濵田　顕 （ハマダ　アキラ）

研究者情報

学位

• 医学博士（2022年09月 山形大学）

ホームページURL

https://jglobal.jst.go.jp/detail?JGLOBAL_ID=201901016932378042

J-Global ID

• 201901016932378042

研究キーワード

• 分子科学   肺癌   

研究分野

• ライフサイエンス / 呼吸器外科学
• ライフサイエンス / 腫瘍生物学

経歴

• 2023年10月 - 現在  近畿大学医学部附属病院 外科学講座呼吸器外科部門 医学部講師
• 2019年04月 - 2023年09月  近畿大学医学部附属病院外科学講座呼吸器外科部門助教
• 2015年10月 - 2019年03月  山形大学医学部付属病院外科学第二講座助教
• 2015年04月 - 2015年10月  国立がん研究センター中央病院呼吸器外科
• 2010年04月 - 2015年03月  日本海総合病院

学歴

• 2015年10月 - 2022年09月   山形大学大学院   医学系研究科医学専攻
• 2004年04月 - 2010年03月   山形大学   医学部   医学科

所属学協会

• 日本内視鏡外科学会   日本呼吸器内視鏡学会   日本外科学会   日本胸部外科学会   日本呼吸器外科学会   日本肺癌学会   

研究活動情報

論文

• Impact of central nervous system metastasis after complete resection of lung adenocarcinomas harboring common EGFR mutation - A real-world database study in Japan: The CReGYT-01 EGFR study.

  Shinya Katsumata; Mototsugu Shimokawa; Akira Hamada; Naoki Haratake; Kotaro Nomura; Kosuke Fujino; Mao Yoshikawa; Ken Suzawa; Kazuhiko Shien; Kenichi Suda; Shuta Ohara; Shota Fukuda; Fumihiko Kinoshita; Kazuki Hayasaka; Hirotsugu Notsuda; Shinkichi Takamori; Satoshi Muto; Yusuke Takanashi; Kiyomichi Mizuno; Akikazu Kawase; Takamitsu Hayakawa; Keigo Sekihara; Michihito Toda; Somei Matsuo; Kyoshiro Takegahara; Masaki Hashimoto; Kenta Nakahashi; Makoto Endo; Hiroki Ozawa; Ryo Fujikawa; Yasuaki Tomioka; Kei Namba; Taichi Matsubara; Jun Suzuki; Hikaru Watanabe; Kazuki Takada; Hironobu Hoshino; Taisuke Kaiho; Takahide Toyoda; Yasunobu Kouki; Satoshi Shiono; Junichi Soh; Yasuhisa Ohde

  European journal of cancer (Oxford, England : 1990) 201 113951 - 113951 2024年04月 

  OBJECTIVES: To clarify the impact of central nervous system (CNS) metastasis on performance status (PS) at relapse, on subsequent treatment(s), and on survival of patients with lung adenocarcinoma harboring common epidermal growth factor receptor (EGFR) mutation. METHODS: We conducted the multicenter real-world database study for patients with radical resections for lung adenocarcinomas between 2015 and 2018 at 21 centers in Japan. EGFR mutational status was examined at each center. RESULTS: Of 4181 patients enrolled, 1431 underwent complete anatomical resection for lung adenocarcinoma harboring common EGFR mutations. Three-hundred-and-twenty patients experienced disease relapse, and 78 (24%) had CNS metastasis. CNS metastasis was significantly more frequent in patients with conventional adjuvant chemotherapy than those without (30% vs. 20%, P = 0.036). Adjuvant chemotherapy did not significantly improve relapse-free survival at any pathological stage (adjusted hazard ratio for stage IA2-3, IB, and II-III was 1.363, 1.287, and 1.004, respectively). CNS metastasis did not affect PS at relapse. Subsequent treatment, mainly consisting of EGFR-tyrosine kinase inhibitors (TKIs), could be equally given in patients with or without CNS metastasis (96% vs. 94%). Overall survival after relapse was equivalent between patients with and without CNS metastasis. CONCLUSION: The efficacy of conventional adjuvant chemotherapy may be limited in patients with lung adenocarcinoma harboring EGFR mutations. CNS metastasis is likely to be found in practice before deterioration in PS, and may have little negative impact on compliance with subsequent EGFR-TKIs and survival after relapse. In this era of adjuvant TKI therapy, further prospective observational studies are desirable to elucidate the optimal management of CNS metastasis.
• 症例報告 胸壁浸潤肺癌に対して術前化学放射線治療後にロボット支援併用下に根治切除した1例

  濵田 顕; 宗 淳一; 千葉 眞人; 下治 正樹; 須田 健一; 津谷 康大

  日本内視鏡外科学会雑誌 29 2 127 - 132 株式会社医学書院 2024年03月
• 【肺がん,悪性胸膜中皮腫,胸腺腫瘍】免疫チェックポイント阻害薬による非小細胞肺がんの術前治療と術後治療の使い分け

  深見 朋世; 須田 健一; 濱田 顕; 津谷 康大

  腫瘍内科 32 6 625 - 630 (有)科学評論社 2023年12月
• 低侵襲手術のエビデンスを熟考する 原発性肺癌に対するロボット支援下手術の段階的発展を目指した取り組み

  宗 淳一; 下治 正樹; 武本 智樹; 深見 朋世; 老木 華; 福田 祥大; 小原 秀太; 濱田 顕; 千葉 眞人; 伊藤 正興; 須田 健一; 光冨 徹哉; 津谷 康大

  肺癌 63 5 407 - 407 (NPO)日本肺癌学会 2023年10月
• 周術期治療の新時代:プラクティスはどう変わったか? PD-L1高発現EGFR変異肺がん外科切除例の検討 術後補助療法の観点から考える

  須田 健一; 老木 華; 福田 祥大; 深見 朋世; 小原 秀太; 濱田 顕; 伊藤 正興; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 光冨 徹哉; 津谷 康大

  肺癌 63 5 412 - 412 (NPO)日本肺癌学会 2023年10月
• 区域切除術後気管支断端瘻・膿胸に対し小開窓術・EWS・閉鎖陰圧療法を組み合わせた後に閉鎖術を行った一例

  老木 華; 千葉 眞人; 宗 淳一; 深見 朋世; 福田 祥大; 小原 秀太; 濱田 顕; 伊藤 正興; 下治 正樹; 武本 智樹; 須田 健一; 光冨 徹哉; 津谷 康大

  肺癌 63 5 530 - 530 (NPO)日本肺癌学会 2023年10月
• Recent Advances in Perioperative Immunotherapies in Lung Cancer.

  Shota Fukuda; Kenichi Suda; Akira Hamada; Yasuhiro Tsutani

  Biomolecules 13 9 2023年09月 

  Several clinical trials have been revolutionizing the perioperative treatment of early-stage non-small cell lung cancer (NSCLC). Many of these clinical trials involve cancer immunotherapies with antibody drugs that block the inhibitory immune checkpoints programmed death 1 (PD-1) and its ligand PD-L1. While these new treatments are expected to improve the treatment outcome of NSCLC patients after pulmonary resection, several major clinical questions remain, including the appropriate timing of immunotherapy (neoadjuvant, adjuvant, or both) and the identification of patients who should be treated with neoadjuvant and/or adjuvant immunotherapies, because some early-stage NSCLC patients are cured by surgical resection alone. In addition, immunotherapy may induce immune-related adverse events that will require permanent treatment in some patients. Based on this fact as well, it is desirable to select appropriate patients for neoadjuvant/adjuvant immunotherapies. So far, data from several important trials have been published, with findings demonstrating the efficacy of adjuvant atezolizumab (IMpower010 trial), neoadjuvant nivolumab plus platinum-doublet chemotherapy (CheckMate816 trial), and several perioperative (neoadjuvant plus adjuvant) immunotherapies (AEGEAN, KEYNOTE-671, NADIM II, and Neotorch trials). In addition to these key trials, numerous clinical trials have reported a wealth of data, although most of the above clinical questions have not been completely answered yet. Because there are so many ongoing clinical trials in this field, a comprehensive understanding of the results and/or contents of these trials is necessary to explore answers to the clinical questions above as well as to plan a new clinical trial. In this review, we comprehensively summarize the recent data obtained from clinical trials addressing such questions.
• Secondary mutations of the EGFR gene that confer resistance to mobocertinib in EGFR exon 20 insertion.

  Akira Hamada; Kenichi Suda; Masaya Nishino; Keiko Obata; Hana Oiki; Tomoyo Fukami; Shota Fukuda; Toshio Fujino; Shuta Ohara; Takamasa Koga; Masato Chiba; Masaki Shimoji; Masaoki Ito; Toshiki Takemoto; Junichi Soh; Yasuhiro Tsutani; Tetsuya Mitsudomi

  Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer 2023年09月 

  INTRODUCTION: Approximately 10% of mutations in the epidermal growth factor receptor (EGFR) gene in non-small cell lung cancer (NSCLC) are in-frame insertions in exon 20 (X20ins). These tumors usually do not respond to conventional EGFR-tyrosine kinase inhibitors (TKIs). Several novel EGFR-TKIs active for X20ins are in clinical development, including mobocertinib, which was recently approved by the US FDA. However, acquired resistance during treatment with these TKIs still occurs as in the case of EGFR-TKIs of earlier generations. METHODS: We chronically exposed Ba/F3 cells transduced with five most common X20ins (A763_Y764insFQEA, V769_D770insASV, D770_N771insSVD, H773_V774insNPH and H773_V774insH) to mobocertinib in the presence of N-ethyl-N-nitrosourea and searched for secondary EGFR mutations. We evaluated the efficacies of several EGFR X20ins inhibitors, including zipalertinib and sunvozertinib, against cells with acquired resistant mutations. RESULTS: All secondary mutations resulting in acquired resistance to mobocertinib were exclusively C797S in insFQEA and insSVD. However, in the case of other X20ins (insASV, insNPH and insH), T790M or C797S secondary mutations contributed to acquired resistance to mobocertinib. The emergence of T790M was more frequent in cells treated with lower drug concentrations. Sunvozertinib showed good activity against resistant cells with T790M. Cells with C797S were refractory to all EGFR-TKIs, except for erlotinib, which was active for insFQEA with C797S. CONCLUSIONS: T790M or C797S, depending on the original X20ins mutations, conferred acquired resistance to mobocertinib. Sunvozertinib may be the treatment of choice for patients with tumors resistant to mobocertinib because of T790M.
• Harmonized SUVmaxの病理学的非浸潤癌予測に対する有効性の検討 多施設共同研究

  安達 剛弘; 吉田 幸弘; 四倉 正也; 中川 加寿夫; 濱田 顕; 須田 健一; 宗 淳一; 竹ヶ原 京志郎; 橋本 昌樹; 長谷川 誠紀; 臼田 実男; 渡辺 俊一; 光冨 徹哉

  日本呼吸器外科学会雑誌 37 3 O55 - 1 (一社)日本呼吸器外科学会 2023年06月
• ロボット支援下手術に特有に起きる合併症とその対策 ロボット支援下解剖学的肺切除術時の気管支損傷を考察する

  宗 淳一; 武本 智樹; 福田 祥大; 小原 秀太; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 津谷 康大

  日本呼吸器外科学会雑誌 37 3 WS2 - 6 (一社)日本呼吸器外科学会 2023年06月
• 原発性肺癌切除例における人工知能解析プログラムを用いた腫瘍体積増大速度の臨床的意義

  福田 祥大; 宗 淳一; 小原 秀太; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 武本 智樹; 津谷 康大

  日本呼吸器外科学会雑誌 37 3 O51 - 4 (一社)日本呼吸器外科学会 2023年06月
• 臨床病期I期非小細胞肺癌におけるRAVATを用いた画像的標準化PET/CT定量値の有用性

  濱田 顕; 須田 健一; 宗 淳一; 吉田 幸弘; 橋本 昌樹; 竹ヶ原 京志郎; 長谷川 誠紀; 臼田 実男; 津谷 康大; 光冨 徹哉

  日本呼吸器外科学会雑誌 37 3 O56 - 2 (一社)日本呼吸器外科学会 2023年06月
• Uniportal VATS区域切除の実際 難点と克服法を動画から

  千葉 眞人; 福田 祥大; 小原 秀太; 濱田 顕; 下治 正樹; 武本 智樹; 須田 健一; 宗 淳一; 光冨 徹哉; 津谷 康大

  日本呼吸器外科学会雑誌 37 3 O60 - 1 (一社)日本呼吸器外科学会 2023年06月
• Prognostic role of preoperative fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography with an image-based harmonization technique: A multicenter retrospective study.

  Akira Hamada; Kazuhiro Kitajima; Kenichi Suda; Takamasa Koga; Junichi Soh; Hayato Kaida; Kimiteru Ito; Tetsuro Sekine; Kyoshiro Takegahara; Hiromitsu Daisaki; Masaki Hashimoto; Yukihiro Yoshida; Takanobu Kabasawa; Takashi Yamasaki; Seiichi Hirota; Jitsuo Usuda; Kazunari Ishii; Tetsuya Mitsudomi

  JTCVS open 14 502 - 522 2023年06月 

  OBJECTIVES: Despite the prognostic impacts of preoperative fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography examination, fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography-based prognosis prediction has not been used clinically because of the disparity in data between institutions. By applying an image-based harmonized approach, we evaluated the prognostic roles of fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography parameters in clinical stage I non-small cell lung cancer. METHODS: We retrospectively examined 495 patients with clinical stage I non-small cell lung cancer who underwent fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography examinations before pulmonary resection between 2013 and 2014 at 4 institutions. Three different harmonization techniques were applied, and an image-based harmonization, which showed the best-fit results, was used in the further analyses to evaluate the prognostic roles of fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography parameters. RESULTS: Cutoff values of image-based harmonized fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography parameters, maximum standardized uptake, metabolic tumor volume, and total lesion glycolysis were determined using receiver operating characteristic curves that distinguish pathologic high invasiveness of tumors. Among these parameters, only the maximum standardized uptake was an independent prognostic factor in recurrence-free and overall survivals in univariate and multivariate analyses. High image-based maximum standardized uptake value was associated with squamous histology or lung adenocarcinomas with higher pathologic grades. In subgroup analyses defined by ground-glass opacity status and histology or by clinical stages, the prognostic impact of image-based maximum standardized uptake value was always the highest compared with other fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography parameters. CONCLUSIONS: The image-based fluorine-18 fluorodeoxyglucose-positron emission tomography/computed tomography harmonization was the best fit, and the image-based maximum standardized uptake was the most important prognostic marker in all patients and in subgroups defined by ground-glass opacity status and histology in surgically resected clinical stage I non-small cell lung cancers.
• 癌免疫療法時代における外科医の役割 肺がん外科領域におけるがん免疫療法の進歩と呼吸器外科医の役割

  須田 健一; 濱田 顕; 宗 淳一; 小原 秀太; 千葉 眞人; 武本 智樹; 光冨 徹哉; 津谷 康大

  日本外科学会定期学術集会抄録集 123回 SY - 4 (一社)日本外科学会 2023年04月
• 呼吸器外科領域でのロボット支援下手術の克服すべき課題と手技の工夫 局所進行肺癌に対する術前化学放射線療法後ロボット支援下胸腔鏡手術の可能性

  宗 淳一; 下治 正樹; 武本 智樹; 福田 祥大; 小原 秀太; 濱田 顕; 千葉 眞人; 須田 健一; 津谷 康大

  日本外科学会定期学術集会抄録集 123回 WS - 6 (一社)日本外科学会 2023年04月
• PD-L1高発現非小細胞肺癌における術前血清フィブリノゲン値の臨床的意義

  小原 秀太; 須田 健一; 福田 祥大; 濱田 顕; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 光冨 徹哉; 津谷 康大

  日本外科学会定期学術集会抄録集 123回 SF - 3 (一社)日本外科学会 2023年04月
• Segmentectomy for patients with early-stage pure-solid non-small cell lung cancer.

  Atsushi Kamigaichi; Akira Hamada; Yasuhiro Tsutani

  Frontiers in oncology 13 1287088 - 1287088 2023年 

  For decades, lobectomy has been the recommended surgical procedure for non-small cell lung cancer (NSCLC), including for small-sized lesions. However, two recent pivotal clinical trials conducted by the Japanese Clinical Oncology Group/West Japan Oncology Group (JCOG0802/WJOG4607L) and the Cancer and Leukemia Group B (CALGB140503), which compared the survival outcomes between lobectomy and sublobar resection (the JCOG0802/WJOG4607L included only segmentectomy, not wedge resection), demonstrated the efficacy of sublobar resection in patients with early-stage peripheral lung cancer measuring ≤ 2 cm. The JCOG0802/WJOG4607L demonstrated the superiority of segmentectomy over lobectomy with respect to overall survival, implying the survival benefit conferred by preservation of the lung parenchyma. Subsequently, the JCOG1211 also demonstrated the efficacy of segmentectomy, even for NSCLC, measuring up to 3 cm with the predominant ground-glass opacity phenotype. Segmentectomy has become the standard of care for early-stage NSCLC and its indications are expected to be further expanded to include solid lung cancers > 2 cm. However, local control is still a major concern for segmentectomy for higher-grade malignant tumors. Thus, the indications of segmentectomy, especially for patients with radiologically pure-solid NSCLC, remain controversial due to the aggressive nature of the malignancy. In this study, we reviewed previous studies and discussed the efficacy of segmentectomy for patients with such tumors.
• 低侵襲胸腔鏡手術が肺癌治療にもたらしたもの Uniportal VATSの発展と適応拡大

  千葉 眞人; 宗 淳一; 福田 祥大; 小原 秀太; 濱田 顕; 下治 正樹; 武本 智樹; 須田 健一; 光冨 徹哉; 津谷 康大

  肺癌 62 6 540 - 540 (NPO)日本肺癌学会 2022年11月
• 低侵襲胸腔鏡手術が肺癌治療にもたらしたもの Uniportal VATSの発展と適応拡大

  千葉 眞人; 宗 淳一; 福田 祥大; 小原 秀太; 濱田 顕; 下治 正樹; 武本 智樹; 須田 健一; 光冨 徹哉; 津谷 康大

  肺癌 62 6 540 - 540 (NPO)日本肺癌学会 2022年11月
• 肺癌術後の経時的ctDNA測定が病勢予測に有用であった1例

  櫻井 真倫; 小原 秀太; 須田 健一; 福田 祥大; 濱田 顕; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 津谷 康大; 光冨 徹哉

  肺癌 62 5 439 - 439 (NPO)日本肺癌学会 2022年10月
• 肺癌術後の経時的ctDNA測定が病勢予測に有用であった1例

  櫻井 真倫; 小原 秀太; 須田 健一; 福田 祥大; 濱田 顕; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 津谷 康大; 光冨 徹哉

  肺癌 62 5 439 - 439 (NPO)日本肺癌学会 2022年10月
• Foretinib can overcome common on-target resistance mutations after capmatinib/tepotinib treatment in NSCLCs with MET exon 14 skipping mutation.

