Papers - NANASHIMA Atsushi
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Nanashima A., Sumida Y., Abo T., Takeshita H., Tanaka K., Sawai T., Yasutake T., Omagari K., Nagayasu T.
Acta Medica Nagasakiensia 51 ( 1 ) 27 - 30 2006.5
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Acta Medica Nagasakiensia
The Tokyo score, a new prognostic staging system consisting of albumin, bilirubin, and size and number of tumor has recently been proposed. To evaluate its usefulness, we examined the survival of 213 patients of hepatocellular carcinoma who had undergone hepatectomy. Disease-free and overall survival rates were calculated and difference in these rates between patients with different Tokyo scores was tested for significance using log-rank test. Regarding disease-free survival, there was a significant difference in survival between patients with Tokyo score of 0 and 1 (p < 0.05); however, there was no significant difference among patients with Tokyo score of 1, 2, 3 and 4. Regarding overall survival, there were a significant difference between patients with Tokyo score 0 and 1 (p < 0.01); however, there was no significant difference among patients with Tokyo score of 1, 2, 3 and 4. The 3- and 5-year disease-free survival rates in patients with Tokyo score of 0 were 61% and 46% respectively, and the 3- and 5-year overall survival rates in them were 97% and 81%, respectively. Survival in patients with Tokyo score of 0 was significantly better than in those with Tokyo score of 1. The Tokyo score, a simple staging system that combines tumor factors and hepatic function, might be a good predictor of prognosis for patients of early-stage hepatocellular carcinoma with hepatectomy.
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Intraductal papillary neoplasm of the bile duct extending superficially from the intrahepatic to extrahepatic bile duct.
Nanashima A, Sumida Y, Tamaru N, Nakanuma Y, Abo T, Tanaka K, Sawai T, Yasutake T, Nagayasu T, Hayashi T, Fukuda Y
Journal of gastroenterology 41 ( 5 ) 495 - 9 2006.5
Language：Japanese Publishing type：Research paper (scientific journal)
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Factors affecting survival after bronchoplasty and broncho-angioplasty for lung cancer: single institutional review of 147 patients.
Nagayasu T, Matsumoto K, Tagawa T, Nakamura A, Yamasaki N, Nanashima A
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 29 ( 4 ) 585 - 90 2006.4
Language：Japanese Publishing type：Research paper (scientific journal)
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Nanashima A., Sumida Y., Tobinaga S., Shibata K., Shindo H., Obatake M., Shibasaki S., Ide N., Nagayasu T.
HPB 8 ( 2 ) 137 - 141 2006.4
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：HPB
Background. α-Fetoprotein (AFP) has been used as a marker for hepatocellular carcinoma (HCC). However, AFP levels are often high in patients with chronic hepatitis or cirrhosis. Protein-induced vitamin K absence or antagonist II (PIVKA-II) is more sensitive for the diagnosis of HCC and prediction of patient survival. Changes in these markers after treatment may reflect treatment curability and patient outcome. Methods. We conducted a retrospective analysis of prognosis of 63 HCC patients with high preoperative levels of AFP and PIVKA-II who underwent hepatectomy and examined the relationship between postoperative changes in both markers at 1 month and patient survival. Subjects were divided into three groups according to changes in these tumour markers after hepatectomy: normalization (N) group, decreased but still above the normal level (D) group and unchanged (U) group. Results. There were no significant differences in the numbers of patients who developed tumour recurrence between changes in AFP and PIVKA-II. Survival analysis showed no significant differences in tumour-free and overall survivals between groups with respect to AFP level. The PIVKA-II-N group showed significantly better tumour-free and overall survival compared with the D and U groups (p < 0.01). Multivariate analysis that included other prognostic factors identified changes in PIVKA-II level as a significant and independent prognostic factor associated with overall survival. Discussion. Although changes in AFP did not correlate with patient prognosis, normalization of PIVKA-II was significantly associated with good patient survival after hepatectomy. Normalization of PIVKA-II after hepatectomy reflected the efficacy of treatment and is a suitable predictor of prognosis in HCC patients. © 2006 Taylor & Francis.
