Japanese journal of clinical oncology最新文献

{"title":"Clinical significance of 4 L lymphadenectomy in solid dominant clinical stage I non-small cell lung cancer in the left upper lobe.","authors":"Yukio Watanabe, Aritoshi Hattori, Mariko Fukui, Takeshi Matsunaga, Kazuya Takamochi, Kenji Suzuki","doi":"10.1093/jjco/hyaf032","DOIUrl":"https://doi.org/10.1093/jjco/hyaf032","url":null,"abstract":"<p><strong>Objectives: </strong>The significance of station 4 L lymph node dissection (LND) for early-stage non-small cell lung cancer (NSCLC) is unknown.</p><p><strong>Methods: </strong>We evaluated 342 patients who underwent complete anatomical resection and mediastinal LND for radiologically solid dominant clinical (c)-Stage I left upper lobe NSCLC between 2008 and 2022. Solid dominant was defined as a consolidation tumor ratio >0.5, on thin-section computed tomography. After matching, postoperative complications and outcomes between the 4 L LND and non-4 L LND groups were compared. Predictors of 4 L metastasis was also identified using logistic regression analysis.</p><p><strong>Results: </strong>4LND was performed in 215 patients (63%), and 4 L metastasis was detected in 11 patients. Matching yielded 108 pairs. Recurrent nerve paralysis was more frequent in the 4LND group (P = 0.02) with no significant differences in the overall survival (OS) (5y OS: 85.2% vs. 86.3%, P = 0.66) and recurrence-free survival (RFS) (5y RFS: 78.4% vs. 78.5%, P = 0.51) between the 4 L LND and non-4 L LND groups. Logistic regression analysis determined solid component size >20 mm (P = 0.02) and pleural indentation (P = 0.02) on computed tomography findings as clinical risk factors for 4 L metastasis. The predictive criteria for 4 L metastasis were defined as solid component size ≤20 mm without pleural indentation (specificity: 100%, positive predictive value: 100%).</p><p><strong>Conclusions: </strong>4 L LND had a higher frequency of recurrent nerve palsy, although no survival improvement was observed in solid dominant c-Stage I left upper NSCLC. 4 L LND may be omitted for solid component size ≤20 mm without pleural indentation.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of objective performance metrics via an intelligent medical network in gynecological oncology robotic surgery.","authors":"Shintaro Yanazume, Yusuke Kobayashi, Nozomi Furuzono, Mika Fukuda, Shinichi Togami, Hiroaki Kobayashi","doi":"10.1093/jjco/hyaf031","DOIUrl":"https://doi.org/10.1093/jjco/hyaf031","url":null,"abstract":"<p><strong>Background: </strong>Automated performance metrics (APMs) are potentially useful to accurately assess and improve surgeon skills and patient outcomes, while their clinical use is currently limited. We report on the use of the Medicaroid Intelligent Network System (MINS™), a network support system platform used together with the \"hinotori\" surgical robot system (hinotori™) for the collection of data logs from surgeries, and discuss its potential to improve surgical outcomes.</p><p><strong>Methods: </strong>This study prospectively evaluated the efficacy of MINS™ for collecting data logs in gynecologic oncologic robotic surgery between December 2022 and February 2024 in nine patients. MINS™ regularly communicated with the hinotori™ via a secure network to collect and send system logs to a cloud server, quantifying various performance data for the evaluation of surgical outcomes.</p><p><strong>Results: </strong>Clinical data on hinotori™ movement were successfully extracted. The number of operation arm (OA) changes was significantly higher in Patient No. 7, who underwent pelvic lymph node dissection. OA3 monopolar was used more frequently than OA1 bipolar for coagulation (mean: 6.7% vs 2.5%, P ˂0.001). The error count and percentage of inactive time associated with OA collisions decreased dramatically after Patient No. 6, following the version upgrade in July 2024.</p><p><strong>Conclusion: </strong>MINS™ utilizes technology to connect the hinotori™ to various systems via the Internet, allowing objective evaluations of surgical procedures from data logs. MINS™ is a clinically applicable APM system that objectively analyzes a surgeon's individuality and has the potential to improve surgical techniques and promote standardization.