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HAGI Takaomi

    Department of Medicine　Lecturer in Medical School
Last Updated :2024/05/19

Researcher Information

J-Global ID

Research Areas

  • Life sciences / Digestive surgery

Published Papers

  • Atsushi Yasuda; Yutaka Kimura; Hiroaki Kato; Tomoya Nakanishi; Masashi Koda; Yoko Hiraki; Takaomi Hagi; Osamu Shiraishi; Masayuki Shinkai; Motohiro Imano; Takushi Yasuda
    Updates in surgery 2024/01 
    Recent reports have described the practicality of laparoscopic intragastric surgery (l-IGS) as an alternative for resecting submucosal tumors (SMTs) near the esophagogastric junction (EGJ), where excision using an exogastric approach would be difficult. However, even using IGS to perform a full-thickness resection of SMTs that are in or extremely close to the EGJ is very difficult to do safely and avoid disrupting or causing stenosis of the EGJ, without advanced experience. This study retrospectively examined the usefulness of l-IGS for gastric SMTs located in or extremely close to the EGJ. Fourteen patients with gastric SMTs < 2 cm of the EGJ and underwent l-IGS were eligible for this study. We examined the tumor location, operative time, intraoperative hemorrhage, degree of deformation, gastroesophageal reflux disease, perioperative complications, and recurrence. Furthermore, we compared patients with tumors in the EGJ with those with tumors near the EGJ and patients in whom three-port l-IGS was performed with those who underwent single-incision laparoscopic surgery. The average tumor size, operative time, intraoperative hemorrhage, and postoperative hospitalization of the 14 patients were 30.9 ± 21.3 mm, 125.2 ± 31.1 min, 30.7 ± 103.3 mL, and 9.2 ± 3.1 d, respectively. No differences in these parameters according to the type of l-IGS or tumor location were observed. All patients underwent l-IGS without complications and were free from EGJ deformation or esophagitis. We believe that l-IGS is useful for gastric SMTs located < 2 cm of the EGJ as it can be safely performed for difficult tumor locations and does not cause deformation of the EGJ.
  • Masayuki Shinkai; Motohiro Imano; Masashi Kohda; Tomoya Nakanishi; Yoko Hiraki; Takaomi Hagi; Hiroaki Kato; Osamu Shiraishi; Atsushi Yasuda; Masanobu Tsubaki; Shozo Nishida; Takushi Yasuda
    Langenbeck's archives of surgery 408 (1) 291 - 291 2023/07 
    PURPOSE: Gastric cancer patients with peritoneal metastasis (PM) are generally treated with systemic chemotherapy. When PM has disappeared because of chemotherapy, radical gastrectomy (so-called conversion surgery) is usually performed. We have previously reported the efficacy of conversion surgery, but there are no reports examining the efficacy of palliative gastrectomy for patients with residual PM after chemotherapy. The purpose of this study was to investigate the efficacy of palliative surgery for gastric cancer patients with PM who still have residual peritoneal dissemination after chemotherapy. METHODS: Twenty-five gastric cancer patients with PM confirmed by laparoscopy and who had received chemotherapy but who still had residual PM were included in this study. Among the 25 patients, palliative surgery was performed in 20 patients (PS group) and chemotherapy was continued in 5 patients (CTx group), and their therapeutic outcomes were compared. RESULTS: In the PS group, total and distal gastrectomies were performed. Clavien-Dindo grade I postoperative complications occurred in two patients (10%). There were no treatment-related deaths. Postoperative chemotherapy was performed all cases. In the PS group, the median survival time (MST) reached 22.5 months, with 1- and 2-year overall survival (OS) rates of 95% and 45%, respectively, whereas in the CTx group, the MST was 15.8 months, and the 1- and 2-year OS rates were 60% and 0%, respectively. The PS group had significantly longer OS than the CTx group (P=0.044). CONCLUSIONS: Palliative surgery is safe and may prolong survival in gastric cancer patients with residual PM after chemotherapy.
