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Biomedical subjects

Y Kakeji

Publications and source records attributed to Y Kakeji.

At least 91 records · Page 5Linked to original sources
PubMed1991

Pertinent risk factors and gastric carcinoma with synchronous peritoneal dissemination or liver metastasis.

From 1965 to 1985, of 1108 patients with advanced gastric cancer who underwent gastric resection in our department, 216 patients (19.5%) had synchronous peritoneal dissemination (PD) or liver metastasis (LM). The 1-year survival rate was 22.5% for PD, 14.7% for LM, and 4.8% for PD plus LM (p less than 0.01). With PD, patients were younger, tumor was larger, Borrmann type 3 and 4 and undifferentiated lesions were more frequent, and the incidence of serosal invasion was higher. Histologic findings showed a pattern of infiltrative growth. With LM, patients were more likely to be male, Borrmann type 2 and 3 and differentiated lesions were frequent, and the antral region was often involved. The degree of serosal invasion was less than with PD. The pattern of growth was the expansive type and vascular involvement was prominent. Rate of lymph node metastasis was high in both groups. The route of metastasis was partly linked to features of the primary lesion. Multivariate analysis showed that independent risk factors involved in the occurrence of each metastasis are serosal invasion, lymph node metastasis, and undifferentiated tissue type for PD, and lymph node metastasis and vascular involvement for LM. When designing treatment in an attempt to suppress a recurrence, even after curative resection, all of these risk factors must be kept in mind.

Female↗
PubMed1991

Prognostic significance of serosal invasion in carcinoma of the stomach.

Two hundred and seventy-seven patients with advanced carcinoma of the stomach invading the serosa were studied with regard to the relationship between the length of the serosal invasion (LSI) and prognosis, with a division made between expanding and infiltrative types of tumors. Among patients with expanding types of tumors, five year survival rates were 40 per cent in patients with LSI less than 4.0 centimeters, 33 per cent in patients with LSI 4.1 to 6.0 centimeters and 13.0 per cent in patients with LSI more than 6.0 centimeters. Among those patients with infiltrative types of tumors, those with less than 2.0 centimeters of LSI had a better prognosis (five year survival rate of 53 per cent), whereas those patients with a LSI more than 2.0 centimeters had a very poor prognosis (five year survival rate of less than 20 per cent) and the significant LSI on prognosis was found to be 2.0 centimeters. Involvement of the lymph node and metastasis to the liver were not affected by LSI, whereas the rates of peritoneal dissemination and direct invasion to neighboring organs increased with an increase in LSI. Knowledge of these factors facilitates the planning of postoperative treatment.

Follow-Up Studies↗
PubMed1991

Laser treatment for poor-risk patients with early gastric cancer: post treatment pathology.

Two patients with early gastric carcinoma and who were poor surgical risks underwent gastrectomy following repeated laser endoscopy. Pathological findings of the resected stomach were reviewed. Lesions in both patients were ulcerative, with evidence of destruction of the muscularis mucosae caused by laser irradiation. Complete coagulation did not occur in the case of infiltrative-type involvement of the submucosal layer. Gastrectomy was carried out when the clinical status improved and both patients are now cancer-free. We propose that laser treatment for early gastric cancer should be considered for poor-risk patients.

Adenocarcinoma↗
PubMed1990

Infiltration of dendritic cells in relation to tumor invasion and lymph node metastasis in human gastric cancer.

The infiltration of dendritic cells determined in 210 patients with gastric carcinoma was investigated from the standpoint of tumor invasion, lymph node metastasis, and prognosis. Dendritic cell infiltration was graded as "slight" and "marked." The 39% frequency in the marked infiltration group at the mucosal stage did not change in proportion to invasion into the deeper layers. The 5-year survival rate was 60.4% in patients with marked infiltration and 38.8% in those with slight infiltration, which was statistically different (P less than 0.01). The difference in survival rates was only statistically significant in those with cancer emerging from the serosa (P less than 0.001). There was a similar incidence of lymph node metastasis between the marked and slight infiltration groups in each grade of tumor invasion. However, marked infiltration of dendritic cells prevented widespread nodal involvement beyond the primary node in cases of advanced carcinoma (P less than 0.05). These findings indicate that infiltrating dendritic cells do not prevent the spread of tumor invasion but do prevent nodal involvement; therefore, for patients with a gastric cancer emerging from the serosa, the prognosis will be good.

