139 results on '"Kazuyoshi Kawabata"'
Search Results
2. Epigenetic inactivation of galanin receptors in salivary duct carcinoma of the parotid gland: Potential utility as biomarkers for prognosis
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Shoichiro Imayoshi, Mikiko Maruta, Hirofumi Fukushima, Hiroshi Nishino, Gen Kusaka, Kiyoshi Misawa, Takeharu Kanazawa, Yuki Misawa, Thomas E. Carey, Hiroyuki Mineta, Kazuyoshi Kawabata, and Yukiko Sato more...
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0301 basic medicine ,Cancer Research ,Salivary duct carcinoma ,03 medical and health sciences ,0302 clinical medicine ,methylation specific PCR ,medicine ,Galanin ,tumor suppressor gene ,Survival rate ,Salivary gland ,epigenetics ,business.industry ,Cancer ,Articles ,medicine.disease ,Molecular medicine ,Head and neck squamous-cell carcinoma ,Parotid gland ,030104 developmental biology ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Cancer research ,business ,parotid gland ,neoplasm - Abstract
Salivary duct carcinoma (SDC) constitutes one of the most aggressive cancers in the salivary gland and is associated with a poor prognosis; however, no established systemic therapy options are available. SDC exhibits biological similarity to prostate and breast cancers, therefore anti-hormone therapy and molecular target therapies are available, however with limited beneficial effects. Galanin and galanin receptors (GALRs) are well established as molecular biomarkers to predict the survival rate and risk of recurrence of head and neck squamous cell carcinoma. The present study investigated the clinicopathological features of patients with SDC and the methylation status of their galanin and GALR genes to demonstrate the prognostic value for this disease. The median overall survival (OS) was 37.2 months. T-stage, N-stage, disease stage, tumor size, and preoperative facial paralysis were significantly associated with OS, whereas human epidermal growth factor receptor 2 (HER2) overexpression was not. GALR1 and GALR2 methylation rates in tumor tissues were significantly increased compared with normal tissues with 9.85- and 4.49-fold increase, respectively. p27kip1 and p57kip2 expression significantly inversely correlated with the methylation rate of GALR1 and GALR2. In addition, the observed GALR1 and/or GALR2 methylation rates were significantly correlated with a decrease in OS. These results suggest that GALR1 and GALR2 may serve as potential prognostic factors and therapeutic targets in SDC. more...
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- 2018
Catalog
3. Salvage surgery for local recurrence of hypopharyngeal squamous cell carcinoma after definitive radiotherapy or chemoradiotherapy or bioradiotherapy
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Kazuyoshi Kawabata, Takeshi Takahashi, Hirofumi Fukushima, Akira Seto, Hiroki Mitani, Kazunori Ichikawa, Wataru Shinbashi, Ryuta Hidaka, Hiroyuki Yonekawa, Ryoto Nagai, Toru Sasaki, Masakatsu Hattori, Toshihiko Sakai, Ryosuke Kamiyama, Yoshikata Nishijima, and Aya Ebina more...
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03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,030220 oncology & carcinogenesis ,Hypopharyngeal squamous cell carcinoma ,medicine ,Salvage surgery ,Radiology ,030223 otorhinolaryngology ,business ,Definitive radiotherapy ,Chemoradiotherapy - Published
- 2018
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4. Japanese Clinical Practice Guideline for Head and Neck Cancer
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Nobuya Monden, Yoshihiro Kimata, Torahiko Nakashima, Ken-ichi Nibu, Takashi Fujii, Kazuyoshi Kawabata, Iwai Tohnai, Kazuto Matsuura, Takahiro Asakage, Akihiro Homma, Tadaaki Kirita, Yuzuru Kamei, Takeshi Kodaira, Seiji Kishimoto, Naomi Kiyota, Toshitaka Nagao, Takeshi Beppu, Koichi Omori, Tetsuo Akimoto, Hiroya Ojiri, Naoki Otsuki, Ryuichi Hayashi, Ken Omura, Sadamoto Zenda, Nobuhiro Hanai, Hirofumi Fujii, Takashi Nakatsuka, and Hiroya Kitano more...
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medicine.medical_specialty ,medicine.medical_treatment ,Cetuximab ,03 medical and health sciences ,Antineoplastic Agents, Immunological ,0302 clinical medicine ,Japan ,Antineoplastic Combined Chemotherapy Protocols ,Adjuvant therapy ,Humans ,Medicine ,030212 general & internal medicine ,Survival rate ,Radiotherapy ,Squamous Cell Carcinoma of Head and Neck ,business.industry ,General surgery ,Head and neck cancer ,Neck dissection ,Chemoradiotherapy ,General Medicine ,Guideline ,medicine.disease ,Otorhinolaryngologic Surgical Procedures ,Radiation therapy ,Otorhinolaryngology ,Head and Neck Neoplasms ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Carcinoma, Squamous Cell ,Physical therapy ,Neck Dissection ,Surgery ,business ,medicine.drug - Abstract
Objective The first revision of “Japanese Clinical Practice Guideline for Head and Neck Cancer” was made in 2013 by the clinical practice guideline committee of Japan Society for Head and Neck Cancer, in response to the revision of the TNM classification. Methods 34 CQs (Clinical Questions) were newly adopted to describe the diagnosis and treatment methods currently considered most appropriate, and offered recommendation grade made by the consensus of the committee. A comprehensive literature search was performed for studies published between 2001 and 2012 using PubMed. Qualified studies were analyzed and the results were evaluated, consolidated and codified by all the committee members. Results Elective neck dissection (ND) does contribute to improvement in survival and should be performed for patients with high-risk tongue cancer. At present, no research has clearly demonstrated the utility of superselective arterial infusion chemotherapy. However, depending on the site and stage of the cancer, combination with radiotherapy may be useful for preserving organ function or improving survival rate. Concurrent CDDP chemotherapy and adjuvant radiotherapy contributes to improvement of survival rate as an adjuvant therapy for advanced squamous cell carcinoma of the head and neck in patients at high risk of recurrence. The anti-EGFR antibody cetuximab (Cmab) has an additive effect with radiotherapy. However, the indication must be carefully considered since this treatment has not been compared with the standard treatment of chemoradiotherapy. Cmab has been shown to have an additive effect with chemotherapy (CDDP/5-FU) in patients with unresectable metastatic or recurrent cancer. Preoperative and postoperative oral care may reduce the risk of postoperative complications such as surgical wound infection and pneumonia in head and neck cancers. Rehabilitation soon after ND for cervical lymph node metastasis is recommended for maintaining and restoring shoulder function. Conclusions In this article, we described most relevant guidelines and CQs for the diagnosis and treatment of head and neck cancer in Japan. These guidelines are not intended to govern therapies that are not shown here, but rather aim to be used as a guide in searching for the most appropriate treatment for individual patient. more...
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- 2017
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5. Indwelling voice prosthesis insertion after total pharyngolaryngectomy with free jejunal reconstruction
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Akira Seto, Hiroyuki Yonekawa, Ryousuke Kamiyama, Takeharu Kanazawa, Hiroki Mitani, Toru Sasaki, Takahiro Asakage, Kiyoshi Misawa, Kazuyoshi Kawabata, Wataru Shimbashi, and Hirofumi Fukushima
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medicine.medical_specialty ,business.industry ,Head and neck cancer ,General Medicine ,Total pharyngolaryngectomy ,medicine.disease ,Voice prosthesis ,Surgery ,Resection ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Chart review ,Medicine ,In patient ,030223 otorhinolaryngology ,Complication ,business ,Standard therapy - Abstract
Objectives Total pharyngolaryngectomy with free jejunal reconstruction is often performed in patients with hypopharyngeal carcinoma. However, postoperative speechlessness significantly decreases patient quality of life. We investigated whether Provox® insertion could preserve speech after total pharyngolaryngectomy with free jejunal reconstruction. Study Design Retrospective chart review. Methods A total of 130 cases of secondary Provox® insertions after total pharyngolaryngectomy with free jejunal reconstruction were analyzed. Communication outcomes were compared using the Head and Neck Cancer Understandability of Speech Subscale. Outcomes and complications associated with insertion site (jejunal insertion vs. esophageal insertion) and adjuvant irradiation therapy were also evaluated. Results Provox® insertion had favorable communication outcomes in 102 cases (78.4%). Neither the insertion site nor irradiation affected the communication outcome. Complications were observed in 20 cases (15.4%). Local infection was the most common complication. Free jejunal insertion, in which the resection range was enlarged, had a lower complication rate than did esophageal insertion, and its complication rate was unaffected by previous irradiation. For all patients, the hospitalization duration and duration of speechlessness were 13.4 days and 14.6 months, respectively. Patients receiving jejunal insertions had a significantly shorter hospitalization duration than did those receiving esophageal insertions. Unlike Provox®2, Provox®Vega significantly reduced the complication rate to zero. Conclusion For jejunal inserson of a Provox® prosthetic, a sufficient margin can be maintained during total pharyngolaryngectomy and irradiation can be performed, and satisfactory communication outcomes were observed. Provox® insertion after total pharyngolaryngectomy with free jejunal reconstruction should be considered the standard therapy for voice restoration. Level of Evidence 4. more...
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- 2017
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6. Prediction of Aspiration by Perceptual Evaluation of Pre-swallow Wet Voice and Wet Expiratory Sounds in Adults Diagnosed with Head and Neck Cancer
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Michiyo Yamakawa, Kazuyoshi Kawabata, Yoshiko Takei, Michael E. Groher, Kaoru Yokoyama, and Koji Takahashi
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medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Head and neck cancer ,Audiology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Perception ,medicine ,business ,030217 neurology & neurosurgery ,media_common - Published
- 2017
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7. Olfactory neuroblastoma. A clinical analysis of 31 cases
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Mitsutaka Adachi, Shunji Takahashi, Tohru Sasaki, Yu Koizumi, Hiroki Mitani, Wataru Shimbashi, Kazuyoshi Kawabata, Mutsukazu Kitano, Hiroyuki Yonekawa, Mariko Sekimizu, Ryosuke Kamiyama, Yukiko Sato, Hirofumi Fukushima, Akira Seto, and Aya Ebina more...