  • Takaomi Hagi; Tomoki Makino; Makoto Yamasaki; Kotaro Yamashita; Koji Tanaka; Takuro Saito; Tsuyoshi Takahashi; Yukinori Kurokawa; Masaaki Motoori; Yutaka Kimura; Kiyokazu Nakajima; Eiichi Morii; Hidetoshi Eguchi; Yuichiro Doki
    Annals of surgery 275 (6) 1121 - 1129 2022/06 
    OBJECTIVE: To evaluate pathological response to NAC in metastatic LNs, and assess its clinical prognostic significance in patients with EC. SUMMARY OF BACKGROUND DATA: The pathological response to preoperative treatment is commonly evaluated in the PT. However, LN metastases strongly correlate with systemic micro-metastases. Thus, pathological evaluation of LN response could more accurately predict prognosis in EC patients undergoing NAC before surgery. METHODS: We enrolled 371 consecutive patients who underwent triplet NAC followed by surgery for EC between January 2010 and December 2016. Pathological LN regression grade was defined by the proportion of viable tumor area within the whole tumor bed area for all metastatic LNs: grade I, >50%; II, 10%-50%; III, <10%; and IV, 0%. We analyzed the correlation of grade with clinico-pathological parameters. RESULTS: Among 319 patients with clinically positive LNs, pathological LN regression grades were I/II/III/IV in 115/51/58/95 patients, and 191 patients (59.9%) showed discordance between the PT and LN pathological regression grades. LN regression grade significantly correlated with cN positive number, ypTNM, lymphovascular invasion, and clinical/pathological PT response. Multivariate analysis for recurrence-free survival revealed that LN regression grade [hazard ratio (HR) = 2.25, P < 0.001], ypT (HR = 1.65, P = 0.005), and ypT (HR = 1.62, P = 0.004) were independent prognostic factors, but not pathological PT regression grade (P = 0.67). CONCLUSIONS: Compared to PT response, pathological LN response better predicted long-term survival in EC patients who received NAC plus curative surgery.
  • Takaomi Hagi; Yukinori Kurokawa; Junki Mizusawa; Takeo Fukagawa; Hitoshi Katai; Takeshi Sano; Kazunari Misawa; Norimasa Fukushima; Yasuyuki Kawachi; Mitsuru Sasako; Takaki Yoshikawa; Masanori Terashima
    Future oncology (London, England) 18 (20) 2511 - 2519 2022/06 
    Background: To improve the diagnostic accuracy of preoperative T staging in gastric cancer, the authors evaluated tumor-related factors that might affect the diagnosis. Materials & methods: The authors analyzed the data of cT2-4b gastric cancer patients enrolled in the prospective, multicenter JCOG1302A study. They used contrast-enhanced computed tomography to analyze the association between tumor-related factors and the diagnostic accuracy of T3-4b staging for gastric cancer. Results: Among 876 cT3-4b tumors, the diagnostic accuracy was relatively low in the lower third of the stomach compared with those in the upper or middle. A multivariable analysis revealed that accuracy was higher in the lesser curvature or entire circumference region than in other areas (p < 0.001), in macroscopic types 3/5 than in types 0/1/2 (p = 0.003) and in the undifferentiated histological type than in the differentiated type (p = 0.011). Conclusion: The authors found tumor-related factors affecting preoperative T staging by enhanced computed tomography.
  • Takaomi Hagi; Yuji Ishii; Kotaro Yamashita; Takuro Saito; Koji Tanaka; Tomoki Makino; Tsuyoshi Takahashi; Yukinori Kurokawa; Makoto Yamasaki; Hidetoshi Eguchi; Yuichiro Doki; Kiyokazu Nakajima
    Surgery today 52 (4) 715 - 720 2022/04 
    PURPOSE: Microfocus computed tomography (micro-CT) has not been widely used at high radiation intensity (industrial micro-CT) in life science fields. In this preliminary study, we investigated its potential value in the detection of micro-hepatic tumors in a mouse model. METHODS: The liver with micro-hepatic tumors was surgically resected en-bloc from mice, and examined with industrial micro-CT and lower intensity micro-CT (small animal micro-CT). The number of hepatic tumors was manually counted on serial images. Then, the accuracy of each technique was determined by preparing matching liver sections and comparing the number of tumors identified in a conventional pathological examination. RESULTS: The number of hepatic tumors evaluated with industrial micro-CT showed high concordance with the results of the pathological examinations (intraclass correlation coefficient [ICC]: 0.984; 95% confidence interval [CI] 0.959-0.994). On the other hand, the number of hepatic tumors evaluated with the small animal micro-CT showed low concordance with the number identified in the pathological examinations (ICC: 0.533; 95% CI 0.181-0.815). CONCLUSION: Industrial micro-CT improved the detection of small structures in resected specimens, and might be a promising solution for life science research.
