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| 1 | Regional lymphadenectomy for gallbladder cancer: Rational extent, technical details, and patient outcomes显示文摘AIM: To define the rational extent of regional lymphadenectomy for gallbladder cancer and to clarify its effect on long-term survival. METHODS: A total of 152 patients with gallbladder cancer who underwent a minimum of 'extended' portal lymph node dissection (defined as en bloc removal of the first-and second-echelon nodes) from 1982 to 2010 were retrospectively analyzed. Based on previous studies, regional lymph nodes of the gallbladder were divided into first-echelon nodes (cystic duct or pericholedochal nodes), second-echelon nodes (node groups posterosuperior to the head of the pancreas or around the hepatic vessels), and more distant nodes. RESULTS: Among the 152 patients (total of 3352 lymph nodes retrieved, median of 19 per patient), 79 patients (52%) had 356 positive nodes. Among nodepositive patients, the prevalence of nodal metastasis was highest in the pericholedochal (54%) and cystic duct (38%) nodes, followed by the second-echelon node groups (29% to 19%), while more distant node groups were only rarely (5% or less) involved. Disease-specific survival after R0 resection differed according to the nodal status (P < 0.001): most node-negative patients achieved long-term survival (median, not reached; 5-year survival, 80%), whereas among nodepositive patients, 22 survived for more than 5 years (median, 37 mo; 5-year survival, 43%). CONCLUSION: The rational extent of lymphadenectomy for gallbladder cancer should include the first-and second-echelon nodes. A considerable proportion of node-positive patients benefit from such aggressive lymphadenectomy. | Yoshio Shirai Toshifumi Wakai Jun Sakata Katsuyoshi Hatakeyama | 2012 | World Journal of Gastroenterology2012，18，22： | 35 |
| 2 | Catheter tract implantation metastases associated with percutaneous biliary drainage for extrahepatic cholangiocarcinoma显示文摘AIM: To estimate the incidence of catheter tract implantation metastasis among patients undergoing percutaneous transhepatic biliary drainage (PTBD) for extrahepatic cholangiocarcinoma, and to provide data regarding the management of this unusual complication of PTBD by reviewing cases reported in the literature.METHODS: A retrospective analysis of 67 consecutive patients who underwent PTBD before the resection of extrahepatic cholangiocarcinoma was conducted. The median follow-up period after PTBD was 106 mo. The English language literature (PubMed, National Library of Medicine, Bethesda, MD, USA), from January 1966through December 2004, was reviewed.RESULTS: Catheter tract implantation metastasis developed in three patients. The cumulative incidence of implantation metastasis reached a plateau (6%)at 20 mo after PTBD. All of the three patients with implantation metastasis died of tumor progression at 3, 9, and 20 mo after the detection of this complication. Among the 10 reported patients with catheter tract implantation metastasis from extrahepatic cholangiocarcinoma (including our three patients), two survived for more than 5 years after the excision of isolated catheter tract metastases.CONCLUSION: Catheter tract implantation metastasis is not a rare complication following PTBD for extrahepatic cholangiocarcinoma. Although the prognosis for patients with this complication is generally poor, the excision of the catheter tract may enable survival in selected patients with isolated metastases along the catheter tract. | Jun Sakata Yoshio Shirai Toshifumi Wakai Tatsuya Nomura Eiko Sakata Katsuyoshi Hatakeyama | 2005 | World Journal of Gastroenterology2005，11，44： | 31 |
