Papers - NANASHIMA Atsushi
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Nakagoe T., Nanashima A., Sawai T., Tuji T., Ohbatake M., Jibiki M., Yamaguchi H., Yasutake T., Ayabe H., Matuo T., Tagawa Y.
Journal of Cancer Research and Clinical Oncology 126 ( 7 ) 375 - 382 2000
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Cancer Research and Clinical Oncology
The deletion of blood group ABH isoantigens on tumor tissues has been reported to be an adverse prognostic marker for patients with various solid tumors. In the present study, we evaluated the prognostic value of altered expression of ABH i soantigens in colorectal carcinomas. Using monoclonal antibodies, the expression of A, B, and H antigens was assessed by immunohistochemistry on paraffin-embedded carcinoma samples from 82 patients who had undergone surgery for colorectal cancer. ABH isoantigens were found to be deleted in 36 carcinomas (43.9%) and expressed in 46 (56.1%). Univariate and multivariate analysis using a logistic regression model revealed that N factor (lymph node metastasis) and blood group type were independently related to the expression of ABH isoantigens. In contrast to previous reports on other cancers, patients whose colorectal carcinomas express ABH isoantigens had a poorer prognosis than those whose carcinomas showed deletion of ABH isoantigens (P = 0.0008). The expression of ABH isoantigens was an independent prognostic variable, in addition to T (depth of tumor invasion), N, and M (distant metastasis) factors, as shown by means of Cox regression analysis. In conclusion, the expression of ABH isoantigens in carcinoma tissue is an important poor prognostic factor in patients with colorectal cancer. This variable needs to be considered in the design of future trials of therapy.
DOI： 10.1007/PL00008485
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Nakagoe T., Sawai T., Tsuji T., Jibiki M., Ohbatake M., Nanashima A., Yamaguchi H., Yasutake T., Ayabe H., Tagawa Y.
Journal of Cancer Research and Clinical Oncology 126 ( 9 ) 542 - 548 2000
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Cancer Research and Clinical Oncology
Recent studies delineated two different patterns of tumor growth in colorectal carcinoma characterized as polypoid and nonpolypoid (PG-type and NPG-type, respectively). We quantified serum sialyl Lewis (Le)a(CA19-9), sialyl Le(x) (SLX), sialyl Tn (STN), and carcinoembryonic antigen (CEA) in 269 colorectal cancer patients to establish whether their levels correlated with any biological or clinical differences between PG-type and NPG-type cancer. Patients were divided into high and low antigen groups (higher or lower than a selected diagnostic-based cut-off value) and compared. Statistical testing was by univariate and multivariate (logistic regression) analyses. Forty-seven (17.5%) patients with PG-type and 222 (82.5%) with NPG-type cancer were studied. In contrast to NPG-type, the characteristics of the PG-type cancers included a low rate of lymph node metastasis and a high serum STN level. In contrast-to a low STN level, a high STN level was independently related to the presence of distant metastasis in patients with PG-type cancer, and also to the presence of distant metastasis and large-sized tumor in patients with NPG-type cancer. These data suggest that differences in STN levels in the serum of patients with PG-type or NPG-type colorectal carcinomas may be at least partly responsible for different tumor progression behavior.
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A case of intramural gastric metastasis from ascending colon cancer
Sawai T., Tsuji T., Nanashima A., Jibiki M., Yamaguchi H., Yasutake T., Nakagoe T., Ayabe H., Yamasaki K.
Japanese Journal of Gastroenterology 96 ( 11 ) 1285 - 1289 1999.11
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japanese Journal of Gastroenterology
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Nanashima A., Yamaguchi H., Sawai T., Yasutake T., Tsuji T., Jibiki M., Yamaguchi E., Nakagoe T., Ayabe H.
