2023/12/01 更新

写真a

カワカツ ショウジ
川勝 章司
KAWAKATSU Shoji
所属
医学部附属病院 消化器・腫瘍外科(肝胆膵) 助教
大学院担当
大学院医学系研究科
職名
助教
 

論文 13

  1. Laparoscopic versus open resection of primary colorectal cancers and synchronous liver metastasis: a systematic review and meta-analysis.

    Morarasu S, Clancy C, Gorgun E, Yilmaz S, Ivanecz A, Kawakatsu S, Musina AM, Velenciuc N, Roata CE, Dimofte GM, Lunca S

    International journal of colorectal disease   38 巻 ( 1 ) 頁: 90   2023年4月

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    記述言語:英語  

    DOI: 10.1007/s00384-023-04375-z

    PubMed

  2. 医原性肝門部胆管狭窄を伴う神経内分泌腫瘍残肝再発に対し肝中央二区域・尾状葉切除+肝内胆管空腸吻合を行った1例

    中島 悠, 水野 隆史, 尾上 俊介, 渡辺 伸元, 川勝 章司, 山口 淳平, 砂川 真輝, 横山 幸浩, 伊神 剛, 江畑 智希

    胆道   37 巻 ( 1 ) 頁: 108 - 115   2023年3月

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    記述言語:日本語   出版者・発行元:一般社団法人 日本胆道学会  

    <p>症例は78歳男性.前医で直腸神経内分泌腫瘍(G1)異時性肝転移に対し肝左内側区域部分切除を施行.術中の胆道損傷による医原性肝門部胆管閉塞に対し総胆管―右肝管磁石圧迫吻合(山内法)が施行された.肝切除44カ月後に胆管再狭窄及び残肝再発を指摘され当科紹介.腹部造影CTで肝門部近傍の左内側区域/尾状葉に13mm大の腫瘤を認め,胆道造影では左右肝管合流部に高度狭窄を認めた.転移性肝腫瘍および医原性胆管狭窄の再燃と診断し,肝中央二区域尾状葉切除+胆道再建にて双方の治療を企図した.安全性を考慮し狭窄して肝門部胆管を温存し肝切除を施行した後,左外側下枝と右後区域枝を術前に挿入したカテーテルを目印に同定し,それぞれに胆管空腸側々吻合を行った.複雑な良性胆道狭窄を伴う肝転移再々発例に対し,肝門部血管損傷を回避しつつ腫瘍切除と胆道再建を一期的に施行し得た症例を経験したので文献的考察を含めて報告する.</p>

    DOI: 10.11210/tando.37.108

    CiNii Research

  3. Impact of S-1 adjuvant chemotherapy longer than 6 months on survival in patients with resected pancreatic cancer: a nationwide survey by the Japan Pancreas Society based on real-world data

    Tomimaru Yoshito, Eguchi Hidetoshi, Inoue Yosuke, Nagakawa Yuichi, Ohba Akihiro, Takami Hideki, Unno Michiaki, Yamamoto Tomohisa, Kawakatsu Shoji, Hayashi Tsuyoshi, Higuchi Ryota, Kitagawa Hirohisa, Hattori Satoshi, Fujii Tsutomu, Hirooka Yoshiki, Igarashi Hisato, Kitano Masayuki, Kuroki Tamotsu, Masamune Atsushi, Shimizu Yasuhiro, Tani Masaji, Tanno Satoshi, Tsuji Yoshihisa, Yamaue Hiroki, Satoi Sohei, Takeyama Yoshifumi

    CANCER   129 巻 ( 5 ) 頁: 728 - 739   2023年3月

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    記述言語:英語   出版者・発行元:Cancer  

