Faculty Profiles - KANDA Mitsuro

Papers - KANDA Mitsuro

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Clinical impact of additional therapy for residual pancreatic cancer. Reviewed

Yamada S, Sonohara F, Tashiro M, Murotani K, Takami H, Hayashi M, Kanda M, Tanaka C, Kobayashi D, Nakayama G, Koike M, Fujii T, Kodera Y

Surgery today Vol. 50 ( 5 ) page： 440 - 448 2020.5

Is the measurement of drain amylase content useful for predicting pancreas-related complications after gastrectomy with systematic lymphadenectomy? Reviewed International journal

Koki Nakanishi, Mitsuro Kanda, Junichi Sakamoto, Yasuhiro Kodera

World journal of gastroenterology Vol. 26 ( 14 ) page： 1594 - 1600 2020.4

Language：Japanese Publishing type：Research paper (scientific journal)

Many studies investigating postoperative pancreatic fistula (POPF) after gastrectomy, including studies measuring drain amylase content (D-AMY) as a predictive factor have been reported. This article reviews previous studies and looks to the future of measuring D-AMY in patients after gastrectomy. The causes of pancreatic fluid leakage are; the parenchymal and/or thermal injury to the pancreas, and blunt injury to the pancreas by compression and retraction. Measurement of D-AMY to predict POPF has become common in clinical practice after pancreatic surgery and was later extended to the gastric surgery. Several studies have reported associations between D-AMY and POPF after gastrectomy, and the high value of D-AMY on postoperative day (POD) 1 was an independent risk factor. To improve both sensitivity and specificity, attempts have been made to enhance the predictive accuracy of factors on POD 1 as well as on POD 3 as combined markers. Although several studies have shown a high predictive ability of POPF, it has not necessarily been exploited in clinical practice. Many problems remain unresolved; ideal timing for measurement, optimal cut-off value, and means of intervention after prediction. Prospective clinical trial could be imperative in order to develop D-AMY measurement in common clinical practice for gastric surgery.

DOI： 10.3748/wjg.v26.i14.1594

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PubMed

Detection of indocyanine green fluorescence to determine tumor location during laparoscopic gastrectomy for gastric cancer: Results of a prospective study.

Tanaka C, Kanda M, Funasaka K, Miyahara R, Murotani K, Tanaka Y, Takeda S, Kobayashi D, Hirooka Y, Fujiwara M, Goto H, Kodera Y

Asian journal of endoscopic surgery Vol. 13 ( 2 ) page： 160 - 167 2020.4

Language：Japanese Publishing type：Research paper (scientific journal)

INTRODUCTION: In laparoscopic gastrectomy, a method to locate the margin of an early-stage cancerous lesion that is invisible from the serosal surface and impalpable during laparoscopic procedures is needed to determine an appropriate transection line. We conducted a prospective study to develop a new marking method using preoperative submucosal injection of indocyanine green (ICG). METHODS: Patients undergoing laparoscopic gastrectomy for T1 gastric cancer were recruited. The first 11 patients comprised the learning set and the subsequent 18 patients the validation set. ICG was endoscopically injected in the submucosal layer of the stomach approximately 1 cm away from the tumor edge 1 or 3 days before surgery. The diameters of the visualized ICG were compared with those of a conventional marking method using India ink in 10 historical controls. RESULTS: In the learning set, the optimal amount of ICG was determined to be 0.1 mL at a concentration of 0.5 mg/mL. In the validation set, the same procedure was repeated. No technical problems or adverse reactions related to ICG injection were observed. In all cases, ICG was successfully detected, and negative surgical margins were pathologically confirmed. The mean long diameter of the visualized ICG fluorescence measured at the mucosal surface of the stomach was significantly smaller in the current study than in the historical controls in whom India ink was used (21 vs 52 mm, P < 0.0001). CONCLUSIONS: The preoperative submucosal ICG marking was safely performed and successfully detected without excessive blurring during laparoscopic gastrectomy.

