31 results on '"Sawako Kaku"'
Search Results
2. Predictors of Morphine Efficacy for Dyspnea in Inpatients with Chronic Obstructive Pulmonary Disease: A Secondary Analysis of JORTC-PAL 07
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Yoshinobu Matsuda, Tatsuya Morita, Hirotaka Matsumoto, Keita Hosoi, Kayo Kusama, Yasuo Kohashi, Hiroshi Morishita, Sawako Kaku, Keisukie Ariyoshi, Shunsuke Oyamada, Yoshikazu Inoue, Satoru Iwase, Takuhiro Yamaguchi, and Mitsunori Nishikawa
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COPD ,dyspnea ,morphine ,opioid treatment ,respiratory illness ,Medicine (General) ,R5-920 - Abstract
Objective: This study aimed to explore the predictors of morphine efficacy in the alleviation of dyspnea in COPD. Background: Dyspnea is prevalent in patients with chronic obstructive pulmonary disease (COPD) and often persists despite conventional treatment. Methods: A secondary analysis of a multi-institutional prospective before?after study was conducted focusing on morphine use for alleviating dyspnea in COPD patients. Subjects included COPD patients with dyspnea at seven hospitals in Japan. Patients received 12 mg/day of oral morphine (or 8 mg/day if they had low body weight or renal impairment). Univariate and multivariate logistic regression analyses were performed with numerical rating scale (NRS) score of the current dyspnea intensity in the evening of day 0, Eastern Cooperative Oncology Group Performance Status (ECOG PS; ?2 or ?3), age, and partial arterial pressure of carbon dioxide (PaCO2) as independent factors; an improvement of ?1 in the evening NRS score of dyspnea from day 0 to 2 was the dependent factor. Results: Thirty-five patients were enrolled in this study between October 2014 and January 2018. Excluding one patient who did not receive the treatment, data from 34 patients were analyzed. In the multivariate analysis, lower PaCO2 was significantly associated with morphine efficacy for alleviating dyspnea (odds ratio [OR] 0.862, 95% confidence interval [CI] 0.747?0.994), whereas the NRS of dyspnea intensity on day 0 (OR 1.426, 95% CI 0.836?2.433), ECOG PS (OR 4.561, 95% CI 0.477?43.565), and patients' age (OR 0.986, 95% CI 0.874?1.114) were not. Discussion: Morphine can potentially alleviate dyspnea in COPD patients with lower PaCO2. Trial registration: UMIN000015288 (http://www.umin.ac.jp/ctr/index.htm)
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- 2021
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3. 'Real' Tumor-Spread Through Air Spaces of Lung Adenocarcinoma Presented Intrapulmonary Metastases Through Bronchiole Air Spaces: A Case Report
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Sawako Kaku, MD, Noriko Motoi, MD, PhD, Hirokazu Watanabe, MD, PhD, Yukihiro Yoshida, MD, PhD, Shun-ichi Watanabe, MD, PhD, and Masahiko Kusumoto, MD, PhD
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Lung adenocarcinoma ,Tumor-spread through air spaces (STAS) ,Micropapillary adenocarcinoma ,Case report ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Here, we report a rare case of lung adenocarcinoma with intrapulmonary metastases that have “spread through air spaces” (STAS) by means of the alveoli and bronchioles. The peripheral intrapulmonary metastases were exhibiting pure ground-glass nodules along the bronchioles on computed tomography. The primary pathologic diagnosis was micropapillary adenocarcinoma with prominent tumor STAS. Histopathologic examination revealed that the cancer cells in the bronchioles around the primary tumor revealed micropapillary clusters on the mucosal surface or in the air spaces and reached peripheral intrapulmonary metastatic nodules. Notably, no vascular and stromal invasion was observed. The pathologic findings suggest that cancer cells are viable in the airspace of the bronchioles and alveoli and may support the significance of STAS as a pattern of airborne metastasis.
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- 2022
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4. Pleural effusion biomarkers and computed tomography findings in diagnosing malignant pleural mesothelioma: A retrospective study in a single center.
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Takehiro Otoshi, Yuki Kataoka, Shunkichi Ikegaki, Emiko Saito, Hirotaka Matsumoto, Sawako Kaku, Masatoshi Shimada, and Masataka Hirabayashi
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Medicine ,Science - Abstract
In this study, we aimed to examine the clinical value of the pleural effusion (PE) biomarkers, soluble mesothelin-related peptide (SMRP), cytokeratin 19 fragment (CYFRA 21-1) and carcinoembryonic antigen (CEA), and the utility of combining chest computed tomography (CT) findings with these biomarkers, in diagnosing malignant pleural mesothelioma (MPM). We conducted a retrospective cohort study in a single center. Consecutive patients with undiagnosed pleural effusions who underwent PE analysis between September 2014 and August 2016 were reviewed. This study included 240 patients (32 with MPM and 208 non-MPM). SMRP and the CYFRA 21-1/CEA ratio had a sensitivity and specificity for diagnosing MPM of 56.3% and 86.5%, and 87.5% and 74.0%, respectively. Using receiver operating characteristics (ROC) curve analysis of the ability of these markers to distinguish MPM from all other PE causes, the area under the ROC curve (AUC) for SMRP and the CYFRA 21-1/CEA ratio was 0.804 and 0.874, respectively. The sensitivity and specificity of SMRP combined with the CYFRA 21-1/CEA ratio were 93.8% and 64.9%, respectively. The sensitivity of the combination of SMRP, the CYFRA 21-1/CEA ratio, and the presence of Leung's criteria (a chest CT finding that is suggestive of malignant pleural disease) was 93.8%. In conclusion, the combined PE biomarkers had a high sensitivity for diagnosing MPM, although the addition of chest CT findings did not improve the sensitivity of SMRP combined with the CYFRA 21-1/CEA ratio. Combination of these biomarkers helped to rule out MPM effectively among patients at high risk of suffering MPM and would be valuable especially for old frail patients who have difficulty in undergoing invasive procedures such as thoracoscopy.