  Toshio Fujino; Kenichi Suda; Takamasa Koga; Akira Hamada; Shuta Ohara; Masato Chiba; Masaki Shimoji; Toshiki Takemoto; Junichi Soh; Tetsuya Mitsudomi

  Journal of hematology & oncology 15 1 79 - 79 2022年06月 

  BACKGROUND: Capmatinib and tepotinib are guideline-recommended front-line treatments for non-small-cell lung cancer (NSCLC) patients with MET exon 14 skipping mutations (METex14). However, the emergence of acquired resistance to capmatinib/tepotinib is almost inevitable partially due to D1228X or Y1230X secondary mutations of the MET. In this study, we explored agents that are active against both D1228X and Y1230X MET to propose an ideal sequential treatment after capmatinib/tepotinib treatment failure in NSCLC patients with METex14. METHODS: The inhibitory effects of 300 drugs, including 33 MET-TKIs, were screened in Ba/F3 cells carrying METex14 plus MET D1228A/Y secondary mutations. The screen revealed four-candidate type II MET-TKIs (altiratinib, CEP-40783, foretinib and sitravatinib). Therefore, we performed further growth inhibitory assays using these four MET-TKIs plus cabozantinib and merestinib in Ba/F3 cells carrying MET D1228A/E/G/H/N/V/Y or Y1230C/D/H/N/S secondary mutations. We also performed analyses using Hs746t cell models carrying METex14 (with mutant allele amplification) with/without D1228X or Y1230X in vitro and in vivo to confirm the findings. Furthermore, molecular dynamics (MD) simulations were carried out to examine differences in binding between type II MET-TKIs. RESULTS: All 6 type II MET-TKIs were active against Y1230X secondary mutations. However, among these 6 agents, only foretinib showed potent activity against D1228X secondary mutations of the MET in the Ba/F3 cell and Hs746t in vitro model and Hs746t in vivo model, and CEP-40783 and altiratinib demonstrated some activity. MD analysis suggested that the long tail of foretinib plays an important role in binding D1228X MET through interaction with a residue at the solvent front (G1163). Tertiary G1163X mutations, together with L1195F/I and F1200I/L, occurred as acquired resistance mechanisms to the second-line treatment foretinib in Ba/F3 cell models. CONCLUSIONS: The type II MET-TKI foretinib may be an appropriate second-line treatment for NSCLCs carrying METex14 after campatinib/tepotinib treatment failure by secondary mutations at residue D1228 or Y1230.
• TKI耐性2次的変異を同定する手法としてのBa/F3細胞モデルの有用性

  須田 健一; 古賀 教将; 藤野 智大; 濱田 顕; 宗 淳一; 光冨 徹哉

  肺癌 62 3 258 - 258 (NPO)日本肺癌学会 2022年06月
• 早期肺癌の質的診断と術式決定 臨床病期I期非小細胞肺癌における標準化PET/CT定量値を用いた肺癌予後層別化の多施設共同研究

  濱田 顕; 須田 健一; 宗 淳一; 吉田 幸弘; 橋本 昌樹; 竹ヶ原 京志郎; 長谷川 誠紀; 臼田 実男; 光冨 徹哉

  日本呼吸器外科学会雑誌 36 Suppl. SY1 - 5 (一社)日本呼吸器外科学会 2022年05月
• 肺癌周術期治療:最新の話題と今後の展開 肺癌術後におけるcirculating tumor DNA検出の意義

  小原 秀太; 須田 健一; 藤野 智大; 濱田 顕; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 36 Suppl. WS2 - 6 (一社)日本呼吸器外科学会 2022年05月
• COVID-19 pandemicが外科切除の対象となる肺がん患者に与えた影響

  須田 健一; 小原 秀太; 藤野 智大; 濱田 顕; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 36 Suppl. O66 - 2 (一社)日本呼吸器外科学会 2022年05月
• Uniportal VATS気管支形成術の経験と導入における工夫

  千葉 眞人; 宗 淳一; 小原 秀太; 藤野 智大; 濱田 顕; 下治 正樹; 須田 健一; 武本 智樹; 光冨 徹哉

  日本呼吸器外科学会雑誌 36 Suppl. O87 - 6 (一社)日本呼吸器外科学会 2022年05月
• 縦隔リンパ節郭清を伴う肺葉切除におけるロボット支援手術の特徴と可能性 ハイブリッド・単孔式と比較して

  宗 淳一; 小原 秀太; 藤野 智大; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 武本 智樹; 光冨 徹哉

  日本呼吸器外科学会雑誌 36 Suppl. O94 - 3 (一社)日本呼吸器外科学会 2022年05月
• 当院における肺癌根治切除後の乳び胸合併症例の検討

  武本 智樹; 小原 秀太; 藤野 智大; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 36 Suppl. O101 - 1 (一社)日本呼吸器外科学会 2022年05月
• 肺癌周術期合併症と糖尿病との関連

  下治 正樹; 須田 健一; 小原 秀太; 藤野 智大; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 36 Suppl. O106 - 6 (一社)日本呼吸器外科学会 2022年05月
• Presence of a Ground-Glass Opacity Component Is the True Prognostic Determinant in Clinical Stage I NSCLC.

  Akira Hamada; Kenichi Suda; Toshio Fujino; Masaya Nishino; Shuta Ohara; Takamasa Koga; Takanobu Kabasawa; Masato Chiba; Masaki Shimoji; Makoto Endoh; Toshiki Takemoto; Junichi Soh; Naoki Yanagawa; Satoshi Shiono; Tetsuya Mitsudomi

  JTO clinical and research reports 3 5 100321 - 100321 2022年05月 

  Introduction: Recent studies have suggested that including presence or absence of ground-glass opacity (GGO) may improve the tumor descriptor (T descriptor) classification in clinical stage I NSCLC. In this study, we analyzed prognostic implications of presence or absence of GGO, size of the solid component, and predominant histology to identify the true prognostic determinant for early-stage NSCLC. Methods: We retrospectively examined 384 patients with clinical stage I NSCLC (solid: 242, part solid: 142) who underwent complete resection between 2009 and 2013. Results: Survival curves of the whole cohort revealed good separation using the current TNM classification. Nevertheless, the part-solid group had a favorable prognosis irrespective of solid component size. Conversely, patients in the solid tumor group with tumors between 3 and 4 cm had a worse prognosis than patients whose tumors were less than or equal to 3 cm. Thus, we propose the following novel T descriptor classification: IA, part-solid tumors; IB, solid tumors less than or equal to 3 cm; and IC, solid tumors between 3 and 4 cm. This novel classification system stratified patient prognosis better than the current classification. On pathologic evaluation, the part-solid group always had better prognoses than the solid group in each subgroup divided by pathologic grade. Conclusions: These results suggest that presence of GGO is the true prognostic determinant of stage I NSCLC, irrespective of the size of the solid component. Our novel T descriptor classification system could more accurately predict prognoses of clinical stage I NSCLC cases.
• Uniportal VATSの習得と発展を目指した手術教育プログラム 動物心肺ハイブリッドモデル・VR・オンラインカンファレンスの活用

  千葉 眞人; 小原 秀太; 藤野 智大; 濱田 顕; 下治 正樹; 須田 健一; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 122回 SP - 3 (一社)日本外科学会 2022年04月
• ICI・TKI・SBRT時代の肺癌の集学的治療と外科手術 局所進行肺がんに対する免疫チェックポイント阻害薬を用いた周術期治療の可能性 WJOG12119L試験

  濱田 顕; 宗 淳一; 大泉 弘幸; 坪井 正博; 堀之内 秀仁; 吉野 一郎; 棚橋 雅幸; 豊岡 伸一; 岡田 守人; 横見瀬 裕保; 山下 素弘; 光冨 徹哉

  日本外科学会定期学術集会抄録集 122回 SY - 1 (一社)日本外科学会 2022年04月
• 胸部悪性腫瘍のトランスレーショナルリサーチ【International】肺がん分子標的治療薬に対するon-targetの獲得耐性機序の同定とその克服

  須田 健一; 古賀 教将; 西野 将矢; 藤野 智大; 濱田 顕; 下治 正樹; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 122回 WS - 4 (一社)日本外科学会 2022年04月
• 同一期間に実施した肺がんハイブリッド手術・単孔式手術・ロボット支援下手術の比較検討

  宗 淳一; 小原 秀太; 藤野 智大; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 武本 智樹; 光冨 徹哉

  日本外科学会定期学術集会抄録集 122回 SF - 1 (一社)日本外科学会 2022年04月
• インシデント・アクシデント報告から考える手術室におけるノンテクニカルスキルの重要性

  武本 智樹; 辰巳 陽一; 小原 秀太; 藤野 智大; 濱田 顕; Chiba Masato; 下治 正樹; 須田 健一; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 122回 SF - 4 (一社)日本外科学会 2022年04月
• 気管食道領域の基礎研究 肺癌切除症例におけるctDNA解析の有用性

  小原 秀太; 須田 健一; 藤野 智大; 濱田 顕; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本気管食道科学会会報 73 2 168 - 168 (NPO)日本気管食道科学会 2022年04月
• Uniportal VATSの習得と発展を目指した手術教育プログラム 動物心肺ハイブリッドモデル・VR・オンラインカンファレンスの活用

  千葉 眞人; 小原 秀太; 藤野 智大; 濱田 顕; 下治 正樹; 須田 健一; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 122回 SP - 3 (一社)日本外科学会 2022年04月
• ICI・TKI・SBRT時代の肺癌の集学的治療と外科手術 局所進行肺がんに対する免疫チェックポイント阻害薬を用いた周術期治療の可能性 WJOG12119L試験

  濱田 顕; 宗 淳一; 大泉 弘幸; 坪井 正博; 堀之内 秀仁; 吉野 一郎; 棚橋 雅幸; 豊岡 伸一; 岡田 守人; 横見瀬 裕保; 山下 素弘; 光冨 徹哉

  日本外科学会定期学術集会抄録集 122回 SY - 1 (一社)日本外科学会 2022年04月
• 胸部悪性腫瘍のトランスレーショナルリサーチ【International】肺がん分子標的治療薬に対するon-targetの獲得耐性機序の同定とその克服

  須田 健一; 古賀 教将; 西野 将矢; 藤野 智大; 濱田 顕; 下治 正樹; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 122回 WS - 4 (一社)日本外科学会 2022年04月
• 同一期間に実施した肺がんハイブリッド手術・単孔式手術・ロボット支援下手術の比較検討

  宗 淳一; 小原 秀太; 藤野 智大; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 武本 智樹; 光冨 徹哉

  日本外科学会定期学術集会抄録集 122回 SF - 1 (一社)日本外科学会 2022年04月
• インシデント・アクシデント報告から考える手術室におけるノンテクニカルスキルの重要性

  武本 智樹; 辰巳 陽一; 小原 秀太; 藤野 智大; 濱田 顕; Chiba Masato; 下治 正樹; 須田 健一; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 122回 SF - 4 (一社)日本外科学会 2022年04月
• 気管食道領域の基礎研究 肺癌切除症例におけるctDNA解析の有用性

  小原 秀太; 須田 健一; 藤野 智大; 濱田 顕; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本気管食道科学会会報 73 2 168 - 168 (NPO)日本気管食道科学会 2022年04月
• Frequent EGFR Mutations and Better Prognosis in Positron Emission Tomography-Negative, Solid-Type Lung Cancer.

  Kenichi Suda; Shuta Ohara; Toshio Fujino; Akira Hamada; Masato Chiba; Masaki Shimoji; Toshiki Takemoto; Junichi Soh; Tetsuya Mitsudomi

  Clinical lung cancer 23 1 e60-e68  2022年01月 

  BACKGROUND: The differential diagnosis of a solitary solid-type lung nodule is diverse. 18F-fluorodeoxyglucose positron emission tomography (PET) has a high sensitivity in the diagnosis of solid-type lung cancers; however, PET-negative, solid-type lung cancers are rarely observed. In this study, we analyzed the clinical/genetic features and prognosis of PET-negative, solid-type lung cancers. PATIENTS AND METHODS: Between January 2007 and February 2020, 709 patients with solid-type lung cancers (tumor size ≥2.0 cm) underwent pulmonary resection. Clinical, genetic, and prognostic features were evaluated in 27 patients (3.8%) with tumors showing negative PET results defined as SUVmax <2.0. RESULTS: All 27 patients had lung adenocarcinoma; 23 had invasive adenocarcinomas and 4 had invasive mucinous adenocarcinomas. The PET-negative group showed high frequencies of females and never-smokers. Recurrence-free survival was significantly better in the PET-negative group compared with PET-positive counterparts extracted using propensity score matching from patients who underwent pulmonary resection during the same period (P = .0052). Furthermore, 83% of PET-negative, solid-type invasive lung adenocarcinoma patients harbored EGFR mutation, which was significantly higher than that of PET-positive, solid-type invasive lung adenocarcinoma patients (38%, n = 225) who received EGFR mutation testing in our cohort (P < .0001). PET-negative, solid-type lung adenocarcinoma patients with EGFR mutations had significantly better recurrence-free survival compared with PET-positive, solid-type lung adenocarcinoma patients with EGFR mutations extracted using propensity score matching (P = .0030). CONCLUSION: PET-negative, solid-type lung cancers are characterized with a high incidence of EGFR mutation and a better prognosis compared with PET-positive, solid-type lung cancer.
• In vitro validation study of HER2 and HER4 mutations identified in an ad hoc secondary analysis of the LUX-Lung 8 randomized clinical trial.

  Akira Hamada; Kenichi Suda; Takamasa Koga; Toshio Fujino; Masaya Nishino; Shuta Ohara; Masato Chiba; Masaki Shimoji; Toshiki Takemoto; Junichi Soh; Tetsuro Uchida; Tetsuya Mitsudomi

  Lung cancer (Amsterdam, Netherlands) 162 79 - 85 2021年12月 

  OBJECTIVES: The LUX-Lung 8 randomized trial (LL8) demonstrated a prolonged progression-free survival (PFS) in patients with metastatic squamous cell carcinoma (SCC) of the lung after treatment with afatinib compared with erlotinib. A secondary analysis of the LL8 reported that the presence of rare HER2/HER4 mutations may be partly responsible for this result. Patients with HER2 (hazard ratio [HR] 0.06/p-value 0.02) or HER4 (HR 0.21/p-value unreported) mutations had longer PFS after treatment with afatinib. However, the biological function of these mutations is unclear. MATERIALS AND METHODS: Ten HER2 and 13 HER4 point mutations that were detected in the secondary analysis were transduced into the mouse pro-B cell line (Ba/F3) to determine changes in interleukin-3 (IL-3) dependence and sensitivity to six EGFR or pan-HER tyrosine kinase inhibitors (TKIs), including afatinib and erlotinib. The efficacy of the six TKIs was compared using a sensitivity index, defined as the 50% inhibitory concentration divided by trough concentration of each drug at clinically recommended doses. RESULTS: Seven out of 10 Ba/F3 clones expressing HER2 mutations and all 13 Ba/F3 clones expressing HER4 mutations did not grow in the absence of IL-3, indicating these mutations were non-oncogenic. Three Ba/F3 clones expressing the HER2 mutations E395K, G815R, or R929W acquired IL-3-independent growth. The sensitivity indices for afatinib were ≤ one-fifth of those for erlotinib in all three lines. Other second/third-generation (2G/3G) TKIs showed high efficacy against clones expressing these HER2 mutations. CONCLUSIONS: The majority of HER2/4 mutations detected in lung SCC from LL8 were not oncogenic in the Ba/F3 models, suggesting that the presence of HER2/4 mutations were not responsible for the superior outcomes of afatinib in the LL8 study. However, SCC of the lung in some patients may be driven by rare HER2 mutations, and these patients may benefit from 2G/3G pan-HER-TKI treatment.
• ロボット支援下左上葉切除術における左肺動脈第一分枝(A3)切離のアプローチ法の考察

  宗 淳一; 武本 智樹; 小原 秀太; 藤野 智大; 古賀 教将; 濱田 顕; 千葉 眞人; 須田 健一; 光冨 徹哉

  日本胸部外科学会定期学術集会 74回 LOD21 - 4 (一社)日本胸部外科学会 2021年10月
• 病理病期IB-IIA期EGFR変異陽性肺がんに対するUFT術後補助療法の有用性

  須田 健一; 濱田 顕; 小原 秀太; 藤野 智大; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 光冨 徹哉

  肺癌 61 6 594 - 594 (NPO)日本肺癌学会 2021年10月
• 原発性肺癌術後早期の再入院リスクの検討

  小原 秀太; 宗 淳一; 須田 健一; 藤野 智大; 濱田 顕; 千葉 眞人; 下治 正樹; 武本 智樹; 光冨 徹哉

  肺癌 61 6 633 - 633 (NPO)日本肺癌学会 2021年10月
• MET exon 14 skipping変異肺癌に対するType I MET-TKI耐性二次的変異とその克服

  藤野 智大; 須田 健一; 小原 秀太; 濱田 顕; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 光冨 徹哉

  肺癌 61 6 645 - 645 (NPO)日本肺癌学会 2021年10月
• ロボット支援下左上葉切除術における左肺動脈第一分枝(A3)切離のアプローチ法の考察

  宗 淳一; 武本 智樹; 小原 秀太; 藤野 智大; 古賀 教将; 濱田 顕; 千葉 眞人; 須田 健一; 光冨 徹哉

  日本胸部外科学会定期学術集会 74回 LOD21 - 4 (一社)日本胸部外科学会 2021年10月
• Intra-tumor and inter-tumor heterogeneity in MET exon 14 skipping mutations and co-mutations in pulmonary pleomorphic carcinomas

  Toshio Fujino; Kenichi Suda; Kazuko Sakai; Isao Murakami; Shigeki Shimizu; Shuta Ohara; Takamasa Koga; Akira Hamada; Junichi Soh; Kazuto Nishio; Tetsuya Mitsudomi

  Clinical Lung Cancer 2021年09月
• Perioperative Therapy for Non-Small Cell Lung Cancer with Immune Checkpoint Inhibitors.