Journal of Gastroenterology and Hepatology (Australia) 14 ( 10 ) 1004 - 1009 1999.10
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Gastroenterology and Hepatology (Australia)
Background: Adhesion molecules are closely involved in the development and growth of metastatic tumours. Methods: We examined the expression of two adhesion molecules in liver metastatic tumours originating from colorectal carcinomas and correlated the expression of E-cadherin (EC) and CD44 variant exon 6 (v6) in these tumours with prognosis after hepatic resection. We examined 39 primary colorectal and 44 liver metastatic tumours obtained from 39 patients and 30 non-metastatic colorectal carcinomas as controls. The expression of EC in primary colorectal carcinomas of the metastasis group was significantly lower than in the non-metastasis group (P < 0.05). The expression of EC was low in metastatic liver tumours. Results: The expression of CD44v6 in primary colorectal carcinomas of the metastasis group was significantly higher than in the non-metastasis group (P < 0.01). Expression of CD44v6 was high in metastatic liver tumours. However, there was no correlation between the expression of EC and CD44v6 or between each of these molecules and clinicopathological features of primary and metastatic tumours. Negative expression of EC and CD44v6 was a poor prognostic factor for survival after hepatic resection. Conclusions: Our results indicate that the lack of expression of EC and CD44v6 in liver metastases of colorectal cancer is associated with poor survival after surgery.
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Expression of multidrug resistance protein in metastatic colorectal carcinomas
Nanashima A., Yamaguchi H., Matsuo S., Sumida Y., Tsuji T., Sawai T., Yasutake T., Nakagoe T., Ayabe H.
Journal of Gastroenterology 34 ( 5 ) 582 - 588 1999.10
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Gastroenterology
To clarify the relationship between multidrug resistance protein (MRP) and clinicopathologic features, the influence of adjuvant chemotherapy, and prognosis of patients who underwent resection of metastatic liver carcinomas originating from colorectal carcinomas, we examined the expression of MRP in tumor tissues by immunostaining. Specimens of 38 primary colorectal tumors and 44 metastatic liver tumors of colorectal origin were examined (metastatic group). We also examined 28 nonmetastatic colorectal carcinomas. The percentages of nonmetastatic tumors and of primary and metastatic tumors of the metastasis group that expressed MRP were similar. MRP expression in primary and metastatic tumors did not correlate with any clinicopathologic features. The use of adjuvant chemotherapy after operation for primary colorectal carcinomas was associated with increased MRP expression among metastatic liver tumors. Expression of MRP in the tumor did not influence the prognosis or survival rate after resection of primary or metastatic tumors. Our data suggest that MRP expression in metachronous liver metastases from colorectal carcinomas may be induced by administration of anticancer drugs but is not associated with clinicopathologic features of the tumor, liver metastasis, or prognosis.
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Yamaguchi K., Omagari K., Kinoshita H., Yoshioka S., Furusu H., Takeshima F., Nanashima A., Yamaguchi H., Kohno S.
Journal of Clinical Gastroenterology 29 ( 2 ) 207 - 209 1999.9
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Clinical Gastroenterology
The authors report a rare case of hepatocellular carcinoma (HCC) that developed 6 years after a sustained and complete response to interferon (IFN) therapy for chronic hepatitis C. A 61-year-old Japanese man presented with a mass in the liver that was diagnosed as HCC. Six years earlier he was treated with IFN-α and responded successfully to therapy, with sustained normalization of serum aminotransferases and eradication of serum hepatitis C virus (HCV)-ribonucleic acid (RNA). HCV-RNA was also not detected in the resected tumorous and nontumorous liver tissues. The findings suggest that all patients with chronic HCV infection should be followed closely for as long as possible for the potential development of HCC even after a complete and sustained response to IFN treatment.
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Nakagoe T., Sawai T., Tuji T., Nanashima A., Yamaguchi H., Yasutake T., Ayabe H.
Journal of Surgical Oncology 71 ( 3 ) 196 - 197 1999.7
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Surgical Oncology
DOI： 10.1002/(SICI)1096-9098(199907)71:3<196::AID-JSO11>3.0.CO;2-R
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High serum concentrations of sialyl Tn antigen in carcinomas of the biliary tract and pancreas
Nanashima A., Yamaguchi H., Nakagoe T., Matsuo S., Sumida Y., Tsuji T., Sawai T., Yamaguchi E., Yasutake T., Ayabe H.
