Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Pancreatic Neoplasms: HELP
Articles by Takao Itoi
Based on 49 articles published since 2010
(Why 49 articles?)
||||

Between 2010 and 2020, T. Itoi wrote the following 49 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Review Pancreatic cancer. 2016

Kamisawa, Terumi / Wood, Laura D / Itoi, Takao / Takaori, Kyoichi. ·Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan. Electronic address: kamisawa@cick.jp. · The Sol Goldman Pancreatic Cancer Research Center, Department of Pathology, Johns Hopkins University, Baltimore, USA. · Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. · Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. ·Lancet · Pubmed #26830752.

ABSTRACT: Pancreatic cancer is a highly lethal disease, for which mortality closely parallels incidence. Most patients with pancreatic cancer remain asymptomatic until the disease reaches an advanced stage. There is no standard programme for screening patients at high risk of pancreatic cancer (eg, those with a family history of pancreatic cancer and chronic pancreatitis). Most pancreatic cancers arise from microscopic non-invasive epithelial proliferations within the pancreatic ducts, referred to as pancreatic intraepithelial neoplasias. There are four major driver genes for pancreatic cancer: KRAS, CDKN2A, TP53, and SMAD4. KRAS mutation and alterations in CDKN2A are early events in pancreatic tumorigenesis. Endoscopic ultrasonography and endoscopic ultrasonography-guided fine-needle aspiration offer high diagnostic ability for pancreatic cancer. Surgical resection is regarded as the only potentially curative treatment, and adjuvant chemotherapy with gemcitabine or S-1, an oral fluoropyrimidine derivative, is given after surgery. FOLFIRINOX (fluorouracil, folinic acid [leucovorin], irinotecan, and oxaliplatin) and gemcitabine plus nanoparticle albumin-bound paclitaxel (nab-paclitaxel) are the treatments of choice for patients who are not surgical candidates but have good performance status.

2 Review [The strategy of pancreatic cancer for early detection]. 2015

Sofuni, Atsushi / Itoi, Takao / Tsuchiya, Takayoshi / Tsuji, Shujiro / Kamada, Kentaro / Ikeuchi, Nobuhito / Tanaka, Reina / Umeda, Junko / Tonozuka, Ryosuke / Honjo, Mitsuyoshi / Mukai, Shuntaro / Fujita, Mitsuru / Yamamoto, Kenjiro / Moriyasu, Fuminori. ·Department of Gastroenterology and Hepatology, Tokyo Medical University. ·Nihon Shokakibyo Gakkai Zasshi · Pubmed #26250128.

ABSTRACT: -- No abstract --

3 Review Current status of preoperative biliary drainage. 2015

Umeda, Junko / Itoi, Takao. ·Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku, Tokyo, 160-0023, Japan. ·J Gastroenterol · Pubmed #26138070.

ABSTRACT: Preoperative biliary drainage (PBD) has been thought to be preferable regardless of the site of biliary strictures, e.g., distal or proximal strictures because PBD by endoscopy or interventional radiology decreases postoperative mortality and morbidity rates. However, recently, several studies have revealed that PBD strategy showed an increased mortality rate or a high frequency of surgical site infection. Herein, we reviewed reports in the literature regarding the current status of PBD and investigated the effects of PBD on patients with distal and proximal biliary obstructions due to potentially resectable pancreatobiliary cancers. Our summary demonstrated that there is as yet no optimal PBD method regardless of the distal and proximal biliary strictures because of the small sample size and the lack of better control groups in previous studies. Thus, prospective randomized studies with a large sample size are needed to establish the optimal mode of PBD and to evaluate the potential benefits of PBD in patients with both distal and proximal biliary obstructions.

4 Review Role of endoscopic ultrasonography in pancreatic cystic neoplasms: where do we stand and where will we go? 2014

Nakai, Yousuke / Isayama, Hiroyuki / Itoi, Takao / Yamamoto, Natsuyo / Kogure, Hirofumi / Sasaki, Takashi / Hirano, Kenji / Tada, Minoru / Koike, Kazuhiko. ·Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. ·Dig Endosc · Pubmed #24219338.

ABSTRACT: We increasingly encounter pancreatic cystic neoplasms (PCN) in clinical practice and the differential diagnoses vary widely from benign to malignant. There is no 'one and only' diagnostic procedure for PCN. Multiple modalities including computed tomography, magnetic resonance imaging, endoscopic retrograde cholangiopancreatography and endoscopic ultrasound (EUS) are widely used, but EUS has the advantage of anatomical proximity to the pancreas and upper gastrointestinal tract. In addition, EUS-guided fine-needle aspiration (EUS-FNA) provides both cytological evaluation and cyst fluid analysis. Although the role of EUS-FNA for PCN is established, the sensitivity of cytology is low and cyst fluid analysis is only useful for differentiation between mucinous and non-mucinous cysts. Recently, novel through-the-needle imaging under EUS-FNA, such as confocal laserendomicroscopy, is expected to attribute to a better diagnostic yield. Moreover, feasibility of cyst ablation has been reported and the role of EUS has expanded from diagnosis to treatment. However, clinical impact of cyst ablation in terms of safety, efficacy and cost-effectiveness should be validated further. In summary, EUS and EUS-guided intervention does and will play a central role in the management of PCN from surveillance to treatment, but many clinical questions remain unanswered, which warrants well-designed prospective clinical trials.

5 Clinical Trial Irreversible Electroporation for Nonthermal Tumor Ablation in Patients with Locally Advanced Pancreatic Cancer: Initial Clinical Experience in Japan. 2018

Sugimoto, Katsutoshi / Moriyasu, Fuminori / Tsuchiya, Takayoshi / Nagakawa, Yuichi / Hosokawa, Yuichi / Saito, Kazuhiro / Tsuchida, Akihiko / Itoi, Takao. ·Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan. · Department of Gastroenterology and Hepatology, International University of Health and Welfare, Sanno Hospital, Japan. · Department of Gastrointestinal Surgery, Tokyo Medical University, Japan. · Department of Radiology, Tokyo Medical University, Japan. ·Intern Med · Pubmed #29984761.

ABSTRACT: Objective To evaluate irreversible electroporation (IRE) for locally advanced pancreatic cancer (LAPC). Methods This study was approved by our local review board. Eight patients with histologically proven LAPC ≤5 cm were prospectively enrolled to undergo ultrasound-guided IRE. The primary endpoint was complications within 90 days. Secondary outcomes were the overall survival (OS) and time to local progression. Safety was assessed using Common Terminology Criteria for Adverse Events Version 4.0. Results All patients were treated successfully. The median procedure time was 150 min. The median largest tumor diameter was 29.5 mm (20.0-48.0 mm) in the pancreatic head (n=5) and body (n=3). Open (n=4) and percutaneous (n=4) approaches were used. No patients died within 90 days after IRE. There were 5 minor complications in 3 patients and 4 major complications in 3 patients. The incidence rates of major complications did not differ significantly between the approaches. The median time to local progression after IRE was 12.0 months, and the median OS was 17.5 months from IRE and 24.0 months from the diagnosis, with no significant differences between the approaches. Conclusions Percutaneous and open IRE may be acceptable for patients with LAPC (despite some major adverse events) and may represent a useful new therapeutic option.