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medicine.medical_specialty ,Oncology ,Otorhinolaryngology ,Clinical pathology ,Olfactory Neuroblastoma ,business.industry ,Cancer research ,Medicine ,Induction chemotherapy ,business - Published
- 2017
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8. Efficacy of double‐scope endoscopic submucosal dissection and long‐term outcomes of endoscopic resection for superficial pharyngeal cancer
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Yukiko Sato, Tomohiro Tsuchida, Tohru Sasaki, Akiyoshi Ishiyama, Kazuyoshi Kawabata, Toshiaki Hirasawa, Masahiro Igarashi, Yorimasa Yamamoto, Junko Fujisaki, Masami Omae, and Toshiyuki Yoshio
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Adult ,Male ,medicine.medical_specialty ,animal structures ,Endoscopic Mucosal Resection ,Endoscope ,Lymphovascular invasion ,Endoscopic mucosal resection ,Complete resection ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Pharyngeal cancer ,Long term outcomes ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Endoscopic resection ,Aged ,Aged, 80 and over ,business.industry ,Gastroenterology ,Pharyngeal Neoplasms ,Endoscopic submucosal dissection ,Middle Aged ,Surgery ,Endoscopes, Gastrointestinal ,Treatment Outcome ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Female ,030211 gastroenterology & hepatology ,Neoplasm Recurrence, Local ,business - Abstract
Owing to increased awareness and use of narrow-band imaging, there are more opportunities to treat superficial pharyngeal cancer (SPC). The present study aimed to describe the short- and long-term outcomes of endoscopic resection (ER) for SPC.This study included 166 consecutive SPC in 113 patients treated during 2006 to 2013 at one referral cancer center. In the first period, we treated patients using endoscopic mucosal resection (EMR), in the second period using conventional ESD (cESD) and in the recent period using double-scope ESD (dsESD), which involves a second thin endoscope for assistance to produce traction. Median follow-up period was 30 months.All lesions were diagnosed as squamous cell carcinoma. Complete resection rate of cESD and dsESD procedures was 56.4% and 82.3% (P 0.01), and local recurrence rate was 2.6% and 0.0%, respectively. Procedure duration was significantly shorter for dsESD than for cESD (P 0.05). Four cases of recurrent lymph node (LN) metastasis were observed; however, all patients with LN metastases survived to a 48-month median interval after neck dissection. Risk factors for LN metastasis included subepithelium invasion, tumor thickness1000 μm, droplet infiltration, and lymphovascular invasion. Overall survival rate after 5 years was 79.5%; no patients died of SPC. Cumulative rate of metachronous SPC after 5 years was 46.5%.ER for SPC is a feasible and effective treatment, although metachronous SPC occurred frequently. For the technique of ER, dsESD was effective. more...
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- 2016
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9. Combination chemotherapy of carboplatin and paclitaxel for advanced/metastatic salivary gland carcinoma patients: differences in responses by different pathological diagnoses
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Yukiko Sato, Kenji Nakano, Hiroki Mitani, Hiroyuki Yonekawa, Kazuyoshi Kawabata, Tohru Sasaki, Shunji Takahashi, Wataru Shimbashi, and Hirofumi Fukushima
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Adult ,Male ,Oncology ,medicine.medical_specialty ,Paclitaxel ,medicine.medical_treatment ,Antineoplastic Agents ,Adenoid ,Salivary Glands ,Carboplatin ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Carcinoma ,Humans ,030223 otorhinolaryngology ,Aged ,Retrospective Studies ,Chemotherapy ,Salivary gland ,business.industry ,Combination chemotherapy ,General Medicine ,Middle Aged ,Salivary Gland Neoplasms ,medicine.disease ,Treatment Outcome ,medicine.anatomical_structure ,Otorhinolaryngology ,chemistry ,Salivary gland cancer ,030220 oncology & carcinogenesis ,Female ,business - Abstract
A standard chemotherapy for recurrent/metastatic salivary gland cancers has not been established. Combination chemotherapy of carboplatin and paclitaxel should be evaluated as a treatment option.This study retrospectively reviewed salivary gland cancer patients who received combination chemotherapy of carboplatin and paclitaxel. The differences in objective responses and in the prognoses according to the different pathological diagnoses were evaluated.A total of 38 patients were enrolled in the study; of them, 18 had salivary duct carcinomas (SDCs), nine had adenoid cystic carcinomas (ACCs), and 11 had other pathological diagnoses. Objective responses were observed in 15 (39%) patients. The median progression-free survival (PFS) was 6.5 months, and the median overall survival (OS) was 26.5 months. ACC patients had relatively low response rates (9%), but there were no significant differences in PFS or OS compared to other sub-types. The treatment was well tolerated, with few adverse events.Salivary gland cancer patients showed a moderate clinical response to the combination chemotherapy of carboplatin and paclitaxel. The objective response rates differed according to the pathological diagnoses, but there were no significant differences in prognoses. more...
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- 2016
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10. Association of impaired renal function and poor prognosis in oropharyngeal squamous cell carcinoma
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Ryuichi Hayashi, Nobuya Monden, Takakuni Kato, Masato Fujii, Kazuto Matsuura, Kazuyoshi Kawabata, Yasuhisa Hasegawa, Akihiro Homma, Kiyoto Shiga, Shigemichi Iwae, Ken-ichi Nibu, and Takashi Fujii
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0301 basic medicine ,medicine.medical_specialty ,Univariate analysis ,Multivariate analysis ,business.industry ,medicine.medical_treatment ,Renal function ,Retrospective cohort study ,medicine.disease ,Comorbidity ,Gastroenterology ,Surgery ,Radiation therapy ,03 medical and health sciences ,Impaired renal function ,030104 developmental biology ,0302 clinical medicine ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Stage (cooking) ,business - Abstract
Background Renal function influences decisions regarding treatment for patients with oropharyngeal squamous cell carcinoma (SCC). However, the importance of renal function in oropharyngeal SCC has not yet been reported. Methods Four hundred sixty patients with oropharyngeal SCC treated with curative intent between April 2005 and March 2007 in 12 institutions in Japan were analyzed retrospectively. Results Four hundred three patients (87.6%) showed a creatinine clearance (CrCl) ≥50 mL/min and 57 (12.4%) with a CrCl more...
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- 2016
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11. Total pharyngolaryngectomy of an advanced hypopharyngeal cancer: a 295-case series study―prognoses, postoperative complications, and quality of life
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Aya Ebina, Hiroki Mitani, Kazuyoshi Kawabata, Yuh Koizumi, Ryosuke Kamiyama, Takahito Kondo, Wataru Shimbashi, Jin Uezato, Hiroyuki Yonekawa, Kazufumi Obata, Toru Sasaki, Masakatsu Hattori, Hirofumi Fukushima, Akira Seto, Ryuta Hidaka, and Kotaro Shirao more...
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medicine.medical_specialty ,Oncology ,Otorhinolaryngology ,Quality of life ,business.industry ,Medicine ,Hypopharyngeal cancer ,business ,Total pharyngolaryngectomy ,medicine.disease ,Surgery ,Case series - Published
- 2016
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12. Surgical management around the paratracheal area of hypopharyngeal cancer
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Ryuichi Hayashi, Takeshi Beppu, Toshifumi Tomioka, Takashi Fujii, Tetsuro Onitsuka, Kazuto Matsuura, Kazuyoshi Kawabata, Takahiro Asakage, Taijirou Ozawa, and Yasushi Fujimoto
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Adult ,Male ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Thyroid Gland ,Disease-Free Survival ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Piriform sinus ,Japan ,medicine ,Paratracheal ,Humans ,Radiology, Nuclear Medicine and imaging ,Aged ,Neoplasm Staging ,Retrospective Studies ,Aged, 80 and over ,Hypopharyngeal Neoplasms ,business.industry ,Paratracheal lymph nodes ,Thyroid ,Hypopharyngeal cancer ,Neck dissection ,General Medicine ,Middle Aged ,medicine.disease ,Trachea ,Dissection ,Hypopharynx ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Lymphatic Metastasis ,Neck Dissection ,030211 gastroenterology & hepatology ,Female ,Radiology ,Neoplasm Recurrence, Local ,business - Abstract
Objective We aimed to clarify the suitable surgical management around the paratracheal area of patients who undergo total pharyngolaryngectomy based on the pathological results of hypopharyngeal cancer. Methods The study was conducted under a multicenter, retrospective observational design in Japan. We analyzed histopathological paratracheal lymph node metastasis and thyroid invasion, and recurrence around the paratracheal area for 184 patients who underwent initial surgery among 280 participants. Results There were significant differences in the frequency of metastasis to paratracheal lymph nodes as cN advances (P = 0.0344) and cT advances (P = 0.00028). By subsite, the paratracheal lymph node metastasis ratio was 22/130 patients (16.9%) in piriform sinus (PS), 8/32 (25.0%) in PW, 5/22 (22.7%) in PC and 10/17 (58.8%) in cervical esophagus (Ce+). The ratio of cases with bilateral paratracheal metastasis tended to be higher in cN2c, posterior wall (PW) and postcricoid (PC). Invasion to the thyroid was histopathologically confirmed in 16/184 patients (8.7%). Invasion from the primary lesion was in 15 patients. Conclusion This study indicates that it is better for patients with advanced hypopharyngeal cancer at minimum undergo ipsilateral paratracheal lymph node dissection. Tumor subsite of PW, PC or cN2c disease or disease extending to the Ce+ should be treated with bilateral paratracheal neck dissection. In order to more reliably perform paratracheal dissection, there is also an option to resect the thyroid lobe in the range of dissection. Preservation of the thyroid gland can be considered if invasion into the thyroid gland has been clearly ruled out. more...
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- 2018
13. A Clinical Study of Pharyngolaryngectomy with Total Esophagectomy
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Hiroki Mitani, Hiroyuki Yonekawa, Wataru Shimbashi, Toru Sasaki, Aya Ebina, Kazuyoshi Kawabata, Yuh Koizumi, Hirofumi Fukushima, Akira Seto, and Ryosuke Kamiyama
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Male ,medicine.medical_specialty ,Esophageal Neoplasms ,Ileus ,medicine.medical_treatment ,Fistula ,Laryngectomy ,Clinical study ,Postoperative Complications ,Japan ,Pharyngectomy ,medicine ,Humans ,Aged ,Neoplasm Staging ,Retrospective Studies ,Hypopharyngeal Neoplasms ,business.industry ,Total esophagectomy ,General surgery ,Hypopharyngeal cancer ,Middle Aged ,Plastic Surgery Procedures ,Esophageal cancer ,Prognosis ,medicine.disease ,Surgery ,Esophagectomy ,Survival Rate ,Otorhinolaryngology ,Quality of Life ,Thyroidectomy ,Neck Dissection ,Female ,business ,Thoracic esophageal cancer - Abstract
Patients with advanced hypopharyngeal or cervical esophageal cancer have a comparatively high risk of also developing thoracic esophageal cancer. Pharyngolaryngectomy with total esophagectomy is highly invasive, and few reports about it exist. We examined the postoperative complications and respective countermeasures and prognoses of patients who underwent pharyngolaryngectomy with total esophagectomy.Case series with chart review.Department of Head and Neck Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Japan.We examined the postoperative complications and respective countermeasures and prognoses of 40 patients who underwent pharyngolaryngectomy with total esophagectomy in our hospital.Postoperative complications were observed in 23 patients (57.5%) and consisted of 8 groups: tracheal region necrosis in 5 patients; neck abscess formation/wound infection in 5; fistula in 4; tracheostomy suture leakage in 2; ileus in 2; lymphorrhea in 2; pulmonary complications in 2; and other complications, including hemothorax, tracheoinnominate artery fistula, temporary cardiac arrest due to intraoperative mediastinum operation, methicillin-resistant Staphylococcus aureus enteritis, and sepsis, in 1 patient each. A lethal complication-brachiocephalic vein hemorrhage due to tracheostomy suture leakage and hemorrhagic shock due to tracheoinnominate artery fistula-occurred in 2 (5%) patients. The crude 5-year survival rate was 48.6%.Serious postoperative complications were related to tracheostomaplasty. Although pharyngolaryngectomy with total esophagectomy is highly invasive, we believe that our outlined treatment method is the most appropriate for cases of advanced hypopharyngeal or cervical esophageal cancer that also requires concurrent surgery for esophageal cancer. more...