  • Tomoki Makino; Takaomi Hagi; Yuichiro Doki
    Annals of surgery 274 (6) e842-e843  2021/12
  • Takaomi Hagi; Yukinori Kurokawa; Tsuyoshi Takahashi; Takuro Saito; Kotaro Yamashita; Koji Tanaka; Tomoki Makino; Makoto Yamasaki; Masaaki Motoori; Yutaka Kimura; Kiyokazu Nakajima; Hidetoshi Eguchi; Yuichiro Doki
    Surgery today 51 (5) 777 - 784 2021/05 
    PURPOSE: To investigate the relationship between changes in taste due to surgical procedures and other clinical factors, we performed a detailed investigation of taste alteration in patients who underwent gastrectomy. METHODS: Questionnaires on taste alteration were distributed to patients who visited our outpatient clinic from July 2018 to January 2019 for the postoperative evaluation of gastric cancer. Associations of clinical characteristics with changes in sensitivity to the four major taste types (sweet, sour, salty, and bitter) were examined. RESULTS: Of the 243 eligible patients, 42 (17.3%) experienced taste alteration after gastrectomy; taste sensitivity decreased in 21 (8.6%) patients and increased in 31 (12.7%) patients. The frequency of a decreased sensitivity to sweet was significantly higher in patients who underwent total gastrectomy than in those who underwent distal gastrectomy (18.8% vs. 3.3%, P = 0.001). Patients who underwent total gastrectomy were significantly more likely than those who received distal gastrectomy to experience increased sensitivity to sour (12.5% vs. 2.2%, respectively; P = 0.004) and bitter (15.6% vs. 3.8%, respectively; P = 0.007) tastes. A multivariate analysis revealed that total gastrectomy was an independent risk factor for total taste alteration. CONCLUSIONS: Patients who underwent total gastrectomy showed a high likelihood of both loss and gain of taste sensitivity.
  • Takaomi Hagi; Yukinori Kurokawa; Noboru Kobayashi; Tsuyoshi Takahashi; Takuro Saito; Kotaro Yamashita; Koji Tanaka; Tomoki Makino; Makoto Yamasaki; Kiyokazu Nakajima; Hidetoshi Eguchi; Yuichiro Doki
    Scientific reports 11 (1) 6268 - 6268 2021/03 
    Perioperative systemic inflammation induced by surgical stress elevates the risk of hematogenous cancer metastasis. This study investigated the anti-metastatic effects and mechanisms of methylprednisolone (MP) administration for surgical stress. We examined the effects of MP on the expression of adhesion molecules in human vascular endothelial cells and in a murine hepatic metastasis model under lipopolysaccharide (LPS) administration, which mimics systemic inflammation induced by surgical stress. Serum E-selectin level was measured in blood samples obtained from 32 gastric cancer patients who were randomly assigned to treat preoperatively with or without MP. The expression of E-selectin in LPS-induced vascular endothelial cells was suppressed by MP. An adhesion assay showed the number of LPS-induced adherent tumour cells was significantly lower following MP. In the in vivo study, LPS significantly elevated the number of hepatic metastases, but pretreatment with MP before LPS significantly inhibited this elevation. The LPS-induced expression of E-selectin in the vascular endothelium of the portal vein was suppressed by MP. In human clinical samples, serum E-selectin level was significantly decreased by preoperative MP. Suppression of surgically induced systemic inflammation by MP administration might prevent hematogenous cancer metastases by suppressing the induction of E-selectin expression in the vascular endothelium.