6 Clinical Trial Randomised phase II trial of irinotecan plus S-1 in patients with gemcitabine-refractory pancreatic cancer. 2017

Ioka, T / Komatsu, Y / Mizuno, N / Tsuji, A / Ohkawa, S / Tanaka, M / Iguchi, H / Ishiguro, A / Kitano, M / Satoh, T / Yamaguchi, T / Takeda, K / Kida, M / Eguchi, K / Ito, T / Munakata, M / Itoi, T / Furuse, J / Hamada, C / Sakata, Y. ·Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan. · Department of Cancer Chemotherapy, Hokkaido University Hospital Cancer Center, 5-chome, Kita 14 Jou Nishi, Kita-ku, Sapporo 060-8648, Japan. · Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan. · Department of Medical Oncology, Kochi Health Sciences Center, 2125-1 Ike, Kochi 781-0111, Japan. · Department of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center Hospital, 2-3-2 Nakao, Asahi-ku, Yokohama 241-8515, Japan. · Department of Surgery and Oncology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. · Department of Gastroenterology, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto-chou, Matsuyama 791-0280, Japan. · Department of Medical Oncology, Hirosaki University, 53 Hon-cho, Hirosaki 036-8562, Japan. · Department of Gastroenterology and Hepatology, Kinki University School of Medicine, 377-2 Onohigashi, Osakasayama 589-8511, Japan. · Faculty of Medicine, Department of Medical Oncology, Kinki University, 377-2 Onohigashi, Osakasayama 589-8511, Japan. · Division of Gastroenterology, Chiba Cancer Center Hospital, 666-2 Nitona-cho, Chuo-ku, Chiba 260-8717, Japan. · Department of Clinical Oncology, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojia-ku, Osaka 534-0021, Japan. · Department of Medicine, Kitasato University School of Medicine, 2-1-1 Asamizodai, Minami-ku, Sagamihara 252-0374, Japan. · Department of Internal Medicine, Medical Oncology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo 173-8605, Japan. · Department of Medicine and Bioregulatory Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. · Department of Medical Oncology, Misawa City Hospital, 164-65 Oazamisawaazahoriuchi, Misawa 033-0022, Japan. · Department of Gastroenterological Medicine, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 166-0023, Japan. · Department of Medical Oncology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, 181-8611, Japan. · Faculty of Engineering, Tokyo University of Science, 6-3-1 Niijuku, Katsushika-ku, Tokyo 125-8585, Japan. ·Br J Cancer · Pubmed #28081543.

ABSTRACT: BACKGROUND: We aimed to compare the efficacy and safety of irinotecan/S-1 (IRIS) therapy with S-1 monotherapy in patients with gemcitabine-refractory pancreatic cancer. METHODS: Patients were treated with oral S-1 (80-120 mg for 14 days every 4 weeks) plus intravenous irinotecan (100 mg m RESULTS: Of 137 patients enrolled, 127 were eligible for efficacy. The median PFS in the IRIS group and S-1 monotherapy group were 3.5 and 1.9 months, respectively (hazard ratio (HR)=0.77; 95% confidence interval (CI), 0.53-1.11; P=0.18), while the median overall survival (OS) were 6.8 and 5.8 months, respectively (HR=0.75; 95% CI, 0.51-1.09; P=0.13). Response rate was significantly higher in the IRIS group than in the S-1 monotherapy group (18.3% vs 6.0%, P=0.03). Grade 3 or higher neutropenia and anorexia occurred more frequently in the IRIS group. CONCLUSIONS: There was a trend for better PFS and OS in the IRIS group that could be a treatment arm in the clinical trials for gemcitabine-refractory pancreatic cancer.

7 Clinical Trial Multicenter, prospective, crossover trial comparing the door-knocking method with the conventional method for EUS-FNA of solid pancreatic masses (with videos). 2016

Mukai, Shuntaro / Itoi, Takao / Ashida, Reiko / Tsuchiya, Takayoshi / Ikeuchi, Nobuhito / Kamada, Kentaro / Tanaka, Reina / Umeda, Junko / Tonozuka, Ryosuke / Fukutake, Nobuyasu / Hoshi, Koki / Moriyasu, Fuminori / Gotoda, Takuji / Irisawa, Atsushi. ·Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. · Department of Hepatobiliary and Pancreato-oncology, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, Japan. · Department of Gastroenterology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Japan. ·Gastrointest Endosc · Pubmed #26522372.

ABSTRACT: BACKGROUND AND AIMS: There are currently no prospective, controlled trials of needle puncture speed in EUS-guided FNA (EUS-FNA). In this study, we prospectively evaluated the accuracy of histological diagnosis and the tissue acquisition rate of EUS-FNA by using the door-knocking method (DKM) with a standard 22-gauge needle. METHODS: From November 2013 to August 2014, 82 patients who had solid pancreatic masses underwent EUS-FNA in which the conventional method (CM) and DKM with 2 respective passes in turn were used. The primary outcomes of this study were the accuracy of histological diagnosis and the rates of tissue acquisition in 2 FNA procedures by using these 2 methods. RESULTS: Although the successful tissue acquisition rate for histology was not significantly different with the DKM and CM (91.5% vs 89.0%, P = .37), the high cellularity tissue acquisition rate for histology with the DKM was significantly superior to that with the CM (54.9% vs 41.5%, P = .03). However, adequate quality rate and accuracy were not different in the DKM and CM (78.0% vs 80.5%, P = .42 and 76.8% vs 78.0%, P = .50, respectively). In the transgastric puncture group, although the adequate quality rate and accuracy were similar in the DKM and CM (84.1% vs 79.4%, P = .30 and 84.1% vs 76.2%, P = .11, respectively), the tissue acquisition rate tended to be higher with the DKM than the CM (93.7% vs 85.7%, P = .06). Moreover, the high cellularity tissue acquisition rate was significantly better with the DKM than the CM (63.5% vs 39.7%, P = .002). On the other hand, in the transduodenal puncture group, although the tissue acquisition rate was similar with the DKM and CM (84.2% vs 100%, P = .13), the adequate quality rate and accuracy were significantly lower with the DKM than with the CM (57.9% vs 84.2%, P = .03 and 52.6% vs 84.2%, P = .02, respectively). CONCLUSION: EUS-FNA by using a 22-gauge needle with the DKM did not improve the accuracy of histological diagnosis, but enabled acquisition of a larger amount of tissue specimen by using transgastric puncture. ( TRIAL REGISTRATION: http://www.umin.ac.jp/english/: UMIN000012127.).

8 Clinical Trial Safety trial of high-intensity focused ultrasound therapy for pancreatic cancer. 2014

Sofuni, Atsushi / Moriyasu, Fuminori / Sano, Takatomo / Itokawa, Fumihide / Tsuchiya, Takayoshi / Kurihara, Toshio / Ishii, Kentaro / Tsuji, Syujiro / Ikeuchi, Nobuhito / Tanaka, Reina / Umeda, Junko / Tonozuka, Ryosuke / Honjo, Mitsuyoshi / Mukai, Shuntaro / Fujita, Mitsuru / Itoi, Takao. ·Atsushi Sofuni, Fuminori Moriyasu, Takatomo Sano, Fumihide Itokawa, Takayoshi Tsuchiya, Toshio Kurihara, Kentaro Ishii, Syujiro Tsuji, Nobuhito Ikeuchi, Reina Tanaka, Junko Umeda, Ryosuke Tonozuka, Mitsuyoshi Honjo, Shuntaro Mukai, Mitsuru Fujita, Takao Itoi, Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo 160-0023, Japan. ·World J Gastroenterol · Pubmed #25071354.

ABSTRACT: AIM: To evaluate the safety and clinical application of high-intensity focused ultrasound (HIFU) therapy for unresectable pancreatic cancer (PC). METHODS: Thirty PC patients (16 cases in stage III and 14 cases in stage IV) with visualized pancreatic tumors were admitted for HIFU therapy as an optional local therapy in addition to systemic chemotherapy or chemoradiotherapy. Informed consent was obtained. This study began at the end of 2008 and was approved by the ethics committee of our hospital [Institutional Review Board (IRB): 890]. The HIFU device used was the FEP-BY02 (Yuande Bio-Medical Engineering, Beijing, China). RESULTS: The mean tumor size after HIFU therapy changed to 30.9 ± 1.7 mm from 31.7 ± 1.7 mm at pre-therapy. There were no significant changes in tumor size, mean number of treatment sessions (2.7 ± 0.1 mm), or mean total treatment time (2.4 ± 0.1 h). The rate of symptom relief effect was 66.7%. The effectiveness of primary lesion treatment was as follows: complete response, 0; partial response, 4; stable disease, 22; progressive disease, 4. Treatment after HIFU therapy included 2 operations, 24 chemotherapy treatments, and 4 best supportive care treatments. Adverse events occurred in 10% of cases, namely pseudocyst formation in 2 cases and mild pancreatitis development in 1. However, no severe adverse events occurred in this study. CONCLUSION: We suggest that HIFU therapy is safe and has the potential to be a new method of combination therapy for PC.