  Junichi Soh; Akira Hamada; Toshio Fujino; Tetsuya Mitsudomi

  Cancers 13 16 2021年08月 

  The emergence of immune checkpoint inhibitors (ICIs) has dramatically changed the treatment landscape for patients with metastatic non-small cell lung cancer (NSCLC). These achievements inspired investigators and pharmaceutical companies to conduct clinical trials in patients with early-stage NSCLC because both adjuvant and neoadjuvant platinum-based doublet chemotherapies (PT-DCs) showed only a 5% improvement in 5-year overall survival. IMpower010, a phase 3 trial (P3), showed that adjuvant PT-DC followed by maintenance atezolitumab significantly prolonged disease-free survival over adjuvant PT-DC alone (hazard ratio, 0.79; stage II to IIIA). Since conventional therapies, including chemotherapy and radiotherapy, can promote immunogenic cell death, releasing tumour antigens from dead tumour cells, ICI combination therapies with conventional therapies are widely proposed. The Checkmate 816 trial (P3) indicated a significantly higher pathological complete response rate of neoadjuvant nivolumab/PT-DC combination therapy than of neoadjuvant PT-DC alone (odds ratio, 13.9, for stage IB to IIIA). Detection of circulating tumour DNA is highly anticipated for the evaluation of minimal residual disease. Multimodal approaches and new ICI agents are being attempted to improve the efficacy of ICI treatment in phase 2 trials. This review presents the development of perioperative treatment using ICIs in patients with NSCLC while discussing problems and perspectives.
• Activity and mechanism of acquired resistance to tarloxotinib in HER2 mutant lung cancer: an in vitro study.

  Takamasa Koga; Kenichi Suda; Masaya Nishino; Toshio Fujino; Shuta Ohara; Akira Hamada; Junichi Soh; Vijaya Tirunagaru; Avanish Vellanki; Robert C Doebele; Tetsuya Mitsudomi

  Translational lung cancer research 10 8 3659 - 3670 2021年08月 

  Background: HER2 (ERBB2) activating mutations are present in 2-3% of lung adenocarcinomas; however, no targeted therapy is approved for HER2-altered lung cancers. A novel pan-HER inhibitor, tarloxotinib, is designed to release the active form (tarloxotinib-E) under hypoxic conditions in tumor tissues after being administered as a prodrug. Following the evaluation of the in vitro activity of tarloxotinib-E in HER2-mutant cells, we explored the mechanisms of resistance to tarloxotinib-E in these cells. Methods: Growth inhibitory assays were performed with tarloxotinib-E and its prodrug using Ba/F3 cells expressing one of six HER2 mutations or wild-type (WT) HER2, in addition to H1781 cells with HER2 exon 20 insertions. Resistant clones were established from N-ethyl-N-nitrosourea (ENU)-treated HER2-mutant Ba/F3 cells and H1781 cells by chronic exposure to tarloxotinib-E. Results: Tarloxotinib-E showed potent activity against HER2-mutant Ba/F3 cells and H1781 cells. Furthermore, the half maximal inhibitory concentration (IC50) of tarloxotinib (inactive form) for WT HER2 was 180 times higher than that of tarloxotinib-E, indicating a wide therapeutic window of tarloxotinib. We established 30 resistant clones with secondary mutations of HER2 by ENU mutagenesis, all of which harbored C805S in exon 20. In the analysis of H1781 cells that acquired resistance to tarloxotinib-E, we found that increased HER3 expression was the molecular mechanism of tarloxotinib-E resistance. Conclusions: Tarloxotinib-E exhibited potent activity against cell line models with HER2 mutations. We identified a secondary C805S HER2 mutation and HER3 overexpression as the mechanisms of acquired resistance to tarloxotinib-E.
• KRAS Secondary Mutations That Confer Acquired Resistance to KRAS G12C Inhibitors, Sotorasib and Adagrasib, and Overcoming Strategies: Insights From In Vitro Experiments.

  Takamasa Koga; Kenichi Suda; Toshio Fujino; Shuta Ohara; Akira Hamada; Masaya Nishino; Masato Chiba; Masaki Shimoji; Toshiki Takemoto; Takeo Arita; Michael Gmachl; Marco H Hofmann; Junichi Soh; Tetsuya Mitsudomi

  Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer 16 8 1321 - 1332 2021年08月 

  INTRODUCTION: KRAS mutations have been recognized as undruggable for many years. Recently, novel KRAS G12C inhibitors, such as sotorasib and adagrasib, are being developed in clinical trials and have revealed promising results in metastatic NSCLC. Nevertheless, it is strongly anticipated that acquired resistance will limit their clinical use. In this study, we developed in vitro models of the KRAS G12C cancer, derived from resistant clones against sotorasib and adagrasib, and searched for secondary KRAS mutations as on-target resistance mechanisms to develop possible strategies to overcome such resistance. METHODS: We chronically exposed Ba/F3 cells transduced with KRASG12C to sotorasib or adagrasib in the presence of N-ethyl-N-nitrosourea and searched for secondary KRAS mutations. Strategies to overcome resistance were also investigated. RESULTS: We generated 142 Ba/F3 clones resistant to either sotorasib or adagrasib, of which 124 (87%) harbored secondary KRAS mutations. There were 12 different secondary KRAS mutations. Y96D and Y96S were resistant to both inhibitors. A combination of novel SOS1 inhibitor, BI-3406, and trametinib had potent activity against this resistance. Although G13D, R68M, A59S and A59T, which were highly resistant to sotorasib, remained sensitive to adagrasib, Q99L was resistant to adagrasib but sensitive to sotorasib. CONCLUSIONS: We identified many secondary KRAS mutations causing resistance to sotorasib, adagrasib, or both, in vitro. The differential activities of these two inhibitors depending on the secondary mutations suggest sequential use in some cases. In addition, switching to BI-3406 plus trametinib might be a useful strategy to overcome acquired resistance owing to the secondary Y96D and Y96S mutations.
• N2肺癌に対する免疫チェックポイント阻害剤を用いた周術期治療の可能性 WJOG12119L試験

  濱田 顕; 宗 淳一; 大泉 弘幸; 坪井 正博; 堀之内 秀仁; 吉野 一郎; 棚橋 雅幸; 豊岡 伸一; 岡田 守人; 横見瀬 裕保; 山下 素弘; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 S - 5 (NPO)日本呼吸器外科学会 2021年05月
• Uniportal VATSにおけるエンブロックな縦隔リンパ節郭清

  千葉 眞人; 宗 淳一; 小原 秀太; 藤野 智大; 西野 将矢; 古賀 教将; 濱田 顕; 下治 正樹; 須田 健一; 武本 智樹; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 RV9 - 1 (NPO)日本呼吸器外科学会 2021年05月
• 【撤回論文】肺葉切除における単孔式手術とロボット支援下手術の利点・欠点を踏まえたベストマッチアプローチ法の検討

  宗 淳一; 千葉 眞人; 武本 智樹; 小原 秀太; 藤野 智大; 古賀 教将; 濱田 顕; 西野 将矢; 下治 正樹; 須田 健一; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 O19 - 6 (NPO)日本呼吸器外科学会 2021年05月 

  【撤回論文】---当論文については「日本呼吸器外科学会雑誌」35巻3号(2021年発行)の巻末に演題取り下げのお知らせが掲載された。
• ロボット支援下肺葉切除時の気管支損傷の2例

  武本 智樹; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 V11 - 7 (NPO)日本呼吸器外科学会 2021年05月
• 胸腺腫瘍切除例におけるCT値とWHO分類の関連

  下治 正樹; 須田 健一; 小原 秀太; 藤野 智大; 西野 将矢; 古賀 教将; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 MO6 - 5 (NPO)日本呼吸器外科学会 2021年05月
• 高齢者肺癌葉切除における縦隔リンパ節郭清の意義

  西野 将矢; 宗 淳一; 小原 秀太; 藤野 智大; 古賀 教将; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 武本 智樹; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 MO70 - 1 (NPO)日本呼吸器外科学会 2021年05月
• 左B1+2分岐異常領域に発生した小型肺癌の1切除例

  藤野 智大; 須田 健一; 小原 秀太; 西野 将矢; 古賀 教将; 濱田 顕; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 MO90 - 3 (NPO)日本呼吸器外科学会 2021年05月
• 「pN陽性」非小細胞肺がんにおけるすりガラス成分の有無の予後因子としての意義

  須田 健一; 小原 秀太; 西野 将矢; 古賀 教将; 藤野 智大; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 MO99 - 5 (NPO)日本呼吸器外科学会 2021年05月
• N2肺癌に対する免疫チェックポイント阻害剤を用いた周術期治療の可能性 WJOG12119L試験

  濱田 顕; 宗 淳一; 大泉 弘幸; 坪井 正博; 堀之内 秀仁; 吉野 一郎; 棚橋 雅幸; 豊岡 伸一; 岡田 守人; 横見瀬 裕保; 山下 素弘; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 S - 5 (NPO)日本呼吸器外科学会 2021年05月
• Uniportal VATSにおけるエンブロックな縦隔リンパ節郭清

  千葉 眞人; 宗 淳一; 小原 秀太; 藤野 智大; 西野 将矢; 古賀 教将; 濱田 顕; 下治 正樹; 須田 健一; 武本 智樹; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 RV9 - 1 (NPO)日本呼吸器外科学会 2021年05月
• 肺葉切除における単孔式手術とロボット支援下手術の利点・欠点を踏まえたベストマッチアプローチ法の検討

  宗 淳一; 千葉 眞人; 武本 智樹; 小原 秀太; 藤野 智大; 古賀 教将; 濱田 顕; 西野 将矢; 下治 正樹; 須田 健一; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 O19 - 6 (NPO)日本呼吸器外科学会 2021年05月
• ロボット支援下肺葉切除時の気管支損傷の2例

  武本 智樹; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 V11 - 7 (NPO)日本呼吸器外科学会 2021年05月
• 胸腺腫瘍切除例におけるCT値とWHO分類の関連

  下治 正樹; 須田 健一; 小原 秀太; 藤野 智大; 西野 将矢; 古賀 教将; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 MO6 - 5 (NPO)日本呼吸器外科学会 2021年05月
• 高齢者肺癌葉切除における縦隔リンパ節郭清の意義

  西野 将矢; 宗 淳一; 小原 秀太; 藤野 智大; 古賀 教将; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 武本 智樹; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 MO70 - 1 (NPO)日本呼吸器外科学会 2021年05月
• 左B1+2分岐異常領域に発生した小型肺癌の1切除例

  藤野 智大; 須田 健一; 小原 秀太; 西野 将矢; 古賀 教将; 濱田 顕; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 MO90 - 3 (NPO)日本呼吸器外科学会 2021年05月
• 「pN陽性」非小細胞肺がんにおけるすりガラス成分の有無の予後因子としての意義

  須田 健一; 小原 秀太; 西野 将矢; 古賀 教将; 藤野 智大; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 35 3 MO99 - 5 (NPO)日本呼吸器外科学会 2021年05月
• Phase II Study of Neoadjuvant Concurrent Chemo-immuno-radiation Therapy Followed by Surgery and Adjuvant Immunotherapy for Resectable Stage IIIA-B (Discrete N2) Non-small-cell Lung Cancer: SQUAT trial (WJOG 12119L).

  Akira Hamada; Junichi Soh; Akito Hata; Kiyoshi Nakamatsu; Mototsugu Shimokawa; Yasushi Yatabe; Hiroyuki Oizumi; Masahiro Tsuboi; Hidehito Horinouchi; Ichiro Yoshino; Masayuki Tanahashi; Shinichi Toyooka; Morihito Okada; Hiroyasu Yokomise; Motohiro Yamashita; Yasumasa Nishimura; Nobuyuki Yamamoto; Kazuhiko Nakagawa; Tetsuya Mitsudomi

  Clinical lung cancer 22 6 596 - 600 2021年04月 

  INTRODUCTION: We describe our ongoing multicenter, prospective, single-arm, phase II trial of neoadjuvant concurrent chemo-immuno-radiation therapy followed by surgical resection and adjuvant immunotherapy for resectable stage IIIA-B (discrete N2) non-small-cell lung cancer (NSCLC) (registered at the Japan Pharmaceutical Information Center, Clinical Trials Information-195069). PATIENTS AND METHODS: Key inclusion criteria include (1) clinical T1-3/T4 (tumor size) N2 stage IIIA-B NSCLC, and (2) pathologically confirmed N2 without extranodal invasion (based on diagnostic imaging). Patients will receive concurrent chemoradiotherapy (carboplatin [area under the curve = 2] and paclitaxel [40 mg/m2] on days 1, 8, 15, 22, and 29, with involved-field radiation therapy [RT] [dose 50 Gy] on days 1-25) and neoadjuvant immunotherapy (durvalumab [1500 mg] on days 1 and 29). Surgical resection with mediastinal lymph node dissection is performed within 2 to 6 weeks after RT. Consolidation therapy with durvalumab is administered for up to 1 year after surgery. The primary endpoint is major pathologic response (MPR) (≤10% residual viable tumor) according to the central pathological assessment. Secondary endpoints are progression-free survival, overall survival, and safety. The sample size is planned to be 31 patients based on the exact binomial distribution with a 1-sided significance level of 5% and a power of 80%, and assuming a threshold MPR rate of 40% and an expected MPR rate of 65%. CONCLUSION: This trial will help establish a novel treatment strategy for resectable N2-positive NSCLC.
• Outcome of thoracoscopic anatomical sublobar resection under 3-dimensional computed tomography simulation.

  Akira Hamada; Hiroyuki Oizumi; Hirohisa Kato; Jun Suzuki; Kenta Nakahashi; Satoshi Takamori; Ri Sho; Mitsuaki Sadahiro

  Surgical endoscopy 2021年04月 

  BACKGROUND: Previous studies have reported the feasibility and efficacy of thoracoscopic anatomical sublobar resection under three-dimensional computed tomography (3DCT) simulation; however, its long-term outcomes have not been clearly established in primary lung cancer. This study aimed to evaluate the long-term outcomes of this technique. METHODS: We retrospectively reviewed data from 112 consecutive patients with selected clinical stage IA non-small cell lung cancer (NSCLC) who underwent thoracoscopic anatomical sublobar resection from 2004 to 2014. This procedure was planned using preoperative 3DCT simulation to ensure sufficient surgical margins and enabled tailor-made surgery for each patient. Patients who had predominantly ground glass opacity lung cancers underwent anatomical sublobar resection as a curative-intent resection. Other patients who were high-risk candidates for lobectomy underwent anatomical sublobar resection as a compromised limited resection. RESULTS: Of the 112 cases, 82 had a curative-intent resection, while 30 had a compromised limited resection. Recurrence occurred in only 2 cases (1.8%), both of which were in the compromised limited group. A second primary lung cancer was observed in 5 cases (4.5%). Of the 5 patients, 4 underwent surgery for a second cancer and had no recurrence. The 5-year overall survival, lung cancer-specific overall survival, and recurrence-free survival rates were 92.5%, 100%, and 98.2%, respectively, for all cases; 97.6%, 100%, and 100%, respectively, in the curative-intent group; and 75.8%, 100% and 92.6%, respectively, in the compromised limited group. CONCLUSIONS: Thoracoscopic anatomical sublobar resection under 3DCT simulation may be an acceptable alternative treatment in selected patients with NSCLC. TRIAL AND CLINICAL REGISTRY: Clinical registration number: IRB No. 2020-98 (Dated: 2020.6.30).
• 外科における多施設臨床試験の意義と方向性 肺癌における医師主導治験の経験

  濱田 顕; 宗 淳一; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 千葉 眞人; 下治 正樹; 須田 健一; 武本 智樹; 光冨 徹哉

  日本外科学会定期学術集会抄録集 121回 NES - 1 (一社)日本外科学会 2021年04月
• 肺癌根治術におけるアプローチ法の優劣:特にリンパ節郭清について-RATS、multiple port VATS、single port VATS- 当院におけるUniportal VATSリンパ節郭清の工夫

  千葉 眞人; 中野 大哉; 小原 秀太; 藤野 智大; 西野 将矢; 古賀 教将; 濱田 顕; 須田 健一; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 121回 DB - 2 (一社)日本外科学会 2021年04月
• ヒト胸郭モデルと豚心肺モデルを用いたハンズオンによる手技の教育と修練システムの構築

  武本 智樹; 櫻井 真倫; 神波 奈央子; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 121回 SF - 1 (一社)日本外科学会 2021年04月
• ロボット支援下肺葉切除術時の胸壁損傷を考察する

  宗 淳一; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 須田 健一; 武本 智樹; 光冨 徹哉

  日本外科学会定期学術集会抄録集 121回 SF - 5 (一社)日本外科学会 2021年04月
• 胸腺上皮性腫瘍切除例におけるFDG-PETのSUVmax値と病理学的所見の関連

  下治 正樹; 須田 健一; 小原 秀太; 藤野 智大; 古賀 教将; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 121回 PS - 4 (一社)日本外科学会 2021年04月
• EGFR野生型非小細胞肺癌における術前血清フィブリノゲン値の臨床的意義の検討

  小原 秀太; 須田 健一; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 121回 PS - 6 (一社)日本外科学会 2021年04月
• 右肺S3区域切除後の残存上葉に高度鬱血をきたしたが、保存的加療で軽快した1切除例

  櫻井 真倫; 武本 智樹; 神波 奈央子; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 121回 RS - 9 (一社)日本外科学会 2021年04月
• MET exon14 skipping変異陽性肺多形癌におけるintra-およびinter-tumor heterogeneityの検討

  藤野 智大; 須田 健一; 坂井 和子; 清水 重喜; 小原 秀太; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 西尾 和人

  日本外科学会定期学術集会抄録集 121回 SF - 4 (一社)日本外科学会 2021年04月
• MET exon14 skipping変異陽性肺多形癌におけるintra-およびinter-tumor heterogeneityの検討

  藤野 智大; 須田 健一; 坂井 和子; 清水 重喜; 小原 秀太; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 下治 正樹; 武本 智樹; 宗 淳一; 西尾 和人

  日本外科学会定期学術集会抄録集 121回 SF - 4 (一社)日本外科学会 2021年04月
• Dose-dependence in acquisition of drug tolerant phenotype and high RYK expression as a mechanism of osimertinib tolerance in lung cancer.