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Modified Japan Integrated Staging is currently the best available staging system for hepatocellular carcinoma patients who have undergone hepatectomy.
Nanashima A, Sumida Y, Abo T, Shindou H, Fukuoka H, Takeshita H, Hidaka S, Tanaka K, Sawai T, Yasutake T, Nagayasu T, Omagari K, Mine M
Journal of gastroenterology 41 ( 3 ) 250 - 6 2006.3
Language：Japanese Publishing type：Research paper (scientific journal)
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Clinical significance of double staining of MIB-1 and AgNORs in primary breast carcinoma.
Kidogawa H, Nanashima A, Yano H, Matsumoto M, Yasutake T, Nagayasu T
Anticancer research 25 ( 6B ) 3957 - 62 2005.11
Language：Japanese Publishing type：Research paper (scientific journal)
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Oncological outcome of ultra-low anterior resection with total mesorectal excision for carcinoma of the lower third of the rectum: Comparison of intrapelvic double-stapled anastomosis and transanal coloanal anastomosis.
Nakagoe T, Ishikawa H, Sawai T, Tsuji T, Takeshita H, Nanashima A, Akamine S, Yamaguchi H, Yasutake T
Hepato-gastroenterology 52 ( 66 ) 1692 - 7 2005.11
Language：Japanese Publishing type：Research paper (scientific journal)
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Nakagoe T., Ishikawa H., Sawai T., Tsuji T., Takeshita H., Nanashima A., Akamine S., Yamaguchi H., Yasutake T.
Hepato-Gastroenterology 52 ( 66 ) 1692 - 1697 2005.11
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Hepato-Gastroenterology
Background/Aims: The purpose of this study was to determine whether the type of ultra-low anterior resection (intrapelvic double-stapled anastomosis or transanal hand-sewn coloanal anastomosis) with total mesorectal excision for primary adenocarcinoma of the lower third of the rectum affects survival and recurrence after curative surgery. Methodology: This retrospective study included 112 patients who underwent curative surgery achieved by ultra-low anterior resection in combination with either intrapelvic anastomosis using a double-stapling technique (DST group; n=82) or transanal hand-sewn coloanal anastomosis (CAA group; n=30). Univariate and corrected (multivariate regression) analyses were used to evaluate data. Median follow-up was 51.2 months for patients alive at the conclusion of this study. Results: Disease-free and disease-specific survivals, and the frequency and location of recurrence after surgery did not differ between the two types of operations. Multivariate analyses showed that the type of operation was not a significant independent variable in predicting disease-free survival or in the development of both local and distant recurrences after surgery. Tumor-related factors (stage or histologic grade) were significant predictors of oncological outcome. Conclusions: The type of ultra-low anterior resection (DST or CAA) did not affect survival and recurrence after curative resection for carcinoma of the lower third of the rectum. © H.G.E. Update Medical Publishing S.A.
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Nanashima A., Omagari K., Tobinaga S., Shibata K., Sumida Y., Mine M., Morino S., Shibasaki S., Ide N., Shindou H., Nagayasu T.
