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Faculty of Medicine College Hospital The first surgery |
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Associate Professor |
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Related SDGs |
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IMAMURA Naoya
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Papers 【 display / non-display 】
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Nanashima A., Arai J., Hiyoshi M., Imamura N., Hamada T., Tsuchimochi Y., Shimizu I., Ochiai T., Kawakami H., Sato Y., Takashi W.
Turkish Journal of Surgery 41 ( 1 ) 5 - 18 2025.3
Language：English Publishing type：Research paper (scientific journal) Publisher：Turkish Journal of Surgery
Objective: To elucidate surgical strategies for patients undergoing radical resection, in cases where solitary distant lymph node metastasis is identified intraoperatively, we investigated the prognostic significance of para-aortic lymph node (PALN) metastases and other regional lymph node (RLN) metastases in pancreatic carcinomas (PC) and biliary duct cancers (BDC). Material and Methods: This study retrospectively analyzed data from 181 PC patients and 116 BDC patients who underwent radical resections at two institutions between 1994 and 2021. Results: Among PC patients, metastases were observed in RLN and PALN in 54% and 9% of cases, respectively. Similarly, RLN and PALN metastases were present among BDC patients in 39% and 9% of cases, respectively. Survival analysis revealed that patients with BDC and PALN metastases exhibited significantly reduced disease-free (DFS) and overall survival (OS) compared to those without PALN involvement. Multivariate analysis identified PALN metastasis as an independent predictor of OS in BDC patients (p<0.05), while RLN metastasis was independently associated with DFS (p<0.05). Additional clinicopathological factors associated with PALN and RLN metastases were also identified. Preoperative serum levels of Duke Pancreas II monoclonal antibody were significantly elevated in patients with PALN metastases. Histological findings of lymphatic or perineural infiltration and hepatic or pancreatic invasion were independently associated with RLN metastases. Conclusion: Based on these findings, radical resection may be considered for PC patients with isolated PALN metastases only in the absence of additional adverse prognostic factors. Prospective clinical trials are warranted to further refine the criteria for surgical intervention when solitary PALN metastases are detected intraoperatively.
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Nanashima A., Hiyoshi M., Imamura N., Hamada T., Tsuchimochi Y., Shimizu I., Ochiai T., Ichihara A., Hamada K., Ichiki N., Kai K., Higuchi K.
Translational Cancer Research 14 ( 1 ) 461 - 472 2025.1
Language：English Publishing type：Research paper (scientific journal) Publisher：Translational Cancer Research
Background: Progression of chronic liver dysfunction influenced by long-term chemotherapy or repeated hepatectomy might be related to patient overall survival as well as tumor factors in colorectal liver metastasis (CLM) patients. Our aim of this study was to clarify the relationship between fibrotic liver damage and malignant behaviors of CLM malignancy or its long-term survivals by the retrospective cohort study. Methods: We examined the relationship between tumor-related factors or six liver fibrosis-associated parameters, including platelet count, hyaluronic acid (HA), mac-2 binding protein glycosylation isomer (M2BPGi), type IV collagen 7S (T4C7), aspartate aminotransferase-to-platelet ratio index (APRI), The fibrosis-4 (Fib-4) index, and clinicopathological parameters, surgical records, and postoperative patient survival in the 45 consecutive patients with CLM who underwent radical hepatectomy. Results: Fibrotic parameters were platelet count of 23.0±8.5 ×104/μL, HA level of 68.9±82.3 ng/mL, M2BPGi of 0.87±0.48 ng/mL, and type IV collagen level of 5.74±3.76 ng/mL. Platelet count was significantly correlated with HA level (P<0.05) and tended to be correlated with M2BPGi levels (P=0.056). HA level was significantly associated with albumin level (P<0.05). Overall survival in this series showed five-year overall survivors after hepatectomy in 44 patients (98%), but cancer-related deaths were observed in only one patient. Patients with higher grades and increased bilirubin levels demonstrated significantly lower cancer-free survival (P<0.05), but fibrotic parameters were not associated with prognostic factors. Conclusions: Fibrotic markers indicating chemotherapy or repeated surgical liver injury were not significant predictive factors reflecting cancer malignant behaviors or patient overall survival, contrary to our hypothesis. The current overall survival status using various modalities for cancer recurrence is satisfactory under our present perioperative management.
