was seen in cases with 3 or 4 factors. CONCLUSIONS: To improve prognosis, gastrectomy should be performed when a patient has far advanced gastric cancer but only demonstrates 1 or 2 of the above 4 factors.

Adult↗

PubMedDate not supplied

Clinicopathological features of lymph node metastasis in early gastric cancer.

From 1979 through 1992, 482 cases with solitary early gastric cancer were resected in the Department of Surgery of the National Kyushu Medical Center Hospital. Among the 482 cases, the incidence of lymph node metastasis was 10.0% (48/482). The features of lymph node metastasis were studied while taking into account the combination of clinicopathological findings of the gastric cancer. Lymph node metastasis was rare in both the differentiated type mucosal cancers and submucosal cancers measuring 20 mm or smaller in size without depression. From these results, for early gastric cancer with the above-mentioned characteristics, either endoscopic therapy or local resection without lymph node dissection is considered to be sufficient treatment to obtain a favorable outcome.

Adult↗

PubMedDate not supplied

In vivo growth regulation by cytokine in breast cancer cells showing an estradiol-inhibitive response in vitro.

The rates of the stimulative, insensitive, and inhibitive responses to 10(-2) nM E2 in sixty clinical breast cancer cases were 24.2%, 45.2%, and 30.6%, respectively. We then examined the expression of mRNAs of such cytokines as TNF-alpha, TGF-alpha, EGF, and TGF-beta, in cancer tissue specimens from these three different groups. In MCF-7 showing an E2-stimulative response, the expression of mRNAs of both TNF-alpha and TGF-alpha were suppressed by 10(-2) nM E2, but these same expressions in KSE-1 showing an E2 stimulative response were enhanced by E2. The mRNA expression of TGF-beta in these two cell lines was suppressed by 10(-2) nM E2, but that of EGF was enhanced. In clinical cases showing an E2-inhibitive response, the mRNA expression ratio of TNF-alpha/TGF-beta was above 2.5, but under 2.5 in E2-uninhibitive response cases. The mRNA expression ratio of TGF-alpha/TGF-beta was over 1.8 in the E2-inhibitive responsive cases, but under 1.8 in the E2-uninhibitive response cases. The mRNA expression ratio of EGF/TGF-beta did not show any regular tendency in three groups showing a different E2-response in vitro. Based on in vitro results and mRNA expression in clinical cases, the cytokine expression for E2-inhibitive cancer cells differed from those of E2-stimulative and -insensitive cells. Therefore, E2-inhibitive cancer cells are thus considered to possibly possess a characteristic growth regulation which is different from that for E2-uninhibitive cancer cells.

Breast Neoplasms↗