  • Takaomi Hagi; Yukinori Kurokawa; Ryohei Kawabata; Takeshi Omori; Jin Matsuyama; Kazumasa Fujitani; Motohiro Hirao; Yusuke Akamaru; Tsuyoshi Takahashi; Makoto Yamasaki; Taroh Satoh; Hidetoshi Eguchi; Yuichiro Doki
    British journal of cancer 123 (6) 965 - 972 2020/09 
    BACKGROUND: Predictive factors of nivolumab treatment response in patients with gastric cancer (GC) remain unclear. METHODS: In this retrospective cohort study, tissue specimens of patients with unresectable or recurrent GC and prior or scheduled treatment with nivolumab as third-line or higher therapy between September 2017 and February 2019 were collected from 23 institutions. The tumour-positive score (TPS) and combined positive score (CPS) of PD-L1 expression and mismatch repair (MMR) were analysed by immunohistochemistry. Associations between clinicopathological factors and tumour-response rate, hyperprogressive disease (HPD) rate and survival were assessed. RESULTS: Of 200 eligible patients, 143 had measurable lesions. The response and HPD rates were 17.5% and 22.1%, respectively. The response rate was significantly higher in patients with performance status (PS) 0-1 (P = 0.026), non-peritoneal metastasis (P = 0.021), PD-L1 TPS ≥ 1 (P = 0.012), CPS ≥ 5 (P = 0.007) or ≥ 10 (P < 0.001) or MMR deficiency (P < 0.001). The HPD rate was significantly higher in patients with PS 2-3 (P = 0.026), liver metastasis (P < 0.001) and CPS < 10 (P = 0.048). Multivariate analysis revealed that CPS (P = 0.001) and MMR (P = 0.002) were independent prognostic factors of progression-free survival, as well as liver metastasis (P < 0.001), peritoneal metastasis (P = 0.004) and CRP (P < 0.001). CONCLUSIONS: PD-L1 CPS and MMR could be useful biomarkers for nivolumab treatment efficacy in GC. CLINICAL TRIAL REGISTRATION: UMIN000032164.
  • Takaomi Hagi; Yukinori Kurokawa; Tsuyoshi Takahashi; Takuro Saito; Kotaro Yamashita; Koji Tanaka; Tomoki Makino; Makoto Yamasaki; Kiyokazu Nakajima; Masaki Mori; Yuichiro Doki
    Oncology 98 (4) 222 - 229 2020 
    INTRODUCTION: Next-generation sequencing (NGS) with molecular barcodes (MB) is a novel method that enables the highly sensitive detection of circulating tumor DNA (ctDNA) in a relatively wide range of genes. OBJECTIVE: The aim of this study was to examine the utility of NGS with MB for detecting ctDNA in patients with esophageal squamous cell carcinoma (ESCC). METHODS: Five patients with ESCC who underwent preoperative treatment followed by esophagectomy were examined. The frequency of TP53 mutations in DNA extracted from tumor tissue and plasma at each time point during the treatment course was analyzed using NGS without MB. In 1 patient, additional analysis using NGS with MB was conducted to compare the sensitivities and to evaluate the clinical utility of this novel method. RESULTS: TP53 mutations in tumor tissue were identified in 3 of 5 patients with ESCC. In 1 patient, the mutational allele frequency in plasma was 1.97% before preoperative treatment, and decreased to 0.09% after preoperative treatment. As the maximum frequency of background errors were 3.22% using NGS without MB and 0.08% with MB, which indicated that the sensitivity of ctDNA detection using NGS with MB was much higher than without MB. In 1 patient who had recurrence half a year after surgery, only NGS with MB could detect ctDNA even at 4 weeks after surgery, at a frequency of 0.20%. CONCLUSIONS: NGS with MB enabled comprehensive and highly sensitive detection of ctDNA in a patient with ESCC. This novel method may be useful for the clinical diagnosis of ESCC.