Carcinoma↗
PubMed1990

Estrogen-receptor-negative breast cancer tissue is chemosensitive in vitro compared with estrogen-receptor-positive tissue.

The chemosensitivities of 18 estrogen-receptor-positive (ER+) tissues were compared with that of 38 estrogen-receptor-negative (ER-) tissues, using the in vitro succinate dehydrogenase inhibition test. These human breast tissue were exposed to six antitumor drugs: carboquone, adriamycin, mitomycin C, aclacinomycin A, cisplatin and 5-fluorouracil. Decrease in succinate dehydrogenase activity was noted in ER- compared to ER+ tissues, exposed to six antitumor drugs, in particular to adriamycin (p less than 0.001) and aclacinomycin A (p less than 0.05). The sensitive rates were higher in ER- than in ER+ tissues, against all six antitumor drugs. The resistance rates to all drugs tested were 25% in ER- and 45% in ER+ tissues. A higher chemosensitivity is associated with the absence of ER. It appeared that the ER status in case of breast cancer is an important predictor of the response to chemotherapy.

Aging↗
PubMed1990

Adjuvant mitomycin-C prolongs survival time of patients undergoing extensive en bloc resection of carcinoma of the stomach invading the adjacent organs.

We retrospectively examined the long-term results of adjuvant chemotherapy with mitomycin-C (MMC) in 50 patients with gastric carcinoma invading the adjacent organs. All patients underwent gastrectomy and en bloc multiple resection of the invaded organs, with the intent of a potential cure. Evidence of direct invasion was confirmed histologically. These patients were classified into 3 groups, according to the dose schedule of MMC: 12 received prolonged, intermittent administration of the drug, in a total dose of 40 mg or more (group A); 19 were given a bolus injection at the time of surgery and/or on the following day, in a total dose of less than 40 mg (group B), and 19 were given no anticancer drugs (group C). These 3 groups were comparable with regard to various prognostic factors. The 5-year survival rates were 50, 32 and 17% in groups A, B and C, respectively. There was a statistical difference in survival between groups A and C (p less than 0.05). These results indicate that extensive en bloc resection plus intensive adjuvant chemotherapy prolong the survival time for those with gastric carcinoma invading the adjacent organs.

Antineoplastic Agents↗
PubMed1990

Long survival of a woman with a huge leiomyosarcoma of the duodenum after pancreaticoduodenectomy and transverse colectomy: a case report.

A woman with a huge leiomyosarcoma of the duodenum that had invaded the pancreas and transverse colon is living and well 10 years after pancreaticoduodenectomy combined with resection of the transverse colon. Malignant potential of the tumor was determined by the mitotic rate and nuclear deoxyribonucleic acid content. The mass exceeded 10 cm yet was characterized by low mitotic activity and a near-diploid pattern. The long survival is attributed to the extensive surgery and low-grade malignancy of the tumor.

DNA, Neoplasm↗
PubMed1990

[Prevention of peritoneal recurrence by combined intra-peritoneal and intra-tumoral injections of OK-432].

Protective effect of OK-432 on peritoneal recurrence was examined in an experimental mouse model with Meth A fibrosarcoma injected into both abdominal wall and intraperitoneal cavity. OK-432 was given through either intratumoral (i.t.), intradermal (i.d.), intraperitoneal (i.p.), or i.p. + i.t. route. A significant antitumor effect against abdominal tumor was observed in mice given i.t. or i.p. + i.t. injection of OK-432. A significant protective effect against peritoneal recurrence and prolonged survival time was obtained in an i.p. + i.t. group, although other treatment groups showed only minimal effect. We conclude that combined i.p. and i.t. administration of OK-432 may prevent peritoneal recurrence and lead to prolongation in clinical patients with advanced GI tract cancer.

