• Journal of Gastric Cancer
• /
• v.23 no.2
• /
• pp.303-314
• /
• 2023

Purpose: The incidence of early gastric cancer is increasing in older patients alongside life expectancy. For early gastric cancer of the upper third of the stomach, laparoscopic function-preserving gastrectomy (LFPG), including laparoscopic proximal gastrectomy (LPG) and laparoscopic subtotal gastrectomy (LSTG), is expected to be an alternative to laparoscopic total gastrectomy (LTG). However, whether LFPG has advantages over LTG in older patients remains unknown. Materials and Methods: We retrospectively analyzed data of consecutive patients aged ≥75 years who underwent LTG, LPG, or LSTG for cT1N0M0 gastric cancer between 2005 and 2019. Surgical and nutritional outcomes, including blood parameters, percentage body weight (%BW) and percentage skeletal muscle index (%SMI) were compared between LTG and LPG or LSTG. Survival outcomes were also compared between LTG and LFPG groups. Results: A total of 111 patients who underwent LTG (n=39), LPG (n=48), and LSTG (n=24) were enrolled in this study. To match the surgical indications, LTG was further categorized into "LTG for LPG" (LTG-P) and "LTG for LSTG" (LTG-S). No significant differences were identified in the incidence of postoperative complications among the procedures. Postoperative nutritional parameters, %BW and %SMI were better after LPG and LSTG than after LTG-P and LTG-S, respectively. The survival outcomes of LFPG were better than those of LTG. Conclusions: LFPG is safe for older patients and has advantages over LTG in terms of postoperative nutritional parameters, body weight, skeletal muscle-sparing, and survival. Therefore, LFPG for upper early gastric cancer should be considered in older patients.

• Journal of Gastric Cancer
• /
• v.23 no.4
• /
• pp.609-621
• /
• 2023

Purpose: Determination of optimal treatment strategies for HER2-positive advanced gastric cancer (AGC) in randomized trials is necessary despite difficulties in direct comparison between trastuzumab deruxtecan (T-DXd) and nivolumab as third or later-line treatments. Materials and Methods: This single-institution, retrospective study aimed to describe the real-world efficacy and safety of T-DXd and nivolumab as ≥ third line treatments for HER2-positive AGC between March 2016 and May 2022. Overall, 58 patients (median age, 64 years; 69% male) were eligible for the study (T-DXd group, n=20; nivolumab group, n=38). Results: Most patients exhibited a HER2 3+ status (72%) and presented metastatic disease at diagnosis (66%). The response rates of 41 patients with measurable lesions in the T-DXd and nivolumab groups were 50% and 15%, respectively. The T-DXd and nivolumab groups had a median progression-free survival of 4.8 months (95% confidence interval [CI], 3.3, 7.0) and 2.3 months (95% CI, 1.5, 3.5), median overall survival (OS) of 10.8 months (95% CI, 6.9, 23.8) and 11.7 months (95% CI, 7.6, 17.1), and grade 3 or greater adverse event rates of 50% and 2%, respectively. Overall, 64% patients received subsequent treatment. Among 23 patients who received both regimens, the T-DXd-nivolumab and nivolumab-T-DXd groups had a median OS of 14.0 months (95% CI, 5.0, not reached) and 19.3 months (95% CI, 9.5, 25.1), respectively. Conclusions: T-DXd and nivolumab showed distinct efficacy and toxicity profiles as ≥ third line treatments for HER2-positive AGC. Considering the distinct features of each regimen, they may help clinicians personalize optimal treatment approaches for these patients.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.4
• /
• pp.1707-1710
• /
• 2014