9 Clinical Trial Endoscopic ultrasound-guided celiac ganglia neurolysis vs. celiac plexus neurolysis: a randomized multicenter trial. 2013

Doi, S / Yasuda, I / Kawakami, H / Hayashi, T / Hisai, H / Irisawa, A / Mukai, T / Katanuma, A / Kubota, K / Ohnishi, T / Ryozawa, S / Hara, K / Itoi, T / Hanada, K / Yamao, K. ·First Department of Internal Medicine, Gifu University Hospital, Gifu 501-1194, Japan. ·Endoscopy · Pubmed #23616126.

ABSTRACT: BACKGROUND AND STUDY AIMS: No prospective comparison of endoscopic ultrasonography-guided direct celiac ganglia neurolysis (EUS - CGN) vs. EUS-guided celiac plexus neurolysis (EUS - CPN) has been reported. The aim of the current study was to compare the effectiveness of EUS - CGN and EUS - CPN in providing pain relief from upper abdominal cancer pain in a multicenter randomized controlled trial. PATIENTS AND METHODS: Patients with upper abdominal cancer pain were randomly assigned to treatment using either EUS - CGN or EUS - CPN. Evaluation was performed at Day 7 postoperatively using a pain scale of 0 to 10. Patients for whom pain decreased to ≤ 3 were considered to have a positive response, and those experiencing a decrease in pain to ≤ 1 were considered to be completely responsive. Comparison between the two groups was performed using intention-to-treat analysis. The primary endpoint was the difference in treatment response rates between EUS - CGN and EUS - CPN at postoperative Day 7. Secondary endpoints included differences in complete response rates, pain scores, duration of pain relief, and incidence of adverse effects. RESULTS: A total of 34 patients were assigned to each group. Visualization of ganglia was possible in 30 cases (88 %) in the EUS - CGN group. The positive response rate was significantly higher in the EUS - CGN group (73.5 %) than in the EUS - CPN group (45.5 %; P = 0.026). The complete response rate was also significantly higher in the EUS - CGN group (50.0 %) than in the EUS - CPN group (18.2 %; P = 0.010). There was no difference in adverse events or duration of pain relief between the two groups. CONCLUSIONS: EUS - CGN is significantly superior to conventional EUS - CPN in cancer pain relief. CLINICAL TRIAL REGISTRATION: http://www.umin.ac.jp/ctr/index.htm (ID: UMIN-000002536).

10 Clinical Trial Randomized phase II study of gemcitabine and S-1 combination versus gemcitabine alone in the treatment of unresectable advanced pancreatic cancer (Japan Clinical Cancer Research Organization PC-01 study). 2012

Ozaka, Masato / Matsumura, Yuji / Ishii, Hiroshi / Omuro, Yasushi / Itoi, Takao / Mouri, Hisatsugu / Hanada, Keiji / Kimura, Yasutoshi / Maetani, Iruru / Okabe, Yoshinobu / Tani, Masaji / Ikeda, Takaaki / Hijioka, Susumu / Watanabe, Ryouhei / Ohoka, Shinya / Hirose, Yuki / Suyama, Masafumi / Egawa, Naoto / Sofuni, Atsushi / Ikari, Takaaki / Nakajima, Toshifusa. ·Department of Gastroenterology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan. masato.ozaka@jfcr.or.jp ·Cancer Chemother Pharmacol · Pubmed #22249272.

ABSTRACT: PURPOSE: To evaluate the efficacy and safety of the combination of gemcitabine (GEM) and S-1 (GS) in comparison to GEM alone (G) for unresectable pancreatic cancer. METHODS: In this multicenter randomized phase II study, we randomly assigned unresectable pancreatic cancer patients to either the GS group or the G group. The GS group regimen consists of intravenous 1,000 mg/m(2) GEM during 30 min on days 1 and 8, combined with 80 mg/m(2) oral S-1 twice daily on days 1-14, repeated every 3 weeks. On the other hand, the G group regimen consists of intravenous 1,000 mg/m(2) GEM on days 1, 8, and 15, repeated every 4 weeks. The primary endpoint was objective response rate (ORR). Secondary end points included treatment toxicity, clinical response benefit, progression-free survival (PFS), and overall survival. RESULTS: We registered 117 patients from 16 institutions between June 2007 and August, 2010. The ORR of the GS group was 28.3%, whereas that of the G group was 6.8%. This difference was statistically significant (P = 0.005). The disease control rate was 64.2% in the GS group and 44.1% in the G group. Median PFS was 6.15 months in the GS group and 3.78 month in the G group. This was also statistically significant (P = 0.0007). Moreover, the median overall survival (OS) of the GS group was significantly longer than that of the G group (13.7 months vs. 8.0 months; P = 0.035). The major grade 3-4 adverse events were neutropenia (54.7% in the GS group and 22.0% in the G group), thrombocytopenia (15.1% in the GS group and 5.1% in the G group), and skin rash (9.4% in the GS group). CONCLUSIONS: The GS group showed stronger anticancer activity than the G group, suggesting the need for a large randomized phase III study to confirm GS advantages in a specific subset.

11 Article Prognostic importance of peritoneal washing cytology in patients with otherwise resectable pancreatic ductal adenocarcinoma who underwent pancreatectomy: A nationwide, cancer registry-based study from the Japan Pancreas Society. 2019

Tsuchida, Hiroyoshi / Fujii, Tsutomu / Mizuma, Masamichi / Satoi, Sohei / Igarashi, Hisato / Eguchi, Hidetoshi / Kuroki, Tamotsu / Shimizu, Yasuhiro / Tani, Masaji / Tanno, Satoshi / Tsuji, Yoshihisa / Hirooka, Yoshiki / Masamune, Atsushi / Mizumoto, Kazuhiro / Itoi, Takao / Egawa, Shinichi / Kodama, Yuzo / Hamada, Shin / Unno, Michiaki / Yamaue, Hiroki / Okazaki, Kazuichi / Anonymous3741095. ·Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan. · Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan. Electronic address: fjt@med.u-toyama.ac.jp. · Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. · Department of Surgery, Kansai Medical University, Osaka, Japan. · Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. · Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. · Department of Surgery, National Hospital Nagasaki Medical Center, Nagasaki, Japan. · Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan. · Department of Surgery, Shiga University of Medical Science, Otsu, Japan. · Department of Gastroenterology, IMS Sapporo Digestive Center General Hospital, Sapporo, Japan. · Department of Clinical Education, Shiga University of Medical Science, Otsu, Japan. · Department of Liver, Biliary Tract and Pancreas Diseases, Fujita Health University, Toyoake, Japan. · Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan. · Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. · Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. · Division of International Cooperation for Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan. · Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. · Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Japan. · Department of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan. ·Surgery · Pubmed #31445763.