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- 2015
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14. Laryngeal function-preserving therapy for hypopharyngeal cancers
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Osamu Fukuoka, Toru Sasaki, Hiroki Mitani, Takahisa Ota, Aya Ebina, Kotaro Shirao, Hirofumi Fukushima, Akira Seto, On Hasegawa, Ryousuke Kamiyama, Ryuta Hidaka, Takanori Hama, Hiroyuki Yonekawa, Wataru Shimbashi, Kazuyoshi Kawabata, Zin Uesato, Yu Koizumi, and Hisayuki Ota more...
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Oncology ,Otorhinolaryngology ,business.industry ,Medicine ,business - Published
- 2015
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15. A comparison of weekly paclitaxel and cetuximab with the EXTREME regimen in the treatment of recurrent/metastatic squamous cell head and neck carcinoma
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Junichi Tomomatsu, Kenji Nakano, Wataru Shimbashi, Hirofumi Fukushima, Hiroki Mitani, Shoko Marshall, Hiroyuki Yonekawa, Yukiko Sato, Toru Sasaki, Shinichiro Taira, Shunji Takahashi, and Kazuyoshi Kawabata more...
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Oncology ,Male ,Cancer Research ,medicine.medical_specialty ,Paclitaxel ,medicine.medical_treatment ,Cetuximab ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,030212 general & internal medicine ,Neoplasm Metastasis ,Adverse effect ,Aged ,Retrospective Studies ,Chemotherapy ,business.industry ,Squamous Cell Carcinoma of Head and Neck ,Hazard ratio ,Combination chemotherapy ,Middle Aged ,medicine.disease ,Prognosis ,Head and neck squamous-cell carcinoma ,Regimen ,Head and Neck Neoplasms ,030220 oncology & carcinogenesis ,Cohort ,Carcinoma, Squamous Cell ,Female ,Oral Surgery ,Neoplasm Recurrence, Local ,business ,medicine.drug - Abstract
Background The effectiveness of the combination chemotherapy of weekly paclitaxel and cetuximab has not yet been compared to that of the current standard regimen, EXTREME (combination of 5-fluorouracil, cisplatin and cetuximab). Methods We retrospectively reviewed the clinical records of R/M SCCHN patients who received cetuximab-containing chemotherapy as a first-line therapy; from these, patients receiving a weekly paclitaxel and cetuximab regimen (cohort A) and the EXTREME regimen (cohort B) were extracted. The responses, prognoses and adverse events of these two cohorts were evaluated. Results A total of 86 patients were included (cohort A, 49; cohort B, 36). Patients with histories of platinum-based chemotherapy were more frequently given the cohort A treatment. Though the response rates were similar in the two cohorts (45% in cohort A and 51% in cohort B; p = 0.83), the progression-free survival (PFS) was significantly more favorable in cohort A by the log-rank test (6.0 months vs 5.0 months; p = 0.027). In the Cox-regression hazard analyses, male gender (hazard ratio [HR] = 2.1, p = 0.010), older age (≥ 70 yo) (HR = 5.0, p = 0.018), PS 0 (HR = 2.2, p = 0.027), no history of platinum chemotherapy (HR = 3.2, p = 0.003) and the presence of a tracheostomy (HR = 2.3, p = 0.039) were favorable factors within cohort A. Conclusion In selected R/M SCCHN patients, the combination of weekly paclitaxel and cetuximab could be the better treatment option than the EXTREME regimen. more...
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- 2017
16. Two Cases of Ectopic Hamartomatous Thymoma Masquerading as Sarcoma
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Kazuyoshi Kawabata, Hiroyuki Yonekawa, Takahito Kondo, Hiroki Mitani, Toru Sasaki, Yukiko Sato, Hiroko Tanaka, Hirofumi Fukushima, and Wataru Shimbashi
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Pathology ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Adipose tissue ,Case Report ,General Medicine ,030230 surgery ,medicine.disease ,lcsh:Otorhinolaryngology ,lcsh:RF1-547 ,Synovial sarcoma ,Benign tumor ,Fusion gene ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Medicine ,Ectopic Hamartomatous Thymoma ,Sarcoma ,Differential diagnosis ,business ,Fluorescence in situ hybridization - Abstract
Ectopic hamartomatous thymoma (EHT) is an extremely rare benign tumor. EHTs are difficult to differentiate from sarcomas, especially synovial sarcomas. We encountered two cases of EHT that were referred from other hospitals because sarcoma was suspected. In these cases, fusion gene detection via polymerase chain reaction or fluorescence in situ hybridization was useful for differentiating EHT from synovial sarcoma. EHT requires accurate diagnosis before surgery to avoid excessive treatment. Both tumor location and the presence of fat inside the tumor are important imaging findings for EHT, and confirmation of spindle cells, epithelial cells, and mature adipose cells in the tumor is an important pathological finding. It is important to exclude synovial sarcoma from the differential diagnosis via fusion gene analysis. more...
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- 2017
17. Surgical Management of Retropharyngeal Nodes Metastases from Papillary Thyroid Carcinoma
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Kazuhisa Toda, Kazuyoshi Kawabata, Sugata Takahashi, Takafumi Togashi, and Iwao Sugitani
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Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Disease-Free Survival ,Thyroid carcinoma ,Young Adult ,medicine ,Carcinoma ,Humans ,Thyroid Neoplasms ,Thyroid cancer ,Lymph node ,Retropharyngeal space ,Aged ,Retrospective Studies ,business.industry ,Neck dissection ,Middle Aged ,medicine.disease ,Carcinoma, Papillary ,Surgery ,Dissection ,medicine.anatomical_structure ,Thyroid Cancer, Papillary ,Cardiothoracic surgery ,Lymphatic Metastasis ,Neck Dissection ,Pharynx ,Female ,Neoplasm Recurrence, Local ,business - Abstract
Papillary thyroid carcinoma (PTC) often metastasizes to the central and lateral neck lymph nodes, but rarely affects retropharyngeal nodes (RPN). We retrospectively reviewed 12 patients (three men, nine women) with PTC who underwent dissection of RPN metastases between 1994 and 2012. Mean age at dissection was 65 years (range 23–77). Dissection was performed with the initial surgery for PTC in eight patients, while the remaining four patients underwent dissection as secondary surgery. RPN metastases arose from an ipsilateral primary in nine patients, bilateral in two, and contralateral in one, with primaries located at the superior pole of the thyroid lobe in nine patients. All patients showed simultaneous or previous lymph node metastases in the upper jugular chain. A transcervical approach was applied for RPN dissection in 11 patients, while a transcervical-transparotid approach was applied in the remaining patient. No patients needed mandibulotomy or showed severe complications. Median duration of follow-up after RPN dissection was 48 months (range 3–206). No recurrences in the retropharyngeal space were identified. Two patients died of the disease, one died from other carcinoma, and five survived with distant metastases from PTC. The remaining four patients remain free of the disease as at the time of writing. If lymph node metastases are identified in the upper jugular chain, the possibility of RPN metastases should be checked. Most RPN metastases from PTC can be dissected safely without mandibulotomy. In particular, low-risk patients can expect favorable outcomes. more...
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- 2014
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18. The role of initial neck dissection for patients with node-positive oropharyngeal squamous cell carcinomas
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Nobuya Monden, Yasuhisa Hasegawa, Ryuichi Hayashi, Takakuni Kato, Tomohiro Sakashita, Kazuyoshi Kawabata, Kazuto Matsuura, Masato Fujii, Kunitoshi Yoshino, Shigemichi Iwae, Ken-ichi Nibu, Akihiro Homma, and Kiyoto Shiga more...
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Male ,Cancer Research ,medicine.medical_specialty ,Regional recurrence ,medicine.medical_treatment ,Gastroenterology ,Nodal disease ,Internal medicine ,Overall survival ,Humans ,Medicine ,In patient ,Definitive radiotherapy ,Planned neck dissection ,Salvage neck dissection ,Clinical Oncology ,business.industry ,Head and neck cancer ,Neck dissection ,Chemoradiotherapy ,medicine.disease ,Surgery ,Survival Rate ,Regional control ,Oropharyngeal Neoplasms ,Treatment Outcome ,Oncology ,Lymphatic Metastasis ,Carcinoma, Squamous Cell ,Neck Dissection ,Female ,Lymph Nodes ,Neoplasm Recurrence, Local ,Oral Surgery ,business - Abstract
Background: The current study sought to assess the role of initial neck dissection (ND) for patients with node-positive oropharyngeal squamous cell carcinomas (OPSCC). Methods: The data for 202 patients with previously untreated node-positive OPSCC were gathered from 12 institutions belonging to the Head and Neck Cancer Study Group in the Japan Clinical Oncology Group. These patients were categorized into two groups, consisting of the initial ND group and the wait-and-see group, according to treatment policy. Results: Regional recurrence was observed in 17 of 93 patients undergoing initial ND, whereas, recurrent or persistent diseases were observed in 40 of 109 patients who did not undergo initial ND. The 4-year overall survival rates (OS) for the wait-and-see group and initial ND groups were 74.0% and 78.7%, respectively, and the 4-year regional control rates (RC) for each group were 77.6% and 84.9%. There were no significant differences in either OS or RC (p = 0.3440 and p = 0.2382, respectively). However, for patients with N3 disease, the 4-year OS of the initial ND group (100%) was favorable. For patients with N2a disease, the 4-year RC of the initial ND group was higher than that of the wait-and-see group statistically (100% vs 62.5%, p = 0.0156). Conclusions: The role of initial ND was limited in patients with node-positive OPSCC. The treatment strategy not involving initial ND is considered feasible and acceptable when nodal evaluation after definitive radiotherapy or chemoradiotherapy is applied adequately. However, it is possible that initial ND improves outcomes in patients with resectable large-volume nodal disease. (C) 2014 Elsevier Ltd. All rights reserved. more...
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- 2014
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19. Multi-institutional retrospective study for the evaluation of ocular function-preservation rates in maxillary sinus squamous cell carcinomas with orbital invasion
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Akihiro Homma, Kazuto Matsuura, Yasushi Fujimoto, Nobuya Monden, Tomohiro Sakashita, Kengo Kato, Yasuhisa Hasegawa, Kunitoshi Yoshino, Kazuyoshi Kawabata, Masato Fujii, Kenji Okami, Ryuichi Hayashi, Tetsuro Onitsuka, Takashi Matsuzuka, and Shigemichi Iwae more...