DOI： 10.1111/ases.12710

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PubMed

Exploration of Exosomal Micro RNA Biomarkers Related to Epithelial-to-Mesenchymal Transition in Pancreatic Cancer. Reviewed International journal

Fuminori Sonohara, Suguru Yamada, Shigeomi Takeda, Masamichi Hayashi, Masaya Suenaga, Yuki Sunagawa, Mitsuru Tashiro, Hideki Takami, Mitsuro Kanda, Chie Tanaka, Daisuke Kobayashi, Goro Nakayama, Masahiko Koike, Michitaka Fujiwara, Yasuhiro Kodera

Anticancer research Vol. 40 ( 4 ) page： 1843 - 1853 2020.4

Language：Japanese Publishing type：Research paper (scientific journal)

BACKGROUND/AIM: Epithelial-to-mesenchymal transition (EMT) plays important roles in cancer progression. This study aimed to identify the exosomal miRNA (exo-miRNA) profiles related to the EMT status in pancreatic cancer (PC). MATERIALS AND METHODS: Comprehensive exo-miRNA-expression profiles in the culture media of PC cell lines were analyzed through microarray technology. The identified miRNAs were analyzed to investigate their clinical implication using The Cancer Genome Atlas (TCGA) dataset and clinical samples. RESULTS: We prioritized 291 exo-miRNAs differentially expressed between epithelial and mesenchymal cell types. Among them, survival analysis based on the TCGA dataset revealed that mir-196b and mir-204 significantly stratify the prognosis of PC cases. In addition, analysis of cell lines indicated miR-196b-3p as a mesenchymal marker and miR-204-3p as an epithelial marker. Finally, we demonstrated that miR-196b-3p and miR-204-3p in serum exosomes were differentially expressed among intraductal papillary mucinous neoplasms, mucinous cystic neoplasms, and PC. CONCLUSION: Serum exo-miRNA biomarkers potentially identify the pancreatic tumor status through less-invasive methods.

DOI： 10.21873/anticanres.14138

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PubMed

Optimized Cutoff Value of Serum Squamous Cell Carcinoma Antigen Concentration Accurately Predicts Recurrence After Curative Resection of Squamous Cell Carcinoma of the Esophagus. Reviewed International journal

Kanda M, Koike M, Shimizu D, Tanaka C, Kobayashi D, Hattori N, Hayashi M, Omae K, Yamada S, Nakayama G, Kodera Y

Annals of surgical oncology Vol. 27 ( 4 ) page： 1233 - 1240 2020.4

Language：Japanese Publishing type：Research paper (scientific journal)

BACKGROUND: Squamous cell carcinoma antigen (SCC-Ag) and carcinoembryonic antigen (CEA) are widely used in clinical practice to predict the prognosis of patients with esophageal squamous cell carcinoma (ESCC). However, their predictive values for prognosis are controversial. This study determined optimal cutoff values of serum SCC-Ag and CEA concentrations for predicting postoperative recurrence of ESCC, which enabled selection of high-risk patients. METHODS: The study retrospectively analyzed 427 patients who underwent curative resection for ESCC. The optimal cutoff values of preoperative SCC-Ag and CEA concentrations for predicting postoperative recurrence were determined using combined analysis of hazard ratios and sensitivities for recurrence. Using the optimal cutoff value, the study evaluated survival, recurrence patterns, and temporal changes in marker concentrations. RESULTS: The preoperative SCC-Ag concentration of 1.1 ng/ml was the optimal cutoff value for predicting postoperative recurrence, whereas precise cutoff values could not be determined for preoperative CEA concentrations. High preoperative SCC-Ag concentrations (> 1.1 ng/ml), which were significantly associated with more aggressive tumor phenotypes and shorter disease-free survival, were identified as an independent prognostic factor in the multivariable analysis. High preoperative SCC-Ag concentrations were significantly associated with greater prevalence of lung/pleura and local recurrences. Normalization of serum SCC-Ag concentrations after neoadjuvant treatment or esophagectomy was not associated with a decreased risk of postoperative recurrence. CONCLUSIONS: The optimal cutoff value of preoperative SCC-Ag concentrations that predicted recurrence of ESCC was 1.1 ng/ml, illuminating the utility of serum SCC-Ag concentrations as an easily measurable tool for selecting a perioperative management strategy.

