Publications by authors named "Daisuke Hashimoto"
Favorable Response Defined by CA19-9 Reduction After Neoadjuvant Treatment for Pancreatic Cancer.
Ann Surg Oncol
September 2025
Background: Neoadjuvant treatment (NAT) for pancreatic cancer has been shown to reduce mortality risk, with carbohydrate antigen (CA)19-9 response indicating survival outcomes. The purpose of this study is to clarify the degree of the CA19-9 response after neoadjuvant treatment (NAT) on prognosis.
Patients And Methods: In this retrospective, multicenter, observational study involving 1811 patients with pancreatic cancer scheduled for surgery, patients were stratified on the basis of pretreatment CA19-9 levels into elevated CA19-9 level and CA19-9 within the normal range groups.
Objective: To evaluate the usefulness of a double coating of polyglycolic acid (PGA) felt for pancreaticojejunostomy in reducing the incidence of clinically relevant postoperative pancreatic fistula (POPF) in patients with a normal pancreas.
Summary Background Data: Despite pancreaticojejunostomy being an advanced procedure in patients undergoing pancreatoduodenectomy (PD), few studies have reported a satisfactory reduction in the incidence of POPF.
Methods: This study was an international multicenter randomized controlled trial conducted between October 2018 and December 2021.
Clinical role of intraperitoneal chemotherapy in patients with pancreatic ductal adenocarcinoma concomitant with occult peritoneal dissemination: A multicenter retrospective study.
Ann Gastroenterol Surg
July 2025
Background: The effectiveness of intraperitoneal chemotherapy using paclitaxel (i.p.-PTX) in pancreatic ductal adenocarcinoma (PDAC) patients with peritoneal dissemination remains elusive.
View Article and Find Full Text PDFPurposes: In pancreaticoduodenectomy for pancreatic ductal adenocarcinoma (PDAC), Prophylactic right-half dissection of the superior mesenteric artery (SMA) nerve plexus has been attempted in pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. In this study, we evaluated the significance of prophylactic right-half dissection of the SMA nerve plexus by extending the observation period to 5 years.
Methods: From April 2014 to June 2018, 74 patients with PDAC in the pancreatic head were randomly assigned to either the dissection group, in which the right half of the nerve plexus of the SMA was dissected (n = 37) or the preservation group, in which the nerve plexus of the SMA was completely preserved (n = 37).
Background: It remains unclear whether there is a difference in overall survival (OS) benefit between (m)FOLFIRINOX and gemcitabine-nab-paclitaxel as preoperative regimens for localised pancreatic adenocarcinoma. This study aimed to investigate the outcome of patients with resected localised pancreatic adenocarcinoma following (m)FOLFIRINOX versus gemcitabine-nab-paclitaxel.
Methods: International multicentre retrospective study (16 centres, 8 countries, 3 continents), including consecutive patients after pancreatic resection for localised pancreatic adenocarcinoma following 2-6 months preoperative (m)FOLFIRINOX or gemcitabine-nab-paclitaxel (2010-2018).
Article Synopsis
- - The study analyzed how changes in chemotherapy based on CA19-9 levels during neoadjuvant therapy (NAT) impact outcomes for patients with pancreatic ductal adenocarcinoma (PDAC).
- - Results from 283 patients showed that those who received a chemotherapy change (particularly those who achieved the desired CA19-9 reduction) had significantly better overall survival compared to those who did not have a chemotherapy change.
- - The findings suggest that adjusting chemotherapy based on CA19-9 levels can enhance treatment outcomes for patients with resectable or borderline resectable PDAC, highlighting the importance of personalized treatment approaches.
Article Synopsis
- Postoperative pancreatic fistula (POPF) is a common complication after distal pancreatectomy (DP), prompting a study (WRAP study) to assess new prevention strategies during minimally invasive DP (MIDP).
- The trial involves 172 patients at 14 centers in Japan, randomly assigning them to either a control group or an intervention group that uses polyglycolic acid (PGA) mesh and fibrin glue to reinforce the pancreatic stump.
- The primary goal is to evaluate whether this reinforcement can reduce the occurrence of clinically relevant POPF, potentially establishing a new best practice in MIDP surgery.