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive variables for intraoperative blood loss and surgical time in resection of malignant soft tissue tumors without reconstruction.","authors":"Tomoki Nakamura, Eisuke Kobayashi, Satoshi Takenaka, Makoto Endo, Katsuhiro Hayashi, Eiji Nakata, Shusa Ohshika, Hiroyuki Kawashima, Tetsuya Hamada, Keisuke Horiuchi, Yoshihiro Nishida, Masahiro Hasegawa, Takeshi Morii","doi":"10.1093/jjco/hyaf030","DOIUrl":"https://doi.org/10.1093/jjco/hyaf030","url":null,"abstract":"<p><strong>Background: </strong>Procedural techniques such as dissection and separation of blood vessels or nerves from the tumor for preserving limbs and functions involves high surgical difficulty. We hypothesized the relation of vessel and/or nerve preservation to surgical time and blood loss, accurately reflecting surgical difficulty. In this study, we elucidated the variables affecting surgical time and intraoperative bleeding in patients with malignant soft tissue tumors who did not undergo any reconstruction after tumor resection.</p><p><strong>Methods: </strong>We included 153 patients with malignant oft tissue tumors in the trunk (n = 72), thigh (n = 68), and upper arm (n = 13) at nine institutions. We analyzed the possible predictive variables affecting surgical time and intraoperative bleeding.</p><p><strong>Results: </strong>Overall, the study included 153 patients (85 men and 68 women) with a mean age of 65 years. The tumors were primary soft tissue sarcoma (STS) (n = 114), local recurrent STS (n = 25), and soft tissue metastasis (n = 14). The median number of participating surgeons was three. The mean and median surgical time were 144.6 and 123 min, respectively. The mean and median intraoperative bleeding were 157.1 and 55 mL, respectively. Tumor size, depth, dissection and separation of blood vessels from the tumor, dissection and separation of nerve from the tumor, and the number of participating surgeons were significantly related to the surgical time and intraoperative bleeding.</p><p><strong>Conclusions: </strong>The procedure of dissection and separation of blood vessels and nerves from the tumor were related to surgical time and intraoperative bleeding in patients with malignant soft tissue tumors, especially large and deep tumors.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cabozantinib for brain metastases in renal cell carcinoma: a single-institution retrospective analysis.","authors":"Yuumi Tokura, Toshiki Kijima, Hidetoshi Kokubun, Toshitaka Uematsu, Kohei Takei, Hironori Betsunoh, Masahiro Yashi, Takao Kamai","doi":"10.1093/jjco/hyaf028","DOIUrl":"https://doi.org/10.1093/jjco/hyaf028","url":null,"abstract":"<p><strong>Objective: </strong>Brain metastases from renal cell carcinoma (RCC) present considerable treatment challenges and poor prognoses. In this study, we evaluated the efficacy of cabozantinib, a multi- tyrosine kinase inhibitors (TKIs), in improving the progression-free survival (PFS) and overall survival (OS) of patients with RCC with brain metastases.</p><p><strong>Methods: </strong>This retrospective study included 30 patients with RCC and brain metastases treated at a single institution between 2010 and 2024. Patient demographics, treatment modalities, and survival outcomes were analyzed. Systemic therapies included cabozantinib, TKIs, and immune checkpoint inhibitors (ICIs). Local therapies included Gamma Knife surgery (GKS) and whole-brain radiation therapy (WBRT). Survival outcomes were evaluated using Kaplan-Meier analysis and Cox proportional hazards models.</p><p><strong>Results: </strong>Cabozantinib-treated patients (n = 12) exhibited significantly longer median PFS (21.6 vs. 4.1 months; P < .001) and OS (25.7 vs. 8.3 months; P = .019) compared to non-cabozantinib patients (n = 18). In patients treated with GKS, cabozantinib further improved PFS (29.6 vs. 3.9 months; P < .001) and OS (25.7 vs. 12.8 months; P < .001). Cox regression analysis identified cabozantinib as the sole independent predictor of improved PFS (hazard ratio [HR], 0.09; P = .004) and OS (HR, 0.17; P = .009).</p><p><strong>Conclusion: </strong>Cabozantinib significantly improved survival outcomes in RCC patients with brain metastases, underscoring its role as an effective systemic therapy. However, potential risks such as brain hemorrhage highlight the importance of careful patient selection and close monitoring. Further prospective studies are warranted to explore optimal combination strategies.