DOI： 10.1245/s10434-019-07977-6

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PubMed

Anti-thyroid antibodies and thyroid echo pattern at baseline as risk factors for thyroid dysfunction induced by anti-programmed cell death-1 antibodies: a prospective study. Reviewed International journal

Norio Okada, Shintaro Iwama, Takayuki Okuji, Tomoko Kobayashi, Yoshinori Yasuda, Eri Wada, Takeshi Onoue, Motomitsu Goto, Mariko Sugiyama, Taku Tsunekawa, Hiroshi Takagi, Daisuke Hagiwara, Yoshihiro Ito, Hidetaka Suga, Ryoichi Banno, Tetsunari Hase, Masahiro Morise, Mitsuro Kanda, Kenji Yokota, Naozumi Hashimoto, Masahiko Ando, Yasushi Fujimoto, Masato Nagino, Yasuhiro Kodera, Mitsuhiro Fujishiro, Hideharu Hibi, Michihiko Sone, Hitoshi Kiyoi, Momokazu Gotoh, Yuichi Ando, Masashi Akiyama, Yoshinori Hasegawa, Hiroshi Arima

British journal of cancer Vol. 122 ( 6 ) page： 771 - 777 2020.3

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

BACKGROUND: Anti-programmed cell death-1 (PD-1) antibodies can cause thyroid dysfunction. However, no predictive biomarkers enabling stratification of thyroid dysfunction risk have been identified. METHODS: A total of 209 patients treated with an anti-PD-1 antibody were evaluated for anti-thyroid antibodies at baseline and prospectively for thyroid function every 6 weeks for 24 weeks after treatment initiation, and then observed until the visits stopped. Thyroid ultrasonography was performed if the patient was positive for anti-thyroid antibodies at baseline. RESULTS: Of the 209 patients, 19 (9.1%) developed thyroid dysfunction (destructive thyroiditis or hypothyroidism). The cumulative incidence of thyroid dysfunction was significantly higher in patients who were positive vs. negative for anti-thyroid antibodies (15/44 [34.1%] vs. 4/165 [2.4%], p < 0.001). Forty-two patients positive for anti-thyroid antibodies at baseline were divided into two groups according to the presence of an irregular echo pattern. The cumulative incidence of thyroid dysfunction was significantly higher in those with an irregular vs. a regular echo pattern (13/23 [56.5%] vs. 1/19 [5.3%], p = 0.001). None of the patients developed thyroid dysfunction after the initial 24-week period. CONCLUSIONS: The risk of thyroid dysfunction induced by anti-PD-1 antibodies can be predicted by evaluation of anti-thyroid antibodies and the thyroid echo pattern at baseline. TRIAL REGISTRATION: UMIN000019024.

DOI： 10.1038/s41416-020-0736-7

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PubMed

Other Link： http://www.nature.com/articles/s41416-020-0736-7

Clinical Implications of Naples Prognostic Score in Patients with Resected Pancreatic Cancer. Reviewed International journal

Nobuhiko Nakagawa, Suguru Yamada, Fuminori Sonohara, Hideki Takami, Masamichi Hayashi, Mitsuro Kanda, Daisuke Kobayashi, Chie Tanaka, Goro Nakayama, Masahiko Koike, Michitaka Fujiwara, Yasuhiro Kodera

Annals of surgical oncology Vol. 27 ( 3 ) page： 887 - 895 2020.3

Language：Japanese Publishing type：Research paper (scientific journal)

BACKGROUND: Nutritional and immunological statuses are attracting increasing attention for their ability to predict surgical outcomes in various cancers. The Naples prognostic score (NPS) consists of the serum albumin level, total cholesterol level, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio and could be useful for predicting survival. PATIENTS AND METHODS: We retrospectively analyzed 196 patients with pancreatic cancer who underwent curative R0/R1 resection with a surgery-first strategy between June 2003 and August 2016. The NPS of the patients was calculated from preoperative data, and the patients were then divided into three groups based on their NPS. Clinicopathological characteristics, surgical outcomes, and long-term survival were compared, and multivariate analysis of overall survival was conducted. RESULTS: Of a total of 196 patients, 22 were classified into group 0 (NPS 0), 113 into group 1 (NPS 1 or 2), and 61 into group 2 (NPS 3 or 4). Median survival time was 103.4 months in group 0, 33.3 months in group 1, and 21.3 months in group 2. Significant survival differences were observed among the 3 groups (group 1 vs. 2, group 0 vs. 2, P = 0.0380, P = 0.0022, respectively). On multivariate analysis, NPS was identified as an independent prognostic factor [hazard ratio (HR) = 1.78; P = 0.0131]; however, there were no significant differences in the incidence of postoperative morbidity among the NPS groups. CONCLUSIONS: The NPS could be an easy scoring system and an independent preoperative predictor of survival.