    Background: Based on the Japan Adjuvant Study Group of Pancreatic Cancer 01 study, the standard duration of adjuvant chemotherapy with S-1 (an oral 5-fluorouracil prodrug consisting of tegafur, gimeracil, and oteracil) in patients with resected pancreatic ductal adenocarcinoma (PDAC) was considered to be 6 months, but the impact of increasing its duration on postoperative survival was unknown. Here, the authors investigated this question by reviewing real-world data from a large cohort of patients with PDAC. Methods: In total, 3949 patients who underwent surgery for PDAC during the study period followed by S-1 adjuvant chemotherapy in board-certified institutions were included. Based on the duration of S-1 chemotherapy, two subgroups were defined: a standard-duration group that included patients who were treated for 180 ± 30 days and a longer duration group that included patients who received treatment for >210 days. Results: The median duration of S-1 chemotherapy was 167 days, with a mean ± standard deviation of 200 ± 193 days. After excluding patients who had a recurrence within 210 days after the initiation of adjuvant chemotherapy, postoperative recurrence-free survival (RFS) and overall survival (OS) in the standard-duration group (n = 1473) and the longer duration group (n = 975) were compared. RFS and OS did not differ significantly between the standard-duration and longer duration groups (5-year RFS: 37.8% vs. 36.2% respectively; p =.6186; 5-year OS: 52.8% vs. 53.4%, respectively; p =.5850). The insignificant difference was verified by multivariate analysis and propensity-score matching analysis. Conclusions: The current findings suggest that extending S-1 adjuvant chemotherapy beyond 6 months has no significant additional effect on survival in patients with PDAC. This could be useful in determining whether to extend S-1 chemotherapy in patients who have completed the standard 6-month treatment.

    DOI: 10.1002/cncr.34580

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  4. Which modality is better to diagnose high-grade transformation in retroperitoneal liposarcoma? Comparison of computed tomography, positron emission tomography, and magnetic resonance imaging

    Nakashima Yu, Yokoyama Yukihiro, Ogawa Hiroshi, Sakakibara Ayako, Sunagawa Masaki, Nishida Yoshihiro, Mizuno Takashi, Yamaguchi Junpei, Onoe Shunsuke, Watanabe Nobuyuki, Kawakatsu Shoji, Igami Tsuyoshi, Ebata Tomoki

    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY   28 巻 ( 3 ) 頁: 482 - 490   2023年3月

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    記述言語:英語   出版者・発行元:International Journal of Clinical Oncology  

    Background: Survival in patients with retroperitoneal liposarcoma (RPLS) depends on the surgical management of the dedifferentiated foci. The present study investigated the diagnostic yield of contrast-enhanced CT, 18F-fluorodeoxyglucose positron emission tomography (PET), and diffusion-weighted MRI in terms of dedifferentiated foci within the RPLS. Methods: Patients treated with primary or recurrent RPLS who underwent the above imaging between January 2010 and December 2021 were retrospectively reviewed. The diagnostic accuracy of the three modalities for histologic subtype of dedifferentiated liposarcoma (DDLS) and French Federation of Cancer Center (FNCLCC) grade 2/3 were compared using receiver operating characteristic curves and areas under the curves (AUCs). Results: The cohort involved 32 patients with 53 tumors; 30 of which exhibited DDLS and 31 of which did FNCLCC grades 2/3. The optimal thresholds for predicting DDLS were mean CT value of 31 Hounsfield Unit (HU) (AUC = 0.880, 95% CI 0.775–0.984; p < 0.001), maximum standardized uptake value (SUVmax) of 2.9 (AUC = 0.865 95% CI 0.792–0.980; p < 0.001), while MRI failed to differentiate DDLS. The cutoff values for distinguishing FNCLCC grades 1 and 2/3 were a mean CT value of 24 HU (AUC = 0.858, 95% CI 0.731–0.985; p < 0.001) and SUVmax of 2.9 (AUC = 0.885, 95% CI 0.792–0.978; p < 0.001). MRI had no sufficient power to separate these grades. Conclusions: Contrast-enhanced CT and PET were useful for predicting DDLS and FNCLCC grade 2/3, while MRI was inferior to these two modalities.

    DOI: 10.1007/s10147-022-02287-6

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  5. Early Prediction of a Serious Postoperative Course in Perihilar Cholangiocarcinoma Trajectory Analysis of the Comprehensive Complication Index

    Kawakatsu Shoji, Yamaguchi Junpei, Mizuno Takashi, Watanabe Nobuyuki, Onoe Shunsuke, Igami Tsuyoshi, Yokoyama Yukihiro, Uehara Kay, Nagino Masato, Matsuo Keitaro, Ebata Tomoki

    ANNALS OF SURGERY   277 巻 ( 3 ) 頁: 475 - 483   2023年3月

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    記述言語:英語   出版者・発行元:Annals of Surgery  