Is multidisciplinary treatment effective for invasive intraductal papillary mucinous carcinoma?
Ann Gastroenterol Surg
September 2024
Article Synopsis
- * 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.
Article Synopsis
- New treatment strategies for unresectable pancreatic ductal adenocarcinoma (UR-M PDAC) are emerging, including the use of maintenance therapy with olaparib after chemotherapy, particularly for patients with BRCA mutations.
- A 47-year-old male patient diagnosed with PDAC and confirmed BRCA2 mutation underwent 16 weeks of triple chemotherapy, followed by 14 weeks of olaparib, leading to normalization of tumor markers and disappearance of liver metastases.
- Following successful chemotherapy, the patient was able to have laparoscopic surgery to remove the tumor, and he has remained cancer-free for 27 months post-surgery, highlighting the potential for long-term survival with this treatment approach.
Article Synopsis
- The study investigates the impact of preoperative chemo(radio)therapy on patients with localized pancreatic adenocarcinoma, focusing on the rare occurrence of pathological complete response (pCR), where no cancer cells are found post-surgery.
- Conducted in 19 centers across 8 countries with 1758 participants, the research shows that only 4.8% of patients achieved pCR, which is linked to better overall survival rates compared to those who did not achieve pCR.
- Factors influencing the likelihood of pCR included the use of multiagent chemotherapy regimens other than the (m)FOLFIRINOX treatment, highlighting the need for tailored therapeutic approaches.
Impact of endoscopic ultrasound-guided tissue acquisition on prognosis and peritoneal lavage cytology in resectable or borderline resectable pancreatic ductal adenocarcinoma.
Pancreatology
August 2024
Article Synopsis
- This study evaluated the effects of preoperative endoscopic ultrasound-guided tissue acquisition (EUS-TA) on patients with resectable or borderline resectable pancreatic cancer.
- Data from 153 patients showed no significant differences in overall survival or positive peritoneal lavage cytology between those who underwent EUS-TA and those who did not.
- The findings suggest that EUS-TA does not negatively affect postoperative survival or the rates of positive cytology in pancreatic cancer surgeries.
Factors Affecting Nonfunctioning Small Pancreatic Neuroendocrine Neoplasms and Proposed New Treatment Strategies.
Clin Gastroenterol Hepatol
July 2024
Article Synopsis
- The study evaluated treatment strategies for nonfunctioning small pancreatic neuroendocrine neoplasms (NF-spNENs) in a large Japanese cohort, with a focus on surgically resected cases.
- A total of 606 NF-spNENs were analyzed, revealing that tumor grade and size significantly impacted outcomes, including lymph node metastasis and recurrence.
- Findings suggest that treatment plans should prioritize personalized approaches based on tumor grading and size rather than relying solely on size for decision-making.
Article Synopsis
- The study explored the effectiveness of neoadjuvant therapy (NAT) for patients with resectable and borderline resectable pancreatic cancer, suggesting it may improve overall survival (OS) rates.
- Among patients with resectable disease, those receiving NAT had better OS compared to those who underwent surgery first, especially if tumor size was ≤25 mm and CA19-9 levels were <100 U/mL.
- For borderline resectable cases, delaying surgery until tumor markers are controlled showed significant OS benefits for patients receiving NAT.
Article Synopsis
- The study evaluates the effectiveness of conversion surgery for patients with liver-only synchronous metastases of pancreatic ductal adenocarcinoma who responded positively to chemotherapy, comparing outcomes with other treatment methods.
- A total of 49 patients were analyzed, divided into three groups: those who had conversion surgery (10), upfront surgery (8), and those who only received chemotherapy (31).
- Results showed that the conversion surgery group had significantly better median survival times (36.7 months) compared to the chemotherapy group (9.9 months) and the upfront surgery group (10.4 months), highlighting the potential benefit of conversion surgery for selected patients.
Central pancreatectomy might be an acceptable surgical procedure for clinical T1 pancreatic body ductal adenocarcinoma: A multicenter retrospective analysis.