ABSTRACT: BACKGROUND: The importance of peritoneal washing cytology status both as a sign of irresectability and as a prognostic factor for pancreatic ductal adenocarcinoma remains controversial. The purpose of this nationwide, cancer registry-based study was to clarify the clinical implications of operative resection in patients who had positive cytology status. METHODS: Clinical data from 1,970 patients who underwent tumor resection were collected from the Pancreatic Cancer Registry in Japan. Clinicopathologic factors and overall survival curves were analyzed, and multivariate Cox proportional hazard models were evaluated. RESULTS: Among the 1,970 patients analyzed, positive cytology status was found in 106 patients and negative cytology status was found in 1,864 patients. The positive cytology status group had a greater frequency of pancreatic body and tail cancer and greater preoperative serum carbohydrate antigen 19-9 levels than the negative cytology status group (P < .001 each). The ratio of peritoneal recurrence tended to be greater in the positive cytology status group (14% vs 43%; P < .001). Overall median survival times were less in the positive cytology status group (17.5 months vs 29.4 months; P < .001). The 5-year survival rates were 13.7% and 31.1% in the positive cytology status and negative cytology status groups, respectively. Multivariate analysis of positive cytology status patients revealed that adjuvant chemotherapy was an independent prognostic factor. CONCLUSION: Positive cytology status was an adverse prognostic factor in patients who underwent resection for pancreatic ductal adenocarcinoma but did not preclude attempted curative resection. Curative resection followed by adjuvant chemotherapy may contribute to long-term prognosis in patients with positive cytology status.

12 Article Changes in tumor vascularity depicted by contrast-enhanced EUS as a predictor of prognosis and treatment efficacy in patients with unresectable pancreatic cancer (PEACE): A study protocol. 2019

Sãftoiu, Adrian / Bhutani, Manoop S / Itoi, Takao / Arcidiacono, Paolo G / Bories, Erwan / Cazacu, Irina M / Constantin, Alina / Coronel, Emmanuel / Dietrich, Christoph F / Duda, Dan G / Garcia, Julio Iglesias / Hocke, Michael / Ignee, Andre / Jenssen, Christian / Jinga, Mariana / Khor, Christopher / Oppong, Kofi W / Pereira, Stephen / Petrone, Maria Chiara / Santo, Erwin / Seicean, Andrada / Seo, Dong Wan / Siyu, Sun / Vilmann, Peter / Waxman, Irving / Yeaton, Paul. ·Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, Craiova, Romania. · Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, Houston, Texas, USA. · Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. · Pancreato-Biliary Endoscopy and Endosonography Division, San Raffaele Scientific Institute, Vita Salute San Raffaele University Milan, Milan, Italy. · Endoscopy Unit, Paoli Calmettes Institute, Marseille, France. · Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, Craiova, Romania; Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, Houston, Texas, USA, USA. · Department of Gastroenterology, Ponderas Academic Hospital, Bucharest, Romania. · Medical Department, Caritas-Krankenhaus, Uhlandstr 7, D-97980 Bad Mergentheim, Germany. · Department of Radiation Oncology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA. · Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostella, Santiago, Spain. · Department of Gastroenterology, Helios Kliniken Meiningen, Meiningen, Germany. · Department of Internal Medicine, Krankenhaus Maerkisch-Oderland, D-15344 Strausberg and Brandenburg Institute of Clinical Ultrasound at Medical University Brandenburg, Germany. · Department of Gastroenterology, Central Clinical Emergency Military Hospital Dr. Carol Davila, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania. · Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore. · HPB Unit, Freeman Hospital, Newcastle upon Tyne, London, UK. · University College London Institute for Liver and Digestive Health, Royal Free Hospital Campus, London, UK. · Tel Aviv Souraski Medical Center, Invasive Endoscopy Unit, Gastroenterology Institute, Tel Aviv, Israel. · Regional Institute of Gastroenterology and Hepatology, University of Medicine and Pharmacy "Iuliu Hațieganu," Cluj-Napoca, Romania. · Asan Medical Center, Seoul, South Korea. · Endoscopy Center, Liaoning Engineering Technology Research Center of Diagnosis and Treatment of Digestive Endoscopy, Shengjing Hospital of China Medical University, Shenyang, China. · Gastrointestinal Unit, Copenhagen University Hospital Herlev, Herlev, Denmark. · Center for Endoscopic Research and Therapeutics, University of Chicago Medicine and Biological Sciences, Chicago, IL, USA. · Carilion Clinic Roanoke, Roanoke, USA. ·Endosc Ultrasound · Pubmed #31249159.

ABSTRACT: Patients with unresectable pancreatic cancer have a poor prognosis. The analysis of prognostic factors before treatment may be helpful in determining the best therapeutic strategies. The aim of the PEACE study is to assess the vascularity of pancreatic malignant tumors using contrast-enhanced harmonic EUS (CEH-EUS) and to clarify the prognostic value of tumor vascularity in patients with locally advanced and metastatic pancreatic cancer. Hereby, we present the protocol of a prospective, nonrandomized, single-arm, multicenter study aiming to assess changes in tumor vascularity using CEH-EUS before and 2 months after treatment initiation in patients with unresectable, locally advanced/metastatic pancreatic cancer and to examine the correlation between vascular changes and treatment response, progression-free survival, and overall survival.

13 Article EUS-FNB with or without on-site evaluation for the diagnosis of solid pancreatic lesions (FROSENOR): Protocol for a multicenter randomized non-inferiority trial. 2019

Crinò, Stefano Francesco / Manfrin, Ermina / Scarpa, Aldo / Baldaque-Silva, Francisco / Carrara, Silvia / De Nucci, Germana / Di Mitri, Roberto / Ginés, Angel / Iglesias-Garcia, Julio / Itoi, Takao / Kitano, Masayuki / Nguyen, Nam Quoc / Deprez, Pierre H / Poley, Jan-Werner / Shami, Vanessa M / Tarantino, Ilaria / Larghi, Alberto. ·Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy. Electronic address: stefanocrino@hotmail.com. · Department of Diagnostics and Public Health, G.B. Rossi University Hospital, Verona, Italy. · Department of Diagnostics and Public Health, G.B. Rossi University Hospital, Verona, Italy; ARC-Net Research Centre, G.B. Rossi University Hospital, Verona, Italy. · Department of Upper GI Diseases, Unit of Gastrointestinal Endoscopy, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden. · Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Milan, Italy. · Department of Gastroenterology, Rho and Garbagnate Milanese Hospital, ASST Rhodense, Milano, Italy. · Gastroenterology and Endoscopy Unit, Arnas Civico Di Cristina Benfratelli Hospital, Palermo, Italy. · Gastrointestinal Department, Clinic Hospital of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain. · Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Spain. · Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. · Department of Gastroenterology and Hepatology, Kindai University School of Medicine, Osakasayama, Japan. · Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, Australia. · Department of Gastroenterology and Hepatology, University Clinic of Saint-Luc, Catholic University of Leuven, Brussels, Belgium. · Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam, The Netherlands. · Division of Gastroenterology and Hepatology, University of Virginia Health System, Charlottesville, VA, USA. · Endoscopy Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized, Palermo, Italy. · Digestive Endoscopy Unit, University Hospital A. Gemelli, IRCCS, Roma, Italy. ·Dig Liver Dis · Pubmed #30975612.

ABSTRACT: BACKGROUND: Rapid on-site evaluation (ROSE) of cytological specimensacquired with EUS-guided fine needle aspiration (EUS-FNA) represents the most accurate available technique to reach a definitive diagnosis in patients with pancreatic solid masses. Recently, needles with high histological yield have been developed for EUS-guided fine needle biopsy (EUS-FNB), with which the need for ROSE can be potentially overcome. AIMS: The primary aim is to compare the diagnostic accuracy of EUS-FNB with or without ROSE. The main endpoint will be measured against the gold standard diagnosis (surgical pathology whenever available or diagnostic work-up in agreement with a clinical course of at least six months). Secondary endpoints include: (a) safety; (b) presence of tissue core; (c) quality of specimens; (d) time of the sampling procedure. Reliability of macroscopic on-site evaluation (MOSE) by endosonographers will be also assessed. METHODS: FROSENOR is an international randomized non-inferiority ongoing study at sixteen centers in four continents. Eight hundred patients will be randomized in two arms (EUS-FNB + ROSE vs. EUS-FNB alone) and outcomes compared. Sample size has been calculated in order to demonstrate the non-inferiority of FNB alone. Randomization and data collection will be performed online. DISCUSSION: This study will ascertain if ROSE is still needed when performing EUS-FNB of solid pancreatic lesions.