- Subjects
medicine.medical_specialty ,Chemotherapy ,genetic structures ,Maxillary sinus ,business.industry ,medicine.medical_treatment ,Retrospective cohort study ,Function preservation ,eye diseases ,Surgery ,Radiation therapy ,Maxillary Sinus Cancer ,medicine.anatomical_structure ,Otorhinolaryngology ,medicine ,sense organs ,business ,Survival rate ,Chemoradiotherapy - Abstract
Background The purpose of this retrospective analysis was to evaluate ocular function and survival rates among treatment modalities in patients with maxillary sinus cancer with orbital invasion. Methods Eighty-seven patients were classified according to the main treatment modality. Ocular function preservation rates and survival rates were evaluated for each therapeutic modality. Results The 5-year overall survival rate for the en bloc resection, conservative surgery, superselective intra-arterial chemotherapy, and radiotherapy (RADPLAT), intravenous chemoradiotherapy (IV-CRT) was 70%, 35%, 49%, and 31%, respectively. The ocular function preservation rate for each group was 15%, 27%, 30%, and 17%, respectively. In the en bloc resection group, there was no significant difference in the 5-year overall survival rate between patients with orbital exenteration and those without orbital exenteration (72% vs 71%; p = .9321). Conclusion The en bloc resection group showed a favorable survival rate but a low preservation rate. Preservation of orbital contents did not reduce the survival rate. © 2014 Wiley Periodicals, Inc. Head Neck 37: 537–542, 2015 more...
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- 2014
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20. A clinical study of diagnosing lymph node metastases from head and neck cancer using ultrasonography
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Wataru Shinbashi, Mutsukazu Kitano, Mariko Ogura, Osamu Fukuoka, Ryousuke Kamiyama, Tohru Sasaki, Kyouichi Terao, Nansei Yamada, Hiroyuki Yonekawa, Kazuhisa Toda, Hirofumi Fukushima, Akira Seto, Ryuta Hidaka, Yu Koizumi, Hiroki Mitani, Yukiko Sato, Aya Ebina, Kazuyoshi Kawabata, Katsumi Doi, Takafumi Togashi, and Eiji Shimura more...
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medicine.medical_specialty ,business.industry ,General surgery ,Head and neck cancer ,medicine.disease ,Clinical study ,medicine.anatomical_structure ,Oncology ,Otorhinolaryngology ,medicine ,Radiology ,Ultrasonography ,business ,Lymph node - Published
- 2014
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21. Thick tumor capsule is a valuable risk factor for distant metastasis in follicular thyroid carcinoma
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Kazuhisa Toda, Wataru Shimbashi, Keiko Yamada, Iwao Sugitani, Hiroki Mitani, Kazuyoshi Kawabata, and Yukiko Sato
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Adult ,Male ,medicine.medical_specialty ,Pathology ,Tumor capsule ,030209 endocrinology & metabolism ,Thyroglobulin ,Gastroenterology ,Iodine Radioisotopes ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Adenocarcinoma, Follicular ,Follicular phase ,medicine ,Humans ,Thyroid Neoplasms ,Risk factor ,Aged ,Retrospective Studies ,Aged, 80 and over ,Univariate analysis ,business.industry ,Distant metastasis ,General Medicine ,Middle Aged ,Combined Modality Therapy ,Survival Analysis ,Serum thyroglobulin ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Multivariate Analysis ,Thyroidectomy ,Female ,Surgery ,Radioactive iodine ,business ,Follow-Up Studies - Abstract
While the biological behavior of follicular thyroid carcinoma (FTC) has been studied in great detail using clinical experience, few studies have investigated pre- or intraoperative factors related to the risk of distant metastasis (DM) among patients with FTC. The aim of this study was to analyze the characteristics of FTC with DM.This study retrospectively investigated 102 patients with FTC who underwent surgery between 1988 and 2013. We compared clinicopathological characteristics between FTC with and without DM.Univariate analysis revealed nodal metastasis (p=0.045), serum thyroglobulin (Tg) at initial operation (≥1000ng/ml; p0.0001), widely invasive appearance according to macroscopic findings (p0.0001), thick tumor capsule (≥1mm; p0.0001), vascular invasion (p=0.0003), extrathyroidal invasion (p=0.047), and venous tumor embolism (p=0.045) as significant risk factors for DM. Multivariate analysis conducted using pre- and intraoperative factors identified thick tumor capsule (≥1mm), serum Tg at initial operation (≥1000ng/ml), and macroscopically widely invasive appearance as risk factors independently associated with development of DM.Patients with these risk factors should undergo total thyroidectomy and radioactive iodine ablation. more...
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- 2018
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22. Effect of local extension sites on survival in locally advanced maxillary sinus cancer
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Satoshi Kano, Kazuyoshi Kawabata, Masato Fujii, Kazuto Matsuura, Shigemichi Iwae, Nobuya Monden, Takashi Matsuzuka, Yasushi Fujimoto, Kenji Okami, Akihiro Homma, Kengo Kato, Yasuhisa Hasegawa, Kunitoshi Yoshino, Ryuichi Hayashi, and Tetsuro Onitsuka more...
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Poor prognosis ,medicine.medical_specialty ,business.industry ,Cranial nerves ,Locally advanced ,Cribriform plate ,Middle cranial fossa ,Surgery ,Maxillary Sinus Cancer ,medicine.anatomical_structure ,Otorhinolaryngology ,medicine ,In patient ,Hard palate ,business - Abstract
Background We analyzed the effects of local extension sites on survival in patients with locally advanced maxillary sinus cancer. Methods The criteria for inclusion in this study were as follows: (1) previously untreated maxillary sinus cancer; (2) squamous cell carcinoma; (3) T4 disease; and (4) curative-intent treatment. The data for 118 patients were obtained from 28 institutions across Japan and analyzed for overall survival and local control rates by local extension site. Results Sites with a poor prognosis included the cribriform plate, dura, nasopharynx, middle cranial fossa, and cranial nerves other than V2. There was a significant correlation among these sites, except for the cranial nerves. Additionally, the hard palate was the only site that correlated with nodal involvement and showed a poor treatment outcome. Conclusion Even in cases presenting with similar T4 maxillary sinus cancer, treatment should be performed in consideration of the local extension site. © 2013 Wiley Periodicals, Inc. Head Neck 36: 1567–1572, 2014 more...
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- 2013
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23. Chemotherapy for anaplastic thyroid cancer using docetaxel and cisplatin: report of eight cases
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Kazuyoshi Kawabata, Takashi Saotome, Iwao Sugitani, Shunji Takahashi, Kazuhisa Toda, and Akira Seto
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Male ,Oncology ,medicine.medical_specialty ,medicine.medical_treatment ,Case Report ,Docetaxel ,Therapeutics ,Thyroid Carcinoma, Anaplastic ,Thyroid carcinoma ,Leukocytopenia ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Adjuvant therapy ,Chemotherapy ,Humans ,Combined Modality Therapy ,Thyroid Neoplasms ,Anaplastic thyroid cancer ,Aged ,Cisplatin ,business.industry ,Anaplastic thyroid carcinoma ,General Medicine ,Middle Aged ,medicine.disease ,Chemotherapy, Adjuvant ,Feasibility Studies ,Female ,Taxoids ,Surgery ,business ,medicine.drug - Abstract
Anaplastic thyroid carcinoma has a dismal prognosis and lacks an established therapeutic strategy. We have recently conducted chemotherapy with docetaxel and cisplatin as part of multimodal treatment for eight patients with anaplastic thyroid carcinoma. Docetaxel (75 mg/m2) and cisplatin (75 mg/m2) were administered on day 1 every 4 weeks for six courses. This chemotherapy was used as induction therapy in one patient, as therapy for distant metastases in five patients and as postoperative adjuvant therapy in two patients. Three patients showed partial responses and three patients showed stable disease. After excluding the two patients receiving the treatment as adjuvant therapy the response rate was 50 %. Grade 3 or 4 leukocytopenia occurred in seven patients (88 %), but these adverse events were tolerable. Chemotherapy with docetaxel and cisplatin may thus be feasible for anaplastic thyroid carcinoma. more...
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- 2013
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24. Clinical utility of CT and MRI in assessing the neck after concurrent chemoradiotherapy for oropharyngeal and hypopharyngeal squamous cell carcinoma
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Hirofumi Fukushima, Hiroko Tanaka, Toru Sasaki, Hiroyuki Yonekawa, Wataru Shinbashi, Yukiko Satoh, Hiroki Mitani, and Kazuyoshi Kawabata
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Oncology ,medicine.medical_specialty ,Otorhinolaryngology ,business.industry ,Hypopharyngeal squamous cell carcinoma ,Internal medicine ,medicine ,business ,Concurrent chemoradiotherapy - Published
- 2013
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25. The current status of treatment for oropharyngeal cancer in Japan
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Kazuto Matsuura, Kiyoto Shiga, Satoshi Kano, Kazuyoshi Kawabata, Takakuni Kato, Nobuya Monden, Yasuhisa Hasegawa, Kunitoshi Yoshino, Ken-ichi Nibu, Ryuichi Hayashi, Masato Fujii, Akihiro Homma, and Shigemichi Iwae more...
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Oncology ,medicine.medical_specialty ,Otorhinolaryngology ,business.industry ,Internal medicine ,medicine ,Cancer ,Current (fluid) ,medicine.disease ,business - Published
- 2013
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26. Management and outcome of submandibular gland carcinoma: a retrospective study of cases at a single institute
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Aya Ebina, Yukiko Sato, Kotaro Shirao, Nansei Yamada, Akira Seto, Hisayuki Ota, Syunji Tkahashi, Hiroki Mitani, Eiji Shimura, On Hasegawa, Yu Koizumi, Ryuta Hidaka, Noriko Yamamoto, Takanori Hama, Jin Uesato, Kazuyoshi Kawabata, Hiroyuki Yonekawa, Hirobumi Fukushima, Osamu Fukuoka, Ryosuke Kamiyama, Mitsutaka Adachi, Wataru Shinbashi, and Toru Sasaki more...
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medicine.medical_specialty ,Oncology ,Otorhinolaryngology ,business.industry ,General surgery ,medicine ,Retrospective cohort study ,business ,Submandibular Gland Carcinoma - Published
- 2013
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27. Unresectable Cancer in the Broncho-esophageal Region
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Hiroyuki Yonekawa, Hiroki Mitani, Toru Sasaki, Hirofumi Fukushima, Kazuyoshi Kawabata, Hiroko Tanaka, and Wataru Shimbashi
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medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Cancer ,Broncho-esophageal ,medicine.disease ,business ,Gastroenterology - Published
- 2013
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28. The current status of the treatment for T4 maxillary sinus cancer in Japan ^|^ndash; a multi-institutional retrospective observation study
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Kenji Okami, Kazuto Matsuura, Akihiro Homma, Yasushi Fujimoto, Kazuyoshi Kawabata, Kunitoshi Yoshino, Masato Fujii, Shigemichi Iwae, Tetsuro Onitsuka, Kengo Kato, Takashi Matsuzuka, Ryuichi Hayashi, Yasuhisa Hasegawa, and Nobuya Monden more...