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological background of local recurrence in high grade sarcoma of the extremity with preoperative chemotherapy: a supplementary analysis of JCOG0304.","authors":"Satoshi Tsukushi, Kazuhiro Tanaka, Toshiyuki Kunisada, Ryunosuke Machida, Satoshi Takenaka, Akira Kawai, Hirohisa Katagiri, Masanobu Takeyama, Makoto Endo, Katsuhiro Hayashi, Robert Nakayama, Hiroshi Hatano, Makoto Emori, Shinichirou Yoshida, Toshio Kojima, Akio Sakamoto, Jungo Imanishi, Ryosuke Kita, Toshifumi Ozaki, Yukihide Iwamoto","doi":"10.1093/jjco/hyaf027","DOIUrl":"https://doi.org/10.1093/jjco/hyaf027","url":null,"abstract":"<p><strong>Background: </strong>The mainstay of treatment for soft-tissue sarcomas is complete resection with negative surgical margins. However, treatment strategies for local control including the frequency of adjuvant radiotherapy (RT) and surgical margin differ greatly between Japan and other countries, and the optimal strategy of local control remains controversial.</p><p><strong>Methods: </strong>A total of 70 patients with high-grade sarcoma who underwent surgery of the 72 patients enrolled in JCOG0304, were included. The primary endpoint was the proportion of local recurrence, and we investigated the clinicopathological background of local recurrence cases, including the surgical margins according to the Japanese Orthopedic Association (JOA) margin classification or histological margin, and use of adjuvant RT.</p><p><strong>Results: </strong>Local recurrence occurred in five patients, with a 5-year local recurrence proportion of 7.1% (95% confidence interval, 2.6%-14.8%) in 70 patients. The histological subtype were four cases of undifferentiated pleomorphic sarcoma (UPS) and 1 case of liposarcoma. The 5-year local recurrence proportions for UPS and non-UPS were 19.0% and 2.0%, respectively. Two of the five recurrent cases (40%) had adjuvant RT. The recurrent cases were four males and one female, median age 54 years (range: 33-66), JOA margin classification showed wide resection in four cases and marginal resection in one case, and histological margin showed negative in all five cases.</p><p><strong>Conclusion: </strong>Despite the low proportion of adjuvant RT, local control of high-grade soft tissue sarcoma with preoperative chemotherapy in JCOG0304 was good. However, more detailed surgical margin evaluation and the use of adjuvant RT should be further investigated in the future for UPS.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized phase III study comparing re-irradiation stereotactic body radiotherapy and conventional radiotherapy for painful spinal metastases: Japan Clinical Oncology Group study JCOG2211 (RESCORE study).","authors":"Ryosuke Kita, Kei Ito, Ryunosuke Machida, Yuta Sekino, Naoki Nakamura, Yujiro Nakajima, Tetsuo Saito, Nobuki Imano, Haruhiko Fukuda, Yoshinori Ito, Takashi Mizowaki","doi":"10.1093/jjco/hyae145","DOIUrl":"10.1093/jjco/hyae145","url":null,"abstract":"<p><p>Bone metastases are often associated with pain and can occur in various types of cancer, significantly affecting patients' quality of life. Despite the high response rates to initial conventional radiotherapy in patients with painful spinal metastases, recurrence and inadequate response still occur. Thus, the development of a highly effective strategy for pain recurrence is crucial to improving the quality of life in patients with advanced metastatic cancer. This randomized phase III trial aims to confirm the superiority of re-irradiation with stereotactic body radiotherapy (24 Gy in 2 fractions) over conventional radiotherapy (8 Gy in a single fraction) in achieving a complete pain response at 12 weeks in patients with previously irradiated painful spinal metastases. A total of 158 patients from 33 hospitals will be enrolled in Japan over 3.5 years. This trial has been registered in the Japan Registry of Clinical Trials as jRCTs1030240172 (https://jrct.niph.go.jp/latest-detail/jRCT1030240172).