14 Article A Consensus Study of the Grading and Typing of Intraductal Papillary Mucinous Neoplasms of the Pancreas. 2019

Furukawa, Toru / Fukushima, Noriyoshi / Itoi, Takao / Ohike, Nobuyuki / Mitsuhashi, Tomoko / Nakagohri, Toshio / Notohara, Kenji / Shimizu, Michio / Tajiri, Takuma / Tanaka, Mariko / Yamaguchi, Hiroshi / Yanagisawa, Akio / Sugiyama, Masanori / Okazaki, Kazuichi. ·Department of Pathology, Jichi Medical University, Shimotsuke. · Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo. · Department of Pathology, Showa University Fujigaoka Hospital, Yokohama. · Department of Surgical Pathology, Hokkaido University Hospital, Sapporo. · Department of Surgery, Tokai University School of Medicine, Isehara. · Department of Pathology, Kurashiki Central Hospital, Kurashiki. · Diagnostic Pathology Center, Hakujikai Memorial Hospital. · Department of Diagnostic Pathology, Tokai University Hachioji Hospital, Hachioji. · Department of Pathology, Graduate School of Medicine, University of Tokyo. · Department of Pathology, Tokyo Medical University, Tokyo. · Department of Pathology, Kyoto Prefectural University of Medicine, Kyoto. · Department of Surgery, Kyorin University School of Medicine, Mitaka. · The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan. ·Pancreas · Pubmed #30946243.

ABSTRACT: OBJECTIVE: The grading and typing of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are challenging for pathologists. We aimed to clarify the points of consistency and disagreement in assessing the grades and types of IPMNs. METHODS: Digital slide images of 20 IPMNs were independently assessed by 10 Japanese pathologists, who then held a consensus meeting to discuss the points of disagreement and develop a consensus and recommendations. RESULTS: The average agreement rates for grade and type were 83.5% (range, 100%-40%) and 82.5% (range, 100%-50%) and the Fleiss' κ values were 0.567 and 0.636, respectively. CONCLUSIONS: The disagreement points and recommendations were as follows: destructed ductal walls with desquamated neoplastic epithelia or mucin lakes partially lined with neoplastic cells could be invasion; intraductal stromal invasion could be dismissed unless vascular or lymphatic invasion existed; elastica staining may help visualize ducts in colloidal nodules; high-grade can be distinguished from low/intermediate grade by marked nuclear disarrangements and complex architecture in the intestinal papillae; oncocytic papillae are characterized by eosinophilic cells with round disoriented nuclei; high-grade gastric papillae can be distinguished from pancreatobiliary papillae by relatively low but complex architecture; and the most dysplastic papillae should be used to assess type in mixed papillae types.

15 Article A retrospective histological comparison of EUS-guided fine-needle biopsy using a novel franseen needle and a conventional end-cut type needle. 2019

Mukai, Shuntaro / Itoi, Takao / Yamaguchi, Hiroshi / Sofuni, Atsushi / Tsuchiya, Takayoshi / Tanaka, Reina / Tonozuka, Ryosuke / Honjo, Mitsuyoshi / Fujita, Mitsuru / Yamamoto, Kenjiro / Matsunami, Yukitoshi / Asai, Yasutsugu / Kurosawa, Takashi / Nagakawa, Yuichi. ·Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. · Division of Diagnostic Pathology, Tokyo Medical University, Tokyo, Japan. · Third Department of Surgery, Tokyo Medical University, Tokyo, Japan. ·Endosc Ultrasound · Pubmed #29786033.

ABSTRACT: Background and Objectives: Recently, a 22G Franseen needle for EUS-guided fine-needle biopsy (EUS-FNB) with three novel symmetric heels has been developed to adequately obtain a core tissue. Methods: All 38 consecutive patients with pancreatic masses who underwent EUS-FNB using a Franseen needle were investigated retrospectively to assess the efficacy and safety of EUS-FNB using the Franseen needle. Then, the EUS-FNB outcomes and histological assessments of the tissue obtained by EUS-FNB using the Franseen needle and EUS-FNA using the conventional end-cut type needle for each of the 30 pancreatic ductal adenocarcinoma cases were compared. Results: An accurate histological diagnosis of the Franseen needle was achieved with a mean of 2 passes in 97.4% of patients. Although the accurate histological diagnosis rate of pancreatic ductal adenocarcinoma was not significantly different (96.7% vs. 93.3%, P = 0.55), the mean number of passes in the Franseen needle was significantly less than that in the conventional needle (2.1 ± 0.4 vs. 3.2 ± 0.8, P < 0.001). The presence of desmoplastic fibrosis with neoplastic cellular elements and venous invasion were significantly higher (96.7% vs. 40.0%, P < 0.001 and 23.3% vs. 0%, P < 0.01, respectively) and the amount of obtained tissue was significantly larger with the Franseen needle (2.13 mm Conclusions: EUS-FNB using the Franseen needle enables the acquisition of a larger amount of tissue sample and achieves an accurate histological diagnosis with a smaller number of passes than the conventional end-cut type needle.

16 Article Effect of storage conditions on salivary polyamines quantified via liquid chromatography-mass spectrometry. 2018

Tomita, Atsumi / Mori, Masayo / Hiwatari, Kana / Yamaguchi, Eri / Itoi, Takao / Sunamura, Makoto / Soga, Tomoyoshi / Tomita, Masaru / Sugimoto, Masahiro. ·Health Promotion and Preemptive Medicine, Research and Development Center for Minimally Invasive Therapies, Tokyo Medical University, Shinjuku, Tokyo, 160-8402, Japan. · Institute for Advanced Biosciences, Keio University, Tsuruoka, Yamagata, 997-0052, Japan. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo, 160-0023, Japan. · Fourth Department of Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, 190-0998, Japan. · Health Promotion and Preemptive Medicine, Research and Development Center for Minimally Invasive Therapies, Tokyo Medical University, Shinjuku, Tokyo, 160-8402, Japan. mshrsgmt@gmail.com. · Institute for Advanced Biosciences, Keio University, Tsuruoka, Yamagata, 997-0052, Japan. mshrsgmt@gmail.com. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo, 160-0023, Japan. mshrsgmt@gmail.com. · Department of Pathology Kanagawa Dental College, Post Graduate School, Yokosuka, Kanagawa, 238-85850, Japan. mshrsgmt@gmail.com. ·Sci Rep · Pubmed #30104641.

ABSTRACT: Salivary polyamines are potential non-invasive tools for screening various types of cancers. For clinical use, the reproducibility of these metabolites should be evaluated under various storage conditions, including duration and temperature, to establish standard operating protocols. Polyamines and amino acids in unstimulated whole saliva were quantified via liquid chromatography-mass spectrometry. Concentrations of time course samples were analysed after short-term storage for up to 240 min and long-term storage for up to 8 days under various storage conditions. As expected, storage at the lowest temperature (-18 °C) exerted the least pronounced effects on the quantified values in both tests. At a higher temperature, polyamines were more stable than amino acids, as evident from polyamine profiling. Addition of ethanol significantly stabilized polyamine profiles even at a higher temperature. Comparative processing of saliva revealed a minor effect of the solvent, whereas drying had a more prominent effect on polyamine profiles. Computational analyses evaluated the ability of polyamines to discriminate pancreatic cancer from controls. Repeated noise added tests were designed on the basis of the results of the storage tests; these analyses confirmed that the discriminative abilities were robust. These data contribute to the standardization of salivary storage conditions, thereby highlighting the clinical utility of saliva.