Journal of Hepato-Biliary-Pancreatic Surgery 6 ( 4 ) 391 - 395 1999.1
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Hepato-Biliary-Pancreatic Surgery
Sialyl-Tn (STn) antigen is a cancer-associated carbohydrate antigen expressed in cancers of the digestive tract. In the present study, we compared the serum level of STn antigen in 14 patients with benign diseases of the biliary tract and pancreas, 15 patients with bile duct cancers, and 9 patients with cancer of the pancreas. High levels of serum STn ( > 45 U/ ml) were frequently detected in patients with carcinoma of the biliary tract (53.3%) or pancreas (55.6%), compared with the detection of high levels in those with benign diseases (14.3%; P < 0.05). Serum levels of STn did not correlate with the presence of jaundice, cholangitis, or pancreatitis, or with the level of carcinoembryonic antigen (CEA) or carbohydrate antigen (CA) 19-9. In cancer tissues, the expression of STn antigen detected by immunostaining correlated significantly with serum STn (P < 0.05). Our results indicate that measurement of serum STn level may be potentially useful for the diagnosis of carcinomas of the biliary tract and pancreas, particularly when combined with other tumor markers such as CEA or CA19-9. © Springer-Verlag 1999.
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Nanashima A., Yamaguchi H., Shibasaki S., Sawai T., Yasutake T., Tsuji T., Nakagoe T., Ayabe H.
Journal of Gastroenterology and Hepatology (Australia) 14 ( 1 ) 61 - 66 1999.1
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Gastroenterology and Hepatology (Australia)
In this study, we determined the proliferation indices of liver metastatic tumours originating from colorectal carcinomas using Ki67 and argyrophil nucleolar organizer region associated pro- reins (AgNOR) stain. We examined the primary and metastatic tumours in 27 patients with liver metastasis and eight cases with non-metastatic colorectal carcinoma as a control. The number of AgNOR dots in metastatic tumours was significantly higher than in the respective primary tumours of the metastasis group or in non-metastatic colorectal carcinomas. The Ki67 labelling index was similar in all groups. The Ki67 labelling index and AgNOR counts did not correlate with each other. There was no significant relationship between proliferation indices and the duration of the disease-free period following hepatic resection for metastases or with prognosis after hepatectomy. We conclude that Ki67 and AgNOR are not useful indicators of prognosis in patients who undergo operation for liver metastasis of colorectal carcinomas.
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A case of node-positive, Is-type rectal cancer measuring 5mm in diameter
Sawai T., Tsuji T., Nanashima A., Jibiki M., Yamaguchi H., Yasutake T., Nakagoe T., Ayabe H.
Japanese Journal of Gastroenterological Surgery 32 ( 9 ) 2292 - 2295 1999
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japanese Journal of Gastroenterological Surgery
A 49-year-old man who had undergone cholecystectomy for cholecystolithiasis visited our hospital for lower abdominal pain and diarrhea. A colonoscopy revealed a protruded lesion with a double elevation, measuring 5 mm in diameter in the upper rectum, 10 cm from the anal verge. Under the diagnosis of tubular adenoma, the lesion was removed by endoscopic polypectomy. Histological findings showed moderately differentiated adenocarcinoma invasion to the submucosa (sm), and was markedly suggestive of submucosal vertical margin involvement. Four weeks after the polypectomy, low anterior resection with dissection of group 1 and group 2 lymph nodes were performed. Although there was no residual carcinoma, metastases were found in three of the 16 dissected nodes. The present case illustrates that minute protruded colorectal carcinomas can have SM invasion, and that the double elevation is useful in diagnosing the massive SM invasion of these lesions.
DOI： 10.5833/jjgs.32.2292
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Left-sided predominance and family history of malignancy in colorectal cancer with DNA multiploidy
Sawai T., Tsuju T., Nanashima A., Jibiki M., Yamaguchi H., Yasutake T., Nakagoe T., Ayabe H., Tagawa Y.
Japanese Journal of Gastroenterological Surgery 32 ( 11 ) 2526 - 2531 1999
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japanese Journal of Gastroenterological Surgery
The purpose of this study was to evaluate the relationship between DNA multiploidy and tumor characteristics of colorectal cancer. Flow cytometric quantification of nuclear DNA content was performed on freshly frozen tissue from 245 patients who underwent surgical resection from 1990 to 1996, at First Department of Surgery, Nagasaki University School of Medicine. The cases were classified into three groups according to DNA ploidy pattern as follows: 1) Dd group, 78 cases (31.8%) with DNA diploidy; 2) Dm group, 36 cases (14.7%) with DNA multiploidy; 3) Da group, 131 cases (53.5%) with DNA aneuploidy except for DNA multiploidy. The Dm group was associated with left colon (compared with Dd group, p=0.0069), absence of metastasis (compared with Da group, p=0.0095), and positive family history of extracolonic malignancy (compared with Dd and Da groups, p=0.031 and p=0.044, respectively). Of the 245 patients, 71 cases were randomly examined by fluorescence in situ hybridization for detection of numerical aberration of chromosome 17. The frequency of chromosomal aberration was lower in the Dm group than in the Da group (p=0.0068).
