Faculty Profiles - OGURA Atsushi

Antitumor Effects of Deep Ultraviolet Irradiation for Pancreatic Cancer. International journal

Kimitoshi Yamazaki, Toshio Kokuryo, Junpei Yamaguchi, Masaki Sunagawa, Atsushi Ogura, Nobuyuki Watanabe, Shunsuke Onoe, Kazushi Miyata, Takashi Mizuno, Kay Uehara, Tsuyoshi Igami, Yukihiro Yokoyama, Tomoki Ebata, Masato Nagino

Anticancer research Vol. 43 ( 2 ) page： 621 - 630 2023.2

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

BACKGROUND/AIM: Deep ultraviolet (DUV) light spans within the 250 nm to 350 nm invisible wavelength range. Although it strongly damages various cells, the efficacy of DUV irradiation on pancreatic cancer cells has never been clarified. The purpose of this study was to reveal the antitumor effects of DUV irradiation on pancreatic cancer cells. MATERIALS AND METHODS: Human pancreatic cancer cell lines were eradicated with DUV or ultraviolet A (UVA) for 5 s. Several angiogenesis-related proteins were studied in cancer cells after DUV irradiation using a protein antibody array. A subcutaneous xenograft model was established by inoculation of pancreatic cancer cells into mice. Tumors in this model were irradiated with DUV or UVA once or twice for two weeks. Tumor volumes in these groups (DUV×1: one irradiation, DUV×2: two irradiations, and untreated) were analyzed one week after the second irradiation. RESULTS: DUV irradiation significantly changed the cytomorphology of pancreatic cancer cells. In addition, DUV irradiation induced apoptosis on pancreatic cancer cells more strongly than UVA irradiation and no irradiation. Interestingly, lower expression of thrombospondin 1 (TSP1) and tissue inhibitor of metalloproteinase 1 (TIMP1) was identified after DUV treatment. The tumor volume in the DUV-treated groups (DUV×1 and DUV×2) was smaller than that in the untreated group. CONCLUSION: Further investigations are required to reveal the precise mechanisms of the antitumor effects of DUV irradiation and to facilitate its clinical application as a new therapy for pancreatic cancer. Overall, DUV irradiation can be potentially used as a therapeutic option of pancreatic malignancy.

DOI： 10.21873/anticanres.16198

下部進行直腸癌における術前化学療法後の側方リンパ節縮小の意義の検討

小倉淳司, 上原圭, 村田悠記, 神原祐一, 小池佳勇, 三品拓也, 小林龍太郎, 宮田一志, 水野隆史, 山口淳平, 國料俊男, 梅田晋一, 服部憲史, 中山吾郎, 横山幸浩, 小寺泰弘, 江畑智希

日本大腸肛門病学会雑誌 Vol. 76 ( 2 ) page： 184 - 184 2023.2

免疫チェックポイント阻害薬により病理学的完全奏功が得られたMSI-High大腸癌腹壁限局播種再発・小腸間膜リンパ節転移の1例

小林龍太朗, 上原圭, 小倉淳司, 村田悠記, 鳥居直矢, 深田浩志, 神原祐一, 梅田晋一, 服部憲史, 中山吾郎, 尾上俊介, 宮田一志, 山口淳平, 水野隆史, 伊神剛, 横山幸浩, 小寺泰弘, 江畑智希

日本大腸肛門病学会雑誌 Vol. 76 ( 2 ) page： 248 - 248 2023.2

Current status of transanal total mesorectal excision for rectal cancer and the expanding indications of the transanal approach for extended pelvic surgeries. International journal

Kay Uehara, Atsushi Ogura, Yuki Murata, Masanori Sando, Toshiki Mukai, Toshisada Aiba, Takeshi Yamamura, Masanao Nakamura

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society Vol. 35 ( 2 ) page： 243 - 254 2023.1