17 Article Clinical and Pathological Features of Solid Pseudopapillary Neoplasms of the Pancreas: A Nationwide Multicenter Study in Japan. 2018

Hanada, Keiji / Kurihara, Keisuke / Itoi, Takao / Katanuma, Akio / Sasaki, Tamito / Hara, Kazuo / Nakamura, Masafumi / Kimura, Wataru / Suzuki, Yutaka / Sugiyama, Masanori / Ohike, Nobuyuki / Fukushima, Noriyoshi / Shimizu, Michio / Ishigami, Kousei / Gabata, Toshifumi / Okazaki, Kazuichi. ·Department of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima. · Department of Gastroenterology, Tokyo Medical University, Tokyo. · Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo. · Department of Gastroenterology, Hiroshima Prefectural Hospital, Hiroshima. · Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya. · Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka. · Faculty of Medicine, First Department of Surgery, Yamagata University, Yamagata. · Department of Surgery, Kyorin University School of Medicine. · Department of Pathology, Showa University Fujigaoka Hospital, Yokohama, Kanagawa. · Department of Pathology, Jichi Medical University, Tochigi. · Diagnostic Pathology Center, Hakujikai Memorial Hospital, Tokyo. · Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka. · Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Kanazawa. · Department of Gastroenterology, Kansai Medical University, Osaka, Japan. ·Pancreas · Pubmed #30059473.

ABSTRACT: OBJECTIVE: The aim of this study was to evaluate the clinicopathological features of solid pseudopapillary neoplasms (SPNs). METHODS: In this retrospective study, 288 SPNs were analyzed. RESULTS: Overall, 214 patients (74%) were female. Distant metastases occurred in 4 patients, and splenic vein tumor thrombus occurred in 1 patient. Although imaging findings showed large (>2.0 cm) SPNs with clear, regular border, and heterogeneous internal structure, small SPNs appeared as almost entirely solid. Surgical resection was performed in 278 cases. The 5-year survival rate was 98.8%. Six patients had tumor recurrence after the initial resection. The detection rate in typical pathological findings was low for small SPNs. Tumor extension to the pancreatic parenchyma was detected in greater than 70% of the cases. Tumor invasion to adjacent organs was detected in 13 cases. One was given a diagnosis of apparent high-grade malignant transformation. CONCLUSIONS: The proportion of male cases was higher than that in previous studies, and there were statistically significant differences in the onset age and tumor diameter between male and female patients. Therefore, women seemed to have an early occurrence of SPNs, suggesting a difference in the developmental stage between men and women. Images and pathological findings of SPNs varied according to tumor size. Our findings indicated that SPN patients have excellent survival after margin-negative surgical resection.

18 Article Surgical Outcomes of Pancreaticoduodenectomy for Pancreatic Cancer with Proximal Dorsal Jejunal Vein Involvement. 2018

Hosokawa, Yuichi / Nagakawa, Yuichi / Sahara, Yatsuka / Takishita, Chie / Nakajima, Tetsushi / Hijikata, Yosuke / Osakabe, Hiroaki / Shirota, Tomoki / Saito, Kazuhiro / Yamaguchi, Hiroshi / Inoue, Keiichiro / Katsumata, Kenji / Tsuchiya, Takayoshi / Sofuni, Atsushi / Itoi, Takao / Tsuchida, Akihiko. ·Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. · Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. ryu37072002@gmail.com. · Department of Radiology, Tokyo Medical University, Tokyo, Japan. · Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan. · Department of Gastroenterological Medicine, Tokyo Medical University, Tokyo, Japan. ·J Gastrointest Surg · Pubmed #29520646.

ABSTRACT: BACKGROUND/PURPOSE: The proximal jejunal vein which branches from the dorsal side of the superior mesenteric vein (SMV) usually drains the inferior pancreatoduodenal veins (IPDVs) and contacts the uncinate process of the pancreas. We focused on this vein, termed the proximal dorsal jejunal vein (PDJV), and evaluated the anatomical classification of the PDJV and surgical outcomes in patients with pancreatic ductal adenocarcinoma (PDAC) with PDJV involvement (PDJVI). METHODS: The jejunal veins that branch from the dorsal side of the SMV above the inferior border of the duodenum are defined as PDJVs. We investigated 121 patients who underwent upfront pancreaticoduodenectomy for PDAC between 2011 and 2017; PDJVs were resected in all patients. The anatomical classification of PDJV was evaluated using multidetector computed tomography. Surgical and prognostic outcomes of pancreticoduodenectomy for PDAC with PDJVI were evaluated. RESULTS: The PDJVs were classified into seven types depending on the position of the first and second jejunal veins relative to the superior mesenteric artery. In all patients, the morbidity and mortality rates were 15.7 and 0.8%, respectively. The rates for parameters including SMV resection, presence of pathological T3-4, R0 resection, and 3-year survival were 46.2, 92.3, 92.3, and 61.1%, respectively, when there was PDJVI (n = 13). When there was no PDJVI (n = 108), the rates were 60.2, 93.5, 86.1, and 58.3%, respectively. Overall, there were no significant differences. CONCLUSIONS: Pancreaticoduodenectomy with PDJV resection is feasible for PDAC with PDJVI and satisfactory overall survival rates are achievable. It may be necessary to reconsider the resectability of PDAC with PDJVI.

19 Article Elevated Polyamines in Saliva of Pancreatic Cancer. 2018

Asai, Yasutsugu / Itoi, Takao / Sugimoto, Masahiro / Sofuni, Atsushi / Tsuchiya, Takayoshi / Tanaka, Reina / Tonozuka, Ryosuke / Honjo, Mitsuyoshi / Mukai, Shuntaro / Fujita, Mitsuru / Yamamoto, Kenjiro / Matsunami, Yukitoshi / Kurosawa, Takashi / Nagakawa, Yuichi / Kaneko, Miku / Ota, Sana / Kawachi, Shigeyuki / Shimazu, Motohide / Soga, Tomoyoshi / Tomita, Masaru / Sunamura, Makoto. ·Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. yacchan85@yahoo.co.jp. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. itoi@tokyo-med.ac.jp. · Research and Development Center for Minimally Invasive Therapies Health Promotion and Preemptive Medicine, Tokyo Medical University, Shinjuku, Tokyo 160-8402, Japan. mshrsgmt@tokyo-med.ac.jp. · Institute for Advanced Biosciences, Keio University, Tsuruoka, Yamagata 997-0052, Japan. mshrsgmt@tokyo-med.ac.jp. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. a-sofuni@amy.hi-ho.ne.jp. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. tsuchiya623@mac.com. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. onakasuicyatta@yahoo.co.jp. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. tonozuka1978@gmail.com. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. 3244honjo@gmail.com. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. maezora1031@yahoo.co.jp. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. fujita.com.com@gmail.com. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. kenjirojiro5544@yahoo.co.jp. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. yukitoshimatsunami1228@yahoo.co.jp. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. takasikurosawa716@yahoo.co.jp. · Third Department of Surgery, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. KKK-miku@ttck.keio.ac.jp. · Institute for Advanced Biosciences, Keio University, Tsuruoka, Yamagata 997-0052, Japan. sana.ota@ttck.keio.ac.jp. · Institute for Advanced Biosciences, Keio University, Tsuruoka, Yamagata 997-0052, Japan. soga@sfc.keio.ac.jp. · Fourth Department of Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo 190-0998, Japan. skawachi@tokyo-med.ac.jp. · Fourth Department of Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo 190-0998, Japan. mt@sfc.keio.ac.jp. · Institute for Advanced Biosciences, Keio University, Tsuruoka, Yamagata 997-0052, Japan. naga@tokyo-med.ac.jp. · Institute for Advanced Biosciences, Keio University, Tsuruoka, Yamagata 997-0052, Japan. shimazu2401@yahoo.co.jp. · Fourth Department of Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo 190-0998, Japan. be7@xui.biglobe.ne.jp. ·Cancers (Basel) · Pubmed #29401744.