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medicine.medical_specialty ,Maxillary Sinus Cancer ,Oncology ,Otorhinolaryngology ,business.industry ,Head and neck cancer ,medicine ,business ,medicine.disease ,Surgery - Published
- 2013
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29. Matched-pair analysis of patients with advanced hypopharyngeal cancer: surgery versus concomitant chemoradiotherapy
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Ryuichi Hayashi, Hidetoshi Matsui, Kyoichi Terao, Masato Fujii, Tetsuro Onitsuka, Kazuto Matsuura, Hiroshi Nishino, Akihiro Homma, Naoki Otsuki, Shigemichi Iwae, Yasushi Fujimoto, Yasuhisa Hasegawa, Takenori Ogawa, Kazuyoshi Kawabata, Ichiro Ota, Ken-ichi Nibu, Takashi Fujii, Koichiro Yonezawa, Takakuni Kato, Nobuya Monden, and Kenji Okami more...
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Adult ,Male ,Matched Pair Analysis ,medicine.medical_specialty ,Matched-Pair Analysis ,Laryngectomy ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Larynx preservation ,Asian People ,Pharyngectomy ,Surgical oncology ,Medicine ,Humans ,030223 otorhinolaryngology ,Aged ,Retrospective Studies ,Aged, 80 and over ,Hypopharyngeal Neoplasms ,business.industry ,Medical record ,Hypopharyngeal cancer ,Hematology ,General Medicine ,Chemoradiotherapy ,Middle Aged ,medicine.disease ,Surgery ,Treatment Outcome ,Oncology ,030220 oncology & carcinogenesis ,Propensity score matching ,Female ,Larynx ,Concomitant Chemoradiotherapy ,business ,Organ Sparing Treatments - Abstract
The aim of this study was to compare the therapeutic outcomes of total pharyngolaryngectomy with those of concomitant chemoradiotherapy in advanced hypopharyngeal cancer. This is a retrospective multi-institutional study. The medical records of 979 patients with hypopharyngeal cancer, who were initially treated between 2006 and 2008, were reviewed. In this study, we matched a group of total pharyngolaryngectomy patients with a second group of chemoradiotherapy patients, according to age, gender, subsite, arytenoid fixation, cartilage invasion, and N classification, and analyzed overall survival, disease-specific survival, and locoregional control rates. The matched-pair analysis included 254 patients. The 5-year overall survival, disease-specific survival, and locoregional control rates were 58.5% and 53.5% (P = 0.30), 68.9% and 68.0% (P = 0.80), and 82.2% and 63.6% (P more...
- Published
- 2016
30. Comparison of synchronous versus staged surgeries for patients with synchronous double cancers of the esophagus and head-and-neck
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Hironobu Shigaki, Koujiro Nishida, Masayuki Watanabe, Akira Matsumoto, Shinji Mine, Kazuyoshi Kawabata, Katsuhiko Yanaga, and Takeshi Sano
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Oncology ,medicine.medical_specialty ,Surgical stress ,business.industry ,Incidence (epidemiology) ,Head and neck cancer ,Gastroenterology ,General Medicine ,Esophageal cancer ,medicine.disease ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Blood loss ,030220 oncology & carcinogenesis ,Internal medicine ,White blood cell ,medicine ,030211 gastroenterology & hepatology ,Esophagus ,business ,Head and neck - Abstract
Esophageal and head and neck (H&N) cancers often occur synchronously, this study aimed to clarify the benefits and disadvantages of synchronous and staged operations for double H&N/esophagus cancers. We retrospectively reviewed 43 patients with synchronous double cancer of H&N and esophagus treated between July 2005 and July 2014, of whom 33 patients underwent synchronous operation (SYN) and 10 underwent staged operations (STG). We compared the short-term outcomes between the groups. Operation time was longer, amount of blood loss was larger, and hospital stay was longer in the SYN group than in each single surgery of the STG group. Incidence of postoperative complications did not differ between the groups. Tracheal necrosis was observed only in the SYN group. One patient died because of postoperative bleeding in the SYN group, whereas no mortality was seen in the STG group. Both the peripheral white blood cell counts and serum CRP levels during postoperative period were significantly higher in the SYN group than each single surgery of STG group. The staged surgery strategy for patients with synchronous esophagus/H&N cancers can attenuate surgical stress and thus may increase safety. more...
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- 2016
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31. Common carotid artery rupture during treatment with lenvatinib for anaplastic thyroid cancer
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Kazuyoshi Kawabata, Shunji Takahashi, Kazuhisa Toda, Iwao Sugitani, Aya Ebina, Yoshiya Sugiura, and Kazufumi Obata
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Sorafenib ,medicine.medical_specialty ,030209 endocrinology & metabolism ,Case Report ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,medicine.artery ,medicine ,Common carotid artery ,Anaplastic thyroid cancer ,Thyroid cancer ,medicine.diagnostic_test ,Sunitinib ,business.industry ,Thyroid ,medicine.disease ,Surgery ,Fine-needle aspiration ,medicine.anatomical_structure ,chemistry ,030220 oncology & carcinogenesis ,Radiology ,Lenvatinib ,business ,medicine.drug - Abstract
Anaplastic thyroid cancer is a fatal disease for which no effective therapeutic strategies exist. Lenvatinib, a tyrosine-kinase inhibitor that targets vascular endothelial growth factor receptor, has recently been approved in Japan for the treatment of patients with unresectable thyroid cancer including anaplastic thyroid cancer. Although lenvatinib, like the other tyrosine-kinase inhibitors, sunitinib and sorafenib, might also confer a risk of bleeding, fatal bleeding as a result of lenvatinib treatment for anaplastic thyroid cancer has not been described. A 61-year-old woman presented with a 7-cm mass in the right lobe of the thyroid, lymph node metastases to the neck and multiple lung metastases. Fine needle aspiration revealed that the tumor was anaplastic thyroid cancer. The TNM classification was T4aN1bM1, stage IVC. Shortly after local curative surgery, a tumor recurred in her neck that was treated with lenvatinib (24 mg/day). Nineteen days later, the common carotid artery ruptured and the lenvatinib was stopped. She received the best possible supportive care but died 40 days after stopping the lenvatinib. Autopsy findings showed that the tumor had invaded the adventitia of the common carotid artery at the region of the neck surgery, and an aneurysm had developed. However, the adventitia of the common carotid artery was preserved at the non-dissected area. Lenvatinib might confer risk for fatal bleeding in patients with recurrent anaplastic thyroid cancer after neck surgery, particularly with dissection around the common carotid artery. more...
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- 2016
32. Cytopathological review of patients that underwent thyroidectomies based on the diagnosis of papillary thyroid carcinoma by fine needle aspiration cytology but were later found to have benign tumors by histopathology
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Kazuyoshi Kawabata, Kazuhisa Toda, Motoko Ikenaga, Noriko Motoi, Iwao Sugitani, Yoshihide Fujimoto, Muneki Hotomi, Mutsukazu Kitano, and Noriko Yamamoto
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Adenoma ,Adult ,Male ,medicine.medical_specialty ,Pathology ,endocrine system diseases ,Cytodiagnosis ,medicine.medical_treatment ,Biopsy, Fine-Needle ,Sensitivity and Specificity ,Diagnosis, Differential ,Thyroid carcinoma ,Surgical oncology ,Cytology ,medicine ,Atypia ,Humans ,False Positive Reactions ,Thyroid Neoplasms ,Diagnostic Errors ,Retrospective Studies ,medicine.diagnostic_test ,Goiter ,business.industry ,Thyroidectomy ,General Medicine ,Middle Aged ,medicine.disease ,Carcinoma, Papillary ,body regions ,Fine-needle aspiration ,Female ,Surgery ,Histopathology ,Radiology ,business - Abstract
The aim of this study is to evaluate the specificity of diagnosing PTC by fine needle aspiration (FNA) cytology. This study retrospectively reviewed the cytopathological reports of 1066 patients that underwent thyroidectomy based on a diagnosis of PTC by FNA between January 1993 and December 2008. This study re-evaluated the cytology and histopathology of the patients that received false positive diagnoses of PTC by FNA. Ten patients (0.9 %) received false positive diagnoses of PTC by FNA. Three patients were overdiagnosed as having PTC by FNA cytology. In contrast, the nuclear features of PTC in the other seven cases were confirmed by the retrospective reviews of the patients’ FNA cytology. Three of the seven patients showed follicular structures in their resection specimens, thus resulting in a diagnosis of either adenomatous goiter or follicular adenoma. However, PTC could not be diagnosed by histopathology in the remaining four patients, even though the histopathology showed the nuclear features of PTC. Most cases of PTC can be easily diagnosed by cytological and morphological atypia with certain limitations. The difficulty in diagnosing PTC by cytology is because the pathological features of PTC also occur in some benign thyroid tumors. Therefore, immunohistochemical or molecular biological approaches must be combined with current cytological diagnostic techniques for the diagnosis of PTC. more...
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- 2012
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33. Mesenteric fibromatosis of the transverse colon with the reconstruction of the superior mesenteric arteries: report of a case
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Rintaro Koga, Hiroaki Kanda, Ken Nakagawa, Mutsuo Machinami, Makoto Seki, Kazuyoshi Kawabata, Masaru Nakagawa, and Akio Saiura
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Microsurgery ,medicine.medical_specialty ,medicine.medical_treatment ,Fibroma ,Anastomosis ,Veins ,Young Adult ,Mesenteric Artery, Superior ,medicine.artery ,Intestine, Small ,Humans ,Medicine ,Mesentery ,Superior mesenteric artery ,Mesenteric arteries ,Peritoneal Neoplasms ,business.industry ,Anastomosis, Surgical ,Transverse colon ,Jejunal arteries ,General Medicine ,SMA ,Small intestine ,medicine.anatomical_structure ,Female ,Surgery ,Radiology ,business ,Colon, Transverse - Abstract
In general, with large mesenteric tumors it may be rather difficult to determine whether infiltration into adjacent large vessels occurred. We wish to stress the importance of preparation for microsurgery when a huge lesion appears close to a large artery in preoperative images, based on our experience of successful microscopical reconstruction of a superior mesenteric artery (SMA) and marked improvement of blocked vascular flow to the small intestine during the surgery. We have experienced a case of mesenteric fibromatosis (MF) invading the SMA and vein, contrary to preoperative expectation. The patient underwent extirpation of a MF, 21 cm in size, with reconstruction of the SMA by microsurgery. The sacrificed small intestine was only 80 cm of the distal ileum with the benefit of microscopic anastomosis between the SMA and a major jejunal artery. Preparations for microscopic surgery must be made with resection of large lesions, because involvement of mesenteric large vessels may be expected. It is possible for microsurgery to extend indications for surgical resection of huge mesenteric tumors. more...