DOI： 10.21037/tcr-24-1138
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Hosokawa A., Tamura H., Ichihara A., Imamura N., Kai K., Fukushima T., Nanashima A., Komohara Y.
Anticancer Research 44 ( 9 ) 4119 - 4125 2024.9
Language：English Publishing type：Research paper (scientific journal) Publisher：Anticancer Research
Background/Aim: Immune checkpoint inhibitors are effective in treating microsatellite instability-high (MSI-H) metastatic colorectal cancer (CRC). Pathological complete response to immune checkpoint inhibitors for MSI-H metastatic CRC have been described in several reports. Liver metastasis is known to predict resistance to ani-programmed death 1 (PD-1)/PD-1 ligand 1 (PD-L1) therapy in several cancers, including CRC. Case Report: Herein, we report the case of a 23-year-old man with MSI-H colorectal liver metastasis who exhibited a pathological complete response to pembrolizumab following systemic chemotherapies. Pathological examination of the primary lesion revealed strong HLA-class I and HLA-DR expression in cancer cells. Elevated PD-L1 expression was observed in areas of increased CD8-postive T cell infiltration. Additional pathological study of regional lymph nodes showed increased PD-L1 and CD169 expression. Conclusion: A detailed pathological examination revealed PD-L1 expression not only in the primary CRC lesion but also in regional lymph nodes. Recent studies have highlighted the significance of regional lymph nodes in anti-cancer immune responses. Therefore, pathological studies using resected lymph nodes might be beneficial for predicting the response of anti-PD-1/PD-L1 therapy.
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Nanashima A., Hamada T., Hiyoshi M., Imamura N., Tsuchimochi Y., Shimizu I., Nagata K., Kawakami H.
Clinical Journal of Gastroenterology 17 ( 3 ) 490 - 496 2024.6
Language：English Publishing type：Research paper (scientific journal) Publisher：Clinical Journal of Gastroenterology
Nowadays, the novel molecular targeting chemotherapy provides possibility of safe hepatectomy for progressive hepatocellular carcinoma (HCC). Further, combination of the conventional transarterial chemoembolization (TACE) may add an effect of tumor shrink. We present a successful radical hepatectomy for a large HCC located in segment 1 accompanied with the preoperative Lenvatinib (LEN)-TACE sequential treatment. We present a woman patient without any complaints who had a 7 cm-in-size of solitary HCC compressing vena cava and right portal pedicle. To achieve radical hepatectomy by tumor shrinking, LEN-TACE for 2 months. After confirming downsizing or devascularization of the HCC, we scheduled radical posterior sectionectomy combined with caudate lobectomy according to tumor location and expected future remnant liver volume from three-dimensional computed tomography simulation before surgery. Under the thoraco-abdominal incision laparotomy, we safely achieved scheduled radical hepatectomy without any vascular injuries. The postoperative course was uneventful and no tumor recurrence were observed for 1 year. Histological findings showed the Japan TNM stage III HCC with 70% necrosis. The multi-modal strategy of LEN-TACE followed by radical hepatectomy by confirming downsizing or devascularization in tumor is supposed to be useful and would be a preoperative chemotherapy option, and promising for curative treatment in HCC patients with progressive or large HCC, which may lead to safety by prevention surrounding major vascular injury.
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MANGOU (Miyazaki Advanced New General Surgery of University) Wet Lab Training Relieves Anxiety About Surgical Skills in Surgical Education: A Cross-Sectional Study. Reviewed
Hiyoshi M, Kai K, Wada T, Tsuchimochi Y, Nishida T, Hamada T, Yano K, Imamura N, Kawano F, Nanashima A
Cureus 16 ( 5 ) e61273 2024.5
Language：English Publishing type：Research paper (scientific journal)
DOI： 10.7759/cureus.61273
MISC 【 display / non-display 】
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Rare resected eight cases of duodenal adenocarcinomas.