ABSTRACT: Detection of pancreatic cancer (PC) at a resectable stage is still difficult because of the lack of accurate detection tests. The development of accurate biomarkers in low or non-invasive biofluids is essential to enable frequent tests, which would help increase the opportunity of PC detection in early stages. Polyamines have been reported as possible biomarkers in urine and saliva samples in various cancers. Here, we analyzed salivary metabolites, including polyamines, using capillary electrophoresis-mass spectrometry. Salivary samples were collected from patients with PC (

20 Article Human Pancreatic Tumor Organoids Reveal Loss of Stem Cell Niche Factor Dependence during Disease Progression. 2018

Seino, Takashi / Kawasaki, Shintaro / Shimokawa, Mariko / Tamagawa, Hiroki / Toshimitsu, Kohta / Fujii, Masayuki / Ohta, Yuki / Matano, Mami / Nanki, Kosaku / Kawasaki, Kenta / Takahashi, Sirirat / Sugimoto, Shinya / Iwasaki, Eisuke / Takagi, Junichi / Itoi, Takao / Kitago, Minoru / Kitagawa, Yuko / Kanai, Takanori / Sato, Toshiro. ·Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan. · Laboratory of Protein Synthesis and Expression, Institute for Protein Research, Osaka University, Suita 565-0871, Japan. · Department of Gastroenterology, Tokyo Medical University, Tokyo 160-0023, Japan. · Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan. · Department of Gastroenterology, Keio University School of Medicine, Tokyo 160-8582, Japan. Electronic address: t.sato@keio.jp. ·Cell Stem Cell · Pubmed #29337182.

ABSTRACT: Despite recent efforts to dissect the inter-tumor heterogeneity of pancreatic ductal adenocarcinoma (PDAC) by determining prognosis-predictive gene expression signatures for specific subtypes, their functional differences remain elusive. Here, we established a pancreatic tumor organoid library encompassing 39 patient-derived PDACs and identified 3 functional subtypes based on their stem cell niche factor dependencies on Wnt and R-spondin. A Wnt-non-producing subtype required Wnt from cancer-associated fibroblasts, whereas a Wnt-producing subtype autonomously secreted Wnt ligands and an R-spondin-independent subtype grew in the absence of Wnt and R-spondin. Transcriptome analysis of PDAC organoids revealed gene-expression signatures that associated Wnt niche subtypes with GATA6-dependent gene expression subtypes, which were functionally supported by genetic perturbation of GATA6. Furthermore, CRISPR-Cas9-based genome editing of PDAC driver genes (KRAS, CDKN2A, SMAD4, and TP53) demonstrated non-genetic acquisition of Wnt niche independence during pancreas tumorigenesis. Collectively, our results reveal functional heterogeneity of Wnt niche independency in PDAC that is non-genetically formed through tumor progression.

21 Article Effects of EUS-guided intratumoral injection of oligonucleotide STNM01 on tumor growth, histology, and overall survival in patients with unresectable pancreatic cancer. 2018

Nishimura, Makoto / Matsukawa, Miho / Fujii, Yuko / Matsuda, Yoko / Arai, Tomio / Ochiai, Yasutoshi / Itoi, Takao / Yahagi, Naohisa. ·Department of Gastrointestinal Endoscopy, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan. · Department of Pathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan. · Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University Hospital, Tokyo, Japan. · Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. ·Gastrointest Endosc · Pubmed #29122598.

ABSTRACT: BACKGROUND AND AIMS: Carbohydrate sulfotransferase 15 (CHST15) promotes tumor growth and invasion and is considered to be an emergent therapeutic target for pancreatic cancer. The aim of this study was to evaluate the safety and efficacy of EUS-guided fine-needle injection (EUS-FNI) of STNM01, the double-stranded RNA oligonucleotide that specifically represses CHST15, for use in patients with pancreatic cancer. METHODS: Six patients with unresectable pancreatic cancer, treated at Tokyo Metropolitan Geriatric Hospital, were used in this open-labeled, investigator-initiated trial. A total of 16 mL STNM01 (250 nM) was injected into the tumor through EUS-FNI. The study's primary endpoint was safety, with a secondary endpoint of tumor response 4 weeks after the initial injection. Some patients received a series of infusions as extensions. The local expression of CHST15 and overall survival (OS) were also evaluated. RESULTS: There were no adverse events. The mean tumor diameter changed from 30.7 to 29.3 mm 4 weeks after injection. Four patients exhibited necrosis of tumor in biopsy specimens. CHST15 was highly expressed at baseline, with 2 patients showing large reductions of CHST15 at week 4. The mean OS of these 2 patients was 15 months, whereas it was 5.7 months for the other 4 patients. CONCLUSIONS: EUS-FNI of STNM01 in pancreatic cancer is safe and feasible. The CHST15 reduction could predict tumor progression and OS. Injections of STNM01 during the beginning of treatment may reduce CHST15 and warrants further investigation.

22 Article Evaluation of novel slim biopsy forceps for diagnosis of biliary strictures: Single-institutional study of consecutive 360 cases (with video). 2017

Yamamoto, Kenjiro / Tsuchiya, Takayoshi / Itoi, Takao / Tsuji, Shujiro / Tanaka, Reina / Tonozuka, Ryosuke / Honjo, Mitsuyoshi / Mukai, Shuntaro / Kamada, Kentaro / Fujita, Mitsuru / Asai, Yasutsugu / Matsunami, Yukitoshi / Nagakawa, Yuichi / Yamaguchi, Hiroshi / Sofuni, Atsushi. ·Department of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023, Japan. · Department of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023, Japan. itoi@tokyo-med.ac.jp. · Third Department of Surgery, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023, Japan. · Department of Pathology, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023, Japan. ·World J Gastroenterol · Pubmed #29085192.

ABSTRACT: AIM: To evaluate the feasibility and reliability of endoscopic transpapillary bile duct biopsy for the diagnosis of biliary strictures. METHODS: A total of 360 patients (241 men) who underwent endoscopic retrograde cholangiopancreatography for biliary strictures with biopsy from April 2012 to March 2016 at Tokyo Medical University Hospital were retrospectively reviewed. This study was approved by our Institutional Review Board (No. 3516). Informed consent was obtained from all individual participants included in this study. The biopsy specimens were obtained using a novel slim biopsy forceps (Radial Jaw 4P, Boston Scientific, Boston, MA, United States). RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 69.6%, 100%, 100%, 59.1%, and 78.8%, respectively. The sensitivity was 75.6% in bile duct cancer, 64% in pancreatic cancer, 61.1% in gallbladder cancer, and 57.1% in metastasis. In bile duct cancer, a lower sensitivity was observed for perihilar bile duct stricture (68.7%) than for distal bile duct stricture (83.1%). In terms of the stricture lengths of pancreatic cancer, gallbladder cancer, and metastasis, a longer stenosis resulted in a better sensitivity. In particular, there was a significant difference between pancreatic cancer and gallbladder cancer ( CONCLUSION: Endoscopic transpapillary biopsy alone using novel slim biopsy forceps is feasible and reliable, but restrictive. Biopsy should be performed in consideration of the stricture level, stricture length, and cancer type.