  • Takaomi Hagi; Tomoki Makino; Makoto Yamasaki; Koji Tanaka; Naohiro Nishida; Daisuke Sakai; Masaaki Motoori; Yutaka Kimura; Taroh Satoh; Masaki Mori; Yuichiro Doki
    Annals of surgical oncology 26 (13) 4754 - 4764 2019/12 
    BACKGROUND: Dysphagia is a major symptom of esophageal cancer (EC) that significantly affects patient quality of life; however, little is known regarding its clinical impact on the treatment course in patients with EC. METHODS: This retrospective study included 434 consecutive patients with EC who received docetaxel, cisplatin, and 5-fluorouracil (DCF) chemotherapy as an initial treatment. We evaluated the relationships between the dysphagia score at diagnosis and clinicopathological factors, including DCF therapy-related adverse events, tumor response, and survival. RESULTS: The dysphagia scores were 0 in 208 patients (47.9%), 1 in 82 patients (18.9%), 2 in 52 patients (12.0%), 3 in 59 patients (13.6%), and 4 in 33 patients (7.6%). High (≥ 3) dysphagia scores were significantly associated with high incidences of grade 3/4 febrile neutropenia (FN) (79.3 vs. 35.7%, P < 0.001) and diarrhea (63.0 vs. 28.1%, P < 0.001) compared with low (≤ 2) scores. Logistic regression analysis further identified the dysphagia scores as an independent predictor of both FN and severe diarrhea during DCF chemotherapy. Furthermore, compared with low scores, high dysphagia scores were associated with a worse clinical response to chemotherapy (response rate 65.2 vs. 78.7%, P = 0.008) and worse 5-year overall survival (35.4 vs. 56.4%, P = 0.001). CONCLUSIONS: The dysphagia score at diagnosis was an independent predictor of FN and severe diarrhea. Furthermore, this score might be useful in predicting chemotherapy response and long-term survival in patients treated with DCF.
  • Yoshiki Taniguchi; Yukinori Kurokawa; Takaomi Hagi; Tsuyoshi Takahashi; Yasuhiro Miyazaki; Koji Tanaka; Tomoki Makino; Makoto Yamasaki; Kiyokazu Nakajima; Masaki Mori; Yuichiro Doki
    Annals of surgical oncology 26 (9) 2831 - 2838 2019/09 
    BACKGROUND: Surgery often introduce inflammatory response, which may promote tumor growth and metastasis of residual cancer cells. We investigated the impacts of methylprednisolone on the tumor growth and peritoneal seedings in mice treated with lipopolysaccharide (LPS), which mimics systemic inflammation induced by surgical stress and postoperative complications. METHODS: The serum interleukin-6 (IL-6) levels, tumor volume, tumor weight, and the number of peritoneal nodules were investigated in tumor growth model and peritoneal seeding model using BALB/c mice and murine CT26 cancer cell lines in vivo. We conducted functional analyses of IL-6 in Western blotting and proliferation assays in vitro. We also investigated whether preoperative administration of methylprednisolone decreased postoperative serum IL-6 levels in cancer patients in a randomized clinical study. RESULTS: In the in vivo study, methylprednisolone inhibited the LPS-induced increase of serum IL-6 levels (mean, 33,756 pg/ml vs. 5917 pg/ml; P < 0.001), tumor volume (mean, 397 mm3 vs. 274 mm3; P = 0.019), tumor weight (mean, 0.38 g vs. 0.15 g; P = 0.020), and the number of peritoneal nodules (mean, 112 vs. 47; P = 0.002). In the in vitro study, IL-6 enhanced JAK/STAT signaling and increased the cell proliferation, and IL-6R-neutralizing antibody attenuated these effects. In the clinical study, serum IL-6 levels were significantly decreased by methylprednisolone (median, 97.5 pg/ml vs. 18.0 pg/ml; P = 0.030). CONCLUSIONS: Surgical stress and postoperative complications may enhance tumor growth due to the increase of IL-6. However, methylprednisolone can decrease serum IL-6 levels, thus inhibiting tumor growth and peritoneal seeding.