| 3 | 'Extended' radical cholecystectomy for gallbladder cancer:Long-term outcomes, indications and limitations显示文摘AIM:To delineate indications and limitations for 'ex tended' radical cholecystectomy for gallbladder cancer:a procedure which was instituted in our department in 1982. METHODS:Of 145 patients who underwent a radi cal resection for gallbladder cancer from 1982 through 2006, 52 (36%) had an extended radical cholecystec tomy, which involved en bloc resection of the gallblad der, gallbladder fossa, extrahepatic bile duct, and the regional lymph nodes (first-and second-echelon node groups). A retrospective analysis of the 52 patients was conducted including at least 5 years of follow up. Residual tumor status was judged as no residual tumor (R0) or microscopic/macroscopic residual tumor (R1 2). athological findings were documented according tothe American Joint Committee on Cancer Cancer Stag ing anual (7th edition). RESULTS:he primary t mor as classified as patho-logical T1 (pT1) in 3 patients, pT2 in 36, pT3 in 12, and pT4 in 1. Twenty three patients had lymph node metastases; 11 had a single positive node, 4 had two positive nodes, and 8 had three or more positive nodes. None of the three patients with pT1 tumors had nodal disease, whereas 23 of 49 (47%) with pT2 or more advanced tumors had nodal disease. One patient died during the hospital stay for definitive resection, giv ing an in hospital mortality rate of 2%. Overall survival (OS) after extended radical cholecystectomy was 65% at 5 years and 53% at 10 years in all 52 patients. OS differed according to the p classification ( < 0.001) and the nodal status ( = 0.010). All of 3 patients with pT1 tumors and most (29 of 36) patients with pT2 tu mors survived for more than 5 years. Of 12 patients with pT3 tumors, 8 who had an R1 2 resection, distant metastasis, or extensive extrahepatic organ involve ment died soon after resection. Of the remaining four pT3 patients who had localized hepatic spread through the gallbladder fossa and underwent an R0 resection, 2 survived for more than 5 years and another survived for 4 years and 2 mo. The only patient with pT4 tumor died of disease soon after resection. Among 23 node positive patients, 11 survived for more than 5 years, and of these, 10 had a modest degree of nodal disease (one or two positive nodes). CONCLUSION:Extended radical cholecystectomy is indicated for pT2 tumors and some pT3 tumors with localized hepatic invasion, provided that the regional nodal disease is limited to a modest degree (up to two positive nodes). Extensive pT3 disease, pT4 disease, or marked nodal disease appears to be beyond the scope of this radical procedure. | Yoshio Shirai Jun Sakata Toshifumi Wakai Taku Ohashi Katsuyoshi Hatakeyama | 2012 | World Journal of Gastroenterology2012，18，34： | 11 |
| 4 | Narrow portion of the terminal choledochus is a cause of upstream biliary dilatation in patients with anomalous union of the pancreatic and biliary ducts显示文摘AIM: To clarify the pathogenesis of biliary dilatation associated with anomalous union of the pancreatic and biliary ducts (AUPBD).METHODS: Direct cholangiopancreatograms of 350 adult patients with or with suspicion of hepatobiliary or pancreatic disorders were reviewed. AUPBD was diagnosed cholangiopancreatographically, when the pancreaticobiliary ductal union was located above the narrow distal segment of the bile duct, which represents the action of the sphincter of Oddi. The narrow portion of the terminal choledochus was defined as symmetrical stricture of the common bile duct just above the pancreaticobiliary ductal union.RESULTS: AUPBD was found in 36 patients. Among cholangiopancreatographic features, the narrow portion of the terminal choledochus was the most pathognomonic for AUPBD (accuracy, 98%); it was present in 29 (81%)patients with AUPBD, but was not found in any patients without AUPBD. Among patients with AUPBD, biliary dilatation (>10 mm) was more frequent in those with the narrow portion of the terminal choledochus (23/29)than in those without (2/7; P = 0.018) AUPBD. Among the patients with both AUPBD and the narrow portion of the terminal choledochus, there was a strong negative correlation between the minimum diameter of the narrow portion and the maximum diameter of the choledochus (r = -0.78, P<0.001), suggesting that the degree of biliary narrowing at the narrow portion correlates with that of upstream biliary dilatation.CONCLUSION: The narrow portion of the terminal choledochus, a pathognomonic radiologic feature of AUPBD, may be a cause of biliary dilatation in patients with AUPBD. | Tatsuya Nomura Yoshio Shirai Toshifumi Wakai Naoyuki Yokoyama Jun Sakata Katsuyoshi Hatakeyama | 2005 | World Journal of Gastroenterology2005，11，41： | 5 |