European Journal of Surgical Oncology 31 ( 8 ) 882 - 890 2005.10
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：European Journal of Surgical Oncology
Aims: In a previous pilot study, we reported the usefulness of the modified the Cancer of the Liver Italian Program (CLIP) score for patients with hepatocellular carcinoma (HCC). To determine the best staging system for predicting the survival of HCC patients, we conducted a comparative analysis of prognosis using multivariate analysis in 210 Japanese HCC patients who underwent hepatic resection. Methods: We compared the survival as predicted by various staging systems, including tumour node metastasis (TNM) stage of the American Joint Commission on Cancer (AJCC) and the Liver Cancer Study Group of Japan, the Japan Integrated Staging (JIS) score (Japanese TNM and Child-Pugh classification), CLIP score and our modified CLIP score using protein induced by vitamin K absence or antagonist II (PIVKA-II). Results: Univariate analysis showed that discrimination of disease-free survival in the early and advanced stages by the JIS score and modified CLIP score was clearer than by the Japanese or AJCC TNM or the original CLIP score. Discrimination between stages of overall survival by all staging systems was significant. Multivariate analysis showed th at the JIS, CLIP and modified CLIP scores were better staging systems for predicting survival than the Japanese and AJCC TNM. The modified CLIP score showed the lowest Akaike information criteria statistical value for disease-free and overall survival, which means the best discrimination ability for patient survival compared with the JIS score and CLIP score. Conclusions: A staging system that combines tumour factors, sensitive tumour marker(s) and hepatic function is the best predictor of prognosis of HCC patients. © 2005 Elsevier Ltd. All rights reserved.
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Comparative analysis of postoperative morbidity according to type and extent of hepatectomy.
Nanashima A, Yamaguchi H, Shibasaki S, Ide N, Morino S, Sumida Y, Tsuji T, Sawai T, Nakagoe T, Nagayasu T
Hepato-gastroenterology 52 ( 63 ) 844 - 8 2005.5
Language：Japanese Publishing type：Research paper (scientific journal)
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Hepatocellular carcinoma in a male patient with early stage (stage I) primary biliary cirrhosis.
Kadokawa Y, Omagari K, Ohba K, Kitamura S, Ohara H, Takeshima F, Mizuta Y, Nanashima A, Yamaguchi H, Kohno S
Internal medicine (Tokyo, Japan) 44 ( 3 ) 207 - 11 2005.3
Language：Japanese Publishing type：Research paper (scientific journal)
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Hepatocellular carcinoma in a male patient with early stage (stage I) primary biliary cirrhosis
Kadokawa Y., Omagari K., Ohba K., Kitamura S., Ohara H., Takeshima F., Mizuta Y., Nanashima A., Yamaguchi H., Kohno S.
Internal Medicine 44 ( 3 ) 207 - 211 2005.3
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Internal Medicine
The true incidence of hepatocellular carcinoma (HCC) in patients with primary biliary cirrhosis (PBC) remains undetermined due to limited epidemiological studies and some conflicting results. Some studies indicated that in PBC, male gender, cirrhosis, hepatitis C virus (HCV) superinfection, and history of blood transfusion are associated with the development of HCC, and the occurrence of HCC in the early stage of PBC is rare. We present herein a 75-year-old male patient with stage I PBC who developed oropharyngeal squamous cell carcinoma, followed by HCC and duodenal adenocarcinoma without hepatitis B or C virus infection. While it could be argued that the concurrence of HCC and stage I-PBC in our patient was coincidental, patients with early stage PBC should be strictly followed up as cirrhotic patients with PBC by monitoring the serum concentration of tumor markers for HCC and appropriate imaging methods.
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Adjuvant photodynamic therapy for bile duct carcinoma after surgery: a preliminary study.
Nanashima A, Yamaguchi H, Shibasaki S, Ide N, Sawai T, Tsuji T, Hidaka S, Sumida Y, Nakagoe T, Nagayasu T
Journal of gastroenterology 39 ( 11 ) 1095 - 101 2004.11
Language：Japanese Publishing type：Research paper (scientific journal)
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Nanashima A., Yamaguchi H., Omagari K., Nakazaki T., Aritomi T., Hatano K., Sumida Y., Shibasaki S., Ide N., Nakagoe T., Nagayasu T.