DOI： 10.1245/s10434-019-08047-7

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PubMed

Preoperative predictors of postoperative complications after gastric cancer resection (vol 50, pg 3, 2020) Reviewed

Kanda Mitsuro

SURGERY TODAY Vol. 50 ( 3 ) page： 321 - 321 2020.3

Association between Lymphovascular Invasion and Recurrence in Patients with pT1N+ or pT2-3N0 Gastric Cancer: a Multi-institutional Dataset Analysis. Reviewed International journal

Keizo Fujita, Mitsuro Kanda, Seiji Ito, Yoshinari Mochizuki, Hitoshi Teramoto, Kiyoshi Ishigure, Toshifumi Murai, Takahiro Asada, Akiharu Ishiyama, Hidenobu Matsushita, Chie Tanaka, Daisuke Kobayashi, Michitaka Fujiwara, Kenta Murotani, Yasuhiro Kodera

Journal of gastric cancer Vol. 20 ( 1 ) page： 41 - 49 2020.3

Language：Japanese Publishing type：Research paper (scientific journal)

Purpose: Patients with pathological stage T1N+ or T2-3N0 gastric cancer may experience disease recurrence following curative gastrectomy. However, the current Japanese Gastric Cancer Treatment Guidelines do not recommend postoperative adjuvant chemotherapy for such patients. This study aimed to identify the prognostic factors for patients with pT1N+ or pT2-3N0 gastric cancer using a multi-institutional dataset. Materials and Methods: We retrospectively analyzed the data obtained from 401 patients with pT1N+ or pT2-3N0 gastric cancer who underwent curative gastrectomy at 9 institutions between 2010 and 2014. Results: Of the 401 patients assessed, 24 (6.0%) experienced postoperative disease recurrence. Multivariate analysis revealed that age ≥70 years (hazard ratio [HR], 2.62; 95% confidence interval [CI], 1.09-7.23; P=0.030) and lymphatic and/or venous invasion (lymphovascular invasion (LVI): HR, 7.88; 95% CI, 1.66-140.9; P=0.005) were independent prognostic factors for poor recurrence-free survival. There was no significant association between LVI and the site of initial recurrence. Conclusions: LVI is an indicator of poor prognosis in patients with pT1N+ or pT2-3N0 gastric cancer.

DOI： 10.5230/jgc.2020.20.e3

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Serum levels of ANOS1 serve as a diagnostic biomarker of gastric cancer: a prospective multicenter observational study. Reviewed

Mitsuro Kanda, Yun-Suhk Suh, Do Joong Park, Chie Tanaka, Sang-Hoon Ahn, Seong-Ho Kong, Hyuk-Joon Lee, Daisuke Kobayashi, Michitaka Fujiwara, Hideaki Shimada, BeLong Cho, Kenta Murotani, Hyung-Ho Kim, Han-Kwang Yang, Yasuhiro Kodera

Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association Vol. 23 ( 2 ) page： 203 - 211 2020.3

Language：Japanese Publishing type：Research paper (scientific journal)

BACKGROUND: Development of high-performance serum biomarkers will likely improve treatment outcomes of patients with gastric cancer (GC). We previously identified the candidate serum markers, anosmin 1 (ANOS1), dihydropyrimidinase-like 3 (DPYSL3), and melanoma-associated antigen D2 (MAGE-D2) and evaluated their clinical significance through a single-center retrospective analysis. Here we conducted a prospective multicenter observational study aimed at validating the diagnostic performance of these potential markers. METHODS: We analyzed serum levels before and after surgery of the three potential biomarkers in patients with GC and healthy volunteers. Quantification of serum and GC tissue levels was performed using an ELISA. RESULTS: Area under the curve (AUC) values that discriminated patients with GC from healthy controls were - 0.7058, 0.6188, and 0.5031 for ANOS1, DPYSL3, and MAGED2, respectively. The sensitivity and specificity of the ANOS1 assay were 0.36 and 0.85, respectively. The AUC value of ANOS1 that discriminated patients with stage I GC from healthy controls was 0.7131. Serum ANOS1 levels were significantly elevated in patients with stage I GC compared with those of healthy controls (median 1179 ng/ml and 461 ng/ml, respectively, P < 0.0001) and decreased after resection of primary GC lesions (P < 0.0001). The combination of serum ANOS1 and DPYSL3 levels increased the AUC value that discriminated patients with GC from healthy controls. Serum levels of ANOS1 did not significantly correlate with those of carcinoembryonic antigen, carbohydrate antigen 19-9, or other markers of inflammation. CONCLUSIONS: Serum levels of ANOS1 may serve as a useful diagnostic tool for managing GC.