    Objective: The aim of this study was to visualize the postoperative clinical course using the comprehensive complication index (CCI) and to propose an early alarming sign for subsequent serious outcomes in perihilar cholangiocarcinoma. Background: Surgery for this disease carries a high risk of morbidity and mortality. The developmental course of the overall morbidity burden and its clinical utility are unknown. Methods: Patients who underwent major hepatectomy for perihilar cholan-giocarcinoma between 2010 and 2019 were reviewed retrospectively. All postoperative complications were evaluated according to the Clavien-Dindo classification (CDC), and the CCI was calculated on a daily basis until postoperative day 14 to construct an accumulating graph as a trajectory. Group-based trajectory modeling was conducted to categorize the trajectory into clinically distinct patterns and the predictive power of early CCI for a subsequent serious course was assessed. Results: A total of 4230 complications occurred in the 484 study patients (CDC grade I, n = 27; II, n = 132; IlIa, n = 290; IIIb, n = 4; IVa, n = 21; IVb, n = 1; and V, n = 9). The trajectory was categorized into 3 patterns: mild (n = 209), moderate (n = 235), and severe (n = 40) morbidity courses. The 90-day mortality rate significantly differed among the courses: 0%, 0.9%, and 17.5%, respectively (P<0.001). The cutoff values of the CCI on postoperative days 1, 4, and 7 for predicting a severe morbidity course were 15.0, 28.5, and 40.6 with areas under the curves of 0.780, 0.924, and 0.984, respectively. Conclusions: The CCI could depict the chronological increase in the overall morbidity burden, categorized into 3 patterns. Early CCI potentially predicted sequential progression to serious outcomes.

    DOI: 10.1097/SLA.0000000000005162

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  6. 特集 血管再建を伴う高難度肝胆膵外科手術 6.肝門部領域胆管癌に対する肝動脈合併切除再建を伴う左側肝切除

    尾上 俊介, 水野 隆史, 渡辺 伸元, 川勝 章司, 横山 幸浩, 伊神 剛, 山口 淳平, 砂川 真輝, 馬場 泰輔, 江畑 智希

    外科   85 巻 ( 2 ) 頁: 145 - 154   2023年2月

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    出版者・発行元:南江堂  

    DOI: 10.15106/j_geka85_145

    CiNii Research

  7. Impact of pancreatic fat infiltration on postoperative pancreatic fistula occurrence in patients undergoing invagination pancreaticojejunostomy

    Dei Hideyuki, Natsume Seiji, Okuno Masataka, Kawakatsu Shoji, Hosoda Waki, Matsuo Keitaro, Hara Kazuo, Ito Seiji, Komori Koji, Abe Tetsuya, Nagino Masato, Shimizu Yasuhiro

    HPB   24 巻 ( 12 ) 頁: 2119 - 2124   2022年12月

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    記述言語:英語   出版者・発行元:HPB  

    Background: No studies to date have determined the impact of pancreatic fat infiltration on postoperative pancreatic fistula (POPF) occurrence in patients undergoing invagination pancreaticojejunostomy (IV-PJ). Methods: The medical records of patients with a soft pancreas who underwent pancreatoduodenectomy followed by IV-PJ were reviewed . The pancreatic fat ratio on computed tomography (CT) images (I-PFR) was determined using preoperative CT and verified by histologic examination. The relationship between the I-PFR and POPF occurrence was determined. Patients were classified into 2 groups based on I-PFR value (fatty and non-fatty pancreas). Postoperative outcomes were compared between the two groups, and specifically among patients who developed POPF. Results: Of 221 patients, POPF occurred in 67 (30.3%). I-PFR was positively correlated with histologic-calculated fat ratio (ρ = 0.517, p < 0.001). This index was shown to be an independent predictor of POPF. Based on an I-PFR cut-off value of 3.2%, 92 patients were classified in the fatty pancreas group. Subgroup analysis of the patients who developed POPF showed that incidence of abscess formation and hemorrhage tended to be higher in patients with fatty pancreas than in those with non-fatty pancreas. Conclusions: Pancreatic fat infiltration is highly associated with POPF and possibly causes subsequent serious complications in patients undergoing IV-PJ.