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- 2017
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5. Influence of social isolation and loneliness on the prognosis of advanced lung cancer patients: a prospective cohort study
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Tomoyasu Takemura, Yuki Kataoka, Nanami Ashi, Chigusa Shirakawa, Koya Okazaki, Azusa Sakurai, Takuma Imakita, Shunkichi Ikegaki, Hirotaka Matsumoto, Emiko Saito, Hirohito Takata, Sawako Kaku, Nobuko Wada, Mariko Shinomiya, Takehiro Otoshi, Masatoshi Shimada, Junichi Nikaido, Reika Iki, Katsuya Hirano, Tomoyuki Hirai, Kazuo Endo, Masataka Hirabayashi, and Toru Naganuma
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Lung Neoplasms ,Social Isolation ,Oncology ,Loneliness ,Humans ,Prospective Studies ,Prognosis - Abstract
Purpose The purpose of this study was to investigate the impact of social isolation and loneliness on the overall survival and death at home in patients with lung cancer. Methods This prospective cohort study was conducted in a Japanese tertiary hospital. The enrollment period was from April 2018 to March 2020. Patients with pathologically diagnosed advanced lung cancer were included in this study. The primary outcome was overall survival, whereas the secondary outcome was death at home. The exposures were social isolation and loneliness. Results A total of 211 patients were enrolled and divided into two groups and further into quartiles according to their social isolation and loneliness level, respectively. The hazard ratios of social isolation were 1.65 (95% confidence interval; 1.12 to 2.44) and 1.87 (95% confidence interval; 1.15 to 3.03) in the univariate analysis, while 1.40 (95% confidence interval; 0.92 to 2.13) in the multivariate analysis with complete case and multiple imputation. The odds ratio of death at home with social isolation was 3.47 (95% confidence interval; 1.08 to 11.1) in the multivariate analysis with multiple imputation. Loneliness was not associated with overall survival or death at home. Conclusions Our study suggests that social isolation may be related to overall survival and death at home among patients with advanced lung cancer. More attention should be given to such patients at the time of diagnosis.
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- 2022
6. Influence of loneliness and social isolation on the diagnosis and treatment of Japanese patients with advanced lung cancer: a prospective cohort study
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Yuki Kataoka, Azusa Sakurai, Shunkichi Ikegaki, Emiko Saito, Nobuko Wada, Masatoshi Shimada, Reika Iki, Takehiro Otoshi, Sawako Kaku, Takuma Imakita, Mariko Shinomiya, Koya Okazaki, Hirohito Takata, Katsuya Hirano, Hirotaka Matsumoto, Toru Naganuma, Tomoyasu Takemura, Masataka Hirabayashi, Kazuo Endo, Junichi Nikaido, Chigusa Shirakawa, and Tomoyuki Hirai
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medicine.medical_specialty ,Lung Neoplasms ,Gene mutation ,Tertiary referral hospital ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Internal medicine ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Social determinants of health ,Social isolation ,Lung cancer ,Prospective cohort study ,Advanced and Specialized Nursing ,Performance status ,business.industry ,Loneliness ,medicine.disease ,Anesthesiology and Pain Medicine ,Social Isolation ,030220 oncology & carcinogenesis ,medicine.symptom ,business - Abstract
Background Social determinants of health (SDHs) are social factors that affect human health; loneliness and social isolation are core SDH factors. There is a possibility that SDHs are related to passive decisionmaking. However, few studies have evaluated SDHs, especially social isolation and loneliness, among lung cancer patients. This study aims to investigate the effects of social isolation and loneliness on the diagnosis and treatment of Japanese lung cancer patients. Methods This is a prospective cohort study that was conducted in a tertiary referral hospital in Japan (University Hospital Medical Information Network registration: UMIN000031810). The enrollment period was between April 2018 and March 2020. Patients with clinical and/or pathological diagnosis of lung cancer were enrolled in this study. Exposures were social isolation and loneliness, and main outcomes were diagnosis methods and whether the initial treatment involved active therapy or best supportive care (BSC). The confounding factors were defined as sex, age, smoking status, respiratory symptoms, weight loss, presentation with any symptoms, Eastern Cooperative Oncology Group (ECOG) performance status, tumor nodes metastasis (TNM) classification, driver gene mutations [i.e., epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK)], and programmed death-ligand 1 (PD-L1) tumor proportion score. Results The study enrolled 264 patients who were divided into quartiles according to their loneliness scores and into two groups according to the social isolation level. Univariate analysis, complete case analysis, and multivariate analysis with multiple imputation failed to detect significant differences in diagnostic method or initial treatment strategy according to loneliness or social isolation level. Conclusions Physicians may not need to consider a patient's loneliness and/or social isolation when diagnosing lung cancer and selecting treatment under universal health insurance coverage. Further studies are needed to understand the influences of loneliness and social isolation on the prognosis of lung cancer patients.
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- 2021
7. Clinical role and safety of tapentadol in patients with cancer: A single-center experience
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Emi Kubo, MD, PhD, Hiroto Ishiki, MD, Kentaro Abe, MS, Sawako Kaku, MD, Sayuri Yokota, MD, Sayaka Arakawa, MD, PhD, Daisuke Kiuchi, MD, Koji Amano, MD, and Eriko Satomi, MD
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Analgesics, Opioid ,Male ,Tapentadol ,Anesthesiology and Pain Medicine ,Neoplasms ,Humans ,Pharmacology (medical) ,Female ,Nausea ,General Medicine ,Middle Aged ,Retrospective Studies - Abstract
Objective: To evaluate real-world data on the use of tapentadol (TAP) in cancer patients.Design: Single-center retrospective study.Setting: Curative/palliative.Patients, participants: Patients who started TAP between October 2014 and December 2018 at our institution.Main outcome measure(s): The primary outcome was the reason for TAP initiation. Secondary outcomes included prescription duration, TAP cessation rate, reason for cessation, and adverse events (AEs). Since the palliative care team (PCT) tended to prescribe to cancer patients with intractable pain more often than patients in usual care, and also tended to prescribe opioids based on their characteristics, we decided to compare patients with and without PCT intervention.Results: There were 175 patients who first received TAP during the study period, of whom 81 patients (46.3 percent) were male. The median age was 60 years. TAP was prescribed for opioid-naive patients in 45 (26 percent) cases and opioid switch in 130 (74 percent) cases. When comparing the PCT group (n = 121) and the non-PCT group (n = 54) using univariate analysis, the PCT group had a higher opioid switch rate (81.8 percent vs 57.4 percent, p < .001), higher proportion of patients with neuropathic pain (NP) (65.3 percent vs 16.7 percent, p < .001), and a higher proportion of patients with a history of nausea (41.3 percent vs 18.5 percent, p < .01). The cessation rate due to AEs was 8 percent overall.Conclusions: Palliative care physicians prescribed TAP for patients with NP or a history of nausea. Opioid-naive patients were preferred by oncologists. TAP has good tolerability in both groups, with a low dropout rate due to AEs.