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- 2012
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34. A Novel Definition of Extrathyroidal Invasion for Patients with Papillary Thyroid Carcinoma for Predicting Prognosis
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Muneki Hotomi, Kazuyoshi Kawabata, Iwao Sugitani, Yoshihide Fujimoto, and Kazuhisa Toda
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Adult ,Male ,Oncology ,medicine.medical_specialty ,Adolescent ,Esophageal Neoplasms ,medicine.medical_treatment ,Gastroenterology ,Decision Support Techniques ,Thyroid carcinoma ,Young Adult ,Internal medicine ,medicine ,Carcinoma ,Recurrent laryngeal nerve ,Humans ,Cranial Nerve Neoplasms ,Neoplasm Invasiveness ,Prospective Studies ,Thyroid Neoplasms ,Esophagus ,Prospective cohort study ,Thyroid cancer ,Survival analysis ,Aged ,Aged, 80 and over ,Recurrent Laryngeal Nerve ,business.industry ,Thyroidectomy ,Middle Aged ,Prognosis ,medicine.disease ,Survival Analysis ,Carcinoma, Papillary ,medicine.anatomical_structure ,Thyroid Cancer, Papillary ,Lymphatic Metastasis ,Female ,Tracheal Neoplasms ,Surgery ,Neoplasm Recurrence, Local ,business ,Vocal Cord Paralysis ,Follow-Up Studies - Abstract
Extrathyroidal invasion is one of the most significant risk factors for patients with papillary thyroid carcinoma (PTC). The purpose of this study was to evaluate a novel definition of extrathyroidal invasion for patients with PTC as a method for predicting a patient’s prognosis. The prospective study was conducted for consecutive 930 patients with primary PTC who received surgery during 1993–2009. We defined only patients who had preoperative recurrent laryngeal nerve palsy or patients in whom the tumor had invaded to the mucosa of the trachea and/or esophagus as Ex3. Patients with minimal invasion were classified as Ex1, and patients with massive invasion, when we could shave off the tumors, were classified as Ex2. Patients without extrathyroidal invasion were classified as Ex0. Patients classified Ex3 showed significantly shorter disease-free survival (p = 0.03) and disease-specific survival (p = 0.007) than patients classified Ex2. The time to recurrence at resection sites was shorter in patients classified Ex3 than in patients classified Ex2 (p = 0.02). The time to death due to distant metastasis of patients classified Ex3 was significantly shorter than that of patients classified Ex2 (p = 0.02). Within the patients classified Ex3, disease-specific survival of patients with invasion to other nearby structures was shorter than that of patients with invasion to only recurrent laryngeal nerve (p = 0.008). The degree and site of invasion is an important prognostic factor for PTC. Our novel classification of extrathyroidal invasion is valuable in predicting the prognosis of PTC. more...
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- 2012
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35. Malignant mucosal melanoma of the head and neck: Results of surgical treatment of 40 cases
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Mariko Ogura, Aya Ebina, Hirofumi Fukushima, Akira Seto, Mutsukazu Kitano, Tohru Sasaki, Hiroyuki Yonekawa, Hiroki Mitani, Yuu Koizumi, Takayuki Kawabata, Wataru Shinbashi, Yushi Ueki, Mitsutaka Adachi, Yuki Saito, Kazuyoshi Kawabata, and Ryosuke Kamiyama more...
- Subjects
medicine.medical_specialty ,Oncology ,Otorhinolaryngology ,business.industry ,medicine ,Mucosal melanoma ,medicine.disease ,Head and neck ,business ,Surgical treatment ,Surgery - Abstract
1980年1月から2010年12月までの30年間にがん研病院頭頸科で一次治療として手術を行った頭頸部原発粘膜悪性黒色腫40例の治療成績を検討した。男女比1:1,年齢は24~79歳(中央値62歳),観察期間は5~174ヶ月(中央値23ヶ月)であった。原発臓器は鼻副鼻腔:28例,口腔:9例,咽頭:3例。TNM分類(AJCC/UICC第7版)ではT3:8例,T4a:23例,T4b:9例でN0:36例,N1:4例,stage III:6例,stage IVA:25例,stage IVB:9例であった。Kaplan-Meier法による5年局所制御率,粗生存率,無再発生存率は70%,43%,29%であった。TNM分類は臨床的な予後とよく相関し,T4b,N1は予後不良であった。原発後方再発の制御が課題と考えられた。後発頸部リンパ節転移も高率にみとめ,頸部郭清が治療成績の維持に一定の効果を認めた。 more...
- Published
- 2012
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36. Clinical study of en bloc resection for squamous cell carcinoma of maxillary sinus
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Tohru Sasaki, Hiroyuki Yonekawa, Mitsutaka Adachi, Hiroki Mitani, Takayuki Kawabata, Wataru Shimbashi, Hirofumi Fukushima, Akira Seto, Aya Ebina, Ryosuke Kamiyama, Mariko Ogura, Mutsukazu Kitano, Kazuyoshi Kawabata, and Yuu Koizumi more...
- Subjects
medicine.medical_specialty ,Maxillary sinus ,business.industry ,En bloc resection ,Surgery ,Clinical study ,medicine.anatomical_structure ,Oncology ,Otorhinolaryngology ,Cat scanning ,medicine ,Combined therapy ,Basal cell ,business - Abstract
当科における上顎癌の治療は1960年代後半から佐藤ら1)の三者併用療法をmodifiedした治療法を行い,その成績は1970年から1980年までの症例で5年粗生存率41.8%が得られていた2)。その後,さらなる成績向上を目指しCT,MRIによる画像診断を取り入れ,術前放射線療法の効果に応じた一塊切除を行なう方法に切り替えた。結果,1980年から2008年までの一塊切除136症例では5年粗生存率:62.1%,5年原発巣制御率75.2%が得られた。術前療法の効果では単独照射より動注照射の方が効果的であった。上顎近傍には眼球等の重要臓器があり顔面形態の保存を含めたQOLを考慮したさまざまな治療方法が示されているが,本稿では上顎扁平上皮癌に対する一塊切除法の成績について報告する。 more...
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- 2011
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37. Management of dysphagia for patients being treated for head and neck cancer in our department
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Michiyo Yamakawa, Kazuyoshi Kawabata, Kaoru Yokoyama, Koji Takahashi, Yuka Nakamichi, Hiromi Hamada, and Risa Uyama
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medicine.medical_specialty ,Oncology ,Otorhinolaryngology ,business.industry ,Head and neck cancer ,medicine ,medicine.symptom ,medicine.disease ,business ,Dysphagia ,Surgery - Abstract
頭頸部癌の治療後にみられる摂食・嚥下障害に対する当科の取り組みを紹介した。嚥下造影検査,嚥下内視鏡検査を行う際には検査時状況画像ならびに嚥下時産生音を同時記録し,記録された患者の姿勢,体格,意識レベル,表情や意欲,摂食運動,発声,呼吸音,嚥下音むせなどの情報を利用することにより摂食・嚥下障害の効率的な臨床的対応を実現している。また摂食・嚥下障害の訓練法ならびに対応法を短期間に確実に習得させるために入院下集中リハビリテーションを行っており,その副次的効果として短期間での摂食レベルの改善を得ている。さらに頭頸部癌術後患者には摂食・嚥下障害の改善のために各種口腔内装置を適用しており,今回は舌接触補助床と下顎復位装置について紹介した。 more...
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- 2011
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38. Cytokeratin expression profiling is useful for distinguishing between primary squamous cell carcinoma of the lung and pulmonary metastases from tongue cancer
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Naohiko Inase, Yukinori Kimura, Takehiko Ohba, Kazuyoshi Kawabata, Sakae Okumura, Yasuyuki Yoshizawa, Noriko Motoi, and Yuichi Ishikawa
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Pathology ,medicine.medical_specialty ,Lung ,Squamous-cell carcinoma of the lung ,business.industry ,Cancer ,General Medicine ,respiratory system ,medicine.disease ,respiratory tract diseases ,Pathology and Forensic Medicine ,Metastasis ,stomatognathic diseases ,Cytokeratin ,medicine.anatomical_structure ,Tongue ,medicine ,Carcinoma ,Lung cancer ,business - Abstract
It can be difficult to distinguish between primary and metastatic squamous cell carcinoma (SCC) in the lung. Surgical specimens were obtained from two groups of patients, 26 lung SCC patients without histories of any other cancer (the definite primary group) and 17 patients who had undergone surgical removal of SCC emerging in the lung after surgery for tongue SCC (the unknown group). From the former, 26 primary lung SCC were obtained. From the latter, 17 lung tumors and 15 primary tumors of the tongue were obtained. Eleven of the 17 lung tumors from the unknown group were metastatic lung SCC. All specimens were immunostained with cytokeratin (CK)5/6, CK7, CAM5.2, CK19 and p63 antibodies. The frequency of CAM5.2 and CK19 expression was significantly higher in the lung SCC of the definite primary group (21 of 26, 81% and 20 of 26, 78%, respectively) than in the metastatic lung SCC (1 of 11, 9% (P < 0.001) and 2 of 11, 18% (P = 0.003), respectively) or primary SCC of the tongue (5 of 15, 33% (P = 0.002) and 2 of 15, 13% (P < 0.001), respectively). CAM5.2 and CK19 are useful for distinguishing between primary SCC of the lung and metastases from tongue cancer. more...
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- 2010
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39. Surgical resection for oral tongue cancer pulmonary metastases☆
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Sakae Okumura, Takahiro Mochizuki, Genichiro Ishii, Kazuyoshi Kawabata, Ryuichi Hayashi, Junji Yoshida, and Yuichi Ishikawa
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Adult ,Male ,Reoperation ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung Neoplasms ,Time Factors ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Disease-Free Survival ,Pneumonectomy ,Bilobectomy ,Japan ,medicine ,Carcinoma ,Humans ,Lost to follow-up ,Aged ,Retrospective Studies ,Lung ,business.industry ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Tongue Neoplasms ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Carcinoma, Squamous Cell ,Female ,Metastasectomy ,Cardiology and Cardiovascular Medicine ,business ,Wedge resection (lung) - Abstract
The aim of this study was to evaluate the efficacy of surgical resection of oral tongue cancer (OTC) pulmonary metastases. Between 1977 and 2003, 23 OTC patients who developed 1-3 pulmonary metastases underwent metastasectomy. There were 14 men and nine women with a median age at the time of first metastasectomy of 56 years. All patients had advanced squamous cell OTC with synchronous or metachronous regional lymph node metastases. The median tumor-free interval after the last OTC treatment was 12 months. Five patients underwent pneumonectomy, three bilobectomy, 13 lobectomy, and two wedge resection. Two patients underwent a second pulmonary metastasectomy. One patient continues to survive, without recurrence 19 years after metastasectomy. Another patient was alive with disease at 24 months after metastasectomy but was lost to follow-up. Twenty-two out of 23 patients developed systemic metastases. The median interval to systemic recurrence after lung resection was 4.1 months, and 21 out of 23 patients died of OTC (median, 9.5 months) after metastasectomy. Most patients who underwent pulmonary metastasectomy died of the disease within two years of metastasectomy. Even for patients with a solitary metastasis, surgical metastasectomy is not a recommended treatment option. more...
