研究等業績 - 原著論文 - 脇田 晃行
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Imai K.
Cancer Imaging ( Cancer Imaging ) 24 ( 1 ) 2024年12月 [査読有り]
研究論文（学術雑誌） 国内共著
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Takahashi Y.
Physiotherapy Research International ( Physiotherapy Research International ) 29 ( 4 ) e2138 2024年10月 [査読有り]
研究論文（学術雑誌） 国内共著
INTRODUCTION: Frailty is significantly correlated with a higher incidence of medical complications during hospitalization after esophagectomy. As frailty is thought to be a reversible condition, improving the reserve capacity through preoperative physical therapy is expected to reduce the risk of postoperative pulmonary complications (PPCs). Herein, we report our experience with preoperative physical therapy in a patient with esophageal cancer who was considered to have inadequate fitness for surgery owing to poor physical performance. CASE PRESENTATION: A 72-year-old man (height: 169.5 cm, weight: 54.7 kg, body mass index: 18.9 kg/m2) with esophagogastric junction tumors (cStage IIIA) was hospitalized and scheduled to undergo surgery based on preoperative screening. He was categorized as frail according to the revised Japanese version of the Cardiovascular Health Study criteria and the Mini Nutritional Assessment Short-Form indicated severe malnutrition. We focused on physical therapy to improve exercise tolerance and prevent PPCs and devised a short-term intensive physical therapy program comprising minimal exercises that the patient could perform efficiently. The program consisted of only inspiratory muscle training and aerobic exercises. His maximal inspiratory pressure (MIP) and 6-min walking distance improved by 30 cm H2O and 145 m, respectively, on the day before surgery compared with those on day 8. The percentage predicted value of the MIP improved from 56.6% at the start of physical therapy to 102.9% on the day before surgery. On day 43, the patient underwent subtotal esophagectomy and was able to ambulate on postoperative day 5 without respiratory complications. CONCLUSION: We conducted a short-term, intensive, and minimal preoperative physical therapy program for a patient with esophageal cancer who had physical frailty. Preoperative physical therapy to increase the reserve capacity may result in a favorable postoperative course even in patients with physical frailty.
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Nozaki S.
Esophagus ( Esophagus ) 21 ( 2 ) 120 - 130 2024年 [査読有り]
研究論文（学術雑誌） 国内共著
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Okura K.
Journal of Surgical Oncology ( Journal of Surgical Oncology ) 128 ( 8 ) 1259 - 1267 2023年12月 [査読有り]
研究論文（学術雑誌） 国内共著
OBJECTIVE: We examined whether preoperative inspiratory muscle weakness (IMW) is a risk factor for postoperative pulmonary complications (PPCs) in patients with esophageal cancer who underwent subtotal esophagectomy. METHODS: This single-center retrospective cohort study enrolled patients with esophageal cancer who underwent a scheduled subtotal esophagectomy between June 2020 and May 2022. Maximal inspiratory pressure (MIP) was measured as inspiratory muscle strength using a respiratory dynamometer, and we defined IMW as MIP < 80% of the predicted value. Our primary outcome comprised overall PPCs. We investigated the relationship between IMW and PPCs using the Bayesian logistic regression model. RESULTS: After exclusion, 72 patients were included in this study. IMW was identified in 26 patients (36%), and PPCs developed in 28 patients (39%). Among patients with IMW, 15 (58%) developed PPCs. Preoperative IMW was associated with PPCs (mean odds ratio [OR]: 3.58; 95% credible interval [95% CrI]: 1.29, 9.73) in the unweighted model. A similar association was observed in the weighted model adjusted for preoperative and intraoperative contributing factors (mean OR: 4.15; 95% CrI: 2.04, 8.45). CONCLUSIONS: Preoperative IMW was associated with PPCs in patients with esophageal cancer who underwent subtotal esophagectomy. This association remained after adjusting for preoperative and intraoperative contributing factors.
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Sato Y.