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- 2022
8. Predictors of Morphine Efficacy for Dyspnea in Inpatients with Chronic Obstructive Pulmonary Disease: A Secondary Analysis of JORTC-PAL 07
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Yasuo Kohashi, Kayo Kusama, Takuhiro Yamaguchi, Yoshikazu Inoue, Mitsunori Nishikawa, Tatsuya Morita, Hirotaka Matsumoto, Yoshinobu Matsuda, Keita Hosoi, Keisukie Ariyoshi, Satoru Iwase, Hiroshi Morishita, Shunsuke Oyamada, and Sawako Kaku
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COPD ,medicine.medical_specialty ,Multivariate analysis ,Evening ,business.industry ,morphine ,Odds ratio ,dyspnea ,medicine.disease ,Logistic regression ,Confidence interval ,respiratory illness ,respiratory tract diseases ,Blood pressure ,Internal medicine ,opioid treatment ,medicine ,Morphine ,Original Article ,business ,medicine.drug - Abstract
Objective: This study aimed to explore the predictors of morphine efficacy in the alleviation of dyspnea in COPD. Background: Dyspnea is prevalent in patients with chronic obstructive pulmonary disease (COPD) and often persists despite conventional treatment. Methods: A secondary analysis of a multi-institutional prospective before-after study was conducted focusing on morphine use for alleviating dyspnea in COPD patients. Subjects included COPD patients with dyspnea at seven hospitals in Japan. Patients received 12 mg/day of oral morphine (or 8 mg/day if they had low body weight or renal impairment). Univariate and multivariate logistic regression analyses were performed with numerical rating scale (NRS) score of the current dyspnea intensity in the evening of day 0, Eastern Cooperative Oncology Group Performance Status (ECOG PS; ≤2 or ≥3), age, and partial arterial pressure of carbon dioxide (PaCO2) as independent factors; an improvement of ≥1 in the evening NRS score of dyspnea from day 0 to 2 was the dependent factor. Results: Thirty-five patients were enrolled in this study between October 2014 and January 2018. Excluding one patient who did not receive the treatment, data from 34 patients were analyzed. In the multivariate analysis, lower PaCO2 was significantly associated with morphine efficacy for alleviating dyspnea (odds ratio [OR] 0.862, 95% confidence interval [CI] 0.747-0.994), whereas the NRS of dyspnea intensity on day 0 (OR 1.426, 95% CI 0.836-2.433), ECOG PS (OR 4.561, 95% CI 0.477-43.565), and patients' age (OR 0.986, 95% CI 0.874-1.114) were not. Discussion: Morphine can potentially alleviate dyspnea in COPD patients with lower PaCO2. Trial registration: UMIN000015288 (http://www.umin.ac.jp/ctr/index.htm).
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- 2021
9. Factors Influencing Social Isolation and Loneliness Among Lung Cancer Patients: A Cross-sectional Study
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Masatoshi Shimada, Emiko Saito, Takuma Imakita, Nobuko Wada, Masataka Hirabayashi, Hirohito Takata, Reika Iki, Koya Okazaki, Chigusa Shirakawa, Sawako Kaku, Takehiro Otoshi, Nanami Ashi, Kazuo Endo, Tomoyasu Takemura, Katsuya Hirano, Junichi Nikaido, Toru Naganuma, Hirotaka Matsumoto, Yuki Kataoka, Azusa Sakurai, Shunkichi Ikegaki, Mariko Shinomiya, and Tomoyuki Hirai
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Adult ,Male ,Gerontology ,Cancer Research ,Lung Neoplasms ,Cross-sectional study ,media_common.quotation_subject ,Care provision ,medicine ,Humans ,Dementia ,Social determinants of health ,Social isolation ,Aged ,media_common ,Aged, 80 and over ,business.industry ,Loneliness ,General Medicine ,Middle Aged ,medicine.disease ,UCLA Loneliness Scale ,Cross-Sectional Studies ,Social Isolation ,Oncology ,Female ,medicine.symptom ,business ,Welfare - Abstract
Background/aim Previous reviews of Social determinants of health in lung cancer patients have not examined essential factors such as social isolation and loneliness. This study aimed to explore the factors affecting social isolation and loneliness among lung cancer patients. Patients and methods A cross-sectional study was conducted. Social isolation, loneliness, and the presence of dementia were measured using Japanese adaptations of the Lubben Social Network Scale, UCLA Loneliness Scale, and Life Function Evaluation for Care Provision, respectively. Results From March 2019 to March 2020, 264 patients were included. Social isolation was significantly higher for patients receiving welfare (adjusted OR=5.28, 95% CI=2.24-12.4). Loneliness was significantly higher for patients receiving welfare (beta coefficient=0.52, 95% Cl=0.13-0.90) with symptoms of dementia (beta coefficient=0.28, 95% Cl=0.03-0.54). Conclusion Results showed that receiving welfare was associated with experiencing social isolation. Receiving welfare and symptoms of dementia were associated with experiencing loneliness.