  Shuta Ohara; Kenichi Suda; Toshio Fujino; Akira Hamada; Takamasa Koga; Masaya Nishino; Masato Chiba; Masaki Shimoji; Toshiki Takemoto; Junichi Soh; Tetsuya Mitsudomi

  Lung cancer (Amsterdam, Netherlands) 154 84 - 91 2021年04月 

  OBJECTIVE: Emergence of acquired resistance is almost inevitable during EGFR-tyrosine kinase inhibitor therapy for non-small-cell lung cancer (NSCLC) harboring EGFR mutations. Drug tolerance, a reversible state of drug insensitivity in the early phases of tyrosine kinase inhibitor therapy, is considered to serve as the basis of recurrent disease. Therefore, it is important to elucidate the molecular mechanisms of drug tolerance. MATERIALS AND METHODS: Five EGFR-mutated NSCLC cell lines were used in this study. We established drug-tolerant cells (DTCs) via 72 h treatment with osimertinib (600 nM) or afatinib (60 nM). Acquisition of drug tolerance was evaluated by growth inhibitory assay, and the molecular mechanisms of drug tolerance were analyzed by phospho-RTK array. RESULTS: DTCs were successfully induced in PC9, HCC4006, and H1975 cells against osimertinib and in PC9 cells against afatinib. We observed that a high drug concentration was required to induce DTCs, and HCC4006 cells become tolerant when a higher dose of afatinib (>180 nM) was used. In the analysis of HCC4006 DTCs against osimertinib, we observed increased receptor-like tyrosine kinase (RYK) expression, and siRNA-mediated RYK knockdown inhibited the proliferation of DTCs. CONCLUSIONS: These results suggest that induction of DTCs is dose-dependent, and increased RYK expression was the mechanism of drug tolerance in HCC4006 cells against osimertinib.
• Inter- and Intratumor Heterogeneity of EGFR Compound Mutations in Non-Small Cell Lung Cancers: Analysis of Five Cases.

  Kenichi Suda; Kazuko Sakai; Keiko Obata; Shuta Ohara; Toshio Fujino; Takamasa Koga; Akira Hamada; Junichi Soh; Kazuto Nishio; Tetsuya Mitsudomi

  Clinical lung cancer 22 2 e141-e145  2021年03月 

  BACKGROUND: Several clinical and preclinical studies suggest that non-small cell lung cancers (NSCLCs) with EGFR compound mutations were associated with lower efficacies of first-generation EGFR inhibitors than tumors with single EGFR mutation. Some researchers hypothesize that EGFR mutation status is heterogeneous in such tumors and that second-generation EGFR inhibitors may eliminate cancer cells with uncommon EGFR mutations from tumors with EGFR compound mutations. However, this hypothesis is currently unproven; therefore, we performed the current study to determine if tumor cells with EGFR compound mutations are present in heterogeneous or homogeneous manners. PATIENTS AND METHODS: Multiregion analysis was performed for surgically resected primary NSCLC tumors with EGFR compound mutations to examine the intratumor heterogeneity of EGFR compound mutations. In addition, we evaluated the intertumor heterogeneity of EGFR compound mutations using 2 pleural disseminations obtained from a patient with NSCLC at exploratory thoracotomy and 9 primary or metastatic lesions obtained from 2 autopsied NSCLC patients. Digital polymerase chain reaction, target sequencing, or direct sequencing were used to detect EGFR mutations. RESULTS: This study included 5 NSCLC cases; their compound mutations were L858R+S768I, G719X+S768I, G719A+R776H, L858R+E709G, and L858R+I759M. Noncancerous pulmonary tissues from each patient did not harbor EGFR mutations, which revealed that all mutations were somatic. We did not detect any intra- or intertumor heterogeneity in these EGFR compound mutations. CONCLUSION: No intra- or intertumor heterogeneity was observed for EGFR compound mutations. Our results indicate that both EGFR mutations were truncal and selective elimination of cancer cells with uncommon EGFR mutations is unrealistic.
• The prevalence and risk factors associated with preoperative deep venous thrombosis in lung cancer surgery.

  Toshiki Takemoto; Junichi Soh; Shuta Ohara; Toshio Fujino; Takamasa Koga; Masaya Nishino; Akira Hamada; Masato Chiba; Masaki Shimoji; Kenichi Suda; Kenji Tomizawa; Tetsuya Mitsudomi

  Surgery today 51 9 1480 - 1487 2021年02月 

  PURPOSE: Few studies have so far focused on the preoperative presence of venous thromboembolism (VTE) in lung cancer patients undergoing surgery. In this study, we investigated the prevalence and risk factors for preoperative deep venous thrombosis (DVT) in patients scheduled to undergo lung cancer surgery. METHODS: Between June 2013 and December 2018, 948 consecutive patients underwent lung cancer surgery in Kindai University Hospital. Four patients did not undergo screening for DVT; thus, 944 patients were enrolled in this study. Preoperatively, venous ultrasonography of the lower extremities was performed in patients deemed at risk for DVT, and the prevalence and risk factors for preoperative DVT were examined. RESULTS: Ninety-one patients (9.6%) were diagnosed with preoperative DVT, and postoperative symptomatic pulmonary thromboembolism occurred in one patient (0.11%). A multivariable logistic regression analysis demonstrated that female sex, age ≥ 72 years, history of VTE, a Wells score ≥ 2 points, chronic obstructive pulmonary disease (COPD), and lower hemoglobin levels were significantly associated with preoperative DVT. CONCLUSION: Female sex, age ≥ 72 years, history of VTE, Wells score ≥ 2 points, COPD, and lower hemoglobin levels were identified to be independent risk factors for preoperative DVT. Monitoring for these risk factors and management considering them should help improve the outcomes after lung cancer surgery.
• Salvage surgery after definitive chemoradiotherapy for patients with non-small cell lung cancer.

  Akira Hamada; Junichi Soh; Tetsuya Mitsudomi

  Translational lung cancer research 10 1 555 - 562 2021年01月 

  Definitive chemoradiotherapy (CRT) has been a standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC). However, locoregional recurrence occurs in about 30% of patients after definitive CRT. Recently, the addition of durvalumab as maintenance therapy has shown to improve the outcome of these patients. However, locoregional recurrence will still remain. "Salvage surgery" has been performed to achieve local control in clinical practice, although its clinical significance is unclear. In this review, we define salvage surgery as lung resection for local control of the tumor which was not planned initially, after failure or insufficient treatment effect of the initial CRT for locally advanced cancer and evaluated nine studies to gain some insights on its role in the treatment of lung cancer. The time from radiotherapy (RT) to salvage surgery varied considerably (range, 3 to 282 weeks). Salvage surgery was performed for persistent disease (47%) and locoregional recurrence (52%). Lobectomy (63%) and mediastinal lymph node dissections (90%) were the most common procedures. However, the rate of pneumonectomy was higher in salvage surgery (28%) compared to that in lung resection in general. The median morbidity was 41% (range, 15% to 62%) and the mortality was 4% (range, 0 to 11%) which appeared acceptable. The median recurrence-free survival and overall survival (OS) after salvage surgery ranged from 10 to 22 months and 13 to 76 months, respectively. Favorable prognostic factors of salvage surgery were longer period from RT to salvage surgery and radiological downstaging. The pathological response was also prognostic, although this information cannot be obtained preoperatively. We conclude that salvage surgery can be considered especially for those with late local recurrence or those with the metabolic response. Given the condition where phase III trials are difficult, the accumulation of real-world evidence in a prospective fashion will be necessary.
• 肺癌根絶のための周術期治療

  宗 淳一; 濱田 顕; 光冨 徹哉

  肺癌 60 Suppl. 891 - 894 (NPO)日本肺癌学会 2020年11月
• Prognostic value of plasma fibrinogen and D-dimer levels in patients with surgically resected non-small cell lung cancer.

  Shuta Ohara; Kenichi Suda; Kenji Tomizawa; Toshiki Takemoto; Toshio Fujino; Akira Hamada; Takamasa Koga; Masaya Nishino; Masato Chiba; Katsuaki Sato; Masaki Shimoji; Junichi Soh; Tetsuya Mitsudomi

  Surgery today 50 11 1427 - 1433 2020年11月 [査読有り]
   

  PURPOSE: A high plasma level of either fibrinogen or D-dimer has been shown to correlate with a poor prognosis in patients with surgically resected non-small-cell lung cancer (NSCLC). The present study aimed to identify whether or not both markers combined had a superior prognostic value to either alone. METHODS: Of the 1344 patients who underwent surgical resection for NSCLC at our institution between January 2007 and December 2016, 1065 had preoperative plasma fibrinogen and D-dimer data available and were included in the analysis. RESULTS: The recurrence-free survival (RFS) and overall survival (OS) rates were similar for patients with high plasma levels of either or both fibrinogen (> 4.0 g/L) or D-dimer (> 1.0 μg/mL); therefore, these three groups were combined for a further analysis into a single group with high plasma levels of either or both proteins. The high-level group had significantly lower 5-year RFS (53% vs. 68%, p < 0.001) and 5-year OS (65% vs. 80%, p < 0.001) rates than patients with normal plasma levels of fibrinogen and D-dimer (control group). CONCLUSIONS: Our results suggest that preoperative tests for both plasma fibrinogen and D-dimer are necessary to identify patients with surgically resected NSCLC likely to have a poor RFS and OS.
• 肺葉切除における単孔式手術とロボット支援下手術の特性と注意点 両術式の導入経験から

  宗 淳一; 千葉 眞人; 武本 智樹; 小原 秀太; 藤野 智大; 濱田 顯; 古賀 教将; 西野 将矢; 下治 正樹; 須田 健一; 光冨 徹哉

  日本胸部外科学会定期学術集会 73回 LRS1 - 10 (一社)日本胸部外科学会 2020年10月
• LUX-Lung 8試験で検出されたHER2変異を有する肺扁平上皮癌におけるアファチニブの有効性に関する検証研究

  濱田 顕; 須田 健一; 藤野 智大; 宗 淳一; 光冨 徹哉

  日本癌学会総会記事 79回 PJ14 - 7 2020年10月
• KRAS G12C阻害剤の感受性ならびに耐性二次変異の検索

  古賀 教将; 須田 健一; 小原 秀太; 藤野 智大; 濱田 顕; 宗 淳一; 光冨 徹哉

  肺癌 60 6 533 - 533 (NPO)日本肺癌学会 2020年10月
• 臨床病期I期肺扁平上皮癌における画像的特徴と治療成績の検討

  宗 淳一; 富沢 健二; 小原 秀太; 藤野 智大; 濱田 顕; 古賀 教将; 西野 将矢; 千葉 眞人; 下治 正樹; 須田 健一; 武本 智樹; 光冨 徹哉

  肺癌 60 6 611 - 611 (NPO)日本肺癌学会 2020年10月
• LUX-Lung 8試験で検出されたHER2変異を有する肺扁平上皮癌におけるアファチニブの有効性に関する検証研究

  濱田 顕; 須田 健一; 藤野 智大; 宗 淳一; 光冨 徹哉

  日本癌学会総会記事 79回 PJ14 - 7 2020年10月
• KRAS G12C阻害剤の感受性ならびに耐性二次変異の検索

  古賀 教将; 須田 健一; 小原 秀太; 藤野 智大; 濱田 顕; 宗 淳一; 光冨 徹哉

  肺癌 60 6 533 - 533 (NPO)日本肺癌学会 2020年10月
• 臨床病期I期肺扁平上皮癌における画像的特徴と治療成績の検討

  宗 淳一; 富沢 健二; 小原 秀太; 藤野 智大; 濱田 顕; 古賀 教将; 西野 将矢; 千葉 眞人; 下治 正樹; 須田 健一; 武本 智樹; 光冨 徹哉

  肺癌 60 6 611 - 611 (NPO)日本肺癌学会 2020年10月
• Spatial heterogeneity of acquired resistance mechanisms to 1st/2nd generation EGFR tyrosine kinase inhibitors in lung cancer.

  Kenichi Suda; Isao Murakami; Keiko Obata; Kazuko Sakai; Toshio Fujino; Takamasa Koga; Shuta Ohara; Akira Hamada; Junichi Soh; Kazuto Nishio; Tetsuya Mitsudomi

  Lung cancer (Amsterdam, Netherlands) 148 100 - 104 2020年10月 

  BACKGROUND: Overcoming acquired resistance against targeted therapies to improve outcomes of lung cancer patients harboring driver mutations is a critical issue. While drug therapy oriented to a resistance mechanism appears attractive, spatial heterogeneity of resistance mechanisms in each patient will diminish treatment efficacy. However, the frequency, clinical backgrounds, clinical implications, and patterns of spatial heterogeneity in resistance mechanisms to EGFR tyrosine kinase inhibitors (TKIs) are largely unknown. PATIENTS AND METHODS: This study included 128 specimens from 24 autopsied patients with lung adenocarcinoma harboring EGFR mutation. Acquired resistance mechanisms reported as relatively frequent in lung cancer, e.g., T790 M and other secondary EGFR mutations, MET and ERBB2 gene amplification, and histological transformation, were retrospectively examined. All patients had received 1st/2nd generation EGFR-TKI and showed acquired resistance to the drug before death. No patient received osimertinib. RESULTS: No resistance mechanism was identified in two patients. T790M mutation was detected in 20 patients (83 %); however, nine of these patients also had lesions without T790M mutation. Among 22 patients whose resistance mechanisms were identified, ten had spatial heterogeneity of resistance mechanisms (45 %), and these patients had significantly shorter time-to-treatment failure compared with those without heterogeneity (median 4.7 months vs. 14.7 months, p = 0.0004). CONCLUSION: We observed significant spatial heterogeneity of acquired resistance mechanisms to EGFR-TKIs in lung adenocarcinoma. Our results also indicate that the incidence of resistance mechanisms may vary based on the biopsied tumor locations.
• Prognostic implications of preoperative versus postoperative circulating tumor DNA in surgically resected lung cancer patients: a pilot study.

  Shuta Ohara; Kenichi Suda; Kazuko Sakai; Masaya Nishino; Masato Chiba; Masaki Shimoji; Toshiki Takemoto; Toshio Fujino; Takamasa Koga; Akira Hamada; Junichi Soh; Kazuto Nishio; Tetsuya Mitsudomi

  Translational lung cancer research 9 5 1915 - 1923 2020年10月 

  Background: Recent studies of advanced lung cancer patients have shown that circulating tumor DNA (ctDNA) analysis is useful for molecular profiling, monitoring tumor burden, and predicting therapeutic efficacies and disease progression. However, the usefulness of ctDNA analysis in surgically resected lung cancers is unclear. Methods: This study included 20 lung cancer patients with clinical stage IIA-IIIA disease. Preoperative and postoperative (3-12 days) plasma samples were collected for ctDNA analysis. Cancer personalized profiling by deep sequencing, which can detect mutations in 197 cancer-related genes, was used for ctDNA detection. The cohort consisted of 18 men and 2 women with a median age of 69 (range, 37-88) years. Sixteen patients (80%) had a history of smoking. Histologically, there were four squamous cell carcinomas, 13 adenocarcinomas, two adenosquamous cell carcinomas, and one small cell carcinoma. Results: At the time of data analysis, the 20 patients had been monitored for a median follow-up of 12 months. Eight patients (40%) were positive for preoperative ctDNA, and this was significantly correlated with tumor size (≥5 vs. <5 cm, P=0.018). Four patients (20%) were positive for postoperative ctDNA, and this was significantly correlated with histological grade (3 vs. 1 or 2, P=0.032). Postoperative positivity for ctDNA also predicted shorter recurrence-free survival (RFS) (P=0.015), while pre- and post-operative carcinoembryonic antigen levels (P=0.150 and P=0.533, respectively) and preoperative positivity for ctDNA (P=0.132) were not correlated with RFS. Conclusions: Detecting ctDNA postoperatively was a poor prognostic factor in surgically resected lung cancer patients that may suggest there is minimal residual disease (MRD).
• 新規低侵襲(単孔式・ロボット支援)手術におけるヒヤリハット Uniportal VATSにおけるヒヤリハット 逸脱例からの考察

  千葉 眞人; 福田 祥大; 小原 秀太; 藤野 智大; 西野 将矢; 古賀 教将; 濱田 顕; 須田 健一; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 VWS2 - 2 (NPO)日本呼吸器外科学会 2020年08月
• ロボット支援下肺葉切除術導入時のヒヤリハットを考察する 胸壁損傷とその対策

  宗 淳一; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顯; 千葉 眞人; 須田 健一; 武本 智樹; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 V1 - 4 (NPO)日本呼吸器外科学会 2020年08月
• 80代IA期非小細胞肺癌の手術成績 GGO成分の有無別の検討

  濱田 顕; 須田 健一; 西野 将矢; 千葉 眞人; 武本 智樹; 宗 淳一; 塩野 知志; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 O35 - 1 (NPO)日本呼吸器外科学会 2020年08月
• ヒト胸郭モデルと豚摘出肺を用いた研修医教育の取り組み

  武本 智樹; 福田 祥太; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 O39 - 4 (NPO)日本呼吸器外科学会 2020年08月
• 切除肺に10個以上の病変を認めた多発肺腺癌の3例

  古賀 教将; 須田 健一; 福田 祥大; 小原 秀太; 藤野 智大; 西野 将矢; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 MO10 - 6 (NPO)日本呼吸器外科学会 2020年08月
• 異所性子宮内膜症由来が疑われた横隔膜明細胞癌の1切除例

  波江野 真大; 武本 智樹; 福田 祥太; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 太田 真見子; 前西 修; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 MO29 - 1 (NPO)日本呼吸器外科学会 2020年08月
• 非小細胞肺癌における術前NLR高値は、腫瘍のPD-L1発現と関連する

  藤野 智大; 須田 健一; 下治 正樹; 濱田 顕; 小原 秀太; 古賀 教将; 西野 将矢; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 MO36 - 5 (NPO)日本呼吸器外科学会 2020年08月
• 掻把術にて根治できなかった難治性術後膿胸に対するクリスタルバイオレットを用いた胸腔内洗浄の有用性

  須田 健一; 小原 秀太; 西野 将矢; 古賀 教将; 藤野 智大; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 MO59 - 1 (NPO)日本呼吸器外科学会 2020年08月
• 新規低侵襲(単孔式・ロボット支援)手術におけるヒヤリハット Uniportal VATSにおけるヒヤリハット 逸脱例からの考察