Current Oncology ( Current Oncology ) 30 ( 5 ) 4724 - 4735 2023年05月 [査読有り]
研究論文（学術雑誌） 国内共著
Most so-called "beneficial bacteria" in gut microbiota are Gram-positive, and TLR6 recognizes the peptidoglycan (PGN) present in their cell walls. We hypothesized that a high TLR6 expression status predicts a more favorable prognosis after esophagectomy. We used an ESCC tissue microarray (TMA) to examine TLR6 expression status in ESCC patients and to determine whether TLR6 expression status correlates with prognosis after curative esophagectomy. We also examined whether PGN influences the cell proliferation activity of ESCC lines. Clinical ESCC samples from 177 patients tested for the expression of TLR6 were categorized as 3+ (n = 17), 2+ (n = 48), 1+ (n = 68), or 0 (n = 44). High TLR6 expression (3+ and 2+) correlated with significantly more favorable 5-year overall survival (OS) and disease-specific survival (DSS) after esophagectomy than a lower TLR6 expression (1+ and 0). Univariate and multivariate analyses showed that TLR6 expression status is an independent prognostic factor that affects 5-year OS. PGN significantly inhibited the cell proliferation activity of ESCC lines. This is the first study to show that high TLR6 expression status predicts a more favorable prognosis in locally advanced thoracic ESCC patients after curative esophagectomy. PGN released from "beneficial bacteria" seems to have potential to inhibit the cell proliferation activity of ESCC.
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Wakita A.
Annals of Gastroenterological Surgery ( Annals of Gastroenterological Surgery ) 7 ( 6 ) 904 - 912 2023年 [査読有り]
研究論文（学術雑誌） 国内共著
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Kemuriyama K.
Genes to Cells ( Genes to Cells ) 28 ( 8 ) 573 - 584 2023年 [査読有り]
研究論文（学術雑誌） 国内共著
Abstract
Tumor‐derived G‐CSF is a well‐known factor to aggravate disease progression in various types of cancers. In this study, we investigated a role of G‐CSF in squamous cell carcinoma (SCC). High expression of G‐CSF in the tumor tissues of esophageal SCC (ESCC) patients correlated with poor prognosis. Murine SCC NR‐S1M cells produce considerable amount of G‐CSF, which expression is correlated with its metastatic potentials. Deletion of G‐CSF in NR‐S1M cells mitigated tumor growth and metastasis to lymph node and lung of subcutaneous NR‐S1M tumors in the mice. Mechanistically, G‐CSF enhanced cell proliferation in autocrine manner in vitro, whereas in NR‐S1M tumor‐bearing mice, accumulation of plasma G‐CSF was associated with expansion of peripheral neutrophils, which led to a decreased proportion of CD8<sup>+</sup> T cells. Antibody depletion of neutrophils restored the number of CD8+ T cells and modestly suppressed tumor outgrowth, albeit no changes in distant metastasis. We propose that G‐CSF produced by NR‐S1M cells facilitates tumor progression in mice through bi‐functional effects to promote neutrophil recruitment and tumor cell proliferation, which may render poor prognosis to the ESCC patients with high G‐CSF expression. -
Ikeda T.
Acta Medica Okayama ( Acta Medica Okayama ) 77 ( 2 ) 193 - 197 2023年 [査読有り]
研究論文（学術雑誌） 国内共著
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食道切除再建術における呼吸サルコペニアと術後肺炎の関連
坂本 理々子, 大倉 和貴, 高橋 裕介, 長谷川 翔, 畠山 和利, 長岐 雄志, 脇田 晃行, 佐藤 雄亮, 粕川 雄司, 宮腰 尚久
呼吸理学療法学 ( (一社)日本呼吸理学療法学会 ) 3 ( Suppl. ) 122 - 122 2023年
研究論文（学術雑誌） 国内共著
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食道切除再建術後の呼吸器合併症の予測モデルにおける吸気筋力と身体機能の重要度の比較
大倉 和貴, 佐藤 雄亮, 高橋 裕介, 坂本 理々子, 長谷川 翔, 畠山 和利, 長岐 雄志, 脇田 晃行, 粕川 雄司, 宮腰 尚久
呼吸理学療法学 ( (一社)日本呼吸理学療法学会 ) 3 ( Suppl. ) 117 - 117 2023年
研究論文（学術雑誌）
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食道切除再建術後の呼吸器合併症の予測モデルにおける吸気筋力と身体機能の重要度の比較
大倉 和貴, 佐藤 雄亮, 高橋 裕介, 坂本 理々子, 長谷川 翔, 畠山 和利, 長岐 雄志, 脇田 晃行, 粕川 雄司, 宮腰 尚久
呼吸理学療法学 ( (一社)日本呼吸理学療法学会 ) 3 ( Suppl. ) 117 - 117 2023年
研究論文（学術雑誌） 国内共著
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Motoyama S.