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

Transanal total mesorectal excision (taTME) has been rapidly accepted as a promising surgical approach to the distal rectum. The benefits include ease of access to the bottom of the deep pelvis linearly over a short distance in order to easily visualize the important anatomy. Furthermore, the distal resection margins can be secured under direct vision. Additionally, a two-team approach combining taTME with a transabdominal approach could decrease the operative time and conversion rate. Although taTME was expected to become more rapidly popularized worldwide, enthusiasm for it has stalled due to unfamiliar intraoperative complications, a lack of oncologic evidence from randomized trials, and the widespread use of robotic surgery. While international registries have reported favorable short- and medium-term outcomes from taTME, a Norwegian national study reported a high local recurrence rate of 9.5%. The characteristics of the recurrences included rapid, multifocal growth in the pelvis, which was quite different from recurrences following traditional transabdominal TME; thus, the Norwegian Colorectal Cancer Group reached a consensus for a temporary moratorium on the performance of taTME. To ensure acceptable baseline quality and patient safety, taTME should be performed by well-trained colorectal surgeons. Although the appropriate indications for taTME remain controversial, the transanal approach is extremely important as a means of goal setting in difficult TME cases and as an aid to the transabdominal approach in various types of extended pelvic surgeries. The benefits in transanal lateral lymph node dissection and pelvic exenteration are presented herein.

DOI： 10.1111/den.14464

A Case Report of Localized Peritoneal Disseminated Recurrence of Microsatellite Instability-High Colorectal Cancer with Pathologic Complete Response after Immune Checkpoint Inhibitor Therapy

Nishimura Motonobu, Uehara Kay, Ogura Atsushi, Murata Yuki, Kobayashi Ryutaro, Mizuno Takashi, Miyata Kazushi, Yokoyama Yukihiro, Ebata Tomoki

The Japanese Journal of Gastroenterological Surgery Vol. 56 ( 4 ) page： 221 - 228 2023

Language：Japanese Publisher：The Japanese Society of Gastroenterological Surgery

Use of immune checkpoint inhibitors (ICIs) has recently been recommended for treatment of unresectable or recurrent colorectal cancer with a microsatellite instability-high (MSI-H) status. We report a case of recurrent sigmoid colon cancer that was treated with ICIs followed by radical resection. One year after primary resection, the patient was diagnosed with localized peritoneal metastasis invading the left lower abdominal wall. The tumor presented as RAS/BRAF wild-type and was treated with FOLFIRI+panitumumab as 1st line chemotherapy. After shrinkage was observed, the patient was referred to our department for possible resection. Treated with ipilimumab plus nivolumab was used for further disease control of the borderline resectable tumor. However, interim imaging showed a slight increase in tumor size, so radical surgery (abdominal wall tumor resection+lymph node dissection+fascia lata abdominal wall reconstruction) was performed after three courses of ICI treatment. The pathological results showed a complete response, and the patient is now under observation with neither adjuvant therapy nor recurrence.

DOI： 10.5833/jjgs.2022.0056

Renal Dysfunction after Rectal Cancer Surgery: A Long-term Observational Study

CiNii Research

Sando Masanori, Uehara Kay, Li Yuanying, Ogura Atsushi, Murata Yuki, Mizuno Takashi, Yatsuya Hiroshi, Ebata Tomoki

Journal of the Anus, Rectum and Colon Vol. 7 ( 3 ) page： 176 - 185 2023

Language：English Publisher：The Japan Society of Coloproctology

Objectives: Despite the high incidence of urinary dysfunction (UD) after rectal surgery, it remains questionable whether UD causes future chronic kidney disease (CKD). This study aimed to clarify the long-term trends in renal function and risk factors for future CKD after rectal resection.Methods: For comparison, patients who underwent rectal resection (n = 129) and colectomy (n = 127) between 2006 and 2017 were identified. The estimated glomerular filtration rate (eGFR) ratio was calculated as the ratio to the baseline. "eGFR ratio < 0.75 at 3-year" was adopted as a surrogate indicator of future CKD.Results: eGFR ratio significantly decreased in the rectal cohort compared with the colon cohort at 1.5 years (0.9 vs. 0.95, p = 0.008) and at 3 years (0.85 vs. 0.94, p < 0.001). Although the preoperative prevalence of CKD was lower in the rectal than the colon cohort (13.9% vs. 23.6%, p = 0.055), it was similar at 3 years (29.5% vs. 30.7%). In multivariate analysis, females, and cT4 were independent risk factors for future CKD, but UD itself was not.Conclusions: Postoperative eGFR significantly decreased after rectal cancer surgery compared to colectomy. The prevalence of CKD more than doubled at 3 years after rectal resection. The female sex and cT4 tumor, instead of the UD, were independent risk factors for future CKD.