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- 2020
10. Epithelioid hemangioendothelioma of the lung: CT findings and clinical course of 35 cases
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Noriko Motoi, Yasushi Goto, Yasuyuki Onishi, Sawako Kaku, and Masahiko Kusumoto
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Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Computed tomography ,Kaplan-Meier Estimate ,030218 nuclear medicine & medical imaging ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Initial treatment ,Radiology, Nuclear Medicine and imaging ,In patient ,Epithelioid hemangioendothelioma ,Aged ,Retrospective Studies ,Lung ,medicine.diagnostic_test ,business.industry ,Clinical course ,General Medicine ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Hemangioendothelioma, Epithelioid ,Multiple Pulmonary Nodules ,Female ,Radiology ,Good prognosis ,medicine.symptom ,Tomography, X-Ray Computed ,business - Abstract
Objectives To evaluate computed tomography findings and assess the clinical course of patients with pulmonary epithelioid hemangioendothelioma. Methods Patients diagnosed with pulmonary epithelioid hemangioendothelioma at our institution between 2000 and 2019 were retrospectively analyzed. Patients with pleural involvement were excluded. Computed tomography findings of the lung at diagnosis were classified into three patterns: multiple small nodules pattern (˂15 mm), multiple nodules with large lesions pattern (≥15 mm) and single lesion pattern. Additionally, the clinical course of patients was evaluated. Results Thirty-five patients (15 men and 20 women; median age, 44 years) with pulmonary epithelioid hemangioendothelioma were identified. The multiple small nodules pattern, multiple nodules with large lesions pattern and single lesion pattern were observed in 25 (71.4%), 8 (22.9%) and 2 (5.7%) patients, respectively. In 22 (62.9%) patients, extra-pulmonary epithelioid hemangioendothelioma lesions were found. Most patients were followed without initial treatment, while two patients with single lesion pattern underwent surgical resection. The median follow-up period was 63 months. Five-year overall survival rate of all patients was 96.3%. Latest clinical information revealed that 20 (20/25, 80%) patients with multiple small nodules pattern were alive without symptoms. In patients with multiple nodules with large lesion pattern, four (4/8, 50%) patients were alive without symptoms, three (3/8, 37.5%) patients were alive with symptoms and one (1/8, 12.5%) died. No recurrence was observed in patients with single lesion pattern. Conclusions Multiple small nodules pattern was the most common findings of pulmonary epithelioid hemangioendothelioma. Patients with pulmonary epithelioid hemangioendothelioma have good prognosis.
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- 2020
11. [Investigation the contents of employment consultation and support in a cancer center hospital]
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Sawako Kaku, Kayoko Miyata, Miyako Tsuchiya, Sachiko Kusaka, Miho Koitabashi, Natsuko Moroi, Rieko Shimizu, Mariko Shimizu, Mari Arai, Masako Yabumoto, Naoko Matsunaga, Ryoko Maeda, Satoru Iwasa, Hidehito Horinouchi, and Eriko Satomi
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Male ,Employment ,Neoplasms ,Public Health, Environmental and Occupational Health ,Humans ,Female ,General Medicine ,Middle Aged ,Cancer Care Facilities ,Toxicology ,Workplace ,Referral and Consultation ,Retrospective Studies - Abstract
This study aimed to analyze and categorize the actual situation of employment consultation and support according to consultation times or employment status at the Consultation Support Center of the National Cancer Center Hospital of Japan.We retrospectively analyzed the patient backgrounds, consultation contents, and the number of employment consultation cases conducted at the Consultation Support Center of the National Cancer Center Hospital during a 6-month period from May to December 2018.During the study period, 117 patients (male: female = 46:71) visited the Consultation Support Center. The median age of patients was 48 years old. The most common primary cancer site was the breast in 28 patients followed by the lung in 16 patients, and then gynecologic cancer in 10 patients. The most common cancer treatment was chemotherapy in 53 patients (45.3%), and 12 patients (10.2%) were recurrent patients. Fifty-two patients were in regular employment, 24 were unemployed, 17 were of unknown employment status, 16 were in non-regular employment, and 8 were classified/categorized as other. In terms of working status, 40 were on leave, 35 were working, 15 were seeking work, 8 were unemployed, and 19 were categorized as other. The median number of consultations was 1 (1,11). The content of consultations was the social security system in 44 cases (37.6%) job seeking in 24 cases (20.5%), how to inform the workplace in 14 cases (12%), and workplace environment adjustment in 13 cases (11.1%).We conducted a survey on the actual status of employment consultation in a cancer center hospital. The majority of consultations were completed in one session. In terms of the content of consultations, there was a high need for consultations on the social security system and job seeking. Further study is needed on the characteristics of employment consultations according to employment status and other attributes.
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- 2021
12. Incidence and prognostic factors in severe drug-induced interstitial lung disease caused by antineoplastic drug therapy in the real world
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Sawako Kaku, Hidehito Horinouchi, Hirokazu Watanabe, Kan Yonemori, Takuji Okusaka, Narikazu Boku, Naoya Yamazaki, Akira Kawai, Yuichiro Ohe, and Masahiko Kusumoto
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Cancer Research ,Oncology ,Incidence ,Neoplasms ,Humans ,Antineoplastic Agents ,General Medicine ,Lung Diseases, Interstitial ,Prognosis - Abstract
Purpose Investigate the frequency and prognostic factors of severe drug-induced interstitial lung disease (DILD) caused by antineoplastic drugs regardless of cancer types or type of drugs. Methods From 2014 to 2018, we reviewed patients with a history of antineoplastic agents administration in the real-world database of our hospital's electronic medical record and extracted patients who experienced "severe" DILD, requiring hospitalization with treatment or developed during hospitalization and required treatment. We collected patients' backgrounds, clinical and radiological features, laboratory data, treatment, and survival outcomes. Results 19,132 cancer patients received antineoplastic drug therapy during the study period, and 120 (0.62%) experienced severe DILD. The incidence of severe DILD in patients with thoracic cancer was highest among the patients included in this analysis (2.52% vs. 0.34% other cancers). Diffuse alveolar damage (DAD) pattern on CT was associated with higher mortality in patients with severe DILD compared with non-DAD pattern (hazard ratio [HR], 11.24; 95% CI, 4.82–26.2). Multivariate analysis revealed that the DAD pattern at diagnosis as severe DILD (HR, 3.59; 95% CI, 1.17–11.03), concurrent/previous interstitial lung disease (HR, 3.20; 95% CI, 1.27–8.10), and ECOG performance status of 2–4 (HR, 3.81; 95% CI, 1.10–13.17) were independent risk factors for mortality in patients with severe DILD. Conclusions The frequency of severe DILD was highest in patients with thoracic cancer. The DAD pattern was associated with a poor outcome. From the perspective of DILD, special attention should be paid when administering antineoplastic agents to patients with thoracic cancer.