Background: The objective of this study was to evaluate baseline use and positive rates of staging images (bone scan, CT) in newly diagnosed patients with prostate cancer (PCa) and to improve staging image overuse. Materials and Methods: This retrospective study covered a consecutive series of patients with PCa who underwent stage imaging at our institution between 2006 and 2011. Various clinical and pathological variables (age, PSA, biopsy Gleason score, clinical T stage, positive biopsy core rate) were evaluated by multivariate logistic regression analysis for their ability to predict a positive staging image. All patients were stratified according to the NCCN risk stratification and positive rates were compared in each risk group. Results: 410 patients (100%) underwent a bone scan and 315 patients (76.8%) underwent a CT scan. Some 51 patients (12.4%) had a positive bone scan, clinical T3 and T4 being significant independent predictors. Positive bone scan rates for low-, intermediate-, high-, and very high-risk groups were 0%, 0%, 8.25%, and 56.6%. Some 59 (18.7%) patients had a positive CT scan, with elevated PSA and clinical T3, T4 as significant independent predictors. Low-, intermediate-, high- and very high-risk group rates were 0%, 0%, 13.8% and 80.0%. Conclusions: The incidences of positive staging image in low- and intermediate- risk group were reasonably low. Following feedback on these results, staging in low- and intermediate- risk groups could be omitted.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.14
• /
• pp.5687-5690
• /
• 2015

Background: Factors predictive of survival have been identified in Western patients with metastatic clear cell renal cell carcinoma (mCCRCC) treated with sunitinib. Less is known, however, about factors predictive of survival in Japanese patients. This study evaluated factors prognostic of survival in Japanese patients with mCCRCC treated with first-line sunitinib. Materials and Methods: This retrospective study evaluated 46 consecutive Japanese mCCRCC patients treated with sunitinib as first line therapy. Clinical and biochemical markers associated with progression-free survival (PFS) were analyzed, with prognostic factors selected by uniand multivariate Cox regression analyses. Results: Univariate analysis showed that factors significantly associated with poor PFS included Memorial Sloan-Kettering Cancer Center poor risk scores, International Metastatic RCC Database Consortium poor risk and high (>0.5 mg/dl) serum C-reactive protein (CRP) concentrations (p<0.001 each). Multivariate analysis showed that high serum CRP was independently associated with poorer PFS (p=0.040). Six month disease control rate (complete response, partial response and stable disease) in response to sunitinib was significantly higher in patients with normal (${\leq}0.5mg/dl$) than elevated baseline CRP (p<0.001). Conclusions: CRP is a significant independent predictor of PFS for Japanese patients with mCCRCC treated with first-line sunitinib. Pretreatment CRP concentration may be a useful biomarker predicting response to sunitinib treatment.

• Journal of Gastric Cancer
• /
• v.24 no.2
• /
• pp.220-230
• /
• 2024

Purpose: Prevention of pancreas-related complications after gastric cancer surgery is critical. Polyglycolic acid (PGA) mesh reduces postoperative pancreatic fistula formation following pancreatic resection. However, the clinical efficacy of PGA mesh in gastric cancer surgery has not been adequately investigated. Materials and Methods: This retrospective study compared the short-term outcomes between two groups: patients who underwent minimally invasive R0 gastrectomy for gastric cancer with the use of a PGA mesh (PGA group) and those without the use of a PGA mesh (non-PGA group) at the Cancer Institute Hospital, Tokyo, between January 2019 and May 2023. Propensity score matching (PSM) was performed to adjust for the possible confounding factors. Results: A total of 834 patients were initially included, of whom 614 (307 in each group) remained after PSM. The amylase levels in the drained abdominal fluid on postoperative days 1 and 3 were similar between the PGA and non-PGA groups. The PGA group had a significantly lower incidence of pancreas-related complications of Clavien-Dindo grade ≥2 than that in the non-PGA group (6.8% vs. 2.9%, P=0.025). In subgroup analyses, the odds ratio for pancreas-related complications appeared to be better in the PGA group than in the non-PGA group in patients with American Society of Anesthesiologists Physical Status Classification score of 2 or 3, those operated via a laparoscopic approach, and those undergoing procedures other than proximal gastrectomy. Conclusions: The use of PGA mesh significantly reduced pancreas-related complications after minimally invasive surgery for gastric cancer and might thus benefit patients at risk of such complications.