DOI： 10.23922/jarc.2022-059

A Case of Cecal Adenocarcinoma with Synchronous Liver Metastasis and BRCA1 Pathological Variant Detected in the Germline as a Secondary Finding ofa Cancer Gene Panel Test

CiNii Research

Nonaka Yukiko, Uehara Kay, Ogura Atsushi, Murata Yuki, Kobayashi Ryutaro, Morikawa Maki, Hatakeyama Miki, Morita Mami, Yokoyama Yukihiro, Ebata Tomoki

Nippon Daicho Komonbyo Gakkai Zasshi Vol. 76 ( 6 ) page： 443 - 446 2023

Language：Japanese Publisher：The Japan Society of Coloproctology

A 75-year-old woman was referred to our hospital with a chief complaint of tiredness. She was diagnosed with cecum cancer, unresectable multiple liver metastases, and peritoneal dissemination. The companion gene test result showed that she was RAS mutant (KRAS G12V), BRAF V600E wild type, and microsatellite stable, and she was treated with FOLFOX + bevacizumab. Her cancer gene panel test revealed a BRCA1 pathological variant in the germline, and she was diagnosed with hereditary breast and ovarian cancer syndrome. With the increasing use of cancer gene panel testing, it is expected that the number of cases in which secondary findings in the germ line are unexpectedly detected, leading to the diagnosis of inherited diseases, will increase. Although this information is always included in the consent document, not only patients but also health care providers are often unaware of the importance of genetic counseling.

DOI： 10.3862/jcoloproctology.76.443

CiNii Research

Minimum radial margin in pelvic exenteration for locally advanced or recurrent rectal cancer. International journal

Toshisada Aiba, Kay Uehara, Yuta Tsuyuki, Atsushi Ogura, Yuki Murata, Takashi Mizuno, Junpei Yamaguchi, Toshio Kokuryo, Yukihiro Yokoyama, Tomoki Ebata

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology Vol. 48 ( 12 ) page： 2502 - 2508 2022.12

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

PURPOSE: The aim of this study was to clarify the suitable radial margin (RM) for favourable outcomes after pelvic exenteration (PE), focusing on the discrepancy between the concepts of circumferential resection margin (CRM) and traditional R status. METHODS: Seventy-three patients with locally advanced (LARC, n = 24) or locally recurrent rectal cancer (LRRC, n = 49) who underwent PE between 2006 and 2018 were retrospectively analysed. Patients were histologically classified into the following 3 groups; wide RM (≥1 mm, n = 45), narrow RM (0-1 mm, n = 10), and exposed RM (n = 18). The analysis was performed not only in the entire cohort but also in each disease group separately. RESULTS: The rates of traditional R0 (RM > 0 mm) and wide RM were 75.3% and 61.6%, respectively, resulting in the discrepancy rate of 13.7% between the two concepts. Preoperative radiotherapy was given in 12.3%. In the entire cohort, the local recurrence and overall survival (OS) rates for narrow RMs were significantly worse than those for wide RMs (p < 0.001 and p = 0.002), but were similar to those for exposed RMs. In both LARC and LRRC, RM < 1 mm resulted in significantly worse local recurrence and OS rates compared to the wide RMs. Multivariate analysis showed that RM < 1 mm was an independent risk factor for local recurrence in both LARC (HR 15.850, p = 0.015) and LRRC (HR 4.874, p = 0.005). CONCLUSIONS: Narrow and exposed RMs had an almost equal impact on local recurrence and poor OS after PE. Preoperative radiotherapy might have a key role to ensure a wide RM.

DOI： 10.1016/j.ejso.2022.06.015