  • 胃癌深達度診断精度に影響する腫瘍因子と施設間差(JCOG1302A副次的解析)
    萩 隆臣; 黒川 幸典; 水澤 純基; 深川 剛生; 片井 均; 佐野 武; 三澤 一成; 福島 紀雅; 河内 保之; 佐藤 雄哉; 笹子 三津留; 吉川 貴己; 寺島 雅典
    日本胃癌学会総会記事 (一社)日本胃癌学会 91回 533 - 533 2019/02
  • Takaomi Hagi; Yohei Hosoda; Izumi Komoto; Shinji Uemoto; Susumu Hijioka; Yoshiro Taki; Kazuhiro Nishiyama; Masayuki Imamura
    Surgical case reports 3 (1) 118 - 118 2017/11 
    BACKGROUND: Primary hepatic gastrinoma causing severe ulcerogenic syndrome is extremely rare. Herein, we report a case of primary hepatic gastrinoma accompanied by hyperplasia of multi-nodular Brunner's glands in a patient who instead, preoperatively, was suspected of having multiple duodenal gastrinomas and hepatic metastasis. CASE PRESENTATION: A 57-year-old woman consulted a clinic complaining of melena, intermittent abdominal pain, diarrhea, and vomiting which had persisted for about 3 years. Six months before her presentation, she underwent segmental resection of the jejunum for acute peritonitis due to the spontaneous jejunal perforation. A blood test revealed that her serum immunoreactive gastrin (IRG) level was 12,037 pg/mL. Subsequently, she was transferred to our hospital. On computed tomography (CT), a hypervascular tumor of 23 mm in the segment 5 (S5) region of the liver was visualized. A selective arterial secretagogue injection test (SASI test) was performed twice. The first SASI test revealed that the hepatic tumor was a gastrinoma, and there was no gastrinoma in the duodeno-pancreatic region. Additionally, somatostatin receptor scintigraphy only visualized the tumor in the liver. However, the second SASI test, which was performed during the administration of a proton pump inhibitor and a somatostatin analog (octreotide acetate), revealed that there may have been gastrinomas existing not only in the liver but also in the upper part of the duodenum or the head of the pancreas. Duodenal endoscopy revealed multiple submucosal tumors in the first and the second portion of the duodenum, although a pathological examination of biopsied specimens obtained from the duodenal lesions was negative for malignant cells. Multiple endocrine neoplasia type 1 (MEN1) was excluded from her family history, and serum levels of both intact parathyroid hormone (iPTH) and calcium were within normal ranges. An anterior segmentectomy of the liver and pancreas-preserving total duodenectomy were performed on September 9, 2013. Postoperatively, her serum immunoreactive gastrin level decreased to less than 50 pg/mL. Pathological study of the resected specimens revealed a gastrinoma in the liver, but no gastrinoma in the duodenum. Interestingly, the duodenal submucosal tumor-like lesions were hyperplastic Brunner's glands. Postoperatively, she has been well without recurrence of hypergastrinemia for 4 years. CONCLUSION: We report a case of primary hepatic gastrinoma in a patient who has been cured for 4 years postoperatively. The diagnosis was somewhat difficult due to the coexisting, multiple hyperplastic Brunner's glands of the duodenum mimicking the submucosal neuroendocrine tumors, which might have developed due to long-term hypergastrinemia.
  • Yoshitoshi Ichikawa; Tamaki Maeda; Gaku Mizojiri; Satoshi Ishikawa; Takaomi Hagi; Kimiaki Hattori; Hiroshi Oka
    Molecular and clinical oncology 7 (3) 355 - 358 2017/09 
    The current study presents a mesenteric mesenchymal tumor case, with unusual features in diagnostic imaging and histology. A 16-year-old male was admitted to the hospital with abdominal pain. Computed tomography (CT) revealed an abdominal mass, 2 cm in diameter. The results of contrast-enhanced CT, magnetic resonance imaging and 18F-fluorodeoxyglucose positron emission tomography indicated no specific features suggestive of its histology. Two arteries branching from the superior mesenteric artery were observed feeding the hypervascular tumor. After endoscopic and other laboratory findings revealed no additional lesions, the lesion was diagnosed as a primary mesenteric tumor. As the possibility of malignancy and future bleeding from this tumor could not be ruled out, a resection of the tumor was performed. During the surgery, the tumor, which was well circumscribed and hypervascular, was located in the mesentery of the jejunum. The resected tumor did not exhibit typical histological characteristics, and was labeled as 'myxoid smooth muscle neoplasm of uncertain biologic potential'. At 2 years after surgery, the patient remained well without evidence of recurrence. As primary mesenteric tumors are rare, particularly in young patients, it is considered important that this type of unusual tumor be included in the differential diagnosis for mesenteric tumors.