• Journal of Preventive Medicine and Public Health
• /
• v.20 no.1 s.21
• /
• pp.137-146
• /
• 1987

The following facts have been identified as a result of epidemiological trend and characteristic of Japanese Encephalitis in Korea for the last 20 years. First: The Epidemiological period which was ten-year and three-year in the past has been disappeared following the start of immunization program at 1970. Second: The Incidence rate was much higher in the south and West areas than northeast area of Korea. City and Province with the highest incidence rate was Chungcheong Nam Province and Cholla Buk Province. Third: Regardless of scope of prevalence, the main season that 90 percent of total incidence occurrs in one month from mid-August through mid-September. Fourth: The number of case by age was that 80 percent of total patients is children aged $3{\sim}15$. Recently there is an increase in the number of patients who are elderly people. Fifth: The study on the ecological conditions of mosquito including wintering and effectiveness of immunization for Japanese Encephalitis and duration on antibody should be done. Sixth: There has been no case of Japanese Encephalitis for the last three years since 1984 mainly due to disinfecting to eradicate mosquitos, immunization for vulnerable group of people aged $3{\sim}15$, individual precaution not to be bitten by mosquito, improvement of environment sanitation. While there has been no case of Japanese Encephalitis during last three years, there is possibility that Japanese Encephalitis becomes prevalent again anytime since its virus has been isolated continuously from the natural reservoirs.

• Journal of Gastric Cancer
• /
• v.5 no.3 s.19
• /
• pp.163-168
• /
• 2005

Purpose: We analyzed cases of advanced gastric cancer (AGC) by using two nodal stagings, UICC and Japanese systems. We also analyzed cases of UICC N3M0 by different ways to see which nodal system or group had better prognostic power. Materials and Methods: From Feb. 1990 to May 2000, 197 UICC M0 patients of AGC who had undergone curative resection were analyzed by using the nodal stagings of the UICC and the Japanese systems. Also, 58 patients with UICC N3M0 gastric cancer were analyzed by using the Japanese n-staging, metastatic ratio and the metastatic number Results: The 5-year survival rates were 62.9%, 33.0% and 21.2% for UICC N1, N2 and N3, and 61.2% and 25.3% for Japanese n1 and n2, respectively in patients of N3M0 AGC, the 5-year survival rates were 62.5% for Japanese n1, and 33.0% and 22.9% for metastatic ratios of less than 0.5 and metastatic numbers below 26, respectively significantly better than the 5-year survival rates for higher ratios and numbers (P=0.018, 0.021). Conclusion: UICC N staging of gastric cancer has better prognostic power with differentiation between stages than Japanese n staging. In patients with UICC N3M0 gastric cancer, the metastatic ratio and the metastatic number, as well as the Japanese n staging, were valuable prognostic factors.