    DOI: 10.1016/j.hpb.2022.08.013

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  8. Is a specific T classification needed for extrahepatic intraductal papillary neoplasm of the bile duct (IPNB) type 2 associated with invasive carcinoma?

    Mitake Yasuhiro, Onoe Shunsuke, Igami Tsuyoshi, Mizuno Takashi, Yamaguchi Junpei, Sunagawa Masaki, Watanabe Nobuyuki, Kawakatsu Shoji, Shimoyama Yoshie, Ebata Tomoki

    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES     2022年11月

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    記述言語:英語   出版者・発行元:Journal of Hepato-Biliary-Pancreatic Sciences  

    Background: The necessity of a specific T classification for extrahepatic intraductal papillary neoplasm of the bile duct (IPNB) type 2, one of the precursors of cholangiocarcinoma (CC), remains unclear. Methods: Patients who underwent resection for extrahepatic biliary tumors were reviewed. Relapse-free survival (RFS) was compared between IPNB type 2 and CC, stratified by T classification. Results: The cohort involved 443 patients with IPNB type 2 (n = 57) and CC (n = 386). In 342 patients with perihilar tumors, 5-year RFS of IPNB type 2 and CC group was 49.8% versus 34.5% (p =.012), respectively. The RFS was 54.6% versus 47.2% (p =.110) for pT1-2 tumors and 28.6% versus 22.7% (p =.436) for pT3-4 tumors, respectively. In 92 patients with distal tumors, 5-year RFS was 47.4% versus 42.1% (p =.678). The RFS was 68.2% versus 49.6% (p =.422) for pT1 tumors and 18.8% versus 38.3% (p =.626) for pT2-3 tumors, respectively. Multivariate analysis identified that poor histologic grade (HR, 2.105; p <.001), microscopic venous invasion (HR, 1.568; p =.002), and nodal metastasis (HR, 1.547; p <.001) were independent prognostic deteriorators, while tumor type (IPNB type 2 vs. CC) was not. Conclusions: Prognostic impact of IPNB type 2 was limited, suggesting unnecessity of a specific T classification for IPNB type 2 with invasive carcinoma.

    DOI: 10.1002/jhbp.1269

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  9. 手術手技 肝外胆管癌に対する肝門部胆管高位切除─肝切除を避けるために

    尾上 俊介, 水野 隆史, 渡辺 伸元, 川勝 章司, 伊神 剛, 江畑 智希

    手術   76 巻 ( 11 ) 頁: 1729 - 1734   2022年10月

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    出版者・発行元:金原出版  

    DOI: 10.18888/op.0000003012

    CiNii Research

  10. ASO Author Reflections: Positive Status of Intraoperative Peritoneal Lavage Cytology in Patients with Pancreatic Ductal Adenocarcinoma: Are They Candidates for Radical Resection?

    Kawakatsu Shoji, Shimizu Yasuhiro, Matsuo Keitaro, Hosoda Waki

    ANNALS OF SURGICAL ONCOLOGY   29 巻 ( 9 ) 頁: 5984 - 5985   2022年9月

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    記述言語:英語   出版者・発行元:Annals of Surgical Oncology  

    DOI: 10.1245/s10434-022-11747-2

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  11. ASO Visual Abstract: Prognostic Significance of Intraoperative Peritoneal Lavage Cytology in Patients with Pancreatic Ductal Adenocarcinoma: A Single-Center Experience and Systematic Review of the Literature

    Kawakatsu Shoji, Shimizu Yasuhiro, Natsume Seiji, Okuno Masataka, Ito Seiji, Komori Koji, Abe Tetsuya, Misawa Kazunari, Ito Yuichi, Kinoshita Takashi, Higaki Eiji, Fujieda Hironori, Sato Yusuke, Ouchi Akira, Nagino Masato, Hara Kazuo, Matsuo Keitaro, Hosoda Waki

    ANNALS OF SURGICAL ONCOLOGY   29 巻 ( 9 ) 頁: 5986 - 5987   2022年9月

  12. Prognostic Significance of Intraoperative Peritoneal Lavage Cytology in Patients with Pancreatic Ductal Adenocarcinoma: A Single-Center Experience and Systematic Review of the Literature