</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"189-193"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized phase III study evaluating dexamethasone-based mouthwash to prevent chemotherapy-induced stomatitis in patients with breast cancer.","authors":"Sayaka Kuba, Sakiko Soutome, Yasuhiro Hagiwara, Yuichiro Kikawa, Takayuki Iwamoto, Takafumi Sangai, Michiko Harao, Takeshi Yamaguchi, Tomoe Taji, Ataru Igarashi, Yusuke Kajimoto, Naomi Sakurai, Kosho Yamanouchi, Kenichi Watanabe, Noriko Maeda, Masahiko Suzuki, Shigeto Maeda, Uhi Toh, Akiko Ebata, Nobutaka Iwakuma, Ryoichi Matsunuma, Miki Yamaguchi, Hirofumi Mukai","doi":"10.1093/jjco/hyae136","DOIUrl":"10.1093/jjco/hyae136","url":null,"abstract":"<p><p>Stomatitis, which is a common side effect of chemotherapy, currently lacks a standardized approach for its prevention. Therefore, this multicenter, randomized, open-label, controlled phase III trial aims to assess the efficacy and safety of a dexamethasone-based mouthwash for preventing chemotherapy-induced stomatitis in patients with early breast cancer. We will randomly assign 230 patients with early breast cancer scheduled to receive chemotherapy in a 1:1 ratio to either the dexamethasone-based mouthwash group (10 ml, 0.1 mg/ml; swish for 2 min and spit 4 times daily for 8 weeks) or the mouthwash-with-tap-water group. The incidence of stomatitis, measured using electronic patient-reported outcomes, is the primary endpoint.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"172-175"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Real-world treatment trends for patients with advanced prostate cancer and renal cell carcinoma and their cost-a survey in Japan.","authors":"","doi":"10.1093/jjco/hyae186","DOIUrl":"10.1093/jjco/hyae186","url":null,"abstract":"","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"204"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Impact of trastuzumab emtansine (T-DM1) on spleen volume in patients with HER2-positive metastatic breast cancer.","authors":"","doi":"10.1093/jjco/hyae166","DOIUrl":"10.1093/jjco/hyae166","url":null,"abstract":"","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"203"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of malignant primary cardiac tumors requires attention to cardiovascular complications: a single-center, retrospective study.","authors":"Kanami Furukawa, Hirofumi Ohmura, Shohei Moriyama, Koki Uehara, Mamoru Ito, Kenji Tsuchihashi, Taichi Isobe, Hiroshi Ariyama, Mitsuhiro Fukata, Hitoshi Kusaba, Akira Shiose, Koichi Akashi, Eishi Baba","doi":"10.1093/jjco/hyae138","DOIUrl":"10.1093/jjco/hyae138","url":null,"abstract":"<p><strong>Background: </strong>Malignant primary cardiac tumors require multimodal approaches including surgery, chemotherapy and radiotherapy, but these treatments can be associated with cardiovascular complications. However, few reports have described the cardiovascular complications related to primary cardiac tumor treatment because of their rarity.</p><p><strong>Methods: </strong>Clinical records of patients with primary cardiac tumors treated at Kyushu University Hospital from January 2010 to August 2021 were retrospectively examined.</p><p><strong>Results: </strong>Of the 47 primary cardiac tumor patients, 13 (28%) were diagnosed with malignancy, including 5 angiosarcomas, 3 intimal sarcomas, 3 diffuse large B-cell lymphomas, 1 Ewing's sarcoma and 1 fibrosarcoma. Cardiovascular events were observed in 10 patients (77%), including cardiac dysfunction in 6 patients, arrhythmias in 5 patients, right heart failure in 2 patients, and excessively prolonged prothrombin time due to the combination of warfarin and chemotherapy in 1 patient. Two patients who showed notable cardiac complications are described. Case A involved a 69-year-old woman who underwent surgery for a left atrial intimal sarcoma, followed by postoperative chemotherapy with doxorubicin plus ifosfamide and radiotherapy. After three cycles of chemotherapy and sequential radiotherapy, her left ventricular ejection fraction decreased to 34%, and ongoing heart failure therapy was required. Case B involved a 66-year-old man who received chemotherapy for primary cardiac lymphoma, resulting in tumor shrinkage. However, due to tumor involvement of the intraventricular septum, atrioventricular block developed, requiring cardiac pacemaker implantation.</p><p><strong>Conclusion: </strong>High incidences of cardiac failure and arrhythmias were observed during multimodal treatments for malignant primary cardiac tumors. Proper management of complications may lead to a favorable prognosis in patients with malignant primary cardiac tumors.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":"113-122"},"PeriodicalIF":1.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}