  千葉 眞人; 福田 祥大; 小原 秀太; 藤野 智大; 西野 将矢; 古賀 教将; 濱田 顕; 須田 健一; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 VWS2 - 2 (NPO)日本呼吸器外科学会 2020年08月
• ロボット支援下肺葉切除術導入時のヒヤリハットを考察する 胸壁損傷とその対策

  宗 淳一; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顯; 千葉 眞人; 須田 健一; 武本 智樹; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 V1 - 4 (NPO)日本呼吸器外科学会 2020年08月
• 80代IA期非小細胞肺癌の手術成績 GGO成分の有無別の検討

  濱田 顕; 須田 健一; 西野 将矢; 千葉 眞人; 武本 智樹; 宗 淳一; 塩野 知志; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 O35 - 1 (NPO)日本呼吸器外科学会 2020年08月
• ヒト胸郭モデルと豚摘出肺を用いた研修医教育の取り組み

  武本 智樹; 福田 祥太; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 O39 - 4 (NPO)日本呼吸器外科学会 2020年08月
• 切除肺に10個以上の病変を認めた多発肺腺癌の3例

  古賀 教将; 須田 健一; 福田 祥大; 小原 秀太; 藤野 智大; 西野 将矢; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 MO10 - 6 (NPO)日本呼吸器外科学会 2020年08月
• 異所性子宮内膜症由来が疑われた横隔膜明細胞癌の1切除例

  波江野 真大; 武本 智樹; 福田 祥太; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 下治 正樹; 須田 健一; 太田 真見子; 前西 修; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 MO29 - 1 (NPO)日本呼吸器外科学会 2020年08月
• 非小細胞肺癌における術前NLR高値は、腫瘍のPD-L1発現と関連する

  藤野 智大; 須田 健一; 下治 正樹; 濱田 顕; 小原 秀太; 古賀 教将; 西野 将矢; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 MO36 - 5 (NPO)日本呼吸器外科学会 2020年08月
• 掻把術にて根治できなかった難治性術後膿胸に対するクリスタルバイオレットを用いた胸腔内洗浄の有用性

  須田 健一; 小原 秀太; 西野 将矢; 古賀 教将; 藤野 智大; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本呼吸器外科学会雑誌 34 3 MO59 - 1 (NPO)日本呼吸器外科学会 2020年08月
• 非小細胞肺癌に対する積極的縮小手術の適応と限界【International】臨床病期I期の充実型非小細胞肺癌患者における部分切除の臨床転帰(Clinical outcome of partial resection in the patients with completely solid non-small cell lung cancer of clinical stage I)

  宗 淳一; 小原 秀太; 藤野 智大; 濱田 顕; 古賀 教将; 西野 将矢; 千葉 眞人; 須田 健一; 武本 智樹; 光冨 徹哉

  日本外科学会定期学術集会抄録集 120回 SY - 6 (一社)日本外科学会 2020年08月
• Nerve Integrity Monitoring(NIM)を用いて反回神経の走行を確認した右側大動脈弓を有する左上葉肺癌の1切除例

  老木 華; 須田 健一; 西野 将矢; 千葉 眞人; 小原 秀太; 藤野 智大; 古賀 教将; 濱田 顕; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 120回 RS - 1 (一社)日本外科学会 2020年08月
• 肺腫瘍切除検体由来のLung Tumor Organoidの樹立と解析

  古賀 教将; 須田 健一; 小原 秀太; 藤野 智大; 西野 将矢; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 120回 SF - 2 (一社)日本外科学会 2020年08月
• Pure solidを呈するもPET陰性であった原発性肺癌の臨床病理学的特徴

  須田 健一; 小原 秀太; 西野 将矢; 藤野 智大; 古賀 教将; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 120回 SF - 7 (一社)日本外科学会 2020年08月
• 非小細胞肺癌切除例における血液型の臨床的意義

  小原 秀太; 須田 健一; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 120回 DP - 2 (一社)日本外科学会 2020年08月
• 非小細胞肺癌切除例における予後栄養指数 低BMI症例においても予後不良因子となるか?

  西野 将矢; 須田 健一; 小原 秀太; 藤野 智大; 古賀 教将; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 120回 DP - 3 (一社)日本外科学会 2020年08月
• 浸潤性腺癌における亜型の充実型・微小乳頭型の有無による臨床病理学的特徴の解析

  武本 智樹; 福田 祥太; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 須田 健一; 宗 淳一; 光冨 徹哉

  日本外科学会定期学術集会抄録集 120回 DP - 1 (一社)日本外科学会 2020年08月
• Next-generation sequencing(NGS)を用いたctDNAの外科切除症例における再発予測因子としての意義

  小原 秀太; 須田 健一; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉; 小原 秀太; 坂井 和子; 西尾 和人

  肺癌 60 2 156 - 157 (NPO)日本肺癌学会 2020年04月
• 肺癌切除検体を用いたLung tumor organoidの樹立と解析

  古賀 教将; 須田 健一; 小原 秀太; 藤野 智大; 西野 将矢; 濱田 顯; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  肺癌 60 2 160 - 160 (NPO)日本肺癌学会 2020年04月
• The preoperative assessment of subpleural lung cancer movement to distinguish thoracic wall adhesion or invasion using four-dimensional computed-tomography.

  Jun Suzuki; Hiroyuki Oizumi; Hikaru Watarai; Akira Hamada; Kenta Nakahashi; Satoshi Takamori; Mitsuaki Sadahiro

  General thoracic and cardiovascular surgery 67 12 1097 - 1099 2019年12月 [査読有り]
   

  Four-dimensional computed tomography (4DCT) is a relatively new technology. A review of the relevant medical literature reveals only very limited previous investigations of the utility of this technique. We report two cases of lung cancer located adjacent to the pleura in which 4DCT was used to assess parietal pleural invasion or adhesion based on the differential movements of tumors. We performed 4DCT to determine the surgical approach after obtaining appropriate informed consent from the patient. Based on 4DCT, Patient 1 showed there was no adhesion and we could perform thoracoscopic right lower lobectomy and the final pathological diagnosis was pT1bN0M0. Patient 2 Based on 4DCT, showed suspicious of invasion or adhesion. we performed chest wall resection because of tumor invasion in the eighth and ninth costal bones; a final pathological diagnosis of pT3N0M0 was made.
• Next-generation sequencing(NGS)を用いた外科切除症例における再発予測因子としての意義

  小原 秀太; 須田 健一; 坂井 和子; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 西尾 和人; 光冨 徹哉

  肺癌 59 6 698 - 698 (NPO)日本肺癌学会 2019年11月
• 第8版Stage分類の妥当性と問題点 IA期非小細胞肺がんの予後は腫瘍径よりGGO成分の有無に依存する

  濱田 顕; 須田 健一; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 千葉 眞人; 武本 智樹; 宗 淳一; 塩野 知志; 光冨 徹哉

  肺癌 59 6 565 - 565 (NPO)日本肺癌学会 2019年11月
• 早期社会復帰を目指したチーム医療の取り組み 胸部手術患者における早期社会復帰を目指した訪問看護ステーションとの連携

  武本 智樹; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 須田 健一; 宗 淳一; 光冨 徹哉

  肺癌 59 6 591 - 591 (NPO)日本肺癌学会 2019年11月
• Occultリンパ節転移の予測因子に関する検討

  古賀 教将; 須田 健一; 小原 秀太; 藤野 智大; 西野 将矢; 濱田 顯; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  肺癌 59 6 679 - 679 (NPO)日本肺癌学会 2019年11月
• MET exon14 skipping変異陽性多形癌におけるInter-tumor Heterogeneityの検討

  藤野 智大; 須田 健一; 村上 功; 小原 秀太; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  肺癌 59 6 695 - 695 (NPO)日本肺癌学会 2019年11月
• Uniportal VATS導入と定型化

  千葉 眞人; 武本 智樹; 福田 祥大; 小原 秀太; 藤野 智大; 西野 将矢; 古賀 教将; 濱田 顕; 須田 健一; 宗 淳一; 光冨 徹哉

  肺癌 59 6 718 - 718 (NPO)日本肺癌学会 2019年11月
• 人生100年時代の肺がん治療 外科医の立場から

  宗 淳一; 富沢 健二; 武本 智樹; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 須田 健一; 杉本 誠一郎; 豊岡 伸一; 光冨 徹哉

  肺癌 59 6 853 - 853 (NPO)日本肺癌学会 2019年11月
• Influx of air into the left atrium during lung resection.

  Kenta Nakahashi; Hiroyuki Oizumi; Jun Suzuki; Akira Hamada; Hikaru Watarai; Satoshi Takamori; Mitsuaki Sadahiro

  General thoracic and cardiovascular surgery 67 10 880 - 883 2019年10月 [査読有り]
   

  OBJECTIVES: In this study, we aimed to determine conditions associated with the development of air bubbles in the pulmonary veins during lung resection. METHODS: A total of 28 patients who underwent lung resection at our institution between October 2016 and March 2018 were included in the study. An intraoperative transesophageal echocardiography was conducted, and the influx of air bubbles in the orifice of the pulmonary vein leading to the left atrium was observed during lung resection. RESULTS: The median age of all patients was 75 years. The study included 13 men and 15 women. Moreover, seven, 14, and seven patients underwent wedge resection, segmentectomy, and lobectomy, respectively. The presence of air bubbles was observed in 15 patients and was detected when the lung parenchyma was cut (13 patients) or compressed (3 patients) using staplers and when an energy device was used (1 patient). No postoperative organ infarction occurred in any patients. CONCLUSIONS: Although the presence of air bubbles was noted in the pulmonary vein during lung resection via transesophageal echocardiography, the clinical condition of the patients in our study did not deteriorate. The clinical significance of air bubbles is not clear. Therefore, more data about such events must be collected in future.
• MET exon 14 skippingモデルを用いたMET-TKI耐性に関わる二次的変異の探索(Comprehensive analysis of secondary resistant mutations to MET-TKIs for MET exon 14 skipping in vitro)

  藤野 智大; 須田 健一; 小林 祥久; 古賀 教将; 西野 将矢; 小原 秀太; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  日本癌学会総会記事 78回 P - 3139 2019年09月
• Uniportal VATS 50例の経験

  千葉 眞人; 武本 智樹; 福田 祥大; 小原 秀太; 藤野 智大; 西野 将矢; 濱田 顕; 古賀 教将; 須田 健一; 宗 淳一; 光冨 徹哉

  肺癌 59 4 424 - 425 (NPO)日本肺癌学会 2019年08月
• 切除した右上葉と左S6に計12個の病変を認めた多発肺腺癌の1例

  古賀 教将; 須田 健一; 小原 秀太; 藤野 智大; 西野 将矢; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉

  肺癌 59 4 428 - 429 (NPO)日本肺癌学会 2019年08月
• [The Novel Procedure for Thoracoscopic Anatomical Segmentectomy].

  Jun Suzuki; Hiroyuki Oizumi; Hirohisa Kato; Akira Hamada; Hikaru Watarai; Kenta Nakahashi; Satoshi Takamori; Mitsuaki Sadahiro

  Kyobu geka. The Japanese journal of thoracic surgery 72 7 535 - 542 2019年07月 [査読有り]
   

  Since 2004, over 300 patients have undergone thoracoscopic segmentectomy without mini-thoracotomy. Thoracoscopic segmentectomy is one of the most complicated surgeries. To perform the complex segmentectomies, pre-operative simulation and 3-dimensional multi-detector computed tomography( 3DCT) are both essential for safely performing operations and for securing adequate surgical margins. Comprehension of the intersegmental and intrasegmental veins to visualize the segmental border facilitates an easier parenchymal dissection. We describe our method and knack for creating an inflation-deflation line for lung segmentectomy that could especially be useful in thoracoscopic procedures for seg-mentectomy. The 5-year over overall survival, cancer specific survival and recurrence free survival rates were 91.8%( curative intent 98.1% versus compromised 74.6%), 100% and 98.1%( curative intent 100% versus compromised 93.3%). According to these technical aspects, our method of thoracoscopic segmentectomy is acceptable for selective patient.
• Primary pulmonary mucosa-associated lymphoid tissue lymphoma with amyloid light chain-type amyloidosis.

  Shuta Ohara; Kenji Tomizawa; Shigeki Shimizu; Kenichi Suda; Toshio Fujino; Akira Hamada; Takamasa Koga; Masaya Nishino; Yoshihisa Kobayashi; Katsuaki Sato; Masato Chiba; Masaki Shimoji; Toshiki Takemoto; Junichi Soh; Tetsuya Mitsudomi

  Surgical case reports 5 1 105 - 105 2019年06月 [査読有り]
   

  BACKGROUND: A total of 75% of patients with Sjögren's syndrome are complicated with pulmonary lesions, of which 12% are lymphoma and 6% are amyloid nodules; the coexistence of both is considered to be rare. CASE PRESENTATION: A 67-year-old female with Sjögren's syndrome presented with multiple pulmonary nodules on chest computed tomography. Since a definitive diagnosis by transbronchial biopsy was not obtained, wedge resection of the nodules was performed. Pathologic diagnosis revealed eosinophilic deposition that stained positive with Congo red. In addition, lymphoepithelial lesions and lymphocytic infiltration were observed. Lymphocytes with monoclonal proliferation predominantly had κ chain. Based on these findings, the nodules were diagnosed as mucosa-associated lymphoid tissue (MALT) lymphoma with amyloid deposition. CONCLUSIONS: The combination of these diseases is very rare, and this is the sixth resected case to the best of our knowledge.
• [Pulmonary Adenocarcinoma with Heterotopic Ossification].

  Jun Suzuki; Naoki Kanauchi; Makoto Endo; Akira Hamada; Hikaru Watanabe

  Kyobu geka. The Japanese journal of thoracic surgery 72 5 363 - 366 2019年05月 [査読有り]
   

  BACKGROUND: Although malignant tumor with heterotopic ossification have often been reported, it is very rare in lung cancer. We report a case of primary lung adenocarcinoma with heterotopic ossification. CASE: A 43-year-old woman undergoing a health check was found an abnormal nodular lesion on chest X-ray. Chest computed tomography (CT) showed a calcified tumor, which was diagnosed adenocarcinoma by transbronchial biopsy. Right lower lobectomy and ND2a-2 lymph node dissection was done. Postoperative pathological examination identified the tumor as a bronchioloalveolar adenocarcinoma with other mixed subtypes, associated with ossification containing bone marrow tissue in the tumor. An immunohistochemical examination showed that cancer cells around the ossification expressed bone morphogenetic protein-2 and osteopontin, which generally induce and stimulate bone formation. CONCLUSION: This finding may serve to elucidate a probable mechanism for the heterotopic ossification observed in cancer lesions.
• 病理学的鑑別に難渋した肺腺癌再発の診断に網羅的癌遺伝子パネル解析が有用であった1例

  中橋 健太; 大泉 弘幸; 鈴木 潤; 濱田 顕; 阿部 昂平; 佐藤 秀則

  日本呼吸器外科学会雑誌 33 4 436 - 441 特定非営利活動法人 日本呼吸器外科学会 2019年 

  <p>症例は67歳男性．胸部大動脈瘤の精査目的のCTで指摘されたすりガラス影を呈する左肺下葉の結節に対して胸腔鏡下左肺部分切除術を施行し，病理診断はLepidic pattern主体の肺腺癌（pT1miN0M0-IA1 UICC8th）であった．術後2年5ヵ月後に呼吸困難で来院し胸部X線写真で左肺に大量の胸水を認め，CTでは左肺底部に胸膜肥厚を認めた．癌性胸膜炎を疑い胸腔鏡下胸膜生検術を施行し，病理診断は低分化腺癌であった．病理学的に異時多発か再発かの鑑別に難渋したため網羅的癌遺伝子パネル解析を施行し，初回と今回の病変いずれもEGFR p.R521K変異が認められ，かつ体細胞変異が約9割（88%）一致したため再発と診断した．現在，シスプラチン＋ペメトレキセドによる化学療法を施行中である．</p>
• 拡大スリーブ肺葉切除術後遅発性に気管支吻合部末梢側に瘻孔を形成した1例

  鈴木 克幸; 貞弘 光章; 大泉 弘幸; 捧 貴幸; 中橋 健太; 濱田 顕; 渡曾 光; 鈴木 潤; 遠藤 誠; 加藤 博久

  気管支学 41 1 23 - 29 特定非営利活動法人 日本呼吸器内視鏡学会 2019年 

  <p><b>背景．</b>気管支形成術の合併症は吻合部狭窄や気管支胸膜瘻，気管支血管瘻など種々報告されているが，いずれも吻合部自体に関するものである．今回われわれは拡大スリーブ肺葉切除術後に吻合部以外の末梢側気管支に遅発性瘻孔をきたした1例を経験し，その原因・対処法につき考察したので報告する．<b>症例．</b>68歳男性．右上葉肺門部原発で中間気管支幹にまで浸潤する扁平上皮癌（cT2aN1M0-IIB）に対して右上葉＋S⁶区域切除，中間気管支幹切除，気管支形成（右主気管支とB^4＋5，B⁷，B^8-10とを三連銃で形成），肺動脈形成，有茎肋間筋弁による吻合部被覆を施行した．術後1カ月の気管支鏡検査で吻合部末梢側に白苔を認めて虚血が疑われたため，高圧酸素療法などを行った．B¹⁰の側壁（非吻合部）に瘻孔が形成され気管支胸膜瘻をきたしたが，空洞が限局的かつCTで空洞や吻合部付近に接する血管がないことから経過観察とした．現在術後
• Learning curve for port-access thoracoscopic anatomic lung segmentectomy.