| 5 | Prophylactic lateral pelvic lymph node dissection in stage Ⅳ low rectal cancer显示文摘AIM To assess the clinical significance of prophylactic lateral pelvic lymph node dissection (LPLND) in stage Ⅳ low rectal cancer.METHODS We selected 71 consecutive stage Ⅳ low rectal cancer patients who underwent primary tumor resection,and enrolled 50 of these 71 patients without clinical LPLN metastasis.The patients had distant metastasis such as liver,lung,peritoneum,and paraaortic LN.Clinical LPLN metastasis was defined as LN with a maximum diameter of 10 mm or more on preoperative pelvic computed tomography scan.All patients underwent primary tumor resection,27 patients underwent total mesorectal excision(TME) with LPLND(LPLND group),and 23 patients underwent only TME(TME group).Bilateral LPLND was performed simultaneously with primary tumor resection in LPLND group.R0 resection of both primary and metastatic sites was achieved in 20 of 50 patients.We evaluated possible prognostic factors for 5-year overall survival (OS),and compared 5-year cumulative local recurrence between the LPLND and TME groups.RESULTS For OS,univariate analyses revealed no significant benefit in the LPLND compared with the TME group (28.7% vs 17.0%,P = 0.523); multivariate analysis revealed that R0 resection was an independent prognostic factor.Regarding cumulative local recurrence,the LPLND group showed no significant benefit compared with TME group (21.4% vs 14.8%,P = 0.833).CONCLUSION Prophylactic LPLND shows no oncological benefits in patients with Stage Ⅳ low rectal cancer without clinical LPLN metastasis. | Hiroshi Tamura Yoshifumi Shimada Hitoshi Kameyama Ryoma Yagi Yosuke Tajima Takuma Okamura Mae Nakano Masato Nakano Masayuki Nagahashi Jun Sakata Takashi Kobayashi Shin-ichi Kosugi Hitoshi Nogami Satoshi Maruyama Yasumasa Takii Toshifumi Wakai | 2017 | World Journal of Clinical Oncology2017，8，5： | 4 |
| 6 | Perimuscular connective tissue contains more and larger lymphatic vessels than the shallower layers in human gallbladders显示文摘AIM: To clarify whether perimuscular connective tissuecontains more lymphatic vessels than the shallowerlayers in human gallbladders.METHODS: Lymphatic vessels were stainedimmunohistochemically with monoclonal antibody D2-40,which is a specific marker of lymphatic endothelium, inrepresentative sections of 12 normal human gallbladdersobtained at the time of resection for colorectal carcinomaliver metastases. In individual gallbladder specimens,nine high-power (× 200) fields with the highestlymphatic vessel density (LVD), termed 'hot spots', wereidentified for each layer (mucosa, muscle layer, andperimuscular connective tissue). In individual hot spots,the LVD and relative lymphatic vessel area (LVA) weremeasured microscopically using a computer-aided imageanalysis system. The mean LVD and LVA values for thenine hot spots in each layer were used for statisticalanalyses.RESULTS: In the mucosa, muscle layer, andperimuscular connective tissue, the LVD was 16.1 ± 9.2,35.4 ± 15.7, and 65.5 ± 12.2, respectively, and the LVAwas 0.4 ± 0.4, 2.1 ± 1.1, and 9.4 ± 2.6, respectively.Thus, both the LVD and LVA differed significantly (P <0.001 and P < 0.001, respectively; Kruskal-Wallis test)among the individual layers of the wall of the gallbladder,with the highest LVD and LVA values in the perimuscularconnective tissue. Most (98 of 108) of the hot spotswithin the perimuscular connective tissue were locatedwithin 500 μm of the lower border of the muscle layer.CONCLUSION: The perimuscular connective tissuecontains more and larger lymphatic vessels than the shallower layers in the human gallbladder. This observation partly explains why the incidence of lymph node metastasis is high in T2 (tumor invading the perimuscular connective tissue) or more advanced gallbladder carcinoma. | Masayuki Nagahashi Yoshio Shirai Toshifumi Wakai Jun Sakata Yoichi Ajioka Katsuyoshi Hatakeyama | 2007 | World Journal of Gastroenterology2007，13，33： | 3 |
| 7 | Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis显示文摘 | Mitsuhiro Yokoyama Hideki Origasa Masunori Matsuzaki Yuji Matsuzawa Yasushi Saito Yuichi Ishikawa Shinichi Oikawa Jun Sasaki Hitoshi Hishida Hiroshige Itakura Toru Kita Akira Kitabatake Noriaki Nakaya Toshiie Sakata Kazuyuki Shimada Kunio Shirato | 2007 | The Lancet2007，，9567： | 2 |