    Kawakatsu Shoji, Shimizu Yasuhiro, Natsume Seiji, Okuno Masataka, Ito Seiji, Komori Koji, Abe Tetsuya, Misawa Kazunari, Ito Yuichi, Kinoshita Takashi, Higaki Eiji, Fujieda Hironori, Sato Yusuke, Ouchi Akira, Nagino Masato, Hara Kazuo, Matsuo Keitaro, Hosoda Waki

    ANNALS OF SURGICAL ONCOLOGY   29 巻 ( 9 ) 頁: 5972 - 5983   2022年9月

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    記述言語:英語   出版者・発行元:Annals of Surgical Oncology  

    Background: The prognostic significance of peritoneal lavage cytology (PLC) in patients with pancreatic ductal adenocarcinoma (PDAC) remains controversial. The purpose of this study was to evaluate the prognostic impact of PLC status in PDAC patients. Methods: Patients intending to undergo resection for PDAC between 2007 and 2020 were included. Survival was compared among patients who underwent resection with negative or positive PLC status and those who did not undergo resection. Univariable and multivariable analyses were conducted to evaluate the prognostic impact of positive PLC status. A systematic literature review was performed to evaluate the correlation between prognosis and the positive PLC rate. Results: A total of 480 patients formed the study cohort and were divided as follows: 438 in the negative PLC group, 18 in the positive PLC group, and 24 in the no resection group. Although the median survival time significantly differed between the negative and positive PLC groups (35.7 vs. 13.6 months, P < 0.001), it did not significantly differ between the positive PLC and no resection groups (13.6 vs. 12.2 months, P = 0.605). Multivariable analyses demonstrated that positive PLC status (hazard ratio = 3.54, 95% confidence interval = 1.97–6.38, P < 0.001) was the strongest poor prognostic factor. Based on statistical analyses for the systematic review, the prognostic impact of positive PLC status weakened significantly as the institutional positive PLC rate increased (P = 0.044). Conclusions: Resection did not improve the prognosis of patients with positive PLC status in our cohort. The institutional positive PLC rate may be a good reference for surgical indication in these patients.

    DOI: 10.1245/s10434-022-11722-x

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  13. Mild Prognostic Impact of Postoperative Complications on Long-term Survival of Perihilar Cholangiocarcinoma

    Kawakatsu Shoji, Ebata Tomoki, Watanabe Nobuyuki, Onoe Shunsuke, Yamaguchi Junpei, Mizuno Takashi, Igami Tsuyoshi, Yokoyama Yukihiro, Matsuo Keitaro, Nagino Masato

    ANNALS OF SURGERY   276 巻 ( 1 ) 頁: 146 - 152   2022年7月

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    記述言語:英語   出版者・発行元:Annals of Surgery  

    Objective:To evaluate the impact of complications on long-term survival in patients with perihilar cholangiocarcinoma.Background:Surgical resection for perihilar cholangiocarcinoma is vulnerable to postoperative complications. The prognostic impact of complications in patients with this disease is unknown.Methods:The medical records of patients who underwent curative-intent hepatectomy for perihilar cholangiocarcinoma between 2010 and 2017 were reviewed retrospectively. The comprehensive complication index (CCI) was calculated based on all postoperative complications, which were graded by the Clavien-Dindo classification (CDC). Patients were divided into high and low CCI groups by the median score, and survival was compared between the 2 groups.Results:Excluding 8 patients who died in hospital, 369 patients were analyzed. The CDC grade was I in 20 (5.4%), II in 108 (29.3%), III in 224 (60.7%), and IV in 17 (4.6%) patients. The CCI increased with increasing CDC grade; the median was 42.9 (range, 15.0-98.9). Overall survival differed significantly between the high (n = 187) and low (n = 182) CCI groups (41.2% vs 47.9% at 5-years; P = 0.041). However, multivariable analyses demonstrated that traditional clinicopathological factors were independent predictors of survival and that the dichotomized CCI was not. In addition, the CCI score as a continuous variable was not an independent prognostic factor for overall survival in the multivariable analyses (hazard ratio per 1 CCI score: 1.00, 95% confidence interval: 0.99-1.01, P = 0.775).Conclusions:Cumulative postoperative complications after resection of perihilar cholangiocarcinoma only moderately deteriorate long-term survival, and should not be an argument to deny surgery in this high-risk population.

    DOI: 10.1097/SLA.0000000000004465

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