Publications by authors named "Takahiro Mizui"

Background: Treatment of liver metastases from rectal cancer has been considered based on research data on liver metastases from colorectal cancer. This study aimed to clarify the impact of clinicopathological factors of the primary lesion, including rectal cancer-specific factors such as lateral lymph node metastasis, on the prognosis after liver resection.

Methods: This was a single-center retrospective study of patients undergoing curative surgical treatment for resectable liver metastases from rectal cancer from January 2010 to June 2023.

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Background/objectives: Positive peritoneal cytology (Cy+) is considered a form of microscopic dissemination and a poor prognostic factor in resected pancreatic cancer (PC). However, the clinical implications of equivocal categories such as atypia of undetermined significance (AUS) and suspicious for malignancy (SFM) remain unclear.

Methods: We retrospectively analyzed patients with PC who underwent surgery at 13 high-volume centers between January 2009 and December 2018.

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Background: Systemic therapy, including liver resection, is crucial for treating metastatic liver tumors. Even when radical resection is successful, early recurrence of advanced or metastatic liver tumors may restrict subsequent treatment options, particularly if delayed liver function recovery (DLFR) occurs after hepatectomy. This study focused on DLFR after right hepatectomy for metastatic liver tumors.

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Background: Lymph node dissection is required for many pancreatic neuroendocrine neoplasms. However, the need for such dissection has rarely been examined in detail by the tumor size, tumor location, or World Health Organization grading. The objective is to determine which characteristics of pancreatic neuroendocrine neoplasms require lymph node dissection, and to what extent lymph node dissection should be performed.

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Background: With the advent of improved chemotherapy options, neoadjuvant chemotherapy has gained acceptance as a multidisciplinary treatment approach for localized pancreatic ductal adenocarcinoma. This study aimed to clarify whether neoadjuvant chemotherapy with gemcitabine and S-1 influences preoperative nutritional status and postoperative outcomes, particularly in patients undergoing highly invasive pancreatic resection.

Methods: Patients with resectable pancreatic ductal adenocarcinoma who underwent pancreaticoduodenectomy as upfront surgery or after neoadjuvant chemotherapy with gemcitabine and S-1 between January 2015 and December 2022 were assessed.

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Purpose: The clinical significance of lymph node dissection (LND) in patients with peripheral type intrahepatic cholangiocarcinoma (ICC) remains unclear. Although LND is usually performed for perihilar type ICC, there is no consensus on whether routine LND should be performed for peripheral type ICC. This study aimed to investigate the prognostic significance of LND in patients who underwent hepatectomy for peripheral type ICC.

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Background: While liver resection remains the best curative option for hepatocellular carcinoma (HCC), it is unclear whether the consistent progress of multidisciplinary approaches in managing HCC over several decades has influenced the outcomes of liver resection.

Methods: Patients undergoing liver resection for HCC from 1993 to 2022 in our institution were retrospectively assessed and stratified into three periods according to the year of liver resection, P1 (1993-2000), P2 (2001-2009), and P3 (2010-2022), and tumor status using the Barcelona Clinic Liver Cancer (BCLC) staging system.

Results: A total of 1257 patients were included (P1:P2:P3 = 385:490:382, BCLC stage 0/A:B:C = 908:214:135).

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Article Synopsis
  • Right liver tumors near the adrenal gland or inferior vena cava can complicate laparoscopic liver surgery, making it difficult to access the liver.
  • To address this, researchers combined laparoscopic liver resection with a technique called retroperitoneoscopy, allowing better access to the liver's dorsal side without moving the right liver.
  • The new method, termed "retlap liver resection," was successfully performed on six patients from 2020 to 2022 without any complications, and the study provides a video demonstration of the procedure.
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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.
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Background: Postoperative pancreatic fistula (POPF) is a major complication of distal pancreatectomy (DP). Although the visceral fat area (VFA) is a risk factor for POPF in DP, its measurement is complicated. This study aimed to identify a simple marker as a predictive indicator of POPF.

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Background: The prognostic implications of the RAS status in colorectal cancer liver metastasis (CRLM) remain unclear. This study investigated the prognostic significance of RAS status after curative hepatectomy, focusing on surgical controllability.

Methods: This retrospective study included liver-only CRLM patients who underwent the first hepatectomy between 2015 and 2022 at the National Cancer Center Hospital.

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Purpose: This study aimed to evaluate the feasibility, safety, diagnostic yield, and technical aspects of percutaneous abdominal lavage cytology screening (PACS) in patients with resectable pancreatic cancer.

Methods: This single-center, retrospective study included patients with resectable pancreatic cancer who underwent PACS before pancreatectomy between May 2022 and October 2023. The technical success rate, position of the drainage tube, volume of fluid administered, volume of fluid retrieved, fluid retrieval rate, and adverse events were evaluated.