DOI： 10.5833/jjgs.32.2526
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Nakagoe T., Sawai T., Tuji T., Nanashima A., Yamaguchi H., Yasutake T., Ayabe Y.
Surgery Today 29 ( 5 ) 443 - 445 1999
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Surgery Today
The management of postoperative rectovaginal fistula (RVF) after low anterior resection for rectal cancer is difficult and the results are often unsatisfactory. Among 140 patients with rectal cancer who underwent low anterior resection with a double-stapled anastomosis at our hospital between 1986 and 1996, 4 (2.9%) developed RVF as a postoperative complication. The RVF developed gradually from 9 to 128 days after low anterior resection. We describe herein our technique of using a modified transvaginal approach for RVF repair with a diverting colostomy. In all four patients, the RVFs were completely eradicated with reestablishment of intestinal continuity and did not recur during the mean follow-up period of 29.5 months, ranging from 12 to 67 months. This report serves to demonstrate that emerging RVFs secondary to stapled anastomosis in low anterior resection for rectal cancer must be recognized, and that a modified transvaginal approach provides an effective method of repair.
DOI： 10.1007/BF02483037
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Nakagoe T., Sawai T., Tuji T., Nanashima A., Yamaguchi H., Yasutake T., Ayabe H.
Surgery Today 29 ( 4 ) 395 - 397 1999
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Surgery Today
Small-bowel obstruction remains one of the most frequent complications after restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Of particular concern is small-bowel adhesion to the pelvic dead space that causes afferent limb obstruction, sometimes necessitating laparotomy. In this report, we describe a technique using an omental pedicle graft (OPG) to fill the pelvic dead space to prevent small-bowel obstruction and the resulting afferent limb obstruction after IPAA. The OPG is created from the left half of the omentum, while maintaining the blood supply from the left gastroepiploic vessels. The omentum is placed into the pelvis along the left paracolic gutter from where the colon has been resected. It is then passed over the pelvic brim and placed behind and along the bilateral sides of the ileal pouch, filling the space. This modified technique was employed in the treatment of four patients with chronic ulcerative colitis, none of whom developed any signs of small-bowel obstruction.
DOI： 10.1007/BF02483074
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Nanashima A., Yamaguchi H., Tsuji T., Yamaguchi E., Sawai T., Yasutake T., Nakagoe T., Ayabe H.
Surgical Endoscopy 12 ( 12 ) 1381 - 1385 1998.12
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Surgical Endoscopy
Background: Differences in the physiological stress response to pneumoperitoneal (PP) and gasless abdominal wall-lifting (AWL) procedures used for laparoscopic cholecystectomy have not been properly evaluated. Methods: We compared leukocyte count, interleukin-6 (IL-6) levels, arterial blood gases, creatinine clearance, plasma renin activity, cardiothoracic ratio, and clinical outcome in 27 patients without systemic complications who underwent laparoscopic cholecystectomy, including 11 by AWL and 16 by PP. Results: Transient leukocytosis and high IL-6 levels were observed at POD 1 (postoperative day) in both groups, but both values returned to baseline by POD 2. IL-6 levels correlated significantly with operation time (p < 0.01). Changes in blood gases, creatinine clearance, plasma renin activity, and cardiothoracic ratio were not different for the two groups. The clinical outcome was similar for both groups. Conclusions: Our results indicate that both PP and AWL are appropriate for patients without serious complications.
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Significance of angiogenic factors in liver metastatic tumors originating from colorectal cancers
Nanashima A., Ito M., Sekine I., Naito S., Yamaguchi H., Nakagoe T., Ayabe H.