| 8 | Prospective and randomized clinical trial for the treatment of hepatocellular carcinoma—a comparison between L-TAE with Farmorubicin and L-TAE with Adriamycin: preliminary results (second cooperative study)显示文摘 | Saburo Kawai Masayoshi Tani Jun Okamura Makoto Ogawa Yasuo Ohashi Morito Monden Shigeki Hayashi Jushiro Inoue Yoshifumi Kawarada Mitsuo Kusano Yasuhiko Kubo Chikazumi Kuroda Yu Sakata Yoshiyuki Shimamura Kenji Jinno Akira Takahashi Kenichi Takayasu Kazuo | 1994 | Cancer Chemotherapy and Pharmacology1994，，1： | 1 |
| 9 | Clinical Significance of Lymph Node Micrometastasis in Ampullary Carcinoma显示文摘 | Eiko Sakata MD Yoshio Shirai MD PhD Naoyuki Yokoyama MD PhD Toshifumi Wakai MD PhD Jun Sakata MD PhD Katsuyoshi Hatakeyama MD PhD FACS | 2006 | World Journal of Surgery2006，，6： | 1 |
| 10 | Effect of poly(ethylene terephthalate) on the pyrolysis of brominated flame retardant containing high impact polystyrene and catalytic debromination of the liquid products显示文摘 | Thallada Bhaskar Jun Kaneko Akinori Muto Yusaku Sakata Emma Jakab Toshiki Matsui Md.Azhar Uddin | 2003 | Journal of Analytical and Applied Pyrolysis2003，，2： | 1 |
| 11 | Ocular surface changes and discomfort in patients with meibomian gland dysfunction 显示文摘 | Jun Shimazaki Miki Sakata Kazuo Tsubota | 1995 | Arch Ophthalmol1995，113，： | 1 |
| 12 | Number of Positive Lymph Nodes Independently Determines the Prognosis After Resection in Patients with Gallbladder Carcinoma显示文摘 | Jun Sakata MD Yoshio Shirai MD Toshifumi Wakai MD Yoichi Ajioka MD PhD Katsuyoshi Hatakeyama MD FACS | 2010 | Annals of Surgical Oncology2010，，7： | 1 |
| 13 | Anatomic Resection Independently Improves Long-Term Survival in Patients with T1–T2 Hepatocellular Carcinoma显示文摘 | Toshifumi Wakai Yoshio Shirai Jun Sakata Kazuhiro Kaneko Pauldion V. Cruz Kouhei Akazawa Katsuyoshi Hatakeyama | 2007 | Annals of Surgical Oncology2007，，4： | 1 |
| 14 | Novel calcium based sorbent (Ca-C) for the dehalogenation (Br, Cl) process during halogenated mixed plastic(PP/PE/PS/PVC and HIPS-Br) pyrolysis显示文摘 | Thallada Bhaskar Toshiki Matsui Jun Kaneko Md Azhar Uddin Akinori Muto Yusaku Sakata | 2002 | Green Chemistry2002，4，： | 1 |
| 15 | Number of Positive Lymph Nodes Independently Determines the Prognosis After Resection in Patients with Gallbladder Carcinoma显示文摘 | Jun Sakata MD Yoshio Shirai MD Toshifumi Wakai MD Yoichi Ajioka MD PhD Katsuyoshi Hatakeyama MD FACS | 2010 | Annals of Surgical Oncology2010，，7： | 1 |
| 16 | Anatomic Resection Independently Improves Long-Term Survival in Patients with T1–T2 Hepatocellular Carcinoma显示文摘 | Toshifumi Wakai MD PhD Yoshio Shirai MD PhD Jun Sakata MD PhD Kazuhiro Kaneko MD Pauldion V. Cruz MD PhD Kouhei Akazawa MD PhD Katsuyoshi Hatakeyama MD PhD FACS | 2007 | Annals of Surgical Oncology2007，，4： | 1 |
| 17 | Characterization of Japanese standards for myocardial sympathetic and metabolic imaging in comparison with perfusion imaging显示文摘 | Shinro Matsuo Kenichi Nakajima Shohei Yamashina Kazuyuki Sakata Mitsuru Momose Jun Hashimoto Shinichiro Kumita Masaya Kawano Koichi Okuda | 2009 | Annals of Nuclear Medicine2009，，6： | 1 |
| 18 | Prospective and randomized clinical trial for the treatment of hepatocellular carcinoma — a comparison of lipiodol-transcatheter arterial embolization with and without Adriamycin (first cooperative study)显示文摘 | Saburo Kawai Jun Okamura Makoto Ogawa Yasuo Ohashi Masayoshi Tani Jushiro Inoue Yoshifumi Kawarada Mitsuo Kusano Yasuhiko Kubo Chikazumi Kuroda Yu Sakata Yoshiyuki Shimamura Kenji Jinno Akira Takahashi Kenichi Takayasu Kazuo Tamura Naofumi Nagasue Yoshimi | 1992 | Cancer Chemotherapy and Pharmacology1992，，1： | 1 |
| 19 | Anatomic Resection Independently Improves Long-Term Survival in Patients with T1–T2 Hepatocellular Carcinoma显示文摘 | Toshifumi Wakai MD PhD Yoshio Shirai MD PhD Jun Sakata MD PhD Kazuhiro Kaneko MD Pauldion V. Cruz MD PhD Kouhei Akazawa MD PhD Katsuyoshi Hatakeyama MD PhD FACS | 2007 | Annals of Surgical Oncology2007，，4： | 1 |
| 20 | Intrahepatic biliary strictures after liver transplantation显示文摘 | Seigo Nishida Noboru Nakamura Jun Kadono Teruo Komokata Ryuzo Sakata Juan R. Madariaga Andreas G. Tzakis | 2006 | Journal of Hepato - Biliary - Pancreatic Surgery2006，，6： | 1 |
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