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- 2021
13. Investigation the contents of employment consultation and support in a cancer center hospital.
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Sawako KAKU, Kayoko MIYATA, Miyako TSUCHIYA, Sachiko KUSAKA, Miho KOITABASHI, Natsuko MOROI, Rieko SHIMIZU, Mariko SHIMIZU, Mari ARAI, Masako YABUMOTO, Naoko MATSUNAGA, Ryoko MAEDA, Satoru IWASA, Hidehito HORINOUCHI, and Eriko SATOMI
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- 2022
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14. Correction to: Incidence and prognostic factors in severe drug-induced interstitial lung disease caused by antineoplastic drug therapy in the real world
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Sawako Kaku, Hidehito Horinouchi, Hirokazu Watanabe, Kan Yonemori, Takuji Okusaka, Narikazu Boku, Naoya Yamazaki, Akira Kawai, Yuichiro Ohe, and Masahiko Kusumoto
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Cancer Research ,Oncology ,General Medicine - Published
- 2022
15. MO16-5 Analysis of employment counseling for advanced cancer patients undergoing cancer drug therapy
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Kayoko Miyata, Mari Arai, Maeda Ryoko, Mariko Shimizu, Masako Yabumoto, Kumie Sakihara, Rieko Simizu, Natsuko Moroi, Asuka Kijima, Sawako Kaku, Takeyuki Wada, Miho Koitabashi, Naoko Matsunaga, Hidehito Horinouchi, Eriko Satomi, and Satoru Iwasa
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Oncology ,medicine.medical_specialty ,business.industry ,Internal medicine ,Cancer drugs ,Medicine ,Hematology ,business ,Advanced cancer - Published
- 2021
16. Acute onset collagenous colitis associated with protein‐losing enteropathy
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Shuhei Yamamoto, Satoru Kitamura, Takahito Omae, Kosho Takasu, Yuki Kataoka, Sawako Kaku Hosokawa, Yuki Yoshimatsu, Masataka Hirabayashi, and Yuichiro Nakaya
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medicine.medical_specialty ,Nausea ,aspirin ,Lansoprazole ,Case Report ,Case Reports ,acute onset ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Internal Medicine ,medicine ,Enteropathy ,Aspirin ,Collagenous colitis ,business.industry ,Protein losing enteropathy ,protein‐losing enteropathy ,medicine.disease ,lansoprazole ,Small intestine ,collagenous colitis ,Diarrhea ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Geriatrics and Gerontology ,medicine.symptom ,Family Practice ,business ,medicine.drug - Abstract
Collagenous colitis is a cause of chronic diarrhea. We report an atypical case of collagenous colitis, presenting with an acute onset, and associated with protein‐losing enteropathy. An 82‐year‐old woman was admitted with a 1 week history of nausea, appetite loss, and diarrhea. Serum albumin level was low. Protein leakage from the small intestine was found by a Technetium‐99m human serum albumin scintigraphy. We diagnosed the patient with collagenous colitis from pathology findings of multiple biopsies taken from the colon. This case implies that collagenous colitis should be considered in acute watery diarrhea, and that it can cause protein‐losing enteropathy.
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- 2017
17. Morphine for dyspnoea in chronic obstructive pulmonary disease: a before-after efficacy study.
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Yoshinobu Matsuda, Tatsuya Morita, Hirotaka Matsumoto, Keita Hosoi, Kayo Kusama, Yasuo Kohashi, Hiroshi Morishita, Sawako Kaku, Keisuke Ariyoshi, Shunsuke Oyamada, Yoshikazu Inoue, Satoru Iwase, Takuhiro Yamaguchi, and Mitsunori Nishikawa
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- 2021
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18. [Current Status and Challenges of Work-Related Issues among Cancer Patients]
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Sawako, Kaku and Miyako, Takahashi
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Adult ,Employment ,Young Adult ,Japan ,Neoplasms ,Humans ,Middle Aged ,Occupations ,Aged - Abstract
The 5-year relative survival rate of cancer patients in Japan has reached 62.1% owing to advances in cancer treatments. Half of the people are diagnosed with cancer at some point in their lifetime, and one-third of cancer patients belong to the working-age generation between the ages of 20 and 65. In Japan, various governmental policies have been developed in a short period of time with the aim of balancing cancer treatment and employment. The Basic Plan to Promote Cancer Control Programs in Japan, enacted in 2017, specifies the need to prevent cancer patients from leaving employment and to support re-employment, as well as the need for further collaboration among medical institutions, occupations, and local communities. However, Japanese people's perceptions regarding employment of cancer patients is still negative. Employment support for cancer patients is regarded as an important topic in cancer survivorship, and various findings have been accumulated in Japan and other countries. The impact of onset of cancer on the employment of patients is influenced not only by medical factors but also by other factors such as individual factors, health status, psychosocial factors, willingness to work, and workplacerelated factors. Hence, the situations of individuals differ greatly. It is necessary to examine the current state of research and support based on these factors. Points to keep in mind when providing support to balance both cancer and employment include: 1 ) there are many persons related to working cancer patients who are involved and 2 ) it is difficult for physicians to understand the full picture of a patient's job based on the labor contract. Appropriate information sharing; environmental improvement; and mutual cooperation in medical treatment sites, workplaces, and local communities are essential.