  Akira Hamada; Hiroyuki Oizumi; Hirohisa Kato; Jun Suzuki; Kenta Nakahashi; Ri Sho; Mitsuaki Sadahiro

  The Journal of thoracic and cardiovascular surgery 156 5 1995 - 2003 2018年11月 [査読有り]
   

  OBJECTIVES: There have been few prospective randomized studies, but many retrospective studies strongly suggest the benefits of segmentectomy in properly selected patients. The indications for video-assisted thoracic surgery segmentectomy are growing because of the effectiveness and minimal invasiveness of the procedure. The aim of the present study was to analyze the learning curve for video-assisted thoracic surgery segmentectomy procedures in our institution. METHODS: We prospectively collected data from patients undergoing video-assisted thoracic surgery segmentectomy and retrospectively reviewed 252 patients from 2004 to 2015. Operative time, bleeding, and complications were analyzed. The learning curve was evaluated using operative time and the cumulative sum value of operative time in all cases with regard to the leading surgeon and nonleading surgeon at our institution. RESULTS: Once we applied the cumulative sum method to all cases, we obtained a graph for the cumulative sum value of operative time that showed 3 well-differentiated phases: phase 1 (n = 61), the initial learning phase; phase 2 (n = 23), the increased competence phase; and phase 3 (n = 168), the highest skill phase. As we compared phases 1 and 2 with phase 3, we observed significant differences in relation to operative time (P < .001) and bleeding (P < .001). Without level 3 segmentectomy, we observed a significant reduction in operative time after 32 cases for the leading surgeon and a significant reduction in operative time and bleeding after 38 cases for the nonleading surgeon. CONCLUSIONS: The data suggest that the inflection point for the learning curve was achieved after 84 cases in our institution. Therefore, increased aptitude with video-assisted thoracic surgery is achievable within a relatively short time.
• Hyperbaric oxygen therapy for postoperative ischemic bronchitis after resection of lung cancer.

  Makoto Endoh; Hiroyuki Oizumi; Hirohisa Kato; Jun Suzuki; Hikaru Watarai; Akira Hamada; Katsuyuki Suzuki; Kenta Nakahashi; Satoshi Shiono; Mitsuaki Sadahiro

  Journal of thoracic disease 10 11 6176 - 6183 2018年11月 [査読有り]
   

  Background: Hyperbaric oxygen therapy (HBOT) has been used successfully in the treatment of specific ischemic injuries, but has been a little evaluated specifically in postoperative ischemic bronchitis (POIB). The purpose of this study was to evaluate the effect of HBOT when used for POIB after resection of lung cancer. Methods: From January 1999 to December 2016, 1,100 patients underwent lymph node dissection (LND) and either anatomic pulmonary resection or lung resection with bronchoplasty for lung cancer. POIB was diagnosed by bronchoscopy. HBOT was administered after POIB was diagnosed. HBOT comprised one 60-minute session daily in the hyperbaric chamber at 2.0 absolute atmospheres with 100% oxygen. We retrospectively analyzed the clinical course, timing of onset of POIB, outcomes, and any adverse events. Results: Seven patients were identified to have had POIB treated with HBOT, all of whom were men with a smoking history and a median age of 65 years (range, 57-72 years). The operative procedures included three lung resections with bronchoplasty, three right lower lobectomies, and one right middle lobectomy performed owing to torsion of the middle lobe after right upper sleeve lobectomy. All 7 patients underwent subcarinal LND. POIB was diagnosed at a median of 11 days (range, 4-41 days) postoperatively. The median duration of an HBOT session was 7 days (range, 3-11 days). POIB resolved in 5 patients but worsened in 2, both of whom required further surgery. Conclusions: Prospective clinical trials are now needed to confirm the potential benefits of HBOT in POIB.
• Venous phase contrast-enhanced computed tomography facilitates the detection of pulmonary venous tumor thrombus.

  Kenta Nakahashi; Hiroyuki Oizumi; Hirohisa Kato; Jun Suzuki; Akira Hamada; Takayuki Sasage; Mitsuaki Sadahiro

  General thoracic and cardiovascular surgery 66 8 488 - 491 2018年08月 [査読有り]
   

  A 64-year-old woman, with a history of hepatocellular carcinoma, developed recurrent metastatic lung nodules after lung metastasectomy 10 years ago. Computed tomography (CT) revealed tumors in the right middle, and left lower lobes. We planned a right middle lobectomy. Before operating, a contrast-enhanced CT in the pulmonary venous phase revealed a tumor in the pulmonary vein resembling a thrombus, indicating that the CT failed to facilitate accurate diagnosis. Following venous clamping and incision, the intravenous polypoid mass was surgically removed. As contrast-enhanced CT focuses on pulmonary arterial phases and might not detect venous lesions, we highlight the usefulness of venous phase contrast-enhanced CT for detecting pulmonary venous tumor thrombosis. Large lung metastatic carcinomas with venous extension may embolize to distant organs. Therefore, venous phase contrast-enhancement is essential for preoperative assessments of large or persisting metastatic lung tumors.
• Port-access thoracoscopic anatomical lung multiplex subsegmentectomy: S6b-S8a-S9a trisubsegmentectomy.

  Hiroyuki Oizumi; Hirohisa Kato; Jun Suzuki; Akira Hamada; Kenta Nakahashi; Takayuki Sasage; Mitsuaki Sadahiro

  Journal of thoracic disease 10 7 4481 - 4483 2018年07月 [査読有り]
   

  A 77-year-old man with chronic obstructive lung disease was referred to our hospital for further management of his lung nodule. Chest computed tomography (CT) showed a lung nodule that increased in size up to 1.9 cm in the S8a of his left lung. Primary lung cancer was suspected. Thoracoscopic anatomical left S6b-S8a-S9a multiplex subsegmentectomy was performed according to the CT simulation. The operative time was 142 min, and the blood loss was 13 mL. Air leakage was not observed and the chest tube was removed on postoperative day (POD) 1. The final diagnosis was a lepidic adenocarcinoma, and he lives well without recurrence in this 4-year period after the surgery.
• Pedicled gastric seromuscular patch for one-stage closure of a bronchopleural fistula: a case report.

  Jun Suzuki; Hiroyuki Oizumi; Hirohisa Kato; Akira Hamada; Hikaru Watarai; Kenta Nakahashi; Takayuki Sasage; Mitsuaki Sadahiro

  Surgical case reports 4 1 38 - 38 2018年04月 [査読有り]
   

  BACKGROUND: One-stage closure and fenestration are the available surgical options for bronchopleural fistula (BPF). One-stage closure may be applicable in cases with favorable infection control. Closing the bronchopleural stump is difficult due to thick adhesion caused by inflammation and a high risk of pulmonary artery injury. We report the successful closure of a BPF using a gastric seromuscular patch with an omental pedicle flap. CASE PRESENTATION: A 73-year-old man underwent right lower lobectomy with ND2a-2 lymph node dissection for lung adenocarcinoma. He was admitted to a local hospital for pneumonia. Three days after admission, his thoracic cavity was drained and a BPF was suspected. During the primary operation, the latissimus dorsi muscle and anterior serratus muscle were dissected via posterolateral incision, and we decided to close the fistula using the gastric seromuscular layer and omental pedicle flap. The patient was discharged 20 days after surgery. After 2 years, he has not had cancer recurrence and currently leads an active life. CONCLUSIONS: This method provided immediate airtight closure and luminal opening of the middle bronchus in our patient with a large BPF and appeared superior to using the omentum alone. This procedure is useful for one-stage closure and does not require fenestration in cases with favorable infection control.
• Determination of the intersegmental plane using the slip-knot method.

  Makoto Endoh; Hiroyuki Oizumi; Hirohisa Kato; Jun Suzuki; Hikaru Watarai; Akira Hamada; Katsuyuki Suzuki; Kenta Nakahashi; Mitsuaki Sadahiro

  Journal of thoracic disease 10 Suppl 10 S1222-S1228 - S1228 2018年04月 [査読有り]
   

  Background: Visualization of intersegmental planes in the lung is desirable for precise anatomical lung segmentectomy. We developed the slip-knot method for creating inflation-deflation lines. This study aimed to assess relevant data for thoracoscopic segmentectomy performed using this method. Methods: In the slip-knot method, the objective segmental bronchus is looped with a monofilament thread. One end of the thread is then pulled during temporary bilateral ventilation, causing the knot to slip toward the bronchus. Thereafter, bronchial ligation is tightened to block the outflow of segmental air, ensuring that the segment remains expanded while the other reserved segments collapse on resumption of unilateral ventilation. Data from 221 patients who underwent thoracoscopic pulmonary segmentectomy between 2010 and 2016 were analyzed. Results: A total of 147 patients (67%) were indicated for the slip-knot method, and 74 cases (33%) were non-adaptive cases. Ninety six percent of 147 cases were well adapted to the slip-knot method, which allowed us to obtain good inflation-deflation line images to determine the intersegmental plane. The mean operative time was 171±51 min (range, 71-367 min). The mean duration of chest tube insertion was 1.5±1.2 days (range, 1-7 days). Three cases (2.0%) had prolonged air-leakage and one (0.7%) case had readmission for late air-leakage. Conclusions: Our method enables determination of anatomical intersegmental planes using only one monofilament thread, thus facilitating thoracoscopic pulmonary anatomical segmentectomy.
• What is the most appropriate procedure for intraoperative localization of small pulmonary nodules?

  Hirohisa Kato; Hiroyuki Oizumi; Jun Suzuki; Akira Hamada; Hikaru Watarai; Kenta Nakahashi; Mitsuaki Sadahiro

  Journal of thoracic disease 10 2 E155-E157 - E157 2018年02月 [査読有り]
  
• 肺癌術後の虚血性気管支炎に対して高圧酸素療法を施行した1例

  野川 ひとみ; 濱田 顕; 鈴木 潤; 加藤 博久; 大泉 弘幸

  気管支学 40 6 608 - 611 特定非営利活動法人 日本呼吸器内視鏡学会 2018年 

  <p><b>背景．</b>高圧酸素療法（Hyperbaric oxygen therapy，以下HBOT）は，創傷治癒促進や軟部組織感染症に有効性が示されている．<b>症例．</b>61歳男性．既往に糖尿病，高血圧．喫煙歴は40本/日×41年間で現喫煙者．血痰を主訴に当院を受診し，肺癌が疑われ右下葉切除＋ND2a-2を施行．病理組織は多形癌，pT1aN2M0-stage IIIAであった．術後第6病日の気管支鏡検査で中間気管支幹および気管支断端に白苔付着，潰瘍形成，粘膜壊死を認め，虚血性気管支炎が疑われ，今後気管支断端瘻のリスクが高いと考えて，同日より12日間HBOT（2 atmosphere，60分，1日1回）を開始した．その2日後に胸水貯留に対し胸腔ドレーンを挿入したが，膿胸には発展しなかった．定期的に気管支鏡検査を施行し，徐々に潰瘍の改善を認め，術後第28病日に退院した．<b>結論．</b>右下葉切除後の虚血性気管支炎に対して，HBOTが気管支断端瘻を防ぎ得たと考えられた．</p>
• A case of seasonal fluctuation of carcinoembryonic antigen during the postoperative follow-up of lung cancer

  Kenta Nakahashi; Hiroyuki Oizumi; Hirohisa Kato; Jun Suzuki; Akira Hamada; Hikaru Watarai

  Japanese Journal of Lung Cancer 58 1 46 - 49 2018年 [査読有り]
   

  Background. Carcinoembryonic antigen (CEA) is an important tumor marker for the diagnosis, treatment, and follow-up of many malignant tumors. We herein report our experience with a patient who showed an elevated CEA level during the winter despite there being no evidence of recurrence of her non-small cell lung cancer during a postoperative follow-up session. Case. The patient was a 64-year-old female. We performed thora-coscopic middle-lobe resection and mediastinal lymph node dissection for the treatment of adenocarcinoma in the right middle lobe. The postoperative diagnosis revealed the following: pT2a(pl2)N0M0-IB UICC 7th. We therefore initiated the treatment with tegafur/uracil and administered prophylactic pleural thermochemical therapy. During the follow-up period, we noticed an elevation in the CEA level during the winter of the same year, but there was no tumor recurrence upon investigation. We then noticed a decrease in the CEA level over the summer, with an increase noted again the following winter, and examination continued to show no evidence of recurrence. The patient has survived without recurrence for eight years since undergoing lung resection. Conclusion. It is important to take the presentation of such rare cases into consideration.
• Thoracoscopic anatomical lung segmentectomy using 3D computed tomography simulation without tumour markings for non-palpable and non-visualized small lung nodules.

  Hirohisa Kato; Hiroyuki Oizumi; Jun Suzuki; Akira Hamada; Hikaru Watarai; Mitsuaki Sadahiro

  Interactive cardiovascular and thoracic surgery 25 3 434 - 441 2017年09月 [査読有り]
   

  OBJECTIVES: Although wedge resection can be curative for small lung tumours, tumour marking is sometimes required for resection of non-palpable or visually undetectable lung nodules as a method for identification of tumours. Tumour marking sometimes fails and occasionally causes serious complications. We have performed many thoracoscopic segmentectomies using 3D computed tomography simulation for undetectable small lung tumours without any tumour markings. The aim of this study was to investigate whether thoracoscopic segmentectomy planned with 3D computed tomography simulation could precisely remove non-palpable and visually undetectable tumours. METHODS: Between January 2012 and March 2016, 58 patients underwent thoracoscopic segmentectomy using 3D computed tomography simulation for non-palpable, visually undetectable tumours. Surgical outcomes were evaluated. RESULTS: A total of 35, 14 and 9 patients underwent segmentectomy, subsegmentectomy and segmentectomy combined with adjacent subsegmentectomy, respectively. All tumours were correctly resected without tumour marking. The median tumour size and distance from the visceral pleura was 14 ± 5.2 mm (range 5-27 mm) and 11.6 mm (range 1-38.8 mm), respectively. Median values related to the procedures were operative time, 176 min (range 83-370 min); blood loss, 43 ml (range 0-419 ml); duration of chest tube placement, 1 day (range 1-8 days); and postoperative hospital stay, 5 days (range 3-12 days). Two cases were converted to open thoracotomy due to bleeding. Three cases required pleurodesis for pleural fistula. No recurrences occurred during the mean follow-up period of 44.4 months (range 5-53 months). CONCLUSIONS: Thoracoscopic segmentectomy using 3D computed tomography simulation was feasible and could be performed to resect undetectable tumours with no tumour markings.
• Port-access thoracoscopic bisubsegmentectomy of right upper lobe posterior and anterior segments.

  Hirohisa Kato; Hiroyuki Oizumi; Jun Suzuki; Akira Hamada; Hikaru Watarai; Kenta Nakahashi; Mitsuaki Sadahiro

  Journal of thoracic disease 9 9 3293 - 3295 2017年09月 [査読有り]
   

  A 64-year-old woman was admitted to our hospital with a 16-mm non-solid tumor with pure ground-glass nodule (GGN) contents in the posterior segment near the anterior segment of her right upper lung lobe that was suspicious of adenocarcinoma in situ (AIS). Three-dimensional computed tomography (3DCT) simulation was performed to identify the subsegmental artery and vein pre- or intra-operatively. Port-access thoracoscopic bisubsegmentectomy of the right upper lobe was performed. A frozen section revealed AIS. The tumor size was 13 mm and the surgical margin from the tumor edge to cutting line was more than 20 mm. The surgical time was 191 minutes and bleeding was 101 mL. The chest tube duration was 3 days and the post-operative hospital stay was 6 days.
• Thoracoscopic left S4a subsegmentectomy.

  Akira Hamada; Hiroyuki Oizumi; Hirohisa Kato; Jun Suzuki; Hikaru Watarai; Katsuyuki Suzuki; Takanori Sasage; Mitsuaki Sadahiro

  Journal of thoracic disease 9 9 3299 - 3301 2017年09月 [査読有り]
   

  A 63-year-old woman who underwent a left hepatic lobectomy for hilar cholangiocarcinoma was referred to our department for further management. Chest computed tomography showed a lung nodule that was increased in size to 8 mm in the S4a. The differential diagnosis was metastasis versus primary lung cancer. Thoracoscopic left S4a subsegmentectomy was performed. The operative time was 158 min. The blood loss was minimal. Air leakage was not observed, and a chest tube was removed on POD 1. The patient was discharged home on POD 3. The final diagnosis was primary lung cancer (T1aN0M0 stage IA). Surgical margin was 2.0 cm.
• [Successful Treatment of Acute Empyema Due to Rupture of Pyogenic Liver Abscess].

  Isamu Watanabe; Naoki Kanauchi; Hikaru Watanabe; Akira Hamada

  Kyobu geka. The Japanese journal of thoracic surgery 70 9 750 - 754 2017年08月 [査読有り]
   

  Cases of rescue after rupture of pyogenic liver abscess into the thorax are rare. Here, we report 2 cases of rescue in patients with acute empyema due to rupture of a suppurative abscess into the thorax. Case 1:A 61-year-old male had high fever of 39 °C and right abdominal pain. Thoracic computed tomography(CT) showed encapsulated pleural effusion in the right thorax and ring-like enhancement in the right liver. The diagnosis was acute empyema caused by rupture of liver abscess. The pathogenic bacteria were Streptococcus group. The drain was removed after 6 days and the patient was discharged 32 days after surgery without reefing the diaphragm. Case 2:A 74-year-old male had a high fever of 39 °C and right chest pain. CT showed encapsulated pleural effusion in the right thorax, but not in the lung, and a low density area in the posterior segment of the liver. The diagnosis was acute empyema caused by rupture of liver abscess. The pathogenic bacteria were Streptococcus group and Bacteroides. The drain was removed after 8 days and the patient was discharged 32 days after surgery without reefing the diaphragm. CONCLUSION: Pathogenic bacteria in a pyogenic liver abscess are usually Gram-negative rods, but recently have also been reported to be Streptococcus anginosus group( SAG). Coinfection with SAG and anaerobic bacteria occurs in elderly patients, compromised hosts, and patients with a severe malignant disease. Therefore, early drainage using surgical treatment regardless of reefing the diaphragm should be considered to control severe infection due to liver abscess rupture.
• Thoracoscopic wedge resection and segmentectomy for small-sized pulmonary nodules.

  Hirohisa Kato; Hiroyuki Oizumi; Jun Suzuki; Akira Hamada; Hikaru Watarai; Kenta Nakahashi; Mitsuaki Sadahiro

  Journal of visualized surgery 3 66 - 66 2017年 [査読有り]
   

  With the recent increase in the detection of small-sized lung nodules because of the widespread use of computed tomography (CT), limited resection and minimally invasive surgery are preferred by patients with these lesions. In particular, the detection of nodules that show ground-glass opacity during high-resolution CT has increased. Although lobectomy and lymph node dissection were the standard procedures used for treating lung cancer, limited wedge resection and segmentectomy have become acceptable for treating small-sized lung cancers with nodules showing ground-glass opacity. These limited procedures are widely performed, especially because they can be accomplished thoracoscopically. Furthermore, not only simple segmentectomy but also complex segmentectomy and subsegmentectomy can be performed using three-dimensional (3D)-CT to achieve sufficient resection based on tumor size. There are, however, technical difficulties in thoracoscopic wedge resection and segmentectomy. While it may be curative for small-sized lung nodules, it is sometimes difficult to correctly perform wedge resection when the tumor is not identified intraoperatively. In such cases, we usually perform tumor marking before operating. However, serious complications, such as cerebral air embolism, have been reported. Further, although it can sufficiently resect small-sized lung nodules, segmentectomy is more technically complex than wedge resection. Therefore, we have developed methods to overcome these technical difficulties. By using a hookwire method in a hybrid operating room and 3D-CT simulation for each wedge resection and segmentectomy, we have obtained good outcomes. Limited resection individualized for each patient will continue to evolve with applications such as CT.
• Swine model for training surgeons in minimally invasive anatomic lung segmentectomy.