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- 2010
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40. Adjuvant chemotherapy with S-1 after curative chemoradiotherapy in patients with locoregionally advanced squamous cell carcinoma of the head and neck: Reanalysis of the ACTS-HNC study
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Akira Kubota, Eiji Nakatani, Kiyoaki Tsukahara, Yasuhisa Hasegawa, Hideki Takemura, Tomonori Terada, Takahide Taguchi, Kunihiko Nagahara, Hiroaki Nakatani, Kunitoshi Yoshino, Yuichiro Higaki, Shigemichi Iwae, Takeshi Beppu, Yutaka Hanamure, Kichinobu Tomita, Naoyuki Kohno, Kazuyoshi Kawabata, Satoshi Teramukai, Masato Fujii, and ACTS-HNC Study Group more...
- Subjects
Male ,Oncology ,Adjuvant Chemotherapy ,medicine.medical_treatment ,Cancer Treatment ,lcsh:Medicine ,Drug research and development ,Metastasis ,Clinical trials ,0302 clinical medicine ,Basic Cancer Research ,Antineoplastic Combined Chemotherapy Protocols ,Medicine and Health Sciences ,030212 general & internal medicine ,Stage (cooking) ,lcsh:Science ,Multidisciplinary ,Pharmaceutics ,Hazard ratio ,Chemoradiotherapy ,Middle Aged ,Phase III clinical investigation ,Drug Combinations ,Surgical Oncology ,Treatment Outcome ,Chemotherapy, Adjuvant ,Head and Neck Neoplasms ,030220 oncology & carcinogenesis ,Female ,Research Article ,medicine.drug ,Clinical Oncology ,Adult ,Antimetabolites, Antineoplastic ,medicine.medical_specialty ,Radiation Therapy ,Surgical and Invasive Medical Procedures ,Tegafur ,Disease-Free Survival ,Drug Administration Schedule ,Cancer Chemotherapy ,03 medical and health sciences ,Drug Therapy ,Internal medicine ,medicine ,Chemotherapy ,Humans ,Uracil ,Aged ,Neoplasm Staging ,Pharmacology ,Squamous Cell Carcinoma of Head and Neck ,business.industry ,lcsh:R ,Head and neck cancer ,medicine.disease ,Research and analysis methods ,Clinical trial ,Radiation therapy ,Oxonic Acid ,lcsh:Q ,Clinical Medicine ,business ,Combination Chemotherapy - Abstract
Background Chemoradiotherapy (CRT) has improved organ preservation or overall survival (OS) of locoregionally advanced head and neck squamous cell cancer (LAHNSCC), but in clinical trials of conventional CRT, increasing CRT intensity has not been shown to improve OS. In the Adjuvant ChemoTherapy with S-1 after curative treatment in patients with Head and Neck Cancer (ACTS-HNC) phase III study, OS of curative locoregional treatments improved more with adjuvant chemotherapy with S-1 (tegafur gimeracil oteracil potassium) than with tegafur/uracil (UFT). ACTS HNC study showed the significant efficacy of S-1 after curative radiotherapy in sub-analysis. We explored the efficacy of S-1 after curative CRT in a subset of patients from the ACTS-HNC study. Methods Patients with stage III, IVA, or IVB LAHNSCC were enrolled in this study to evaluate the efficacy of S-1 compared with UFT as adjuvant chemotherapy after curative CRT in the ACTS-HNC study. Patients received S-1 at 80–120 mg/day in two divided doses for 2 weeks, followed by a 1-week rest, or UFT 300 or 400 mg/day in two or three divided doses daily, for 1 year. The endpoints were OS, disease-free survival, locoregional relapse-free survival, distant metastasis-free survival (DMFS), and post-locoregional relapse survival. Results One hundred eighty patients (S-1, n = 87; UFT, n = 93) were included in this study. Clinical characteristics of the S-1 and UFT arms were similar. S-1 after CRT significantly improved OS (hazard ratio [HR], 0.46; 95% confidence interval [CI], 0.22–0.93) and DMFS (HR, 0.50; 95% CI, 0.26–0.97) compared with UFT. Conclusion As adjuvant chemotherapy, S-1 demonstrated better efficacy for OS and DMFS than UFT in patients with LAHNSCC after curative CRT and may be considered a treatment option following curative CRT. For this study was not preplanned in the ACTS-HNC study, the results is hypothesis generating but not definitive. more...
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- 2018
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41. Analysis of 59 cases with free flap thrombosis after reconstructive surgery for head and neck cancer
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Seiichi Yoshimoto, Hiroki Mitani, and Kazuyoshi Kawabata
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Adult ,Male ,Reoperation ,Microsurgery ,medicine.medical_specialty ,Reconstructive surgery ,Critical Care ,medicine.medical_treatment ,Free flap ,Vascular occlusion ,Surgical Flaps ,Necrosis ,Postoperative Complications ,Risk Factors ,medicine ,Humans ,Alprostadil ,Aged ,Venous Thrombosis ,Heparin ,business.industry ,Head and neck cancer ,Graft Occlusion, Vascular ,Thrombosis ,Ultrasonography, Doppler ,General Medicine ,Pedicled Flap ,Middle Aged ,Vascular surgery ,medicine.disease ,eye diseases ,Surgery ,Otorhinolaryngologic Neoplasms ,Otorhinolaryngology ,Female ,medicine.symptom ,business ,Bed Rest ,Blood Flow Velocity ,Follow-Up Studies - Abstract
Objective There have been few reports addressing methods of dealing with free flap thrombosis after reconstructive surgery for head and neck cancer. The present study, through a detailed analysis of the subsequent course of patients who developed postoperative flap thrombosis, aims to clarify possible methods of salvage surgery in the event of vascular occlusion despite rigorous postoperative follow-up. Methods We analyzed 59 cases of postoperative thrombosis in 1031 patients who underwent free flap transfer and considered the most appropriate salvage surgery in the event of total flap necrosis. Results The flap salvage rate through vascular reanastomosis was highest for radial forearm flaps, with salvage of jejunal flaps being problematic if postoperative thrombosis occurred. For cases of postoperative thrombosis among patients who underwent reconstruction using a jejunal flap, the period of hospitalization was significantly extended for those patients in whom a second jejunal flap grafting was impossible. For cases of postoperative thrombosis among patients who underwent reconstruction using a radial forearm flap (FA), rectus abdominis flap (RA), or anterior lateral thigh flap (ALT), no significant difference was observed between those undergoing re-grafting with a free flap and those with a pedicled flap. Conclusion We concluded that, among patients who undergo reconstruction using a jejunal flap, thrombosis should be discovered at an early stage to enable another jejunal flap re-grafting. For patients who undergo reconstruction using a FA, RA, or ALT, if thrombosis can be discovered at an early stage, there is a possibility of salvaging the flap by means of vascular reanastomosis. If it should prove impossible to salvage the flap, however, primary suture of the defect or reconstruction with a pedicled flap may also be considered. more...
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- 2010
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42. Factors involved in free flap thrombosis after reconstructive surgery for head and neck cancer
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Seiichi Yoshimoto, Hiroki Mitani, and Kazuyoshi Kawabata
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Adult ,Male ,Reoperation ,Microsurgery ,medicine.medical_specialty ,Reconstructive surgery ,medicine.medical_treatment ,Free flap ,Surgical Flaps ,Necrosis ,Postoperative Complications ,medicine ,Humans ,Aged ,Aged, 80 and over ,business.industry ,General surgery ,Graft Survival ,Head and neck cancer ,Graft Occlusion, Vascular ,Cancer ,Thrombosis ,General Medicine ,Middle Aged ,Vascular surgery ,medicine.disease ,Surgery ,Otorhinolaryngologic Neoplasms ,Otorhinolaryngology ,Female ,business ,Chemoradiotherapy - Abstract
Objective Reconstructive surgery in which a free flap is used following extended resection for head and neck cancer has been popular for more than a quarter of a century. However, postoperative total flap necrosis has not been completely resolved, and few studies have analyzed the specific risk factors for this complication. Methods Over a three-year period from 2005 to 2007, 388 flaps were used for reconstructive surgery on 384 patients at Department of Head and Neck of the Cancer Institute Hospital of Japanese Foundation for Cancer Research, and the results for 22 flaps with thrombosis were analyzed. Results The only statistically significant risk factor for free flap thrombosis was the history of radical concurrent chemoradiotherapy. Conclusions It will be necessary to keep this observation in mind when performing salvage surgery following chemoradiotherapy, which is expected to be performed more often in the future. more...
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- 2010
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43. Quality of life after neck dissection: a multicenter longitudinal study by the Japanese Clinical Study Group on Standardization of Treatment for Lymph Node Metastasis of Head and Neck Cancer
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Masahisa Saikawa, Yasuhiro Ebihara, Mitsuru Ebihara, Ken-ichi Nibu, Takashi Fujii, Kazuyoshi Kawabata, and Tetsuro Onitsuka
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Adult ,Shoulder ,medicine.medical_specialty ,Accessory nerve ,medicine.medical_treatment ,Dissection (medical) ,Accessory Nerve ,Quality of life ,Neck Muscles ,Surveys and Questionnaires ,medicine ,Humans ,Longitudinal Studies ,Range of Motion, Articular ,Aged ,Pain Measurement ,Aged, 80 and over ,Rehabilitation ,business.industry ,Head and neck cancer ,Neck dissection ,Hematology ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Oncology ,Head and Neck Neoplasms ,Lymphatic Metastasis ,Quality of Life ,Neck Dissection ,Range of motion ,Sternocleidomastoid muscle ,business - Abstract
We performed a multicenter longitudinal study using our neck dissection questionnaire (NDQ) and arm abduction test (AAT) to assess the impact of rehabilitation and surgical modification on postoperative quality of life (QOL). Patients who had undergone neck dissection for the treatment of head and neck cancer answered the NDQ and completed the AAT 1, 3, 6, and 12 months after surgery. All patients enrolled in this study underwent a rehabilitation program designed for neck dissection. The obtained data were statistically analyzed according to the types of neck dissection and compared with the data of patients who had undergone neck dissection but not rehabilitation. A total of 224 patients were enrolled in this study. Our findings revealed that resection of the sternocleidomastoid muscle (SCM) and spinal accessory nerve (SAN) resulted in shoulder drop. Lowering the dissection level and preservation of the SAN and SCM significantly reduced various sensory symptoms of the neck, such as stiffness, pain, numbness, and constriction, and improved shoulder function. Postoperative rehabilitation had a significant effect on arm abduction ability, particularly when the SCM and SAN were resected. The study demonstrated that rehabilitation, in addition to modifications to radical neck dissection, contributed to the improvement of postoperative QOL after neck dissection. more...