Digestive Diseases and Sciences 43 ( 12 ) 2634 - 2640 1998.12
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Digestive Diseases and Sciences
We examined the expression of vascular endothelial growth factor (VEGF) and microvessel counts expressed by CD34 staining in 39 patients with primary and 44 patients with metastatic liver tumors of metastatic colorectal carcinoma, and 29 patients with nonmetastatic colorectal carcinoma as control in order to determine their value in the evaluation of prognosis and recurrence after hepatectomy. Microvessel counts in primary colorectal carcinomas of the metastatic group were significantly higher than those in control (P < 0.05). Neither factor correlated with any clinicopathological feature of primary or metastatic liver carcinomas. Higher microvessel counts in metastatic liver tumors tended to be associated with a shorter disease- free interval to second recurrence in the remaining liver (P = 0.069) and were significantly associated with poor prognosis after hepatectomy (P < 0.05). We conclude that microvessel count is an important marker of liver metastatasis and prognosis in patients with colorectal carcinoma treated with hepatectomy.
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Tagawa Y., Nanashima A., Tsuji T., Sawai T., Yamaguchi H., Yasutake T., Nakagoe T., Ayabe H.
Journal of Gastroenterology 33 ( 5 ) 670 - 677 1998.10
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Gastroenterology
The incidence of non-familial multiple primary cancer in colorectal cancer patients has increased in recent years in Japan. To clarify the characteristic genetic aberrations in such multiple cancers, we examined structural chromosomal aberrations by fluorescence in situ hybridization, using chromosome 17-specific and p53 cosmid DNA probes. We established short-term cultures of 78 surgical specimens and were able to obtain observable metaphase spreads in 23 single colorectal cancer specimens and in 6 colorectal cancer specimens from patients with double primary cancers. The frequency of chromosome 17 and/or p53 locus translocation was significantly greater in tumors with double cancer than in single colorectal cancers (P < 0.05 and P < 0.01, respectively). These aberrations in double cancers frequently appeared even at an early Dukes' stage (A and B) of colorectal carcinoma. Our results suggest that translocation of chromosome 17 and the p53 locus may be specific genetic events probably associated with carcinogenesis of multiple primary cancers in colorectal cancer.
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Sawai T., Sasano O., Tsuji T., Nanashima A., Yamaguchi H., Yasutake T., Nakagoe T., Ayabe H., Tagawa Y.
Journal of Gastroenterology 33 ( 4 ) 495 - 499 1998.8
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Gastroenterology
Numerical aberrations of chromosome 17 and nuclear DNA content were compared in patients with hereditary non-polyposis colorectal cancer (HNPCC) and those with sporadic colorectal cancer (SCRC). During a period of 22 years, 30 cases (3.2%) from 28 families satisfied the Japanese clinical criteria of HNPCC. Using freshly frozen tissue samples, we investigated chromosomal aberration with fluorescence in situ hybridization with alpha satellite DNA probe for chromosome 17. Flow cytometric quantification of nuclear DNA content showed DNA aneuploidy in 9 of 15 patients (60.0%) with HNPCC and in 160 of 234 patients (68.4%) with SCRC; there was no significant difference between HNPCC and SCRC. The mean proportion of nuclei with aneusomy 17 (numerical chromosome aberration index: NCAI) in 14 patients with HNPCC was significantly higher than that in 42 patients with SCRC (46.8 ± 5.0% vs 39.0 ± 10.3%, P < 0.01). NCAI increased in proportion with the progression of the disease in SCRC (26.1% in stage I, 33% in stage II, 38.8% in stage IIIa, 42.7% in stage IIIb, and 46.2% in stage IV, P < 0.01), whereas NCAI in HNPCC was high in all stages (43.5%-49.2%). The proportion of patients with multiple numerical aberration of chromosome 17 was significantly higher in HNPCC (9/14) than among SCRC (11/42). Our data suggest that chromosome 17 is present in an unstable condition in HNPCC.
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Nakagoe T., Fukushima K., Tuji T., Sawai T., Nanashima A., Yamaguchi H., Yasutake T., Hara S., Ayabe H., Matuo T., Kamihira S.