  • Yoshitoshi Ichikawa; Akifumi Kanazawa; Nobuhiro Dan; Satoshi Ishikawa; Takaomi Hagi; Gaku Mizojiri; Mituo Tsubakimoto; Hiroshi Oka
    Asian journal of endoscopic surgery 10 (3) 328 - 330 2017/08 
    A previously healthy 35-year-old man visited the emergency room complaining of epigastric pain and vomiting. The pain was sudden in onset. His blood tests were within normal limits except for a mild neutrophilia of 14 300/μL. Enhanced abdominal CT scan showed the small intestine dilated into the space between the portal vein and inferior vena cava from the foramen of Winslow. Under the diagnosis of herniation through the foramen of Winslow (HFW), we performed emergency laparoscopic surgery. Laparoscopy revealed an internal herniation of the dilated small intestine through the foramen of Winslow. Because the herniated small intestine was viable, intestinal resection was unnecessary. We released the incarceration under laparoscopy. HFW is very rare and often overlooked, but abdominal CT examination enabled a precise preoperative diagnosis because of characteristic findings. We should consider the possibility of HFW in patients with internal herniation of unknown origin. Laparoscopic surgery for HFW is effective.
  • Goro Ueno; Satoshi Ishikawa; Yoshitoshi Ichikawa; Takaomi Hagi; Nobuatsu Taniura; Hyonsu Chong; Akifumi Kanazawa; Shouichi Takayama; Masayoshi Nishihara; Kentaro Maruyama; Mamoru Shimada; Kyowon Lee; Hiroshi Oka; Tamaki Maeda
    Gan to kagaku ryoho. Cancer & chemotherapy 41 (12) 1521 - 3 0385-0684 2014/11 
    A 58-year-old man was diagnosed with liver dysfunction during a health exam and subsequently visited a doctor. Abdominal ultrasonography revealed space-occupying lesions in the gall bladder and bile duct, and he was hospitalized for further examination and treatment. Computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP), and magnetic resonance cholangiopancreatography (MRCP) revealed double cancer of the gall bladder and bile duct with pancreaticobiliary maljunction (PBM), and we performed a pancreatoduodenectomy. Pathological examination revealed gall bladder and bile duct cancer, and severe dysplasia of the papilla of Vater. We diagnosed synchronous triple cancer because none of the cancers had continuity or vascular invasion. Each cancer was at Stage I, and the patient has survived for 2 years and 6 months without recurrence and no additional treatment. PBM is a mutation of the junction of the pancreatic and bile ducts outside of the duodenal wall, and is a known complication of biliary tract cancer due to the reflux of pancreatic juice and bile. Because K-ras and p53 gene mutations occur in the biliary tract mucosal epithelium, PBM increases the risk of developing multicentric cancer. It is important to consider the existence of double cancer when biliary tract cancer is detected in a PBM patient.
  • Shouichi Takayama; Kentaro Maruyama; Hiroki Takehara; Satoshi Sugimoto; Satoshi Ishikawa; Takaomi Hagi; Yoshitoshi Ichikawa; Hyonsu Chong; Nobuatsu Taniura; Goro Ueno; Akifumi Kanazawa; Masayoshi Nishihara; Goki Gon; Mamoru Shimada; Kyowon Lee; Hiroshi Oka
    Gan to kagaku ryoho. Cancer & chemotherapy 41 (12) 1548 - 50 0385-0684 2014/11 
    A 68 -year-old man underwent a pancreaticoduodenectomy after being diagnosed with primary duodenal cancer. The postoperative pathological diagnosis was tub2, SE, ly1, v1, panc3, pn+, N0. Although adjuvant chemotherapy was administered, local recurrence in the portal region was detected 18 months later. The recurrent tumor pressed against the region of the bile duct anastomosis, which caused obstructive jaundice. After serum bilirubin levels were reduced, resection of the recurrent tumors was performed. This required resection of the transverse colon, parts of the portal vein, and the inferior vena cava. The bile duct anastomotic region, which had been infiltrated by the tumor, was excised and rebuilt. The postoperative pathological diagnosis was tub2. The patient continued to receive adjuvant chemotherapy and showed no signs of recurrence 9 months after surgery. Extended resection for local recurrences of primary duodenal cancer may be an effective means of disease control.