23 Article Serum Metabolomic Profiles for Human Pancreatic Cancer Discrimination. 2017

Itoi, Takao / Sugimoto, Masahiro / Umeda, Junko / Sofuni, Atsushi / Tsuchiya, Takayoshi / Tsuji, Shujiro / Tanaka, Reina / Tonozuka, Ryosuke / Honjo, Mitsuyoshi / Moriyasu, Fuminori / Kasuya, Kazuhiko / Nagakawa, Yuichi / Abe, Yuta / Takano, Kimihiro / Kawachi, Shigeyuki / Shimazu, Motohide / Soga, Tomoyoshi / Tomita, Masaru / Sunamura, Makoto. ·Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. itoi@tokyo-med.ac.jp. · Institute for Advanced Biosciences, Keio University, Tsuruoka, Yamagata 997-0052, Japan. msugi@sfc.keio.ac.jp. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. junko.umeda@gmail.com. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. a-sofuni@amy.hi-ho.ne.jp. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. tsuchiya623@mac.com. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. g.shujiro@gmail.com. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. onakasuicyatta@yahoo.co.jp. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. tonozuka1978@gmail.com. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. honjo3244@yahoo.co.jp. · Division of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. moriyasu@tokyo-med.ac.jp. · Third Department of Surgery, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. kasuya-k@jcom.home.ne.jp. · Third Department of Surgery, Tokyo Medical University, Shinjuku, Tokyo 160-0023, Japan. naga@tokyo-med.ac.jp. · Fourth Department of Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji,Tokyo 193-0998, Japan. abey3666@gmail.com. · Fourth Department of Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji,Tokyo 193-0998, Japan. kiminoriman526@yahoo.co.jp. · Fourth Department of Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji,Tokyo 193-0998, Japan. skawachi@tokyo-med.ac.jp. · Fourth Department of Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji,Tokyo 193-0998, Japan. shimazu2401@yahoo.co.jp. · Institute for Advanced Biosciences, Keio University, Tsuruoka, Yamagata 997-0052, Japan. soga@sfc.keio.ac.jp. · Institute for Advanced Biosciences, Keio University, Tsuruoka, Yamagata 997-0052, Japan. mt@sfc.keio.ac.jp. · Fourth Department of Surgery, Tokyo Medical University Hachioji Medical Center, Hachioji,Tokyo 193-0998, Japan. be7@xui.biglobe.ne.jp. ·Int J Mol Sci · Pubmed #28375170.

ABSTRACT: This study evaluated the clinical use of serum metabolomics to discriminate malignant cancers including pancreatic cancer (PC) from malignant diseases, such as biliary tract cancer (BTC), intraductal papillary mucinous carcinoma (IPMC), and various benign pancreaticobiliary diseases. Capillary electrophoresismass spectrometry was used to analyze charged metabolites. We repeatedly analyzed serum samples (

24 Article Clinicopathological Characteristics of Young Patients With Pancreatic Cancer: An Analysis of Data From Pancreatic Cancer Registry of Japan Pancreas Society. 2016

Eguchi, Hidetoshi / Yamaue, Hiroki / Unno, Michiaki / Mizuma, Masamichi / Hamada, Shin / Igarashi, Hisato / Kuroki, Tamotsu / Satoi, Sohei / Shimizu, Yasuhiro / Tani, Masaji / Tanno, Satoshi / Hirooka, Yoshiki / Fujii, Tsutomu / Masamune, Atsushi / Mizumoto, Kazuhiro / Itoi, Takao / Egawa, Shinichi / Kodama, Yuzo / Tanaka, Masao / Shimosegawa, Tooru / Anonymous6240867. ·From the *Japan Pancreas Society, Sendai; †Department of Surgery, Graduate School of Medicine, Osaka University, Osaka; ‡Second Department of Surgery, Wakayama Medical University, Wakayama; §Department of Surgery and ∥Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai; ¶Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka; #Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki; **Department of Surgery, Kansai Medical University, Osaka; ††Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya; ‡‡Department of Surgery, Shiga University of Medical Science, Otsu; §§Department of Gastroenterology, IMS Sapporo Digestive Center General Hospital, Sapporo; ∥∥Department of Endoscopy, Nagoya University Hospital; and ¶¶Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya; ##Kyushu University Hospital Cancer Center, Fukuoka; ***Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo; †††Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto; and ‡‡‡Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. ·Pancreas · Pubmed #27171511.

ABSTRACT: OBJECTIVES: The aim of this study was to determine the characteristics of patients with pancreatic ductal adenocarcinoma younger than 40 years. METHODS: Data from the Japan Pancreas Society's nationwide Pancreatic Cancer Registry were analyzed retrospectively. Clinicopathological characteristics were compared in patients who were grouped according to age, namely, younger than 40 years versus 40 years and older. RESULTS: Of the 36 145 patients in the database, the younger group included 526 (1.5%) patients. A family history of pancreatic cancer was not more frequent in the younger group. The frequency of Union Internationale Contre le Cancer T4 and M1 were both significantly higher in younger patients, resulting in a higher percentage of patients with Union Internationale Contre le Cancer stage IV. Pancreatectomy was performed less frequently in the younger group, and R0 resection was also less frequent. The overall survival rate was significantly better in the older group, whereas in surgically resected patients, the overall survival and recurrence-free survival rates were not different between the 2 groups. CONCLUSIONS: Younger patients with pancreatic adenocarcinoma were more often diagnosed at advanced stages, and the overall survival rate was worse than that in older patients. Family genetic background and the prognoses of patients who underwent surgery were similar between the 2 groups.

25 Article Randomized trial comparing a side-port needle and standard needle for EUS-guided histology of pancreatic lesions. 2016

Ishiwatari, Hirotoshi / Hayashi, Tsuyoshi / Kawakami, Hiroshi / Isayama, Hiroyuki / Hisai, Hiroyuki / Itoi, Takao / Ono, Michihiro / Kawakubo, Kazumichi / Yamamoto, Natsuyo / Tanaka, Mariko / Itokawa, Fumihide / Oshiro, Hisashi / Sonoda, Tomoko / Hasegawa, Tadashi / Anonymous900862. ·Department of Medical Oncology and Hematology, Sapporo Medical University, Sapporo, Japan. · Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Japan. · Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. · Department of Gastroenterology, Japanese Red Cross Date General Hospital, Hokkaido, Japan. · Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. · Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. · Department of Pathology, Tokyo Medical University, Tokyo, Japan. · Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan. · Department of Surgical Pathology, Sapporo Medical University School of Medicine, Sapporo, Japan. ·Gastrointest Endosc · Pubmed #26995688.

ABSTRACT: BACKGROUND AND AIMS: A side-port needle has been developed to improve diagnostic accuracy by obtaining more cellular material during EUS-guided FNA (EUS-FNA). We compared the accuracy rate of histology and the quality of histologic specimens from 22-gauge (G) side-port and standard needles for EUS-FNA of a solid pancreatic mass in a multicenter, prospective, randomized control trial. METHODS: Between January 2013 and September 2013, 160 consecutive patients with a suspected solid pancreatic mass at 5 tertiary referral centers were enrolled. Patients were randomized to the 22G side-port needle or 22G standard needle group. The primary endpoint was the diagnostic accuracy of histology. Secondary endpoints were the quality of the histologic specimen (quantity of tissue, degree of GI contamination, and amount of blood). RESULTS: An analysis of 154 patients (side-port, 76, vs standard, 78) was performed. Six patients were excluded because of no pancreatic mass on EUS. There was no significant difference in the rate of diagnostic accuracy of histology (side-port, 87% [66/76], vs standard, 82% [64/78]; P = .51). Samples that enabled histologic interpretation were obtained in 64% (47/73) and 43% (33/77) of patients from the side-port and standard groups, respectively (P = .009). No significant difference was seen in the degree of GI contamination and amount of blood between groups. CONCLUSIONS: There was no significant difference in the accuracy rate of histology between needle types. The side-port needle was superior to the standard needle in terms of obtaining samples that enabled histologic interpretation.

Next