  Hiroyuki Oizumi; Hirohisa Kato; Makoto Endoh; Jun Suzuki; Hikaru Watarai; Akira Hamada; Katsuyuki Suzuki; Kenta Nakahashi; Mitsuaki Sadahiro

  Journal of visualized surgery 3 72 - 72 2017年 [査読有り]
   

  BACKGROUND: Despite the increasing demand for thoracoscopic lung segmentectomy, the appropriate training method is not well established. Therefore, we developed a swine model for anatomical thoracoscopic lung segmentectomy training. METHODS: Three-month-old pigs, weighing 40 to 45 kg, were used in this model. Anterior segmentectomy of the left cranial lobe and segmentectomy of the most anterior left caudal lobe were performed under general anesthesia and differential ventilation. Participants from several institutions participated in this program, which included training lectures and surgical skill drills. RESULTS: From 2010 to 2015, 33 pigs were used for the lung segmentectomy training with 51 trainees. Eight pigs were operated on using the hybrid approach, and 25 pigs were operated on using the complete thoracoscopic approach. Among 25 pigs in which the complete thoracoscopic approach was used, conversion to thoracotomy was required in 3 pigs, owing to hemorrhage in two and failure of differential ventilation in one. The no-touch method in supine position provided sufficient intersegmental delineation of 20 (76%) planes among 26 left anterior segmentectomies in the cranial lobe. CONCLUSIONS: Our live swine model of anatomical thoracoscopic lung segmentectomy is considered a good choice for training surgeons on how to perform minimally invasive lung segmentectomy in humans.
• How to demarcate intersegmental plane with resected-segments inflation method using the slip knot technique in thoracoscopic anatomic segmentectomy.

  Makoto Endoh; Hiroyuki Oizumi; Hirohisa Kato; Jun Suzuki; Hikaru Watarai; Akira Hamada; Katsuyuki Suzuki; Satoshi Shiono

  Journal of visualized surgery 3 100 - 100 2017年 [査読有り]
   

  Intersegmental demarcation line on the surface of the visceral pleura could not be found at thoracoscopic findings. The resected segments inflation (RSI) method has been reported as a useful technique for visualizing the intersegmental demarcation line during segmentectomy. Thoracoscopic anatomic segmentectomy is performed as follows: firstly, the pulmonary vein and artery of the segment planned for resection are dissected from the hilum in order to isolate the segmental bronchus located behind the pulmonary artery. Secondly, a monofilament non-absorbable suture is passed through the segmental bronchus, and a slip-knot is made outside the thorax. Thirdly, bilateral lung ventilation with pure oxygen is conducted. When the affected segment has inflated sufficiently, the slip knot suture is pulled and the segmental bronchus is ligated and collapse of the lung is made on reserved segments. Fourthly, as inflation of the affected segment and collapse of the reserved segments could be found, resection of intersegmental plane could be easily performed with the inflation-deflation line and the intersegmental pulmonary vein. If resected segmental bronchus could be identified, thoracoscopic segmentectomy with the slip-knot technique would be applicable. This slip-knot procedure is economical and is not need special instrument.
• Video-assisted thoracoscopic subsegmentectomy for small-sized pulmonary nodules.

  Hirohisa Kato; Hiroyuki Oizumi; Jun Suzuki; Akira Hamada; Hikaru Watarai; Kenta Nakahashi; Mitsuaki Sadahiro

  Journal of visualized surgery 3 105 - 105 2017年 [査読有り]
   

  Segmentectomy has been widely performed as one of the types of limited resections that are performed for the resection of small-sized lung nodules. Video-assisted thoracoscopic surgery has also been in demand as a minimally invasive surgery. Subsegmentectomy is a much more limited resection than segmentectomy, but the technique is complex because it requires keen anatomical identification of small pulmonary structures. Therefore, there has been little reported about subsegmentectomy in medical literature. The recent development of computed tomography is remarkable, and some reports describe three-dimensional computed tomography as providing useful information because it assists surgeons in the performance of thoracoscopic anatomical subsegmentectomy. The creation of an intersubsegmental line is a key process in subsegmentectomy, therefore, some methods have been reported. We have safely and accurately performed some video-assisted thoracoscopic subsegmentectomies for small-sized lung tumors, using the three-dimensional computed tomography simulation and creating the intersubsegmental line with the inflation-deflation technique. In this article, we describe the recent techniques and roles of video-assisted thoracoscopic subsegmentectomy, and offer prospects for this procedure with our clinical data.
• [Curative Left Pulmonary Resection Combined with Total En Bloc Spondylectomy for Lung Cancer Invading the Second and Third Thoracic Vertebral Bodies].

  Makoto Endoh; Hiroyuki Oizumi; Hirohisa Kato; Jun Suzuki; Hikaru Watarai; Akira Hamada; Katsuyuki Suzuki; Kenta Nakahashi; Toshiko Funata; Ai Takahashi; Mitsuaki Sadahiro

  Kyobu geka. The Japanese journal of thoracic surgery 69 10 811 - 7 2016年09月 [査読有り]
   

  Introduction of spinal surgery into the operation of lung cancer has made extensive surgical treatment feasible with acceptable long-term survival. We report our experience on total en bloc total spondylectomy for lung cancer invading the spine. A 60-year-old man was diagnosed with lung adenocarcinoma of the apicodorsal segment of the left lobe with invasion of the 2nd and 3rd thoracic vertebral bodies. After induction chemoradiotherapy, we performed en bloc resection through a posterolateral thoracotomy in the right decubitus position and a posterior median approach in the prone position. The thoracic manipulation was done earlier, making it useful for the dissection of the prevertebral plane from the posterior mediastinum at the upper thoracic level in addition to confirmation of non-N2 disease. Vertebral stabilization was achieved with rod fixation and placement of a titanium mesh cage between the remaining vertebral bodies.
• [Complete Resection of Non-seminomatous Germ Cell Tumor with Plastron Approach].

  Jun Suzuki; Hiroyuki Oizumi; Hirohisa Kato; Makoto Endoh; Hikaru Watarai; Akira Hamada; Katsuyuki Suzuki; Kenta Nakahashi; Takayuki Sasage; Mitsuaki Sadahiro

  Kyobu geka. The Japanese journal of thoracic surgery 69 7 499 - 502 2016年07月 [査読有り]
   

  A 17-year-old man was admitted to our hospital for the abnormal chest shadow. Chest computed tomography(CT) demonstrated mediastinal tumor, measuring 13 cm in diameter with high serum level of alpha fetoprotein (AFP) and human chorionic gonadotropin (hCG). The lesions were diagnosed as mixed germ cell tumors including a non-seminomatous malignant component by CT guided needle biopsy. After 5 courses of chemotherapy, the serum AFP and hCG were decreased almost normal level but the tumor size was not changed. Because it seemed to be difficult to get sufficient operating field with standard median sternotomy and patient wanted to treat funnel chest, we selected tumor resection with plastron approach. The tumor was completely resected with a good operation field by this procedure.
• [Chest Wall Reconstruction Using Titanium Plates Sandwiched Between Sheets after Resection of Chest Wall Chondrosarcoma].

  Makoto Endoh; Hiroyuki Oizumi; Hirohisa Kato; Jun Suzuki; Hikaru Watarai; Akira Hamada; Katsuyuki Suzuki; Ai Takahashi; Kenta Nakahashi; Masato Sugawara; Takashi Tsuchiya; Mitsuaki Sadahiro

  Kyobu geka. The Japanese journal of thoracic surgery 69 7 511 - 5 2016年07月 [査読有り]
   

  Extensive chest wall resection carries the risk of difficult reconstruction and surgical complications. We report our experience on chest wall reconstruction using titanium plates for a wide thoracic defect after tumor resection. A 74-year-old man was diagnosed with chondrosarcoma of the 6th rib on the right. He needed extensive chest wall resection because of skip lesions on 4th rib noted on operative inspection, leaving a defect measuring 33 × 20 cm. Reconstruction using 5 transverse titanium plates sandwiched between an expanded polytetrafluoroethylene patch and a polypropylene mesh sheet stabilized the chest wall. This reconstruction allowed successful separation from ventilatory support after operation. The postoperative course was uneventful, and he was discharged on postoperative day 20. The advantages of this form of reconstruction over conventional prostheses are rigidity, and stability and usability.
• 有茎横隔膜筋弁が有効であった有瘻性部分膿胸の一例

  鈴木 潤; 大泉 弘幸; 加藤 博久; 渡会 光; 濵田 顕; 貞弘 光章

  日本呼吸器外科学会雑誌 30 6 777 - 781 特定非営利活動法人 日本呼吸器外科学会 2016年 

  再発性有瘻性膿胸に対し，横隔膜筋弁を用いて瘻孔閉鎖し，有効であった症例を経験したので報告する．

  症例は65歳，女性．右胸腔鏡下膿胸腔掻爬術を行い経過良好で退院したが，術後第52病日目に発熱，咳嗽が出現した．胸部CTで，空気を伴う胸水貯留像を認め，有瘻性膿胸が疑われ再手術の方針となった．

  術中所見では，横隔膜近傍の肺に瘻孔を認めた．縫合閉鎖は困難な部位であり，腹膜を温存しつつ有茎横隔膜筋弁を作成し瘻孔部を縫合閉鎖した．以後7年の間，再発を認めていない．

• [Pulmonary Lipomatous Hamartoma Suspected to be an Endobronchial Lipoma].

  Hikaru Watanabe; Naoki Kanauchi; Isamu Watanabe; Akira Hamada

  Kyobu geka. The Japanese journal of thoracic surgery 68 12 1004 - 7 2015年11月 [査読有り]
   

  We report a rare case of pulmonary lipomatous hamartoma. A 61-year-old male was referred to our hospital due to abnormal mass densities on a chest radiograph. Thoracic computed tomography (CT) revealed a tumor with a maximum diameter of 42 mm. Bronchoscopic examination indicated the presence of a tumor at the orifice of the lateral segmental bronchus which was obstructed by the tumor. Endobronchial lipoma, was suspected by transbronchial biopsy, and we carried out a left upper lobectomy to prevent obstructive pneumonia. The pathological diagnosis was lipomatous hamartoma.
• [Mediastinal Nonseminomatous Germ Cell Tumor with Sarcoid-like Reaction in the Regional Lymph Nodes].

  Akira Hamada; Naoki Kanauchi; Katsuyuki Suzuki; Hikaru Watanabe; Isamu Watanabe

  Kyobu geka. The Japanese journal of thoracic surgery 68 6 412 - 5 2015年06月 [査読有り]
   

  A 26-year-old man was admitted because of an abnormal shadow on a chest roentgenogram. Computed tomography(CT) revealed a very large tumor in the anterior mediastinum and bilateral mediastinal lymphadenopathy. Examination of a CT-guided biopsy specimen revealed a yolk-sac tumor. The patient received 4 courses of bleomycin, etoposide, and cisplatin chemotherapy. After chemotherapy, the tumor was markedly reduced in size, but the lymphadenopathy remained. The patient underwent thoracoscopic biopsy of the mediastinal lymph nodes. Sarcoid nodules were found in all the biopsied nodes, and the lymphadenopathy was thought to be a sarcoid-like reaction associated with the germ cell tumor. Resection of the residual tumor was performed according to the treatment algorithm of the International Germ Cell Cancer Collaborative Group. There were no viable tumor cells in the resected tissue. The patient is free of recurrence and without any sign of generalized sarcoidosis 3 years after the surgery.
• 肺内型巨大気管支動脈瘤の1例

  濱田 顕; 渡辺 勇; 渡辺 光; 鈴木 克幸; 金内 直樹; 高橋 牧郎

  気管支学 37 Suppl. S211 - S211 (NPO)日本呼吸器内視鏡学会 2015年05月
• 原発性肺癌手術例において血清D-dimer値は予後予測因子となる

  濱田 顕; 渡辺 勇; 渡辺 光; 鈴木 克幸; 金内 直樹

  日本呼吸器外科学会雑誌 29 3 O35 - 6 (NPO)日本呼吸器外科学会 2015年04月
• 肺膿瘍穿破による急性有瘻性膿胸に対する醸膿胸膜切除、肋間筋弁被覆術

  金内 直樹; 濱田 顕; 鈴木 克幸; 渡辺 光; 渡辺 勇

  日本呼吸器外科学会雑誌 29 3 V26 - 4 (NPO)日本呼吸器外科学会 2015年04月
• 縮小手術を施行したcT1aN0M0非小細胞肺癌患者における再発症例の検討

  濱田 顕; 渡辺 勇; 渡辺 光; 金内 直樹; 塩野 知志; 安孫子 正美; 佐藤 徹

  肺癌 54 5 543 - 543 (NPO)日本肺癌学会 2014年10月
• 若年者に発生した心臓脂肪肉腫の1例

  渡辺 勇; 中橋 健太; 渡辺 光; 鈴木 克幸; 濱田 顕; 金内 直樹

  肺癌 54 5 598 - 598 (NPO)日本肺癌学会 2014年10月
• 高度不全分葉に対する気管支切離先行による胸腔鏡下肺葉切除術の検討

  金内 直樹; 濱田 顕; 渡辺 光; 鈴木 克幸; 渡辺 勇; 中橋 健太

  日本内視鏡外科学会雑誌 19 7 835 - 835 (一社)日本内視鏡外科学会 2014年10月
• 肝膿瘍胸腔内穿破による急性膿胸の2手術例

  渡辺 勇; 金内 直樹; 濱田 顕; 鈴木 克幸; 渡辺 光; 中橋 健太

  日本呼吸器外科学会雑誌 28 3 1 - 4 (NPO)日本呼吸器外科学会 2014年04月
• 肺膿瘍穿破に伴う急性膿胸手術例の検討

  金内 直樹; 濱田 顕; 鈴木 克幸; 渡辺 光; 中橋 健太; 渡辺 勇

  日本呼吸器外科学会雑誌 28 3 O24 - 6 (NPO)日本呼吸器外科学会 2014年04月
• 原発性肺癌患者における周術期口腔管理による術後肺炎予防の検討

  濱田 顕; 金内 直樹; 鈴木 克幸; 中橋 健太; 渡辺 勇

  日本呼吸器外科学会雑誌 28 3 1 - 2 (NPO)日本呼吸器外科学会 2014年04月
• ステロイドパルス療法後にSVC合併切除した胸腺腫の一例

  濱田 顕; 金内 直樹; 鈴木 克幸; 中橋 健太; 渡辺 勇

  日本呼吸器外科学会雑誌 28 3 2 - 8 (NPO)日本呼吸器外科学会 2014年04月
• 胸膜裂傷を来した癌性胸膜炎の1手術例

  中橋 健太; 金内 直樹; 遠藤 誠; 濱田 顕; 鈴木 克幸; 渡辺 勇

  日本臨床外科学会雑誌 74 12 3514 - 3514 日本臨床外科学会 2013年12月
• 包括医療制度における肺癌外科治療の現状

  金内 直樹; 濱田 顕; 鈴木 克幸; 中橋 健太; 渡辺 勇

  肺癌 53 5 487 - 487 (NPO)日本肺癌学会 2013年10月
• bevacizumab投与後に肺癌手術を施行した7例の検討

  濱田 顕; 金内 直樹; 鈴木 克幸; 中橋 健太; 渡辺 勇

  肺癌 53 5 616 - 616 (NPO)日本肺癌学会 2013年10月
• 末梢発生した肺腺様嚢胞癌肺転移の1例

  中橋 健太; 金内 直樹; 濱田 顕; 鈴木 克幸; 渡辺 勇; 大泉 弘幸

  肺癌 53 5 624 - 624 (NPO)日本肺癌学会 2013年10月
• 異所性骨化を伴った原発性肺癌の2切除例

  渡辺 勇; 金内 直樹; 濱田 顕; 鈴木 克幸; 中橋 健太

  肺癌 53 5 671 - 671 (NPO)日本肺癌学会 2013年10月
• [Giant cell tumor of the ribs that required emergency surgery due to massive hemothorax; report of a case].

  Akira Hamada; Naoki Kanauchi; Makoto Endoh; Jun Suzuki

  Kyobu geka. The Japanese journal of thoracic surgery 65 7 591 - 3 2012年07月 [査読有り]
   

  A 63-year-old man with a left rib tumor, which had been diagnosed as a giant cell tumor 2 years previously, had been followed up at another hospital after embolization of a feeding artery of the tumor. He was admitted to the emergency room of our hospital with complaints of breathing difficulties. A chest computed tomography (CT) revealed a left chest wall tumor, about 11 cm in size, originating from the 8th rib and a massive left hemothorax. Emergency operation was performed to releave hemorrhagic shock. Bleeding from the tumor was confirmed at thoracotomy. Tumor was removed with combined resection of the adjacent chest wall and diaphragm. His postoperative course was uneventful and he was discharged on the 8th postoperative day.

