Publications by authors named "Akio Yanagisawa"

Background: Intraductal papillary mucinous neoplasms (IPMNs) are classified into three epithelial types with distinct biological behaviors. However, their effects on the postoperative outcomes remain unclear.

Methods: This multicenter retrospective study included 556 patients with IPMNs who underwent surgical resection.

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  • * Analyzing data from 1183 patients, it found that completing 6 months of postoperative adjuvant therapy significantly improved overall, disease-specific, and recurrence-free survival, especially for high-risk patients.
  • * Additionally, neoadjuvant therapy showed benefits for those with borderline resectable IPMC, and any treatment for recurrence after surgery was linked to longer survival compared to no treatment.
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  • The study evaluated the effectiveness of preoperative pancreatic juice cytology (PJC) in diagnosing intraductal papillary mucinous neoplasm (IPMN) of the pancreas to inform treatment strategies.
  • Out of 1,130 patients, 852 underwent PJC, showing an overall accuracy of 55% for distinguishing cancerous from noncancerous lesions, with varying rates based on IPMN type.
  • Despite low sensitivity, the high positive predictive value suggests PJC may still be useful in uncertain surgical cases but is generally not recommended as a reliable diagnostic tool.
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  • * The patient's condition was diagnosed through imaging techniques, revealing a low-density area in the liver and subsequent surgical extraction of a tissue specimen.
  • * Pathological analysis showed necrotizing eosinophilic granuloma containing nematode larvae, confirming the presence of A. pegreffii through molecular and phylogenetic methods, aiding in the future identification of Anisakis species.
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Background/objectives: The detection of malignancy is a major concern in the management of intraductal papillary mucinous neoplasm (IPMN). The height of the mural nodule (MN), estimated using endoscopic ultrasound (EUS) and computed tomography (CT), has been considered crucial for predicting malignant IPMN. Currently, whether surveillance using CT or EUS alone is sufficient for detecting MNs remains unclear.

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  • A solid pseudopapillary neoplasm (SPN) of the pancreas is a rare tumor primarily found in young women, and a case of spontaneous regression is reported.
  • A 48-year-old woman was diagnosed with a pancreatic mass after complaining of back pain, and various imaging studies characterized the tumor without significant abnormalities in enzyme levels or markers.
  • After being advised for surgery, the patient opted for monitoring and, after one year, an MRI revealed that the tumor had spontaneously regressed, suggesting that hormonal changes related to menopause might influence SPN growth.
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  • A multicenter randomized trial compared the diagnostic effectiveness of 22-gauge standard needles and 22-gauge Franseen needles in EUS-guided tissue acquisition for solid pancreatic lesions.
  • The study included 523 patients, with both needle types showing high technical success rates, but the Franseen needle demonstrated significantly better diagnostic accuracy and sensitivity on the first pass as well as in subsequent passes.
  • The findings suggest that using the Franseen needle not only improves diagnostic outcomes, especially for patients needing immunostaining, but also requires fewer needle passes compared to the standard needle.
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Background: As the malignant potential of main duct (MD-) type intraductal papillary mucinous neoplasm (IPMN) has been discussed together with Mixed-type in most previous studies, the malignant potential of pure MD-type IPMN remains unclear. This study evaluated the specific characteristics and predictors of high-grade dysplasia (HGD) and invasive intraductal papillary mucinous carcinoma (IPMC) for pure MD-type IPMN.

Methods: From 1,100 patients with IPMN, this study includes 387 patients that underwent surgery.

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Background: Expression of human equilibrative nucleoside transporter-1 (hENT1) is reported to predict survival of gemcitabine (GEM)-treated patients. However, predictive values of immunohistochemical hENT1 expression may differ according to the antibodies, 10D7G2 and SP120.

Aim: We aimed to investigate the concordance of immunohistochemical hENT1 expression between the two antibodies and prognosis.

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Objectives: This study aimed to evaluate the pathological features and imaging findings of pancreatic carcinoma in situ (PCIS).

Methods: Twenty patients with PCIS were categorized as flat (F) (n = 6) and low papillary (LP) (n = 14) types.

Results: None of F type and 8 (57%) of 14 with LP type lesions showed intraductal infiltrations of the main pancreatic duct (MPD) greater than 10 mm.

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Background And Objectives: Differential diagnosis to estimate the malignant potential of gastric submucosal tumor (g-SMT) is important for decision-making. This study evaluated the use of a 20G needle with a core trap for EUS-guided fine-needle biopsy (EUS-FNB) for g-SMT.

Methods: This multicentric prospective trial was registered in the University Hospital Medical Information Network (UMIN000021410).