  • Akifumi Kanazawa; Satoshi Ishikawa; Takaomi Hagi; Yoshitoshi Ichikawa; Hyons Chong; Goro Ueno; Nobuatsu Taniura; Shouichi Takayama; Kentaro Maruyama; Masayoshi Nishihara; Mamoru Shimada; Kyowon Lee; Hiroshi Oka; Tamaki Maeda
    Gan to kagaku ryoho. Cancer & chemotherapy 41 (12) 2481 - 3 0385-0684 2014/11 
    Here, we present the case of a 60-year-old man in whom abdominal computed tomography showed a solid abdominal tumor (11 cm in diameter) in the pelvic space, with widely disseminated nodular lesions. Emergency surgery was performed following the rapid onset of intense abdominal pain. Peritoneal disseminations were widespread and the tumor was confirmed to be in the pelvic space. The tumor was not connected to any segment of the intestinal tract but rather to the retroperitoneum. Immunohistochemical staining was positive for c-kit (exon 11 mutation) and CD34 but negative for S-100 protein. Careful postoperative examination did not reveal any lesions in the upper or lower alimentary tract. On the basis of these findings we diagnosed the tumor as an extragastrointestinal stromal tumor (EGIST) originating from the retroperitoneum. After surgery, intravenous infusion of imatinib was started at a full dose of 400mg/day; however, owing to strong adverse effects, the dose was reduced to 200mg/day. Despite halving the dose, the patient has remained lesion-free according to computed tomography for 36 months after the operation. Low-dose imatinib chemotherapy remained efficacious in controlling progression in this case.

MISC

  • 食道癌DCF(DTX+CDDP+5FU)化学療法による消化管関連有害事象の検討
    萩 隆臣; 牧野 知紀; 田中 晃司; 山崎 誠; 宮崎 安弘; 高橋 剛; 黒川 幸典; 中島 清一; 森 正樹; 土岐 祐一郎  日本食道学会学術集会プログラム・抄録集  72回-  222  -222  2018/06

Research Grants & Projects

  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research
    Date (from‐to) : 2019/04 -2021/03 
    Author : Hagi Takaomi
     
    In this study, tissue specimens of patients with gastric cancer and treated with nivolumab as third-line or higher therapy were collected. PD-L1 expression, mismatch repair (MMR) status, and ARID1A expression were analyzed by immunohistochemistry. Associations with tumor-response rate and survival were assessed. The response rate was 17.5%. The response rate was significantly higher in patients with performance status (PS) 0-1 (P = 0.026), non-peritoneal metastasis (P =0.021), PD-L1 TPS ≧1 (P = 0.012), CPS ≧5 (P = 0.007) or ≧10 (P < 0.001) or MMR deficiency (P < 0.001). Multivariate analysis revealed that CPS (P = 0.001) and MMR (P = 0.002) were independent prognostic factors of progression-free survival, as well as liver metastasis (P < 0.001), peritoneal metastasis (P = 0.004) and CRP (P < 0.001).
  • Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research
    Date (from‐to) : 2017/08 -2019/03 
    Author : Hagi Takaomi
     
    Trefoil factor 3 (TFF3) is a small molecule secreted by the mammalian gastrointestinal tract and is overexpressed in some human malignant tumors. We investigated the prognostic values of immunohistochemical (IHC) TFF3 expression and serum TFF3 levels in patients with gastric cancer, and whether TFF3 influenced tumor proliferation and invasion in vitro. IHC TFF3 expression showed significant associations with depth of invasion , lymph node metastasis, and RFS . Serum TFF3 levels were correlated with IHC TFF3 expression. RFS was significantly poorer in patients with high compared to low serum TFF3 levels. In vitro assays, TFF3 down regulation significantly inhibited both proliferation and invasion of gastric cancer cells. Serum TFF3 levels could be useful prognostic markers in patients with gastric cancer. TFF3 may play various biological roles in proliferation and invasion of gastric cancer cells.

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