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Pancreatic Neoplasms: HELP
Articles by Kazuma Fujimoto
Based on 3 articles published since 2008
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Between 2008 and 2019, Kazuma Fujimoto wrote the following 3 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Guideline Validation of the American Gastroenterological Association guidelines on management of intraductal papillary mucinous neoplasms: more than 5 years of follow-up. 2018

Imbe, Koh / Nagata, Naoyoshi / Hisada, Yuya / Takasaki, Yusuke / Sekine, Katsunori / Mishima, Saori / Kawazoe, Akihito / Tajima, Tsuyoshi / Shimbo, Takuro / Yanase, Mikio / Akiyama, Junichi / Fujimoto, Kazuma / Uemura, Naomi. ·Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan. · Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan. nnagata_ncgm@yahoo.co.jp. · Department of Gastrointestinal Oncology, National Cancer Center East Hospital, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. · Departments of Diagnostic Radiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan. · Ohta Nishinouchi Hospital, 2-5-20 Nishinouchi, Koriyama city, Fukushima, 963-8558, Japan. · Department of Internal Medicine & Gastrointestinal Endoscopy, Faculty of Medicine, Saga University, 1 Honjo-machi, 840-8502, Saga, Japan. · Department of Gastroenterology and Hepatology, Kohnodai Hospital, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa, 272-8516, Chiba, Japan. ·Eur Radiol · Pubmed #28770404.

ABSTRACT: OBJECTIVES: Recent guidelines suggest that imaging surveillance be conducted for 5 years for patients with at most one high-risk feature. If there were no significant changes, surveillance is stopped. We sought to validate this follow-up strategy. METHODS: In study 1, data were analysed for 392 patients with intraductal papillary mucinous neoplasms (IPMNs) and at most one high-risk feature who were periodically followed up for more than 1 year with imaging tests. In study 2, data were analysed for 159 IPMN patients without worsening high-risk features after 5 years (stop surveillance group). RESULTS: In study 1, pancreatic cancer (PC) was identified in 12 patients (27.3%) in the endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) indication group and none in the non-EUS-FNA indication group (P < 0.01). In the EUS-FNA indication group, 11 patients (25%) died, whereas 29 (8.3%) died in the non EUS-FNA indication group (P < 0.01). In study 2 (stop surveillance group), PC was identified in three patients (1.9%) at 84, 103 and 145 months. CONCLUSIONS: PC risk and mortality for IPMNs not showing significant change for 5 years is likely to be low, and the non-EUS-FNA indication can provide reasonable decisions. However, three patients without worsening high-risk features for 5 years developed PC. The stop surveillance strategy should be reconsidered. KEY POINTS: • The AGA guidelines provide reasonable clinical decisions for the EUS-FNA indication. • In stop surveillance group, PC was identified in 3 patients (1.9%). • In stop surveillance group, 2 of 3 PC patients died from PC. • Risk of pancreatic cancer in "stop surveillance" group is not negligible.

2 Article The Palliative Effect of Endoscopic Uncovered Self-expandable Metallic Stent Placement Versus Gastrojejunostomy on Malignant Gastric Outlet Obstruction: A Pilot Study with a Retrospective Chart Review in Saga, Japan. 2018

Yukimoto, Takahiro / Morisaki, Tomohito / Komukai, Sho / Yoshida, Hisako / Yamaguchi, Daisuke / Tsuruoka, Nanae / Miyahara, Koichi / Sakata, Yasuhisa / Shibasaki, Shinichi / Tsunada, Seiji / Noda, Takahiro / Yunotani, Seiji / Fujimoto, Kazuma. ·Departments of Gastroenterology, National Hospital Organization Ureshino Medical Center, Japan. · Department of Internal Medicine, Saga Medical School, Japan. · Department of Clinical Research Center, Saga Medical School, Japan. · Departments of Gastroenterology, Karatsu Red Cross Hospital, Japan. · Departments of Surgery, National Hospital Organization Ureshino Medical Center, Japan. · Departments Surgery, Karatsu Red Cross Hospital, Japan. ·Intern Med · Pubmed #29434131.

ABSTRACT: Objective Endoscopic self-expandable metallic stent (SEMS) placement and gastrojejunostomy (GJY) are palliative treatments for malignant gastric outlet obstruction (GOO). The aim of the present study was to compare the palliative effects of these treatments and identify predictors of a poor oral intake after treatment. Methods and Patients In total, 65 patients with GOO at multiple centers in Saga, Japan, were evaluated. Thirty-eight patients underwent SEMS placement, and 27 underwent GJY from January 2010 to December 2016. The characteristics and outcomes of the two groups were compared to detect predictors of treatment failure. Results No significant differences in the technical success, clinical success, post-treatment total protein, hospital discharge, duration from eating disability to death, or post-treatment overall survival were present between the SEMS and GJY groups. More patients in the GJY group than in the SEMS group received chemotherapy (51.4% vs. 26.3%, respectively; p=0.042). The period from treatment to the first meal was longer in the GJY group than in the SEMS group (4.5 vs. 3.0 days, respectively; p=0.013). The present study did not identify any risk factors for failure of SEMS placement. Although the stent length tended to be associated with a poor prognosis, the correlation was not statistically significant (odds ratio: 0.60, 95% confidence interval: 0.36-1.01, p=0.053). Conclusion Patients with GOO started meals more promptly after SEMS than after GJY, but the clinical outcomes were not markedly different between the SEMS and GJY groups. These findings suggest that endoscopic uncovered SEMS placement might be a feasible palliative treatment for GOO.

3 Article Natural history of intraductal papillary mucinous neoplasm and non-neoplastic cyst: long-term imaging follow-up study. 2017

Hisada, Yuya / Nagata, Naoyoshi / Imbe, Koh / Takasaki, Yusuke / Sekine, Katsunori / Tajima, Tsuyoshi / Yanase, Mikio / Fujimoto, Kazuma / Akiyama, Junichi / Uemura, Naomi. ·Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan. · Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan. · Department of Gastroenterology, Saga Medical School, Saga, Japan. · Kohnodai Hospital, Chiba, Japan. ·J Hepatobiliary Pancreat Sci · Pubmed #28512773.

ABSTRACT: BACKGROUND: To identify differences in incidence and mortality of pancreatic cancer (PC) between intraductal papillary mucinous neoplasm (IPMN) and non-neoplastic cyst. METHODS: Patients with pancreatic cyst (n = 526; 263 with IPMN and 263 with non-neoplastic cyst matched for age, sex, and diagnosis year) were periodically followed-up with imaging. Hazard ratio (HR), standardized incidence ratio (SIR), and standardized mortality ratio (SMR) for PC and PC-related mortality were estimated. RESULTS: During a mean follow-up of 57.5 months with 3,376 computed tomography scans and 1,079 magnetic resonance imaging scans, 5-year cumulative PC incidence was 4.0% for IPMN and 0% for non-neoplastic cyst, respectively (HR 5.2; P = 0.031). During a mean follow-up of 73.1 months, 5-year cumulative PC-related mortality was 2.6% for IPMN and 0% for non-neoplastic cyst, respectively (HR 4.5; P = 0.05). Compared with the general population in Japan, patients with IPMN, but not those with non-neoplastic cyst, had significantly increased risks of PC incidence (SIR 22.03) and related mortality (SMR 15.9). CONCLUSIONS: During long-term imaging follow-up, patients with IPMN developed PC over time, whereas none of the patients with non-neoplastic cyst developed it within 5 years. Compared with the general population, patients with IPMN, but not those with non-neoplastic cyst, were at risk of PC and related mortality.