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- 2019
19. Morphine for dyspnoea in chronic obstructive pulmonary disease: a before-after efficacy study
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Takuhiro Yamaguchi, Keisuke Ariyoshi, Satoru Iwase, Yasuo Kohashi, Yoshikazu Inoue, Sawako Kaku, Hiroshi Morishita, Mitsunori Nishikawa, Tatsuya Morita, Keita Hosoi, Yoshinobu Matsuda, Hirotaka Matsumoto, Kayo Kusama, and Shunsuke Oyamada
- Subjects
medicine.medical_specialty ,Evening ,Nausea ,Vital signs ,Medicine (miscellaneous) ,Anorexia ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Internal medicine ,Medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Adverse effect ,Morning ,COPD ,Morphine ,Oncology (nursing) ,business.industry ,General Medicine ,medicine.disease ,Analgesics, Opioid ,Medical–Surgical Nursing ,Dyspnea ,medicine.symptom ,business ,Somnolence - Abstract
ObjectivesDyspnoea in patients with chronic obstructive pulmonary disease (COPD) is frequent and often persists despite conventional treatment. This study aimed to evaluate the efficacy and safety of oral morphine for dyspnoea in Japanese COPD patients.MethodsWe conducted a multi-institutional, prospective, before–after study of morphine in COPD patients with dyspnoea at rest in seven hospitals. Patients received 12 mg of oral morphine per day (or 8 mg per day if low body weight or renal impairment). Primary outcome was change in the numerical rating scale (NRS) of current dyspnoea in the evening from Day 0 to Day 2. Secondary outcomes included changes in dyspnoea intensity in the evening from Day 0 to Day 1, dyspnoea intensity between the morning from Day 0 to Day 1 and Day 2, vital signs, nausea, somnolence, anorexia and other adverse events (AEs).ResultsA total of 35 patients were enrolled in this study between October 2014 and January 2018. One patient did not receive study treatment. Data from 34 patients was analysed. The NRS of dyspnoea intensity in the evening significantly decreased from 3.9 on Day 0 (95% CI: 3.1 to 4.8) to 2.4 on Day 2 (95% CI: 1.7 to 3.1; p=0.0002). Secondary outcomes significantly improved in a similar manner. There were no apparent changes in the mean scores of the opioid-related AEs and vital signs. One patient experienced grade 3 lung infection not associated with morphine. Other AEs were mild.ConclusionOral morphine is effective in alleviating dyspnoea in Japanese COPD patients.Trial registrationUMIN000015288 (http://www.umin.ac.jp/ctr/index.htm).
- Published
- 2019
20. A Case of Unresolving Pneumonia
- Author
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Taro Shimizu, Yuki Kataoka, Shuhei Yamamoto, and Sawako Kaku Hosokawa
- Subjects
030203 arthritis & rheumatology ,Pediatrics ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Interstitial lung disease ,Physical examination ,medicine.disease ,Rash ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Pneumonia ,0302 clinical medicine ,Pharmacotherapy ,Internal Medicine ,medicine ,Prednisolone ,Geriatrics and Gerontology ,Respiratory system ,medicine.symptom ,Family Practice ,business ,Myositis ,medicine.drug - Abstract
A 33-year-old woman was transferred to our hospital for an unresolving pneumonia, who initially presented with dyspnea. Initially antibiotic therapy was started under the suspicion of community-acquired pneumonia, however, her respiratory status worsened at the previous hospital. Computed tomography (CT) on presentation showed peripheral ground glass opacities in both sides of the upper lobe. Also despite additional prednisolone therapy, her respiratory status worsened. On admission to our hospital, physical examination showed Gottoron's sign in her right elbow. From the nature of the rash, the absence of myositis symptoms and rapid respiratory worsening, we suspected clinically amyopathic dermatomyositis (CADM). After the triple drug therapy, her respiratory status improved.
- Published
- 2016
21. Corrigendum to 'External validation of prognostic indices for overall survival of malignant pleural mesothelioma' [Lung Cancer 113 (November) (2017) 88–92]
- Author
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Shingo Fukuma, Sawako Kaku, Shunichi Fukuhara, Masataka Hirabayashi, Yosuke Yamamoto, Taiichiro Otsuki, Yuki Kataoka, Takashi Nakano, and Nobuko Maehashi-Wada
- Subjects
Pulmonary and Respiratory Medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,Pleural mesothelioma ,External validation ,medicine.disease ,Text mining ,Internal medicine ,Overall survival ,medicine ,business ,Lung cancer - Published
- 2020
22. Influence of social determinants of health on patients with advanced lung cancer: a prospective cohort study
- Author
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Tomoyuki Hirai, Azusa Sakurai, Hirohito Takata, Kazuo Endo, Masatoshi Shimada, Toru Naganuma, Junichi Nikaido, Hirotaka Matsumoto, Mariko Shinomiya, Takehiro Otoshi, Tomoyasu Takemura, Emiko Saito, Nobuko Wada, Katsuya Hirano, Shunkiti Ikegaki, Reika Iki, Takuma Imakita, Koya Okazaki, Yuki Kataoka, and Sawako Kaku
- Subjects
Male ,medicine.medical_specialty ,Multivariate analysis ,Lung Neoplasms ,Social Determinants of Health ,Disease ,03 medical and health sciences ,0302 clinical medicine ,Clinical Protocols ,Japan ,Risk Factors ,Epidemiology ,medicine ,Protocol ,Humans ,030212 general & internal medicine ,Social determinants of health ,Prospective Studies ,Social isolation ,Prospective cohort study ,Respiratory Medicine ,business.industry ,respiratory tract tumours ,Loneliness ,General Medicine ,Institutional review board ,Survival Analysis ,Socioeconomic Factors ,030220 oncology & carcinogenesis ,Family medicine ,Female ,epidemiology ,medicine.symptom ,business - Abstract
IntroductionSocioeconomic factors with an influence on human health are known as social determinants of health (SDH). There are some SDH studies in patients with lung cancer, but important exposures such as social isolation and loneliness have not been adequately investigated. This study will assess the influence of SDH, particularly social isolation and loneliness, on patients with advanced lung cancer in Japan.Methods and analysisThe inclusion criteria for this prospective cohort study will be as follows: a diagnosis of advanced lung cancer; unsuitability for curative surgery; and willingness to participate. The primary outcome will be the initial choice of treatment and the secondary outcomes will be overall survival, changes in disease staging or performance status, route to diagnosis and place of death. The exposures will be social isolation, loneliness, employment, insurance type, education and dementia. The study enrolment period will be 1 year and the follow-up duration will be 2 years. The log-rank test will be used to compare overall survival between patients when grouped according to the study exposures and multivariate analysis will be performed using Cox proportional hazards regression. The Χ2test will be used to compare the initial treatment, changes in disease stage and place of death, and logistic regression will be used for multivariate analysis of these factors. A p value Ethics and disseminationThis study has been approved by the Institutional Review Board at Hyogo Prefectural Amagasaki General Medical Center (No 29-164). A manuscript summarising the outcome of this study will be submitted to a peer-reviewed journal and the data will be presented at conferences.Trial registration numberUMIN000031810.