Nanashima Atsushi, Tanoue Yukinori, Imamura Naoya, Hiyoshi Masahide, Yano Koichi, Hamada Takeomi, Nishida Takahiro, Kai Kengo, Suzuki Yasuto, Sato Yuichiro, Nakashima Koji, Hosokawa Ayumu, Nagayasu Takeshi
International journal of surgery case reports 86 106384 2021.9
Language：Japanese Publishing type：Rapid communication, short report, research note, etc. (scientific journal)
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胆管内腔発育型腫瘍の概念と実態：表層進展型胆道系腫瘍． Invited Reviewed
濵田剛臣，矢野公一，今村直哉，旭吉雅秀，藤井義郎，七島篤志
肝胆膵 75 ( 6 ) 1151 - 1158 2017.12
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
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十二指腸乳頭部癌−現状の問題点と今後の展望−：経十二指腸的乳頭部切除の手技と適応． Invited Reviewed
今村直哉，七島篤志，濵田剛臣，矢野公一，旭吉雅秀，藤井義郎，武野慎祐，池田拓人，河野文彰，久保田良政，坂 哲臣，河上 洋
胆と膵 38 ( 7 ) 691 - 696 2017.7
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
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胆膵内視鏡自由自在〜基本手技を学び応用力をつける集中講座〜：ERCP関連手技編 乳頭処置 Bridge to Surgery 悪性肝門部領域胆管閉塞． Invited Reviewed
河上 洋，久保田良政，今村直哉，旭吉雅秀，藤井義郎，七島篤志
胆と膵 37 ( (臨増特大) ) 1279 - 1285 2016.11
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
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新たに定義された“肝門部領域胆管癌”の診断と治療: 術前胆道ドレナージ-経皮経肝胆道ドレナージ-. (共著)
藤井義郎，濱田朗子，西田卓弘，土持有貴，濱田剛臣，矢野公一，今村直哉，土屋和代，河野文彰，旭吉雅秀，大内田次郎，池田拓人，七島篤志
胆と膵 37 ( 1 ) 71 - 74 2016.1
Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (scientific journal) Publisher：医学図書出版(株)
Presentations 【 display / non-display 】
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転移性肝腫瘍に対する腹腔鏡下肝切除術の周術期成績の検討.
濵田剛臣，矢野公一，土持有貴，今村直哉，旭吉雅秀，七島篤志
第30回日本内視鏡外科学会総会 (京都) 日本内視鏡外科学会
Event date： 2017.12.7 - 2017.12.9
Language：Japanese Presentation type：Poster presentation
Venue：京都
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臨床外科学会 国内外科研修報告報告.金属アレルギーを有する患者の内視鏡外科手術について．
今村直哉，七島篤志，濵田剛臣，矢野公一，旭吉雅秀，藤井義郎
第9回膵臓内視鏡外科研究会 (京都) 膵臓内視鏡外科研究会
Event date： 2017.12.6
Language：Japanese Presentation type：Oral presentation (general)
Venue：京都
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新規約におけるBorderline resectable膵癌の治療成績の再検討.
今村直哉，七島篤志，池ノ上実，和田 敬，濵田剛臣，矢野公一，旭吉雅秀，藤井義郎
第79回日本臨床外科学会総会 (東京) 日本臨床外科学会
Event date： 2017.11.23 - 2017.11.25
Language：Japanese Presentation type：Oral presentation (general)
Venue：東京
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EUS-FNAが術前診断に有用であった嚢胞性変化を伴う膵腺房細胞癌の１切除例.
池ノ上実，清水一晃，緒方祥吾，和田 敬，濵田剛臣，矢野公一，今村直哉，旭吉雅秀，藤井義郎，田中弘之，秋山 裕，片岡寛章，七島篤志
第79回日本臨床外科学会総会 (東京) 日本臨床外科学会
Event date： 2017.11.23 - 2017.11.25
Language：Japanese Presentation type：Poster presentation
Venue：東京
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シンポジウム1 外科と病理の協調 病理医は外科医からの疑問にどう応えるか：胆管内乳頭状腫瘍（IPNB）の胆道腫瘍における位置づけ.
七島篤志，今村直哉，佐藤勇一郎，角田順久，旭吉雅秀，藤井義郎
第22回日本外科病理学会学術集会 (栃木) 日本外科病理学会
Event date： 2017.11.10 - 2017.11.11
Language：Japanese Presentation type：Symposium, workshop panel (public)
Venue：栃木