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- 2010
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44. Quality of life after neck dissection -Multicenter study
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Madoka Furukawa, Ken-ichi Nibu, Takashi Fujii, Ryuichi Hayashi, Masashi Sugasawa, Morimasa Kitamura, Masato Fujii, Kazuyoshi Kawabata, Masahisa Saikawa, Nobuya Monden, Masao Asai, Hiroya Ojiri, Tetsuo Onitsuka, Yusuhisa Hasegawa, Hiroaki Nakatani, Takashi Yoshizumi, Watarau Nishijima, Yoshinobu Tomita, Masakazu Miyazaki, Kazunori Matsuura, Naoyuki Kohno, Katsuyuki Doi, Seiji Kishimoto, Tadasi Nakashima, and Takahiro Asakage more...
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medicine.medical_specialty ,Oncology ,Otorhinolaryngology ,Multicenter study ,Quality of life ,business.industry ,medicine.medical_treatment ,medicine ,Neck dissection ,business ,Surgery - Abstract
厚生労働省科学研究費補助金「頭頸部がんのリンパ節転移に対する標準的治療法の確立に関する研究」(斉川班)で作成した頸部郭清術後機能評価法を用いて,本研究班において見学調査され詳細な術式の情報が得られた症例を対象として,郭清範囲の縮小や非リンパ組織の温存,術後照射が,頸部郭清術後Quality of Lifeに与える影響を検討した。郭清範囲をレベルIIIまでに縮小することで,「肩や首の硬さ」や「締め付け感」などの悩みが減ること,レベルVを郭清しても胸鎖乳突筋や副神経を温存すれば,これらの後遺症を軽減させることができること,胸鎖乳突筋の切除により有意に「肩の下がり」がみられること,副神経切除例では「首の痛み」や「外観」での悩みが多いこと,50Gy以上の放射線治療例では「首が硬い」という訴えが強くなること等が確認された。 more...
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- 2010
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45. Hemangioma of the Thyroid
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Noriko Yamamoto, Akihiro Sakai, Kazuyoshi Kawabata, and Iwao Sugitani
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Anterior neck ,endocrine system ,medicine.medical_specialty ,Pathology ,endocrine system diseases ,business.industry ,Thyroid ,Cancer ,General Medicine ,Blood flow ,medicine.disease ,lcsh:Otorhinolaryngology ,lcsh:RF1-547 ,eye diseases ,body regions ,Hemangioma ,medicine.anatomical_structure ,Cytology ,medicine ,sense organs ,Radiology ,Ultrasonography ,Differential diagnosis ,business - Abstract
Introduction Thyroid hemangioma is very rare, and only a few cases have previously been reported. We encountered a patient with thyroid hemangioma diagnosed after surgery. Case Report A 71-year-old woman visited our hospital with a mass in the left thyroid region. A 5-cm, elastic mass of the thyroid was palpable in the left anterior neck. On cytology by fine-needle aspiration (FNA), the specimen mainly contained blood components without apparent atypical cells. A tumor with abundant blood flow was suspected based on Doppler ultrasonography. Adenomatous goiter was suspected, and subtotal thyroidectomy was performed. A blood clot was present in the tumor, and hemangioma was diagnosed on postoperative histopathological examination. Discussion Preoperative diagnosis of thyroid hemangioma is difficult. However, Doppler ultrasonography and FNA are useful for diagnosis. A differential diagnosis of hemangioma should be considered when blood flow is abundant and only blood components are collected. more...
- Published
- 2009
46. Indications for thyroid cancer surgery in elderly patients
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Iwao Sugitani, Hiroshi Matsuyama, Kazuyoshi Kawabata, and Yoshihide Fujimoto
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Adult ,Male ,Reoperation ,medicine.medical_specialty ,Adolescent ,Statistics, Nonparametric ,Thyroid carcinoma ,Young Adult ,Quality of life ,Risk Factors ,medicine ,Carcinoma ,Humans ,Thyroid Neoplasms ,Young adult ,Thyroid cancer ,Survival rate ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Thyroid ,Age Factors ,Cancer ,General Medicine ,Prognosis ,medicine.disease ,Carcinoma, Papillary ,humanities ,Surgery ,Survival Rate ,Treatment Outcome ,medicine.anatomical_structure ,Quality of Life ,Female ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
To define the indications for thyroid cancer surgery in elderly patients. We compared the clinical characteristics of thyroid cancers in 85 elderly patients, defined as those aged ≥75 years, with those of 37 young patients, defined as those aged more...
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- 2009
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47. Seamless collaboration for head and neck reconstructive surgery
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Iwao Sugitani, Shiro Tanaka, Makoto Kurose, Tohru Sasaki, Kiyoaki Tsukahara, Chihiro Fushimi, Shin-etsu Kamata, Masafumi Yoshida, Hiroyuki Yonekawa, Hiroki Mitani, Hirofumi Fukushima, Hirobumi Shoji, Keisuke Yamazaki, Akihiro Sakai, Seiichi Yoshimoto, Senri Oguri, Kensuke Aoki, Wataru Shimbashi, Takeshi Beppu, Kazuyoshi Kawabata, and Hiroshi Matsuyama more...
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medicine.medical_specialty ,Reconstructive surgery ,Oncology ,Otorhinolaryngology ,business.industry ,medicine ,business ,Head and neck ,Surgery - Abstract
頭頸部再建手術においては,切除側と再建側がお互いの要望するところを熟知し,協調性をもって計画的にチーム医療を実施することが大事である。切除側の注意点には,特に原発巣切除断端の良好な血流ならびに健常組織の保存,血管吻合の候補となる血管の愛護的操作と保存がある。一方再建側の注意点には,最適なvolumeを持ち血流の安定した皮弁の採取,術後機能を最大限に引き出し,かつ合併症を回避すべく工夫を施した再建が挙げられる。実際の手術が時間の点でも,人員配置の点でも継ぎ目なく有効に行われるためには,切除,再建の両者が要求する細かい部分までをよく熟知し,お互いが協調していく体制が必須である。 more...
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- 2009
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48. A Study of Patients with Papillary Thyroid Cancer who Underwent Tracheal Shaving
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Kiyoaki Tsukahara, Iwao Sugitani, and Kazuyoshi Kawabata
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Oncology ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Urology ,medicine.disease ,business ,Papillary thyroid cancer - Abstract
甲状腺乳頭癌の甲状腺外他臓器浸潤は重要な予後不良因子の一つである。われわれは気管浸潤が肉眼的に気管粘膜面に達しない場合は気管表層切除(以下シェービング)を行っている。気管シェービングを行った症例での局所制御率,遠隔転移率,生存率についてretrospectiveに検討した。対象は1994年1月から2005年12月の間に癌研病院頭頸科で気管シェービングを行った甲状腺乳頭癌22例である。22例中21例(95%)で局所制御されていた。22例中6例(27%)に遠隔転移を認めた。5年生存率93%,10年生存率41%で,現在2例が担癌生存中である。気管シェービングは気管全層切除に比べ術後の患者QOLが高く,気管粘膜面に達しない浸潤であれば局所制御良好であった。しかしながら気管浸潤のない甲状腺乳頭癌に比べると遠隔転移の合併が多く,気管以外の臓器への浸潤も少なくないため高危険度リスク群に該当する症例が多い。特に遠隔再発に注意して慎重に経過観察する必要があると考えられる。 more...
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- 2009
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49. Diagnostic imaging of the parotid gland tumors: Characteristic MR findings
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Hiroyuki Yonekawa, Hirofumi Fukushima, Hiroki Mitani, Tohru Sasaki, Atsushi Kohno, Hiroko Tanaka, Takeshi Beppu, and Kazuyoshi Kawabata
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medicine.anatomical_structure ,Oncology ,Otorhinolaryngology ,medicine.diagnostic_test ,business.industry ,Medical imaging ,Medicine ,Magnetic resonance imaging ,business ,Nuclear medicine ,Parotid gland - Abstract
耳下腺腫瘍のMRIにおける鑑別診断法について,2005年3月から2008年4月まで癌研究会有明病院頭頸科で組織診断が確定した97腫瘤を対象として,良性腫瘍を多形腺腫とワルチン腫瘍,その他良性腫瘤の3つ,悪性腫瘍を癌と悪性リンパ腫の2つの合計5つの腫瘍型に分けて検討した。良・悪性の鑑別診断には腫瘤の形態と被膜構造の有無が重要である。良性腫瘍は類円形あるいは分葉状形態で,全周性被膜構造を有するものが多く,悪性腫瘍は不整形で被膜構造の無いものが多い。多形腺腫は拡散強調像から得られるみかけの拡散係数最高値(ADC最高値)が2.0以上と高値であることが多い。ワルチン腫瘍は造影剤を用いたダイナミック造影の時間信号強度曲線が急増・急減の特徴的パタンを呈した。これらの結果から,耳下腺腫瘍の良・悪性の鑑別診断にはMRIで特徴的所見を得ることが有用であると考えられた。 more...
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- 2008
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50. Results of reconstructive surgery for wide defects of base of tongue
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Seiichi Yoshimoto, Tohru Sasaki, Hirofumi Fukushima, Takeshi Beppu, Kouji Takahashi, Hiroyuki Yonekawa, Kazuyoshi Kawabata, Hiroki Mitani, and Wataru Shimbashi
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Reconstructive surgery ,medicine.medical_specialty ,medicine.anatomical_structure ,Oncology ,Otorhinolaryngology ,Tongue ,business.industry ,medicine ,business ,Surgery - Abstract
(目的)舌根の広範囲切除症例において,術後嚥下機能を評価することで最適な再建手術方法を検討する。(方法)癌研有明病院頭頸科で2007年1月から12月までに手術を行った口腔中咽頭癌症例のうち,舌根を半分以上切除しかつ喉頭を保存した症例5例を対象とした。再建については,まず残存舌根の能動的な動きを確認し,下端の粘膜を寄せて狭い咽頭腔を作成した後,ボリュームのある皮弁を咽頭腔に突出するように縫着した。全例,喉頭挙上術や輪状咽頭筋切断術は行っていない。これらの術後経過と嚥下機能を詳細に観察して検討した。(結果)5例全てにおいて経口摂取が可能であった。2例が術後早期に再発を生じていた。(結論)この方法によりある程度良好な嚥下機能が期待できると思われた。ただし予後の悪い症例もあるため術式選択や術後管理には十分注意すべきと思われた。 more...
- Published
- 2008
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