- Published
- 2018
23. Prognostic Impact of Inflammation-related Biomarkers on Overall Survival of Patients with Inoperable Malignant Pleural Mesothelioma
- Author
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Yuki Kataoka, Masataka Hirabayashi, Reika Iki, Takehiro Otoshi, and Sawako Kaku
- Subjects
Male ,Mesothelioma ,0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Multivariate analysis ,Neutrophils ,Pleural Neoplasms ,Inflammation ,Kaplan-Meier Estimate ,General Biochemistry, Genetics and Molecular Biology ,Leukocyte Count ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Overall survival ,medicine ,Humans ,Lymphocytes ,Neutrophil to lymphocyte ratio ,Serum Albumin ,Aged ,Neoplasm Staging ,Retrospective Studies ,Aged, 80 and over ,Pharmacology ,business.industry ,Proportional hazards model ,Medical record ,Mesothelioma, Malignant ,Hazard ratio ,Middle Aged ,Prognosis ,Combined Modality Therapy ,Confidence interval ,C-Reactive Protein ,030104 developmental biology ,030220 oncology & carcinogenesis ,Female ,Inflammation Mediators ,medicine.symptom ,business ,Biomarkers ,Research Article - Abstract
Aim The aim of the present study was to assess the prognostic utility of the pretreatment blood neutrophil-to-lymphocyte ratio (NLR) and the C-reactive protein-to-albumin ratio (CAR) in patients with inoperable malignant pleural mesothelioma (MPM). Materials and methods The medical records of consecutive patients with histologically confirmed MPM from our hospital between January 2007 and August 2017 were retrospectively reviewed. The primary outcome was overall survival (OS). Univariate and multivariate analyses for the prognostic factors were performed using a Cox proportional hazards model. Results A total of 143 patients with inoperable MPM were included. On multivariate analysis, pretreatment CAR was an independent factor associated with worse OS (hazard ratio(HR)=1.72; 95% confidence interval(CI)=1.11-2.67; p=0.016). However, NLR was not associated with OS in any of the analyses. Conclusion CAR appears to be a prognostic factor in patients with inoperable MPM.
- Published
- 2018
24. Pleural effusion biomarkers and computed tomography findings in diagnosing malignant pleural mesothelioma: A retrospective study in a single center
- Author
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Emiko Saito, Sawako Kaku, Masataka Hirabayashi, Shunkichi Ikegaki, Takehiro Otoshi, Hirotaka Matsumoto, Yuki Kataoka, and Masatoshi Shimada
- Subjects
Mesothelioma ,Male ,Lung Neoplasms ,Pulmonology ,Pleural effusion ,lcsh:Medicine ,Single Center ,Biochemistry ,Lung and Intrathoracic Tumors ,0302 clinical medicine ,Carcinoembryonic antigen ,Medicine and Health Sciences ,lcsh:Science ,Multidisciplinary ,medicine.diagnostic_test ,biology ,Thorax ,Pleural Diseases ,Middle Aged ,Oncology ,030220 oncology & carcinogenesis ,Pleurae ,Female ,Radiology ,Anatomy ,Research Article ,medicine.medical_specialty ,Histology ,Pleural Neoplasms ,03 medical and health sciences ,Pleural disease ,Diagnostic Medicine ,Antigens, Neoplasm ,Thoracoscopy ,medicine ,Cancer Detection and Diagnosis ,Humans ,Aged ,Retrospective Studies ,Keratin-19 ,Receiver operating characteristic ,business.industry ,lcsh:R ,Mesothelioma, Malignant ,Cancers and Neoplasms ,Biology and Life Sciences ,Retrospective cohort study ,medicine.disease ,Pleural Effusion ,030228 respiratory system ,biology.protein ,lcsh:Q ,business ,Tomography, X-Ray Computed ,Biomarkers - Abstract
In this study, we aimed to examine the clinical value of the pleural effusion (PE) biomarkers, soluble mesothelin-related peptide (SMRP), cytokeratin 19 fragment (CYFRA 21-1) and carcinoembryonic antigen (CEA), and the utility of combining chest computed tomography (CT) findings with these biomarkers, in diagnosing malignant pleural mesothelioma (MPM). We conducted a retrospective cohort study in a single center. Consecutive patients with undiagnosed pleural effusions who underwent PE analysis between September 2014 and August 2016 were reviewed. This study included 240 patients (32 with MPM and 208 non-MPM). SMRP and the CYFRA 21-1/CEA ratio had a sensitivity and specificity for diagnosing MPM of 56.3% and 86.5%, and 87.5% and 74.0%, respectively. Using receiver operating characteristics (ROC) curve analysis of the ability of these markers to distinguish MPM from all other PE causes, the area under the ROC curve (AUC) for SMRP and the CYFRA 21-1/CEA ratio was 0.804 and 0.874, respectively. The sensitivity and specificity of SMRP combined with the CYFRA 21-1/CEA ratio were 93.8% and 64.9%, respectively. The sensitivity of the combination of SMRP, the CYFRA 21-1/CEA ratio, and the presence of Leung's criteria (a chest CT finding that is suggestive of malignant pleural disease) was 93.8%. In conclusion, the combined PE biomarkers had a high sensitivity for diagnosing MPM, although the addition of chest CT findings did not improve the sensitivity of SMRP combined with the CYFRA 21-1/CEA ratio. Combination of these biomarkers helped to rule out MPM effectively among patients at high risk of suffering MPM and would be valuable especially for old frail patients who have difficulty in undergoing invasive procedures such as thoracoscopy.