Anticancer Research ( Anticancer Research ) 42 ( 12 ) 6105 - 6112 2022年12月 [査読有り]
研究論文（学術雑誌） 国内共著
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Changes in Serum Trace Element Concentrations before and after Surgery in Resectable Breast Cancer
Takahashi E.
Anticancer Research ( Anticancer Research ) 42 ( 11 ) 5323 - 5334 2022年11月 [査読有り]
研究論文（学術雑誌） 国内共著
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食道切除再建術における術前の横隔膜筋厚変化率と術後呼吸器合併症の関連
大倉 和貴, 高橋 裕介, 坂本 理々子, 長谷川 翔, 斉藤 公男, 粕川 雄司, 脇田 晃行, 佐藤 雄亮
呼吸理学療法学 ( (一社)日本呼吸理学療法学会 ) 8th.Meeting O - 01 2022年11月
研究論文（学術雑誌） 国内共著
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食道癌手術における術後肺炎リスク要因としての栄養指標の比較
坂本 理々子, 大倉 和貴, 高橋 裕介, 畠山 和利, 脇田 晃行, 佐藤 雄亮
日本呼吸ケア・リハビリテーション学会誌 ( (一社)日本呼吸ケア・リハビリテーション学会 ) 32 ( Suppl. ) 156s - 156s 2022年10月
研究論文（学術雑誌） 国内共著
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Motoyama S.
Annals of Surgery ( Annals of Surgery ) 276 ( 1 ) E16 - E23 2022年07月 [査読有り]
研究論文（学術雑誌） 国内共著
OBJECTIVE: To determine whether esophagectomy provides a survival advantage in octogenarians with resectable thoracic esophageal cancer. SUMMARY BACKGROUND DATA: Elderly patients with thoracic esophageal cancer do not always receive the full standard treatment; however, advanced age alone should not preclude the use of effective treatment that could meaningfully improve survival. METHODS: We retrieved the 2008 to 2011 data from the National Database of Hospital-based Cancer Registries from the National Cancer Centerin Japan, divided the patients into a ≥75 group (75-79 years; n = 2935) and a ≥80 group (80 years or older; n = 2131), and then compared the patient backgrounds and survival curves. A multivariable Cox proportional hazards regression model was developed to compare the effects of esophagectomy and chemoradiotherapy in the 2 groups. RESULTS: A significantly greater percentage of patients were treated with esoph-agectomy in the ≥75 group (34.6%) than the ≥80 group (18.4%). Among patients who received esophagectomy, the 3-year survival rate was 51.1% in the ≥ 75 group and 39.0% in the ≥80 group (P < 0.001). However, among patients who received chemoradiotherapy, there was no difference in survival curve between the 2 groups (P = 0.17). Multivariable Cox proportional hazard analysis revealed that esoph-agectomy for clinical Stage ii-iii patients was significantly associated to better survival (adjusted HR: 0.731) (95%CI: 0.645-0.829, P < 0.001) in the ≥75 group but not the ≥ 80 group when compared with chemoradiotherapy. CONCLUSIONS: Many octogenarians do not necessarily get a survival benefit from esophagectomy. However, patients should be evaluated based on their overall health before ruling out surgery based on age alone.
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Fujita K.
Esophagus ( Esophagus ) 19 ( 1 ) 146 - 152 2022年01月 [査読有り]
研究論文（学術雑誌） 国内共著
BACKGROUND: Platinum agents are taken up into cells by copper transporter (CTR) 1 (gene code: SLC31A1) and are excreted from cells by copper-transporting P-type adenosine triphosphatase (ATP7B) and multidrug resistance-associated protein (MRP) 2 (gene code: ABCC2). In addition, glutathione S transferase (GST) P1 is involved in the metabolism of platinum agents. The present study aimed to determine whether the rate of grade 3-4 hematological toxicity associated with platinum plus 5-fluorouracil (5-FU) therapy in 239 patients with esophageal cancer was affected by the SLC31A1 rs10981694A>C and rs12686377G>T, ATP7B rs9535828A>G, GSTP1 rs1695A>G, and ABCC2 -24C>T polymorphisms. METHODS: Chemotherapy consisted of protracted infusion of 5-FU (800 mg/m2/day) on days 1-5 and cisplatin or nedaplatin (80 mg/m2/day) on day 1. RESULTS: A total of 82 of 239 patients developed grade 3-4 hematological toxicity after chemotherapy. Univariate analysis showed that ABCC2 -24C/T + T/T genotypes (P = 0.038), radiation therapy (P = 0.013), baseline white blood cell count < 6000/μL (P = 0.003), and baseline neutrophil count < 3900/μL (P = 0.021) were statistically significant predictors of grade 3-4 hematological toxicity. Multivariate analysis revealed that ABCC2 -24C/T + T/T genotypes (P = 0.036), radiation therapy (P = 0.005), and baseline white blood cell count < 6000/μL (P < 0.001) were significant risk factors. CONCLUSIONS: We determined that ABCC2 -24C>T is significantly associated with grade 3-4 hematological toxicity after platinum plus 5-FU therapy. These findings might contribute to improved treatment strategies for patients with esophageal cancer.