DOI： 10.1007/s10120-019-00995-z

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PubMed

FGFR1は胃癌細胞のEMTを促進し腹膜播種形成に関連する Reviewed

清水大, 園原史訓, 高見秀樹, 猪川祥邦, 服部憲史, 林真路, 神田光郎, 田中千恵, 小林大介, 山田豪, 中山吾郎, 小池聖彦, 藤原道隆, 三森功士, 小寺泰弘

日本胃癌学会総会記事 Vol. 92回 page： 393 - 393 2020.3

今後の胃癌バイオマーカー胃癌腹膜播種再発を予測する腹膜洗浄液中の分子バイオマーカー(Upcoming biomarkers for gastric cancer Molecular biomarkers in peritoneal lavages to predict the peritoneal recurrences of gastric cancer) Reviewed

Kanda Mitsuro, Nakanishi Koki, Tanaka Chie, Kobayashi Daisuke, Shimizu Dai, Sonohara Fuminori, Takami Hideki, Inokawa Yoshikuni, Hattori Norifumi, Hayashi Masamichi, Yamada Suguru, Nakayama Goro, Koike Masahiko, Fujiwara Michitaka, Kodera Yasuhiro

日本胃癌学会総会記事 Vol. 92回 page： 233 - 233 2020.3

FGFR1は胃癌細胞のEMTを促進し腹膜播種形成に関連する Reviewed

清水大, 園原史訓, 高見秀樹, 猪川祥邦, 服部憲史, 林真路, 神田光郎, 田中千恵, 小林大介, 山田豪, 中山吾郎, 小池聖彦, 藤原道隆, 三森功士, 小寺泰弘

日本胃癌学会総会記事 Vol. 92回 page： 393 - 393 2020.3

胃癌手術のエビデンスと実際のデータ基礎幽門側胃切除後のBillroth I再建法とRoux-en-Y再建法に関する術後合併症の比較(Evidences and real world data of gastric cancer surgery: Basic Billroth I vs Roux-en-Y after distal gastrectomy in postoperative complications) Reviewed

Nakanishi Koki, Kanda Mitsuro, Ito Seiji, Mochizuki Yoshinari, Teramoto Hitoshi, Ishigure Kiyoshi, Murai Toshifumi, Asada Takahiro, Ishiyama Akiharu, Matsushita Hidenobu, Shimizu Dai, Tanaka Chie, Kobayashi Daisuke, Fujiwara Michitaka, Kodera Yasuhiro

日本胃癌学会総会記事 Vol. 92回 page： 214 - 214 2020.3

高齢者胃切除手術症例における自立度の転帰 Reviewed

田中千恵, 神田光郎, 猪川祥邦, 清水大, 園原史訓, 小林大介, 高見秀樹, 服部憲史, 林真路, 山田豪, 中山吾郎, 小池聖彦, 藤原道隆, 小寺泰弘

日本胃癌学会総会記事 Vol. 92回 page： 251 - 251 2020.3

高齢者胃切除手術症例における自立度の転帰 Reviewed

田中千恵, 神田光郎, 猪川祥邦, 清水大, 園原史訓, 小林大介, 高見秀樹, 服部憲史, 林真路, 山田豪, 中山吾郎, 小池聖彦, 藤原道隆, 小寺泰弘

日本胃癌学会総会記事 Vol. 92回 page： 251 - 251 2020.3

Predictive value of the modified systemic inflammation score in patients undergoing curative resection of squamous cell carcinoma of the esophagus Reviewed

Kanda Mitsuro, Koike Masahiko, Shimizu Dai, Tanaka Chie, Kobayashi Daisuke, Sonohara Fuminori, Takami Hideki, Inokawa Yoshikuni, Hattori Norifumi, Hayashi Masamichi, Yamada Suguru, Nakayama Goro, Fujiwara Michitaka, Kodera Yasuhiro

JOURNAL OF CLINICAL ONCOLOGY Vol. 38 ( 4 ) 2020.2

Propensity-score-matched analysis of a multi-institutional dataset to compare the postoperative complications after distal gastrectomy between Billroth I and Roux-en-Y Reviewed