- Published
- 2017
25. External validation of prognostic indices for overall survival of malignant pleural mesothelioma
- Author
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Shunichi Fukuhara, Taiichiro Otsuki, Masataka Hirabayashi, Takashi Nakano, Shingo Fukuma, Nobuko Maehashi-Wada, Sawako Kaku, Yuki Kataoka, and Yosuke Yamamoto
- Subjects
Pulmonary and Respiratory Medicine ,Oncology ,Male ,Mesothelioma ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,medicine.medical_treatment ,Pleural Neoplasms ,Kaplan-Meier Estimate ,Tertiary Care Centers ,03 medical and health sciences ,0302 clinical medicine ,Asian People ,Japan ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Outcome Assessment, Health Care ,Overall survival ,Medicine ,Humans ,030212 general & internal medicine ,Stage (cooking) ,Pneumonectomy ,Aged ,Retrospective Studies ,Chemotherapy ,business.industry ,Mesothelioma, Malignant ,Palliative Care ,External validation ,Cancer ,Reproducibility of Results ,Retrospective cohort study ,medicine.disease ,Prognosis ,Confidence interval ,Surgery ,Regimen ,030220 oncology & carcinogenesis ,Pleura ,Female ,business - Abstract
Objective There are several prognostic indices (PIs) to predict overall survival (OS) in malignant pleural mesothelioma (MPM) patients. Before using a clinical prediction model in the actual clinical setting, empiric evaluation of its performance based on datasets that were not used to develop the model (i.e., external validation) is essential. The purpose of this study was to conduct an external validation of the PIs for MPM. Materials and methods A retrospective cohort study was performed on MPM patients treated at 2 tertiary hospitals in Japan between 2007 and 2015. The primary outcome was OS. Harrell’s c-index, and was calculated to examine the discrimination of three models. The bootstrapping technique was used to evaluate optimism. Results The participants comprised 183 patients who underwent surgical treatment (n = 61), chemotherapy (n = 101), and best supportive care (BSC, n = 21). The median OS rates were 1014 days for surgery, 690 days for chemotherapy, and 545 days for best supportive care (BSC). The respective discriminations (95% confidence interval) of the Eastern Cooperative Oncology Group Performance Status, the European Organisation for Research and Treatment of Cancer index, regimen, PS, histology or stage (rPHS) index, and Tagawa index for the OS of MPM patients were 0.532 (0.444–0.620), 0.560 (0.472–0.648), 0.584 (0.452–0.716), and 0.525 (0.453–0.596) for surgery; 0.632 (0.539-0.724), 0.622 (0.548–0.696), 0.677 (0.587–0.766), and 0.545 (0.436–0.653) for chemotherapy; and 0.504 (0.365–0.644), 0.583 (0.456-–0.710), 0.704 (0.508–0.899), and 0.583 (0.436–0.730) for BSC. Conclusions Each PI showed poor discrimination for MPM patients who underwent surgical treatment. The rPHS index showed moderate discrimination for patients given chemotherapy and BSC.
- Published
- 2017
26. A Case of Unresolving Pneumonia
- Author
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Hosokawa, Sawako Kaku, primary, Yamamoto, Shuhei, additional, Kataoka, Yuki, additional, and Shimizu, Taro, additional
- Published
- 2016
- Full Text
- View/download PDF
27. Collagenous Colitis Associated with Protein-losing Enteropathy
- Author
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Satoru Kitamura, Yuichiro Nakaya, Sawako Kaku Hosokawa, and Yuki Kataoka
- Subjects
medicine.medical_specialty ,Aspirin ,Collagenous colitis ,business.industry ,Protein losing enteropathy ,Lansoprazole ,General Medicine ,medicine.disease ,Gastroenterology ,Acute onset ,Internal medicine ,Internal Medicine ,medicine ,business ,medicine.drug - Published
- 2015
28. Influence of social determinants of health on patients with advanced lung cancer: a prospective cohort study.
- Author
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Tomoyasu Takemura, Yuki Kataoka, Koya Okazaki, Azusa Sakurai, Takuma Imakita, Shunkiti Ikegaki, Hirotaka Matsumoto, Emiko Saito, Hirohito Takata, Sawako Kaku, Nobuko Wada, Mariko Shinomiya, Takehiro Otoshi, Masatoshi Shimada, Junichi Nikaido, Reika Iki, Katsuya Hirano, Tomoyuki Hirai, Kazuo Endo, and Toru Naganuma
- Abstract
Introduction Socioeconomic factors with an influence on human health are known as social determinants of health (SDH). There are some SDH studies in patients with lung cancer, but important exposures such as social isolation and loneliness have not been adequately investigated. This study will assess the influence of SDH, particularly social isolation and loneliness, on patients with advanced lung cancer in Japan. Methods and analysis The inclusion criteria for this prospective cohort study will be as follows: a diagnosis of advanced lung cancer; unsuitability for curative surgery; and willingness to participate. The primary outcome will be the initial choice of treatment and the secondary outcomes will be overall survival, changes in disease staging or performance status, route to diagnosis and place of death. The exposures will be social isolation, loneliness, employment, insurance type, education and dementia. The study enrolment period will be 1 year and the follow-up duration will be 2 years. The log-rank test will be used to compare overall survival between patients when grouped according to the study exposures and multivariate analysis will be performed using Cox proportional hazards regression. The χ2 test will be used to compare the initial treatment, changes in disease stage and place of death, and logistic regression will be used for multivariate analysis of these factors. A p value <0.05 will be considered statistically significant. Ethics and dissemination This study has been approved by the Institutional Review Board at Hyogo Prefectural Amagasaki General Medical Center (No 29-164). A manuscript summarising the outcome of this study will be submitted to a peer-reviewed journal and the data will be presented at conferences. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
29. Collagenous Colitis Associated with Protein-losing Enteropathy
- Author
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Nakaya, Yuichiro, primary, Hosokawa, Sawako Kaku, additional, Kataoka, Yuki, additional, and Kitamura, Satoru, additional
- Published
- 2015
- Full Text
- View/download PDF
30. Predictive values of activity of daily livings score for the identification of worse performance status
- Author
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Yuki Kataoka, Masataka Hirabayashi, Reika Horiguchi, Shimada Masatoshi, Nobuko Maehashi, Sawako Kaku Hosokawa, Kazuo Endo, Junichi Nikaido, Katsuya Hirano, and Mariko Shinomiya
- Subjects
Gerontology ,Identification (information) ,Oncology ,Performance status ,Karnofsky Performance Status ,business.industry ,Medicine ,Hematology ,business
31. How to obtain the raw sample of non-small cell lung cancer for mutation screening in a tertialy hospital
- Author
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Mariko Shinomiya, Katsuya Hirano, Naoki Nakajima, Takemura Tomoyasu, Masataka Hirabayashi, Nobuko Maehashi, Kazuo Endo, Yuki Kataoka, Kosyo Takasu, and Sawako Kaku Hosokawa
- Subjects
Oncology ,medicine.medical_specialty ,Pathology ,business.industry ,Sample (material) ,Hematology ,medicine.disease ,Internal medicine ,Mutation (genetic algorithm) ,medicine ,Mutation screening ,Non small cell ,Lung cancer ,business
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