Animals↗
PubMedDate not supplied

Peritoneal dissemination after a curative gastrectomy in patients with undifferentiated adenocarcinoma of the stomach.

Peritoneal dissemination is the major pattern of recurrence in patients with gastric cancer. Among the 1,337 patients with gastric cancer who underwent a curative resection, a multivariate analysis showed that the independent risk factors for the occurrence of peritoneal dissemination were an undifferentiated tissue type and serosal invasion. We focus our attention on 477 patients with undifferentiated type tumor, in which the postoperative prognosis and the pattern of recurrence after curative resection were evaluated with regard to the depth of the cancerous invasion in the gastric wall. Patients with tumors limiting to the subserosal layer had a satisfactory post-operative course, with five-year survival rates of 98.5%, 97.4%, and 82.5% in patients with tumors limiting to the submucosal layer, the muscularis propria and subserosal layer, respectively. In 179 patients with tumors invading to the subserosal layer, however, the five year survival rate was only 48.2%. Seventy-one died of peritoneal dissemination, while 24 and 15 were due to hematogenous and local recurrences, respectively. Only 50 (27.9%) survived over 5 years without any recurrence.

Adenocarcinoma↗
PubMedDate not supplied

Prognostic value of depth and pattern of stomach wall invasion in patients with an advanced gastric carcinoma.

We reviewed data on 467 patients with advanced gastric carcinoma, taking into consideration tumor size, shape and depth of invasion, and growth pattern, either expanding or infiltrative. Three patterns of penetration were identified: i.e., funnel, column, and mountain patterns. The funnel pattern was predominant in tumors extending into the muscularis propria (pm) or subserosa (ss), and were more widely distributed than the column pattern. The majority of the column type tumors were less than 8 cm in pm or ss, and the mountain type was found in only one case in ss, but their size was widely distributed once cancer cells penetrated the serosa. Patients with the funnel type had a better prognosis than the column or the mountain type, and the difference was significant when cancer invasion extended to the serosa.

Gastric Mucosa↗
PubMedDate not supplied

Helix pomatia agglutinin binding activity and lymph node metastasis in patients with gastric cancer.

We made use of Helix pomatia agglutinin (HPA) staining to examine 218 gastric cancer tissues (163 primary tumors and 55 metastatic lymph nodes), using the avidin-biotin-peroxidase complex method. The positive HPA staining rate was 59% (96/163) for the primary tumors, and this positive staining correlated well (with statistical significance) with lymphatic invasion and metastasis (P < 0.01). In the metastatic lymph nodes, the majority of cancer cells (49/55:89%) stained positively for HPA. Tumors with positive HPA staining often metastasized to lymph nodes. Patients with gastric cancer and positive HPA staining of their tumor tissues lived for a shorter time than did those with a negative staining, even in the absence of metastasis to the lymph nodes (P < 0.01). Careful follow-up and aggressive therapy are required postoperatively for patients with an HPA-positive gastric cancer.

Animals↗
PubMedDate not supplied

Surgery for gastric carcinoma is feasible for patients over 80 years of age.

We report here the outcome of surgical treatment for gastric cancer in 54 patients over 80 years of age presenting from 1967 to 1989. The mean observation interval of the postoperative period was 24 days. In most cases, preoperative examinations revealed pulmonary, renal or cardiac disturbances. The postoperative morbidity rate was 40.7%, most commonly as a result of pulmonary complications. In the 2 patients with multiple organ disturbances, 1 died 1 day after operation following myocardial infarction and the other died of pneumonia 12 days postoperatively. Intensive care treatments were needed in the early postoperative period. The increased morbidity rate proved to be related to wide resectional procedures such as total gastrectomy, operative time in excess of 3 hours, and intraoperative blood loss greater than 300 ml (p less than 0.05). When adjustment for confounding variables was made in the multivariate discriminant analysis, the type of surgery proved to be a major independent risk factor related to postoperative complications. The majority of tumors (92.6%) could be removed by standard resectional procedures and curative operation was feasible for 36 (66.7%) patients. There were 24 deaths due to progression of the cancer. The crude overall 5-year actuarial survival rate was 23.8%, while the rate was 36.9% when correction was made for sex and age. The probability of long-term survival for patients in a relatively early stage of disease (T1-2, N0-1) was statistically better than for those with a more advanced disease (T3-4, N2, M1). Thus, even for patients in the 8th decade of life, gastric surgery can be considered, for carefully selected patients.