Nakanishi Koki, Kanda Mitsuro, Ito Seiji, Mochizuki Yoshinari, Teramoto Hitoshi, Ishigure Kiyoshi, Mmurai Toshifumi, Asada Takahiro, Ishiyama Akiharu, Matsushita Hidenobu, Shimizu Dai, Tanaka Chie, Kobayashi Daisuke, Fujiwara Michitaka, Kodera Yasuhiro

JOURNAL OF CLINICAL ONCOLOGY Vol. 38 ( 4 ) 2020.2

A prospective trial to evaluate treatment effects of a β-hydroxy-β-methylbutyrate containing nutrient for leakage at the anastomotic site after esophagectomy. Reviewed

Mitsuro Kanda, Masahiko Koike, Masahide Fukaya, Kazushi Miyata, Chie Tanaka, Daisuke Kobayashi, Masamichi Hayashi, Suguru Yamada, Goro Nakayama, Kenta Murotani, Michitaka Fujiwara, Masato Nagino, Yasuhiro Kodera

Nagoya journal of medical science Vol. 82 ( 1 ) page： 33 - 37 2020.2

Language：Japanese Publishing type：Research paper (scientific journal)

Anastomotic leakage after esophagectomy is associated with prolonged hospitalization and increased medical cost. Additionally, it sometimes leads to a fatal condition and impaired postoperative quality of life. During the process of wound healing, β-hydroxy-β-methylbutyrate (HMB) is important for collagen biosynthesis. An open-label prospective intervention trial has been designed to evaluate the treatment effect of an enteral nutrient containing HMB with arginine and glutamine (Abound, Abbott Japan Co., Ltd.) for leakage at the anastomotic site after esophagectomy. Patients in whom leakage at the anastomotic site developed within 14 days after esophagectomy are eligible and Abound (24 g) is administered for 14 days through an enteral feeding tube. The target sample size is 10. The primary endpoint is duration between diagnosis and cure of leakage. Surgical procedure, safety, length of fasting, drainage placement and hospital stay, and nutritional status are determined as secondary endpoints. A historical control consisting of 20 patients who had leakage at the anastomotic site after esophagectomy between 2005 and 2018 at Nagoya University Hospital is compared with enrolled patients.

DOI： 10.18999/nagjms.82.1.33

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PubMed

Preoperative six-minute walk distance as a predictor of postoperative complication in patients with esophageal cancer. International journal

Inoue T, Ito S, Kanda M, Niwa Y, Nagaya M, Nishida Y, Hasegawa Y, Koike M, Kodera Y

Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus Vol. 33 ( 2 ) 2020.2

Language：Japanese Publishing type：Research paper (scientific journal)

Surgery for esophageal cancer is associated with high morbidity and mortality. Reduced pulmonary functions and exercise capacity are known as risk factors for complications after esophagectomy. The 6-minute walk distance (6MWD) measured by the 6-minute walk test (6MWT) is a simple field test that can be used to evaluate the functional exercise capacity of patients who undergo thoracic surgery. The aim of this study was to evaluate the association of the preoperative 6MWD with postoperative complications in patients with esophageal cancer. Records of a total of 111 patients who underwent thoracic surgery followed by postoperative rehabilitation from January 2013 to December 2015 were retrospectively reviewed. Data of patients who experienced Clavien-Dindo grade II or severer (grade ≥ II) complications were compared with those who experienced grade ≤I complications. The 6MWD was significantly correlated with age, serum albumin concentration, hemoglobin concentration, and hand grip strength. A total of 42 patients experienced grade ≥II. The 6MWD of patients with grade ≥ II complications was significantly shorter than that of those with grade ≤I complications. In receiver operating characteristic analysis, 6MWD ≤ 454 m was a threshold for predicting grade ≥II complications with 71.0% sensitivity and 54.8% specificity. The incidence of grade ≥II complications led to delayed ambulation and longer stays in hospital. In the multiple regression analysis, the preoperative risk factors for incidence of grade ≥II complications included lower levels of preoperative 6MWD and % of the predicted value of forced expiratory volume in 1 second. Our results indicate that the 6MWT is useful to assess preoperative physical status in patients with esophageal cancer.

DOI： 10.1093/dote/doz050

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PubMed

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Papers - KANDA Mitsuro