Acta Medica Nagasakiensia 49 ( 3 ) 87 - 91 2004.9
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Acta Medica Nagasakiensia
To identify the effect of local treatments for hepatocellular carcinoma (HCC) in our associated institutes in Nagasaki prefecture, we performed a comparative study of hepatic resection and local ablative therapies, including alcohol injection, microwave coagulation and radio-frequency ablation. We examined the patient demographics, outcomes and tumor-free and overall survival between a hepatectomy group (n=210) and a local ablative therapy group (n=52). In the ablative therapy group, there were significantly more patients with cirrhosis and poorer hepatic function than in the hepatectomy group (p < 0.001). Larger tumors and vascular involvement in the hepatectomy group were significantly more frequent than in the ablative therapy group (p < 0.001 and p=0.002, respectively). The multivariate Cox regression analysis indicated no significant difference either in the time to the first recurrence of tumor after surgery or in mortality between ablative therapy and hepatectomy. By making full use of various modalities in each specialty, the satisfactory HCC treatment could be achieved at this stage.
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Factors influencing proper clinical evaluation of depth of tumor invasion in gastric cancer
Tanaka K., Yasutake T., Hidaka S., Takeshita H., Shibasaki S., Tsuji T., Nanashima A., Sawai T., Yamaguchi H., Nakagoe T., Nagayasu T.
Acta Medica Nagasakiensia 49 ( 3 ) 93 - 97 2004.9
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Acta Medica Nagasakiensia
The purpose of this study was to elucidate the factors that influence the clinical evaluation of the depth of tumor invasion in patients with T1 (tumor invasion of mucosa or submucosa) gastric cancer. The depth of tumor invasion was determined in 593 patients with gastric cancer. Patients were divided into two groups based on the agreement between clinical and pathological evaluation of depth of tumor invasion. Of 320 patients with clinical T1 gastric cancer, consistent diagnoses were made in 308 (96.2%) patients (consistent diagnosis group) while inconsistent diagnoses were made in 12 (3.8%) patients (inconsistent diagnosis group). In the clinical T1 gastric cancer, multivariate logistic regression analysis revealed that the disagreement between the clinical and pathological evaluation of the depth of tumor invasion was independently related to two variables; tumor location (upper stomach) and maximum tumor diameter (≥30 mm). For clinical T1 gastric cancer with ≥30 mm in maximum tumor diameter located in the upper stomach, caution should be exercised when selecting therapy.
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Nanashima A., Sumida Y., Morino S., Yamaguchi H., Tanaka K., Shibasaki S., Ide N., Sawai T., Yasutake T., Nakagoe T., Nagayasu T.
European Journal of Surgical Oncology 30 ( 7 ) 765 - 770 2004.9
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：European Journal of Surgical Oncology
Aims. The new Japanese staging system for hepatocellular carcinoma (HCC), the Japan integrated staging (JIS) score, accounts for both Child-Pugh classification and Japan tumour node metastasis (TNM) staging. However, in HCC patients who undergo hepatectomy, liver function is relatively good and a better prognostic classification of hepatic function is necessary. Methods. The present study was designed to analyse the modified JIS score using liver damage grade by the Liver Cancer Study Group of Japan instead of the Child-Pugh classification (using the category indocyanine green retention rate at 15 min [ICGR15] instead of encephalopathy), and to compare the Japan TNM stage in 101 patients who underwent resection of HCC. Results. The liver damage grade showed significantly better discrimination of disease-free and overall survival than did the Child-Pugh classification. The modified JIS score system showed significant differences of disease-free and overall survivals in each score and this system was superior for discriminating survivals compared with the TNM staging. Conclusions. The combined staging system of hepatic function, particularly ICGR15, and tumour stage provides a better prediction of prognosis. The JIS score using the liver damage grade was a useful predictor of prognosis of HCC patients who underwent hepatic resection. © 2004 Elsevier Ltd. All rights reserved.
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Differences in prognosis of colorectal cancer patients based on the expression of sialyl Lewisa, sialyl Lewisx and sialyl Tn antigens in serum and tumor tissue.
Akamine S, Nakagoe T, Sawai T, Tsuji T, Tanaka K, Hidaka S, Shibasaki S, Nanashima A, Yamaguchi H, Nagayasu T, Yasutake T
Anticancer research 24 ( 4 ) 2541 - 6 2004.7
Language：Japanese Publishing type：Research paper (scientific journal)
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Akamine S., Nakagoe T., Sawai T., Tsuji T., Tanaka K., Hidaka S., Shibasaki S., Nanashima A., Yamaguchi H., Nagayasu T., Yasutake T.