J Hepatobiliary Pancreat Sci
December 2023
Article Synopsis
- Central pancreatectomy (CP) is a surgery that preserves pancreatic function and has been studied for treating benign tumors, but its use for pancreatic cancer is limited.
- This study involved analyzing 50 patients with clinical T1 pancreatic body cancer, comparing those who had CP to those who had distal pancreatectomy (DP) between 2013 and 2020 at three hospitals.
- Results showed a 100% 5-year survival rate for the CP group, compared to 42% for the DP group, indicating that CP might be a promising option for certain patients with this type of cancer.
Preoperative carbohydrate antigen 19.9 level predicts lymph node metastasis in resectable adenocarcinoma of the head of the pancreas: a further plea for biological resectability criteria.
Int J Surg
October 2024
Article Synopsis
- Lymph-nodal involvement (N+) is a negative prognostic factor for patients undergoing pancreatoduodenectomy for pancreatic adenocarcinoma, and existing preoperative diagnostic tools are not very effective at detecting it.
- This study analyzed data from 2034 patients to determine if preoperative levels of the tumor marker CA19.9 could predict N+ status in resectable pancreatic cancer (R-PDAC).
- The results indicated a significant association between elevated CA19.9 levels (above 37 U/L) and N+ status, particularly in patients classified as cT3, suggesting that high CA19.9 could help identify patients at greater risk for lymph-nodal involvement before surgery.
Pancreatic ductal adenocarcinoma (PDAC) is a typical refractory malignancy, and many patients have distant organ metastases at diagnosis, such as liver metastasis and peritoneal dissemination. The standard treatment for unresectable PDAC with distant organ metastasis (UR-M) is chemotherapy, but the prognosis remained poor. However, with recent dramatic developments in chemotherapy, the prognosis has gradually improved, and some patients have experienced marked shrinkage or disappearance of their metastatic lesions.
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- Locally advanced pancreatic cancer (LAPC) used to be considered unresectable, but advancements in chemotherapy and chemoradiation have led to the possibility of successful surgical resection, known as "conversion surgery."
- An international consensus meeting held in Kyoto in July 2022 focused on improving LAPC management and shared best practices from experts, covering aspects like preoperative treatments and surgical procedures.
- Experts agreed that understanding cancer biology is essential for improving LAPC treatment outcomes, and emphasized the need for continued collaboration and guideline development in the field.
Standard versus delayed initiation of S-1 adjuvant chemotherapy after surgery for pancreatic cancer: a secondary analysis of a nationwide cohort by the Japan Pancreas Society.
J Gastroenterol
August 2023
Background: Based on the Japan Adjuvant Study Group of Pancreatic Cancer-01 results, S-1 adjuvant chemotherapy has been the standard in resected pancreatic ductal adenocarcinoma (PDAC) patients in Japan and elsewhere, initiated within 10 weeks after surgery. To assess the clinical impact of this timing, we conducted a secondary analysis of a nationwide survey by the Japan Pancreas Society.
Methods: A total of 3361 patients were divided into two groups: 2681 (79.
Although nanoliposomal irinotecan combined with 5-fluorouracil and leucovorin (nal-IRI+5-FU/LV) has been used to treat first-line resistant unresectable pancreatic cancer, the efficacy and safety data among the elderly remain limited. We retrospectively analyzed clinical outcomes among elderly patients. Patients treated with nal-IRI+5-FU/LV were assigned to the elderly (≥75 years) and non-elderly (<75 years) groups.
View Article and Find Full Text PDFPurpose: Since 2002, the Japan Surgical Society has established a board certification system for surgeons to be certified for a specialty. Surgery remains a male-dominated field in Japan. This study aimed to clarify if the Japanese surgical residency training system is equally suitable for female and male residents.
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- Several case reports indicate that patients with IgD multiple myeloma (MM) may successfully stop hemodialysis, although specific predictive factors have not been established.
- A 57-year-old Japanese woman with renal issues from IgD-λ multiple myeloma underwent bortezomib-based chemotherapy and was able to withdraw from hemodialysis after 50 days.
- This review suggests that younger age and starting bortezomib-based treatment early could be key indicators for successfully stopping hemodialysis in similar patients.