Aged↗
PubMedDate not supplied

Tissue distribution of cis-diamminedichloroplatinum(II) following intraperitoneal administration to patients with recurrent gastric cancer.

Using atomic absorption spectrophotometry, we determined the concentration of platinum in tissues obtained at autopsy of 4 patients with recurrent gastric cancer. Patients had been given intraperitoneal cis-diamminedichloroplatinum(II) (cisplatin, CDDP). There was no correlation between the concentration of platinum and the dose of CDDP. Platinum was distributed in all organs examined, the highest amount being in the liver. Thus, when CDDP is administered intraperitoneally for treatment of patients with malignant disease, the toxicity to various organs, including the liver and the kidney, needs to be considered.

Adipose Tissue↗
PubMedDate not supplied

Predictive value of preoperative carcinoembryonic antigen levels for the prognosis of patients with well-differentiated gastric cancer. A multivariate analysis.

Serum carcinoembryonic antigen (CEA) levels were determined preoperatively in 221 patients with well-differentiated gastric cancer. The mean preoperative serum CEA level was 15.9 +/- 88.5 ng/ml (1.0-1,133.0 ng/ml) for all patients, and the incidence of an elevated CEA (> 5 ng/ml) was 11.8% (26/221). The CEA-positive patients had larger tumors, a more prominent serosal invasion, more frequent lymphatic and vascular involvement, less expansive tumor growth and higher rates of lymph node and hepatic metastases than did the CEA-negative patients. Thus, the CEA-positive patients had a more advanced stage of disease, and 61.5% underwent noncurative resection (vs. 11.3% in CEA-negative patients). The survival rate of the CEA-positive patients was lower than that of the CEA-negative ones (p < 0.01). As the multivariate analysis revealed the preoperative CEA level to be an independent prognostic factor for survival, an assay for this antigen prior to surgery is to be recommended.

Adenocarcinoma↗
PubMedDate not supplied

Thymidine phosphorylase activity and angiogenesis in gastric cancer.

Angiogenesis has an important role in the growth and metastasis of solid tumors. Several angiogenic factors have been identified, one being platelet-derived endothelial cell growth factor (PD-ECGF), which is identical to thymidine phosphorylase (dThdPase). We investigated the activity of dThdPase in 84 samples of 42 human gastric cancers, by liquid chromatography. The dThdPase activity significantly correlated to the microvessel density assessed by immunostaining to CD-31 antigen (P<0.05). Expression of dThdPase has an important role in the promotion of angiogenesis in human gastric cancer.

Adult↗
PubMedDate not supplied

Heterogeneity and clinical role of thymidine phosphorylase activity in gastric cancer.

We examined the dThdPase activity in primary gastric cancer and metastatic lymph nodes from human subjects. The dThdPase activities were significantly higher in primary tumors than in the normal gastric wall, particularly in the center of the tumor rather than in the periphery (P<0.01). Tumors with a high dThdPase activity often had venous invasion (P<0.01). The dThdPase activities were significantly higher in metastatic lymph nodes than in the nodes without metastasis (P<0.01). The intratumoral heterogeneity of dThdPase activity was identified and cancer cells with high dThdPase activity may indicate that metastasis will likely occur.

Adult↗
PubMedDate not supplied

Total gastrectomy.

Total gastrectomy with lymph node dissection is one of the standard operations for gastric malignancies without distant metastases. Surgical procedures of total gastrectomy are described with illustrations easy to understand anatomy. Practical application and survival of patients are also shown.

Anastomosis, Surgical↗