Cancer Detection and Prevention 22 ( 6 ) 499 - 505 1998
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Cancer Detection and Prevention
The expression of blood group antigens A, B, and H, as well as sialylated and nonsialylated forms of Lewis(a) and Lewis(x), was studied using immunohistochemical methods in normal and tumor tissues in the following cohort of patients: 51 patients with primary breast carcinoma, 13 with metastatic lymph node lesions, and 16 with benign tumors of the breast. As a control, normal tissue was obtained from a similar group of 22 patients with breast cancer. The noncancerous tissues expressed the same A/B/H antigens as the patients' red blood cells and also usually expressed Lewis-related antigens. Seventy-six percent of primary carcinomas failed to express the appropriate A/B/H antigens, and in one blood group A patient the tumor tissue expressed B antigen. In the metastatic lesions, Lewis(a)/sialyl Lewis(a) expression was reduced when compared with the primary tumors, but Lewis(x)/sialyl Lewis(x) antigens were still expressed. These results suggest a possible relationship between the metastatic behavior of the tumor and expression of the blood group antigens.
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Preoperative estimation of lymphatic vessel invasion on gastric carcinoma
Yasutake T., Terada R., Yamaguchi E., Tsuji T., Nanashima A., Sawai T., Yamaguchi H., Nakagoe T., Ayabe H., Tagawa Y.
Japanese Journal of Gastroenterological Surgery 31 ( 10 ) 2171 - 2175 1998
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japanese Journal of Gastroenterological Surgery
Preoperative estimation of lymphatic invasion by gastric carcinoma was attempted by using clinicopathological or cell and molecular biological methods. In 1129 cases of gastric carcinoma, the size of cancers with lymphatic invasion (71 mm) was significantly (p<0.001) greater than that of cancers without lymphatic invasion (43 mm). Stainability of nm23 was relatively low in cases of positive for lymphatic invasion. Simultaneous attempts to detect of proliferating cell nuclear antigen (PCNA) and numerical chromosomal aberrations were also performed in 100 cases of gastric carcinoma. PCNA was detected by the immunofluorescence method using anti-PCNA antibody (PC-10) after acetone-ethanol fixatin. Numerical chromosomal aberrations were detected by fluorescence in situ hybridization (FISH) using the probe for chromosome 17 centromere. The frequency of the cells with positive PCNA staining that had numerical aberration of chromosome 17 was significantly (p = 0.0001) higher in the cases with lymphatic invasion (15.3%), compared to the cases without lymphatic invasion (9.0). The percentage of the cells that were PCNA-negative with numerical chromosomal aberrations was unrelated to lymphatic invasion. These results revealed that lymphatic vessel invasion is not induced by chromosome aberration or the cell cycle alone, but by a combination of both of them. This method can be performed preoperatively. The results also indicated that tumor size and tha rate of PCNA positivity with numerical aberration of chromosome 17 could be a marker for lymphatic invasion of gastric carcinoma.
DOI： 10.5833/jjgs.31.2171
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Right-sided predominance of superficial early cancers in synchronous multiple colorectal carcinomas
Sawai T., Tsuji T., Yamaguchi E., Nanashima A., Yamaguchi H., Yasutake T., Nakagoe T., Ayabe H.
Journal of the Japan Society of Colo-Proctology 51 ( 8 ) 567 - 572 1998
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of the Japan Society of Colo-Proctology
Between 1989 and 1996, there were 54 patients with synchronous multiple colorectal carcinomas identified in an operative series of 569 patients in the First Department of Surgery, Nagasaki University School of Medicine, for a frequency of 9.6 percent. When comparing the mean age of patients, sex distribution, histological stage, the incidence of extra colonic malignancies, and family history of malignancies in a first degree relatives, there was no significant difference between the group with and without synchronous carcinomas. The anatomical distribution of tumors in the group with synchronous carcinomas revealed a higher percentage of tumors located on right-sided colon (p < 0.05). There were higher incidences of superficial tumors, early carcinomas, well differentiation, and associated adenomatous polyps in the group with synchronous carcinomas (p < 0.00001, respectively). In 74 tumors of early colorectal carcinomas, superficial tumors were significantly more often in right-sided tumors than in left-sided-tumors (p < 0.0002). Non-polypoid growth carcinomas were also more often in right-sided- tumors than in left-sided tumors (p < 0.05). These results suggest the importance of preoperative pancolonoscopy for the identification of early carcinomas and adenomatous polyps in patients with colorectal cancer especially with right-sided tumors.