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Article Synopsis
  • EUS tissue acquisition (EUS-TA) is an effective method for diagnosing small solid pancreatic lesions (≤10 mm), with a high technical success rate of 99.1% in a study of 109 patients.
  • The study found strong diagnostic performance metrics, including a sensitivity of 90.1%, specificity of 97.3%, and overall accuracy of 92.6%.
  • Important factors influencing diagnostic accuracy included the number of punctures and tumor type, while no instances of needle-tract seeding were reported.
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Background: The incidence of non-hepatitis B and non-hepatitis C hepatocellular carcinoma (NBNC-HCC) is increasing in our country. This study assesses the feasibility of employing an identical surgical treatment strategy for resectable NBNC-HCC as that for hepatitis virus-associated HCC (HV-HCC).

Methods: A retrospective analysis (1993-2023) of 1321 curative liver resections for HCC at a single institution was performed.

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Purpose: Whether surgical intervention for patients with oligometastatic recurrence can improve their post-recurrent prognosis is unclear. In this study, we introduce a novel concept of oligometastasis in post-surgical pancreatic ductal adenocarcinoma (PDAC) patients with hepatic recurrence, which we call "oligo-like liver metastasis (OLLM)." Patients with OLLM have better post-recurrence prognosis and could therefore be eligible for surgical intervention.

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Article Synopsis
  • Patients with distal cholangiocarcinoma (DCC) often have high recurrence rates and poor survival outcomes, prompting this study to examine the effect of surgical margin status on these factors.
  • A retrospective analysis of 133 patients showed that while 21.8% had R1cis and 17.3% had R1inv margins, surgical margin status did not significantly affect overall and recurrence-free survival rates.
  • However, R1 status was associated with a higher likelihood of isolated distant recurrence, suggesting that comprehensive treatment approaches are crucial for improving patient outcomes.
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Subcutaneous space has been considered an attractive site for islet graft transplantation; however, the oxygen tension and vascularization are insufficient for islet graft survival. We investigated whether subcutaneous pre-implantation of a recombinant peptide (RCP) device with adipose tissue-derived stem cells (ADSCs) enhanced subcutaneous islet engraftment. RCP devices with/without syngeneic ADSCs were pre-implanted into the subcutaneous space of C57BL/6 mice.

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Article Synopsis
  • Peptide receptor radionuclide therapy (PRRT) proves effective in treating unresectable liver metastases from pancreatic neuroendocrine tumors (PNETs), leading to rare surgical opportunities.
  • A case study of a 52-year-old man shows that after PRRT treatment and the use of somatostatin analogs (SSAs), previously unresectable liver metastases became operable, resulting in no viable tumor cells post-surgery.
  • The findings emphasize the potential of combining PRRT and SSAs as a promising multimodal treatment for patients with difficult-to-operate PNETs.
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Background: Extrahepatic cholangiocarcinoma (eCCA) is a rare and aggressive disease and consisted of conventional eCCA and intraductal papillary neoplasm of the bile duct (IPNB). Intraepithelial spread (IES) of cancer cells beyond the invasive area is often observed in IPNBs; however, the prevalence of IES remains to be examined in conventional eCCAs. Here, we evaluated the clinicopathological features of eCCAs according to tumor location, with a focus on the presence of IES.

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Objective Primary hepatobiliary neuroendocrine neoplasms (NENs) are rare tumors exhibiting several morphological and behavioral characteristics. Considering the lack of relevant data on this topic, we evaluated the clinicopathological features and treatment outcomes of patients with primary hepatobiliary NENs. Methods/Patients We examined 43 consecutive patients treated at the National Cancer Center Hospital with pathological diagnoses of primary hepatobiliary NEN between 1980 and 2016.

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Background: The prognostic benefit of preoperative chemotherapy leading to conversion surgery for unresectable colorectal liver metastases (CRLM) is well recognized, while that of neoadjuvant chemotherapy (NAC) compared with upfront surgery (UFS) for resectable CRLM is negligible. This study aims to assess the prognostic benefit and search for optimal indication of NAC for resectable advanced CRLM by establishing an objective definition of biologically borderline resectable (bBR) CRLM.

Methods: A bicentric retrospective analysis of patients with CRLM undergoing curative-intent initial liver resection between 2007 and 2021 was performed.

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Background: For non-functioning pancreatic neuroendocrine tumors (pNETs) ≤ 20 mm, most guidelines consider follow-up observations as an option; however, the various treatment strategies are defined by size alone, even though the Ki-67 index is important for malignancy grading. Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is the standard for the histopathological diagnosis of solid pancreatic lesions; however, recent results for small lesions remain unclear. Therefore, we examined the efficacy of EUS-TA for solid pancreatic lesions ≤ 20 mm suspected as pNETs or requiring differentiation and the non-increase rate in tumor size in follow-up cases.

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Objectives: Real-time virtual sonography (RVS) is an artificial-intelligence-assisted ultrasonographic navigation system that displays synchronized preoperative computed tomography (CT) images corresponding to real-time intraoperative ultrasonograms (IOUS). This study aimed to investigate whether RVS can enhance IOUS identification of small intrahepatic targets found in preoperative CT.

Methods: Patients with small intrahepatic targets detected by preoperative thin-slice dynamic CT before liver resection were included.

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Background: Progress of non-surgical treatments in the last decade has improved the prognosis of pancreatic neuroendocrine neoplasms (PanNEN). However, the improvement of surgery for advanced PanNEN remains unknown. This study aimed to investigate the chronological changes of the clinical impact of pancreatectomy for PanNEN.

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