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Background: The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014.

Methods: In this 3rd version, clinical questions (CQs) were proposed on six topics. The recommendation, grade for recommendation, and statement for each CQ were discussed and finalized by an evidence-based approach.

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Objectives: Preoperative grading of pancreatic neuroendocrine tumors (PanNET) is challenging. The aim of this study was to prospectively evaluate the use of a 25-gauge needle with a core trap for diagnosis and grading of PanNET.

Methods: This multicenter prospective trial was registered with the University Hospital Medical Information Network (UMIN000021409).

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Background: In intraductal papillary mucinous neoplasm, a mural nodule ≥5 mm is an important predictor of malignancy. Surgical indication is less clear in cases of intraductal papillary mucinous neoplasm without mural nodule ≥5 mm. This is a retrospective study evaluating predictors of high-grade dysplasia or invasive intraductal papillary mucinous carcinoma for intraductal papillary mucinous neoplasm without mural nodule ≥5 mm.

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The high expression of human equilibrative nucleoside transporter-1 (hENT1) and the low expression of dihydropyrimidine dehydrogenase (DPD) are reported to predict a favorable prognosis in patients treated with gemcitabine (GEM) and 5-fluorouracil (5FU) as the adjuvant setting, respectively. The expression of hENT1 and DPD were analyzed in patients registered in the JASPAC 01 trial, which showed a better survival of S-1 over GEM as adjuvant chemotherapy after resection for pancreatic cancer, and their possible roles for predicting treatment outcomes and selecting a chemotherapeutic agent were investigated. Intensity of hENT1 and DPD expression was categorized into no, weak, moderate or strong by immunohistochemistry staining, and the patients were classified into high (strong/moderate) and low (no/weak) groups.

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Background: Although there are numerous reports focusing on surgical indication for intraductal papillary mucinous neoplasm (IPMN), the recurrence patterns following surgery are less widely reported. To ascertain optimal treatment and postoperative surveillance for IPMN patients, we analyzed patterns and risk factors for recurrence after surgery for IPMN.

Methods: This study is a retrospective, multi-institutional, observational study, including 1074 patients undergoing surgery for IPMN at 11 academic institutions.

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Intraductal papillary mucinous neoplasm (IPMN) of pancreas has a high risk to develop into invasive cancer or co-occur with malignant lesion. Therefore, it is important to assess its malignant risk by less-invasive approach. Pancreatic juice cell-free DNA (PJD) would be an ideal material in this purpose, but genetic biomarkers for predicting malignant risk from PJD are not yet established.

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The aim of this study was to assess the prognostic significance of residual cancer volume (RCV) in patients with esophageal squamous cell carcinoma (ESCC) who received esophagectomy after neoadjuvant chemotherapy. We measured RCV by using complete stepwise sections at 6- to 8-mm intervals obtained from 81 ESCC patients with clinical stages IB to III. RCV was defined as the summation of all products of residual cancer area and thickness, and its cutoff value was set by receiver operator characteristic curve analysis on 3-year disease-specific survival (DSS).

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Objective: The grading and typing of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are challenging for pathologists. We aimed to clarify the points of consistency and disagreement in assessing the grades and types of IPMNs.

Methods: Digital slide images of 20 IPMNs were independently assessed by 10 Japanese pathologists, who then held a consensus meeting to discuss the points of disagreement and develop a consensus and recommendations.

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It has been reported that endoscopic retrograde cholangiopancreatography (ERCP) is of value in evaluating precise pancreatograms of the pancreatic duct (PD). Recently, institutions have tended to perform magnetic resonance cholangiopancreatography (MRCP) for the diagnosis of PD due to post-ERCP pancreatitis (PEP). In small pancreatic cancer (PC), including PC in situ (PCIS) which is undetectable on cross sectional images, endoscopic ultrasonography (EUS) and MRCP serve important roles in detecting local irregular stenosis of the PD or small cystic lesions.

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Background And Aims: Various risk factors for lymph node metastasis (LNM) have been reported in colorectal T1 cancers. However, the factors available are insufficient for predicting LNM. We therefore investigated the utility of the new histological factor "pure well-differentiated adenocarcinoma" (PWDA) as a safe factor for predicting LNM in T1 and T2 cancers.

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Objective: To create a simple, objective model to predict the presence of malignancy in patients with intraductal papillary mucinous neoplasm (IPMN), which can be easily applied in daily practice and, importantly, adopted for any lesion types.

Background: No predictive model for malignant IPMN has been widely applied in clinical practice.

Methods: The clinical details of 466 patients with IPMN who underwent pancreatic resection at 3 hospitals were retrospectively analyzed for model development.

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