• Journal of Gastric Cancer
• /
• v.21 no.4
• /
• pp.325-334
• /
• 2021

Purpose: Although dumping symptoms are thought to involve postprandial glycemic changes, postprandial glycemic variability without dumping symptoms remains poorly understood due to the lack of a method that allows the easy and continuous measurement of blood glucose levels. Materials and Methods: Patients having undergone distal gastrectomy with Billroth-I (DG-BI) or Roux-en-Y reconstruction (DG-RY), total gastrectomy with RY (TG-RY) and pylorus preserving gastrectomy (PPG) for gastric cancer 3 months to 3 years prior, diagnosed as pathological stage I or II, were prospectively enrolled from March 2018 to January 2020. The interstitial tissue glycemic levels were measured every 15 min, up to 14 days by continuous glucose monitoring. Moreover, using a diary recording the diet and symptoms, asymptomatic glucose profiles without sugar supplementation within 3 h postprandially were compared among the four procedures. Results: A total of 40 patients were enrolled, 10 patients for each of the four procedures. There were 47 glucose profiles with DG-BI, 46 profiles with DG-RY, 38 profiles with TG-RY, and 46 profiles with PPG. PPG showed the slowest increase with a subsequent gradual decrease in glucose fluctuations, without hyperglycemia or hypoglycemia, among the four procedures. In contrast, TG-RY and DG-RY showed spike-like glycemic variability, sharp rises during meals, and rapid drops. The glucose profiles of DG-BI were milder than those of RY. Conclusions: The asymptomatic glycemic changes after meals differ among the types of surgical procedures for gastric cancer. Given the mild glycemic fluctuations in PPG and the glucose spikes in TG-RY and DG-RY, pylorus preservation and physiological reconstruction without changes in food pathways may optimize postprandial glucose profiles after gastrectomy.

• Journal of Sasang Constitutional Medicine
• /
• v.25 no.4
• /
• pp.289-296
• /
• 2013

Objectives This study was aimed to validate Sasang Constitution Questionnaire for Japanese (SSCQ-J). Methods Sasang Constitution Questionnaire for Patients (SSCQ-P) was developed by joint researches between the Society of Sasang Constitutional Medicine and Korea Institute of Oriental Medicine. We translated SSCQ-P into Japanese and modified some items of that for Japanese. By getting approval from the Institutional Review Board（IRB）of School of Medicine, Keio University, we conducted a questionnaire survey of patients who visited Oriental Medicine Center from early January until mid-February 2011. The total of 364 patients filled out that Questionnaire and gave an interview with a Sasang constitution specialist. Using this Questionnaire data, we made Sasang constitutional classification functions and calculated diagnostic accuracy rate of SSCQ-J using discrimination analysis. Results 1. Male group's diagnostic accuracy rate of SSCQ-J was 77.01% and female was 78.10%. 2. Diagnostic accuracy of SSCQ-J was a little higher than SSCQ-P Conclusions 1. SSCQ-J can be considered to have good discriminant power compared with SSCQ-P 2. Further research with SSCQ-J will be helpful in the comparison study on the usual symptoms between Korean and Japanese as well as development of good discriminant function.

• Journal of Acupuncture Research
• /
• v.29 no.6
• /
• pp.85-89
• /
• 2012

Objectives : This study is to evaluate the current situation of Japanese tourists for medical tour of Daejeon University hospital and to draw up a plan for better policies. Methods : 59 Japanese tourists visiting oriental medicines hospital of Daejeon University from January 2012 to September 2012, were analysed in the statistics. And 8 of them answer a questionnaire about reasons for selection of Daejeon University hospital, satisfaction for thread embedding therapy and side effects of thread embedding therapy. Results : A total of 59 foreigners visited oriental medicines hospital of Daejeon University for medical service, consisting of 54 females(92 %), the thirties to fifties 71 % by age. The 87.5 % of patients answered that the reason for choosing this hospital was the subsidization of the medical expenses, and 50 % for appropriate payment, 37.5 % for safety, 12.5 % for recommendation of the people who had good experience at this hospital. The 71% of patients selected thread-embedding therapy for treating wrinkles. The degree of satisfaction was evaluated as quite satisfaction of 87.5 %, full satisfaction of 12.5 % showing that a whole number of the patients treated with thread-embedding therapy showed relative satisfaction. This evaluation is, however, a short term survey which should lead to a further term study. For the evaluation of side effects of thread-embedding therapy, 75 % of patients answered as pain occurred during the therapy, 62.5 % as edema, 50 % as hypodermal bleeding. Conclusion : First of all, there should be more constructive promotion and support for medical tour of oriental medicines, ultimately leading to promoting better clusters of oriental medicines. Secondly, support in terms of a medical law should be established for medical disputes, and the best follow-up service should be considered.