書籍

• 肺癌診療 虎の巻 Ⅲ 肺癌の手術と術前、術後化学療法 3. 非小細胞肺癌に対する術前化学療法・化学放射線療法 4. 非小細胞肺癌に対する術後補助化学療法

  クリニコ出版 2022年
• がん分子標的治療 Vol.19, No.2 切除可能非小細胞肺がんに対する術前補助療法としての免疫チェックポイント阻害薬の有効性 – CheckMate 816試験・NEOSTAR試験の結果から –

  メディカルレビュー社 2022年

講演・口頭発表等

• 20年後の肺がん集学的治療の研究開発を見据えて―日本の医師主導治験の環境整備について考える―  [招待講演]

  濱田 顕

  第39回日本呼吸器外科学会学術集会 2022年05月 シンポジウム・ワークショップパネル（指名）
• 臨床病期I期非小細胞肺癌における標準化PET/CT定量値を用いた肺癌予後層別化の多施設共同研究  [通常講演]

  濱田 顕; 須田 健; 宗 淳一; 吉田 幸弘; 橋本 昌樹; 竹ヶ原 京志郎; 長谷川 誠紀; 臼田 実男; 光冨 徹哉

  第39回日本呼吸器外科学会学術集会 2022年05月 シンポジウム・ワークショップパネル（公募）
• 切除可能N2Ⅲ期非小細胞肺癌における臨床試験で解決すべき課題  [招待講演]

  濵田顕

  第62回日本呼吸器学会 2022年04月 シンポジウム・ワークショップパネル（指名）
• 局所進行肺がんに対する免疫チェックポイント阻害薬を用いた周術期治療の可能性-WJOG12119L 試 験-  [通常講演]

  濱田顕; 宗淳一; 大泉弘幸; 坪井正博; 堀之内秀仁; 吉野一郎; 棚橋雅幸; 豊岡伸一; 岡田守人; 横見瀬裕保; 山下素弘; 光冨徹哉

  第122回日本外科学会定期学術集会 2022年04月 シンポジウム・ワークショップパネル（公募）
• N2肺癌に対する免疫チェックポイント阻害剤を用いた周術期治療の可能性- WJOG12119L試験 -  [通常講演]

  濵田 顕; 宗 淳一; 大泉 弘幸; 坪井 正博; 堀之内 秀仁; 吉野 一郎; 棚橋 雅幸; 豊岡 伸一; 岡田 守人; 横見瀬 裕保; 山下 素弘; 光冨 徹哉

  第38回日本呼吸器外科学会学術集会 2021年05月 シンポジウム・ワークショップパネル（公募）
• 肺癌における医師主導治験の経験  [通常講演]

  濵田顕; 宗淳一; 小原秀太; 藤野智大; 古賀教将; 西野将矢; 千葉眞人; 下治正樹; 須田健一; 武本智樹; 光冨徹哉

  第121回日本外科学会定期学術集会 2021年04月 シンポジウム・ワークショップパネル（公募）
• IA期非小細胞肺がんの予後は 腫瘍径よりGGO成分の有無に依存する  [通常講演]

  濵田 顕

  第60回日本肺癌学会学術集会 2019年12月 シンポジウム・ワークショップパネル（公募）
• 臨床病期IA期非小細胞肺癌における三次元画像解析を使用した胸腔鏡下解剖学的肺区域切除術の短期および長期成績  [通常講演]

  濵田 顕

  第72回日本胸部外科学会定期学術集会 2019年11月 ポスター発表
• Lecture 2: 免疫チェックポイント阻害剤と分子標的薬による導入療法のエビデンスと我が国の課題  [招待講演]

  濵田 顕

  第 1 回肺癌術前治療に関する肺癌学会・PMDA ワークショップ 2019年07月 公開講演，セミナー，チュートリアル，講習，講義等
• 気管支内過誤腫に対して 胸腔鏡下左S10a亜区域切除楔状気管支形成 を施行した一例  [通常講演]

  濵田 顕

  第42回日本呼吸器内視鏡学会 2019年07月 口頭発表（一般）
• 当院の末梢小型肺癌における区域切除後の長期成績と第二癌発症状況  [通常講演]

  濵田 顕

  第35回日本呼吸器外科学会総会 2018年05月 シンポジウム・ワークショップパネル（公募）
• 当院における細径器具を用いた胸腔鏡手術  [通常講演]

  濵田 顕

  第30回日本内視鏡外科学会総会 2017年12月 シンポジウム・ワークショップパネル（公募）
• Learning Curve For Video-Assisted Thoracic Surgery Segmentectomy  [通常講演]

  濵田 顕

  25th European Conference on General Thoracic Surgery 2017年05月 ポスター発表
• 触知困難肺病変に対する胸腔鏡下手術戦略  [通常講演]

  濵田 顕

  第29回日本内視鏡外科学会総会 2016年12月 シンポジウム・ワークショップパネル（公募）

MISC

• EGFR陽性肺癌におけるEGFR-TKIを用いた術後補助療法—Adjuvant therapy using EGFR-TKI in resected EGFR-mutated NSCLC—特集 肺癌診療ガイドライン2022年版を読み解く : 薬物治療を中心に ; 周術期治療

  濵田 顕; 須田 健一; 津谷 康大; 光冨 徹哉 呼吸器内科 = Respiratory medicine / 呼吸器内科編集委員会 編 44 (4) 387 -391 2023年10月
• 胸壁浸潤を伴う局所進行肺癌に対する術前化学放射線療法後ロボット支援下手術の可能性

  宗淳一; 下治正樹; 武本智樹; 福田祥大; 小原秀太; 濱田顕; 千葉眞人; 須田健一; 津谷康大 日本ロボット外科学会学術集会プログラム・抄録集 15th 2023年
• 肺がん周術期がん免疫治療の現状とバイオマーカー

  須田健一; 小原秀太; 濱田顕; 千葉眞人; 伊藤正興; 下治正樹; 武本智樹; 宗淳一; 光冨徹哉; 津谷康大 日本気管食道科学会総会ならびに学術講演会プログラム・予稿集 74th 2023年
• 末梢小型肺癌に対する区域切除における最適な切除マージンの確保-SuReFInDを用いた術中モニタリングの有用性-

  吉川真理子; 須田健一; 千葉眞人; 深見朋世; 小原秀太; 濱田顕; 下治正樹; 伊藤正興; 武本智樹; 宗淳一; 津谷康大 日本胸部外科学会定期学術集会(Web) 76th 2023年
• ロボット支援下胸腔鏡手術における術中損傷のピットフォールを考察する

  下治正樹; 宗淳一; 福田祥大; 老木華; 深見朋世; 小原秀太; 浜田顕; 千葉眞人; 伊藤正興; 須田健一; 武本智樹; 津谷康大 日本胸部外科学会定期学術集会(Web) 76th 2023年
• ロボット支援下解剖学的肺切除術時の気管支損傷を考察する

  宗淳一; 武本智樹; 福田祥大; 小原秀太; 濱田顕; 千葉眞人; 下治正樹; 須田健一; 津谷康大 日本呼吸器外科学会総会(Web) 40th 2023年
• 原発性肺癌切除例における人工知能解析プログラムを用いた腫瘍体積増大速度の臨床的意義

  福田祥大; 宗淳一; 小原秀太; 濱田顕; 千葉眞人; 下治正樹; 須田健一; 武本智樹; 津谷康大 日本呼吸器外科学会総会(Web) 40th 2023年
• Uniportal VATS区域切除の実際-難点と克服法を動画から-

  千葉眞人; 福田祥大; 小原秀太; 濱田顕; 下治正樹; 武本智樹; 須田健一; 宗淳一; 光冨徹哉; 津谷康大 日本呼吸器外科学会総会(Web) 40th 2023年
• 臨床病期I期非小細胞肺癌におけるRAVATを用いた画像的標準化PET/CT定量値の有用性

  濱田顕; 須田健一; 宗淳一; 吉田幸弘; 橋本昌樹; 竹ヶ原京志郎; 長谷川誠紀; 臼田実男; 津谷康大; 光冨徹哉 日本呼吸器外科学会総会(Web) 40th 2023年
• Uniportal VATSの発展と適応拡大

  千葉眞人; 宗淳一; 福田祥大; 小原秀太; 浜田顕; 下治正樹; 武本智樹; 須田健一; 光冨徹哉; 津谷康大 日本肺癌学会学術集会号 63rd (CD-ROM) 2022年
• 肺癌術後の経時的ctDNA測定が病勢予測に有用であった1例

  櫻井真倫; 小原秀太; 須田健一; 福田祥大; 浜田顕; 千葉眞人; 下治正樹; 武本智樹; 宗淳一; 津谷康大; 光冨徹哉 肺癌(Web) 62 (5) 2022年
• Uniportal VATSの適応拡大-縦隔リンパ節郭清・気管支形成・複雑区域切除への応用-

  千葉眞人; 宗淳一; 福田祥大; 小原秀太; 浜田顕; 下治正樹; 武本智樹; 須田健一; 光冨徹哉; 津谷康大 日本胸部外科学会定期学術集会(Web) 75th 2022年
• Next-generation sequencing(NGS)を用いたctDNAの外科切除症例における再発予測因子としての意義

  小原秀太; 須田健一; 藤野智大; 古賀教将; 西野将矢; 浜田顕; 千葉眞人; 武本智樹; 宗淳一; 光冨徹哉; 小原秀太; 坂井和子; 西尾和人 肺癌(Web) 60 (2) 2020年
• 第8版Stage分類の妥当性と問題点 IA期非小細胞肺がんの予後は腫瘍径よりGGO成分の有無に依存する

  濱田 顕; 須田 健一; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 千葉 眞人; 武本 智樹; 宗 淳一; 塩野 知志; 光冨 徹哉 肺癌 59 (6) 565 -565 2019年11月
• 早期社会復帰を目指したチーム医療の取り組み 胸部手術患者における早期社会復帰を目指した訪問看護ステーションとの連携

  武本 智樹; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 須田 健一; 宗 淳一; 光冨 徹哉 肺癌 59 (6) 591 -591 2019年11月
• Occultリンパ節転移の予測因子に関する検討

  古賀 教将; 須田 健一; 小原 秀太; 藤野 智大; 西野 将矢; 濱田 顯; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉 肺癌 59 (6) 679 -679 2019年11月
• MET exon14 skipping変異陽性多形癌におけるInter-tumor Heterogeneityの検討

  藤野 智大; 須田 健一; 村上 功; 小原 秀太; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉 肺癌 59 (6) 695 -695 2019年11月
• Uniportal VATS導入と定型化

  千葉 眞人; 武本 智樹; 福田 祥大; 小原 秀太; 藤野 智大; 西野 将矢; 古賀 教将; 濱田 顕; 須田 健一; 宗 淳一; 光冨 徹哉 肺癌 59 (6) 718 -718 2019年11月
• 人生100年時代の肺がん治療 外科医の立場から

  宗 淳一; 富沢 健二; 武本 智樹; 小原 秀太; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 須田 健一; 杉本 誠一郎; 豊岡 伸一; 光冨 徹哉 肺癌 59 (6) 853 -853 2019年11月
• Next-generation sequencing(NGS)を用いた外科切除症例における再発予測因子としての意義

  小原 秀太; 須田 健一; 坂井 和子; 藤野 智大; 古賀 教将; 西野 将矢; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 西尾 和人; 光冨 徹哉 肺癌 59 (6) 698 -698 2019年11月
• MET exon 14 skippingモデルを用いたMET-TKI耐性に関わる二次的変異の探索(Comprehensive analysis of secondary resistant mutations to MET-TKIs for MET exon 14 skipping in vitro)

  藤野 智大; 須田 健一; 小林 祥久; 古賀 教将; 西野 将矢; 小原 秀太; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉 日本癌学会総会記事 78回 P -3139 2019年09月
• Uniportal VATS 50例の経験

  千葉 眞人; 武本 智樹; 福田 祥大; 小原 秀太; 藤野 智大; 西野 将矢; 濱田 顕; 古賀 教将; 須田 健一; 宗 淳一; 光冨 徹哉 肺癌 59 (4) 424 -425 2019年08月
• 切除した右上葉と左S6に計12個の病変を認めた多発肺腺癌の1例

  古賀 教将; 須田 健一; 小原 秀太; 藤野 智大; 西野 将矢; 濱田 顕; 千葉 眞人; 武本 智樹; 宗 淳一; 光冨 徹哉 肺癌 59 (4) 428 -429 2019年08月

受賞

• 2022年07月 近畿大学医学会 近畿大学医学会賞
  
• 2021年07月 近畿大学医学会 近畿大学医学会賞
  
• 2016年11月 Uniportal VATS Lobectomy & VATS Segmentectomy video contest in 2016 Award of Great Potential
   Thoracoscopic left S4a subsegmentectomy 

  受賞者: 濵田 顕

共同研究・競争的資金等の研究課題

• 早期肺腺がん進行の機序解明と克服を目指した基礎的研究

  日本学術振興会：科学研究費助成事業

  研究期間 : 2023年09月 -2027年03月 

  代表者 : 宗 淳一; 津谷 康大; 小原 秀太; 須田 健一; 濱田 顕
• EGFR/HER2 exon 20 挿入変異モデルに対する新規 TKI の獲得耐性機序の解明

  日本学術振興会：科学研究費助成事業

  研究期間 : 2023年04月 -2026年03月 

  代表者 : 濱田 顕
• 長鎖非コードRNAを標的としたEGFR-TKI耐性肺癌に対する新規治療法の創出

  日本学術振興会：科学研究費助成事業 基盤研究(C)

  研究期間 : 2020年04月 -2023年03月 

  代表者 : 邵 力; 鈴木 潤; 張 旭紅; 濱田 顕

   

  肺癌の進展における長鎖非コードRNA(long noncoding RNA,lncRNA)の果たす役割は明らかにされつつあるが、その成果を臨床応用するための橋渡し研究はまだ少ない。本研究は、我々が新規に同定した癌遺伝子型lncRNA S180122に着目して、薬剤耐性を獲得した肺腺癌患者由来の癌細胞塊を用いた培養法(cancer tissue-originated spheroid、CTOS法)により、lncRNAを標的とした核酸医薬の探索とバイオマーカーへの展開を目的とする。そのため、1)EGFR-TKIに耐性を獲得した肺腺癌患者の血液を用いて、S180122のバイオマーカーとしての可能性を明らかにすること、2)細胞株及び耐性を獲得した患者腫瘍組織に由来するスフェロイドを用いた薬剤応答の解析を通じて、S180122を標的としたlncRNA阻害剤の肺腺癌再発の抑制効果を評価することを計画した。 本年度では、患者から採取した肺癌組織のCTOSの調製方法を検討し、3D培養条件を最適化して培養皿の上で肺癌オルガノイドの樹立に成功した。中短期間に(2-3ヶ月)培養されたオルガノイドに、患者体内の腫瘍と類似した遺伝子発現パターンがあることを確認した。この結果によって、今後、患者肺癌組織に由来するオルガノイドを用いた薬剤応答の解析が可能になった。また、肺腺癌細胞株を用いてS180122を標的としたlncRNA阻害剤を検討したところ、2D培養細胞により最適阻害剤の選定に成功したが、阻害剤の3Dスフェロイドへのデリバリー効率の改善が本研究の次なる進展の鍵となることが示唆された。
• 網羅的生体情報を活用した肺がんゲノム治療の確立

  日本学術振興会：科学研究費助成事業 若手研究

  研究期間 : 2020年04月 -2023年03月 

  代表者 : 濱田 顕

   

  本年度は、LUX-Lung 8 試験（Soriaら、Lancet Oncol 2015）で同定された臨床的意義の不明なHER2変異（VUS：Variants of Unknown Significance）について検討を行った。LUX-Lung 8 試験は、ⅢB/Ⅳ期の肺扁平上皮がん患者を対象とし、EGFR-TKIであるアファチニブとエルロチニブの効果を比較検証した第Ⅲ相試験であり、その二次解析では（Gossら、JAMA Oncol 2018）、10種類のHER2遺伝子のVUSが報告されている。この10種類のHER2遺伝子をIL-3依存性細胞株である、マウスpro-B細胞株（Ba/F3細胞）に導入し、人工的な腫瘍細胞モデルを作成した。これらのHER2遺伝子のVUSの腫瘍原性を、IL-3除去下での増殖能を検証することで評価し、E395K変異、G815R変異、R929W変異で腫瘍原性があることを確認した。これらの変異を有する人工的な腫瘍細胞モデルに対して、アファチニブとエルロチニブを含む種々のEGFRチロシンキナーゼ阻害剤（EGFR-TKI）の効果をMTTアッセイで評価し、すべての変異で、エルロチニブよりもアファチニブが有効であることを確認した。さらに、これらのMTTアッセイの結果を、Western Blottingでも確認した。
• FDG-PET/CTの標準化と癌の新しいバイオマーカーの確立：多施設共同臨床試験

  日本学術振興会：科学研究費助成事業 基盤研究(C)

  研究期間 : 2019年04月 -2022年03月 

  代表者 : 北島 一宏; 山門 亨一郎; 甲斐田 勇人; 伊藤 公輝; 関根 鉄朗; 大崎 洋充; 濱田 顕

   

  参加4施設の乳癌症例のPET画像を集め、PETの定量値（腫瘍の最大集積であるSUVmax、集積の体積であるMTV、SUVmeanとMTVの積であるTLG）にファントム実験で検証したガウシャンフィルターをかけてハーモナイゼーション（標準化）を行う事に成功した。 手術が施行された乳癌stageⅠ～Ⅲ期の乳癌患者546人において、estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negativeの344人とHER2-positiveの110人とtriple-negative caseの92人に分けて、ハーモナイゼーションしたPET定量値（最大SUVmax、MTVの合計、TLGの合計）が予後予測（再発や死亡の予測）に有用であることを明らかにし、Oncotarget. 2021 Jan 19;12(2):95-105. doi: 10.18632/oncotarget.27851に論文発表できた。 化学療法で治療されたstageⅣ期の乳癌患者65人において、estrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negativeの29人, HER2-positiveの23人とtriple-negative caseの13人分けて、ハーモナイゼーションしたPET定量値（最大SUVmax、MTVの合計、TLGの合計）が予後予測（再発や死亡の予測）に有用であることを明らかにし、Hell J Nucl Med. 2020 Sep-Dec;23(3):272-289.に論文発表できた。

委員歴

• 2024年01月 - 現在   Scientific Reports Editorial Board Member
• 2022年06月 - 現在   特定非営利活動法人 日本呼吸器外科学会   若手教育部会
• 2022年01月 - 現在   若手呼吸器外科医会（NEXT）   近畿支部副代表
• 2021年12月 - 現在   特定非営利活動法人西日本がん研究機構（WJOG）   呼吸器外科部会
• 2019年08月 - 現在   特定非営利活動法人西日本がん研究機構（WJOG）   呼吸器グループ若手の会（WING）第2期、第5期、Steering Committee
• 2019年01月 - 現在   日本肺癌学会   肺癌術前治療に関する肺癌学会・PMDA ワークショップ 運営委員会
• 2021年10月   若手呼吸器外科医研究グループCReGYT（Clinical Research Group of Young Thoracic Surgeon in Japan）   運営委員
• 2017年07月 - 2019年12月   Journal of Thoracic Disease   Section Editor (Thoracic Surgery)

その他のリンク

researchmap

https://researchmap.jp/hamadaakira1006