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Fujita H.
Surgery (United States) ( Surgery (United States) ) 171 ( 6 ) 1535 - 1542 2022年 [査読有り]
研究論文（学術雑誌） 国内共著
BackgroundThe mechanism underlying cancer cell metastasis from the tumor to regional lymph nodes is not yet fully understood. We hypothesized that peritumoral neutrophil accumulation promotes regional lymph node metastasis in thoracic esophageal squamous cell cancer.MethodsBetween 2010 and 2019, 126 thoracic esophageal squamous cell cancer patients received curative (R0) esophagectomy without preoperative treatment in our hospital. Using paraffin-embedded resected tumors, we performed immunohistochemical analysis of CD16b-positive neutrophil accumulation in the peritumoral area, which was defined as a 1-mm region centered on the border separating the malignant cell nests from the host tissue. The relationship between the density of peritumoral CD16b staining and pathological lymph node metastasis or 5-year overall survival was evaluated.ResultsAlthough the clinicopathological characteristics of CD16b-high and CD16b-low patients did not differ, greater pathological lymph node metastasis (P < .001) and lymphatic invasion by the tumor (P = .024) and a poorer 5-year survival (P = .010) were seen in CD16b-high patients. Moreover, CD16b-positive neutrophil density was generally higher in the peritumoral area than within the tumor itself. Univariate and multivariate analyses showed that CD16b-positive neutrophil accumulation was an independent factor for lymph node metastasis with an odds ratio >25 (P < .001). On the other hand, blood neutrophil counts did not correlate with lymph node metastasis.
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Motoyama S.
Scientific Reports ( Scientific Reports ) 11 ( 1 ) 2021年12月 [査読有り]
研究論文（学術雑誌） 国内共著
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Nagaki Y.
World Journal of Surgical Oncology ( World Journal of Surgical Oncology ) 19 ( 1 ) 105 - 105 2021年12月 [査読有り]
研究論文（学術雑誌）
BACKGROUND: A pathological complete response (pCR) after neoadjuvant chemoradiotherapy (NACRT) ensures long-term survival in esophageal squamous cell carcinoma (ESCC) patients following esophagectomy, but pCR patients are a minority. The aim here was to identify prognostic factors in patients with non-pCR ESCC after NACRT. METHODS: This is a retrospective study. Investigated were 5-year overall survival (OS), disease-specific survival (DSS), and relapse-free survival (RFS) among non-pCR ESCC patients divided into pT0N0, primary site pCR (pT0N+), lymph node pCR (pT+N0), and non-pCR in both the tumor and lymph node (pT+N+) subgroups after NACRT and esophagectomy. Focusing on the SUVmax reduction rate in the primary tumor in 88 patients who underwent FDG-PET before and after NACRT, we used univariate and multivariate Cox proportional hazard models to identify prognostic factors. RESULTS: Although there were no significant survival differences among non-pCR ESCC patients with pT0N+, pT+N0, or pT+N+, survival rate among pT+N+patients was the poorest. After setting a 60% cutoff for the SUVmax reduction rate in the tumor, RFS curves for non-pCR patients significantly differed between patients above the cutoff and those below it. For pT+N+ patients, the SUVmax reduction rate (<60% vs ≥ 60%) was an independent prognostic factor of OS, DSS, and RFS. CONCLUSION: Because ESCC patients with SUVmax reduction rates of <60% in the tumor after NACRT and categorized as pT+N+ after NACRT had significantly poorer prognoses, even after esophagectomy, a change in treatment strategy may be an option to improve survival.