Anticancer Research 24 ( 4 ) 2541 - 2546 2004.7
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Anticancer Research
Purpose: To clarify the differences in prognosis of colorectal cancer patients based on the expression of sialyl Lewis a , sialyl Lewis x and sialyl Tn antigens in serum and tumor tissue. Patients and Methods: Preoperative serum levels (by radioimmunoassay) and tumor tissue expression (by immunohistochemistry) of these antigens were simultaneously determined in 52 patients. For each antigen, patients were classified into one of four groups: Group S - /T - , S - /T + , S + /T - and S + /T + . (S denotes serum, T denotes tumor tissue, and negative and positive represent expression). Results: For sialyl Lewis a antigen, the survival time of Group S + /T + was significantly shorter than Group S - /T - or Group S - /T + (p=0.027 or p=0.032, respectively). For sialyl Lewis x antigen, the survival time of Group S - /T + was significantly shorter than Group S-/T- (p = 0.048). Conclusion: Increased expressions of sialyl Lewisa antigen in serum and sialyl Lewis x antigen in tumor tissue may be associated with poor prognosis in colorectal cancer patients.
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Nanashima A., Yasutake T., Sawai T., Hidaka S., Tsuji T., Tagawa Y., Nakagoe T., Tomita M., Nagayasu T.
Acta Medica Nagasakiensia 49 ( 1-2 ) 25 - 32 2004.6
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Acta Medica Nagasakiensia
To clarify the relationship with development of colorectal cancer, we investigated chromosomal aberrations in 715 specimens of the colorectal neoplasm by cytogenetic analysis. A gain of chromosome 17 was observed in the transitional epithelium around non-polypoid carcinomas, although the normal epithelium exhibited diploidy. Most tubular adenomas were diploid, however, loss of chromosome 11 and gain of chromosome 17 were increased in adenomas in association with an increased villous component. DNA aneuploidy, aneusomy and p53 deletion were predominantly observed in carcinomas, even in early cancers. Alterations of chromosomes 11 and 18 reflected different tumor morphologies in the early carcinomas. Gains of chromosomes 11, 17 and 18, and deletion of chromosomes 11 and 17p and p53 became more frequent following an increase in the depth of invasion. Aneusomy of chromosome 11 was a risk factor for patient survival after operation. Gains of chromosome 20 and 20q13.2 were associated with liver metastasis. Aneusomy and translocations of chromosome 17 and the p53 locus were predominantly observed in patients with multiple cancers and hereditary non-polyposis colorectal cancer. Our results indicate that in the process of development of colorectal carcinomas, specific chromosomal aberrations might be related to each step of development, or an alternative pathway of de novo carcinogenesis.
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Primary bile duct cystadenocarcinoma with direct invasion to the gastric wall
Tanaka K., Yasutake T., Hidaka S., Takeshita H., Shibasaki S., Tsuji T., Nanashima A., Sawai T., Yamaguchi H., Yamasaki K., Nakagoe T., Nagayasu T.
Acta Medica Nagasakiensia 49 ( 1-2 ) 59 - 62 2004.6
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Acta Medica Nagasakiensia
Bile duct cystadenocarcinomas are rare cystic neoplasms of the liver. A 70-year-old woman with a cystadenocarcinoma with the invasion to the stomach as a submucosal tumor is presented. There were unrepresentative findings in a pre-operative examination, and it was difficult to distinguish whether this cystic tumor was malignant or benign. The tumor in the stomach was diagnosed as submucosal prior to operation, but was revealed as an invasive tumor from a bile duct cystadenocarcinoma in a left lobe of the liver during surgery. As it metastasized to the stomach and spread intraductally, a left lobectomy was performed. The operation was noncurative but the patient has been alive for 19 months since.