Faculty Profiles - FUJIWARA Toshiyoshi

Papers - FUJIWARA Toshiyoshi

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Phase I dose-escalation study of endoscopic intratumoral injection of OBP-301 (Telomelysin) with radiotherapy in oesophageal cancer patients unfit for standard treatments. International journal

Yasuhiro Shirakawa, Hiroshi Tazawa, Shunsuke Tanabe, Nobuhiko Kanaya, Kazuhiro Noma, Takeshi Koujima, Hajime Kashima, Takuya Kato, Shinji Kuroda, Satoru Kikuchi, Shunsuke Kagawa, Kuniaki Katsui, Susumu Kanazawa, Yasuo Urata, Toshiyoshi Fujiwara

European journal of cancer (Oxford, England : 1990) 153 98 - 108 2021.8

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

PURPOSE: OBP-301 (Telomelysin) is an attenuated type-5 adenovirus that contains the human telomerase reverse transcriptase promoter to regulate viral replication. OBP-301 sensitises human cancer cells to ionising radiation by inhibiting DNA repair, and radiation enhances coxsackievirus and adenovirus receptor-mediated OBP-301 infection on the contrary. We assessed OBP-301 with radiotherapy in oesophageal cancer patients unfit for standard chemoradiation treatments. METHODS: A phase I dose-escalation study of OBP-301 with radiotherapy was conducted in 13 histologically confirmed oesophageal cancer patients deemed unfit to undergo surgery or chemotherapy. Study treatment consisted of OBP-301 administration by intratumoural needle injection using a flexible endoscope on days 1, 18 and 32. Radiotherapy was administered concurrently over 6 weeks, beginning on day 4, to a total of 60 Gy. RESULTS: Of the 13 patients, 7, 3 and 3 patients were treated with 1010, 1011 and 1012 virus particles, respectively. Study group comprised 10 males and 3 females, with a median age of 82 years (range, 53-91 years). All patients developed a transient, self-limited lymphopenia. Distribution studies revealed transient virus shedding in the plasma. Eight patients had local complete response (CR); all of them exhibited no pathologically viable malignant cells in biopsy specimens, and 3 patients had a partial response. The objective response rate was 91.7%. The clinical CR rate was 83.3% in stage I and 60.0% in stage II/III. Histopathological examination revealed massive infiltration of CD8+ cells and increased PD-L1 expression. CONCLUSION: Multiple courses of endoscopic intratumoural OBP-301 injection with radiotherapy are feasible and provide clinical benefits in patients with oesophageal cancer unfit for standard treatments.

DOI： 10.1016/j.ejca.2021.04.043

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【分子標的治療の最前線】ウイルスによるがん治療食道がんに対するウイルス療法の現状と今後の展望

藤原俊義, 田澤大, 田辺俊介, 白川靖博

腫瘍内科 28 ( 2 ) 179 - 184 2021.8

Usefulness of Middle Colic Artery Transposition Technique for Hepatic Arterial Reconstruction in Conversion Surgery for an Initially Unresectable, Locally Advanced Pancreatic Cancer.

Ryuichi Yoshida, Takahito Yagi, Kazuya Yasui, Yuzo Umeda, Kazuhiro Yoshida, Tomokazu Fuji, Kosei Takagi, Kenjiro Kumano, Masashi Yoshimoto, Toshiyoshi Fujiwara

Acta medica Okayama 75 ( 4 ) 543 - 548 2021.8

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

The outcomes of pancreatectomy with resection and reconstruction of the involved arteries for locally advanced pancreatic cancer following chemotherapy have improved in recent years. In pancreatic head cancers in which there is contact with the common and proper hepatic arteries, margin-negative resection requires pancreati-coduodenectomy, with the resection of these arteries and the restoration of hepatic arterial flow. Here, we describe a middle colic artery transposition technique in hepatic arterial reconstruction during pancreatoduo-denectomy for an initially unresectable locally advanced pancreatic cancer. This technique was effective and may provide a new option for hepatic artery reconstruction in such cases.

DOI： 10.18926/AMO/62410

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骨肉腫における腫瘍関連マクロファージの役割とin vitro実験による検証

近藤宏也, 田澤大, 久禮美穂, 藤原智洋, 佐藤浩平, 畑利彰, 中田英二, 国定俊之, 藤原俊義, 尾崎敏文

日本整形外科学会雑誌 95 ( 8 ) S1556 - S1556 2021.8

Prediction of Early Recurrence After Surgery for Liver Tumor (ERASL): An International Validation of the ERASL Risk Models. International journal

Berend R Beumer, Kosei Takagi, Bastiaan Vervoort, Stefan Buettner, Yuzo Umeda, Takahito Yagi, Toshiyoshi Fujiwara, Ewout W Steyerberg, Jan N M IJzermans

Annals of surgical oncology 28 ( 13 ) 8211 - 8220 2021.7

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

BACKGROUND: This study aimed to assess the performance of the pre- and postoperative early recurrence after surgery for liver tumor (ERASL) models at external validation. Prediction of early hepatocellular carcinoma (HCC) recurrence after resection is important for individualized surgical management. Recently, the preoperative (ERASL-pre) and postoperative (ERASL-post) risk models were proposed based on patients from Hong Kong. These models showed good performance although they have not been validated to date by an independent research group. METHODS: This international cohort study included 279 patients from the Netherlands and 392 patients from Japan. The patients underwent first-time resection and showed a diagnosis of HCC on pathology. Performance was assessed according to discrimination (concordance [C] statistic) and calibration (correspondence between observed and predicted risk) with recalibration in a Weibull model. RESULTS: The discriminatory power of both models was lower in the Netherlands than in Japan (C statistic, 0.57 [95% confidence interval {CI} 0.52-0.62] vs 0.69 [95% CI 0.65-0.73] for the ERASL-pre model and 0.62 [95% CI 0.57-0.67] vs 0.70 [95% CI 0.66-0.74] for the ERASL-post model), whereas their prognostic profiles were similar. The predictions of the ERASL models were systematically too optimistic for both cohorts. Recalibrated ERASL models improved local applicability for both cohorts. CONCLUSIONS: The discrimination of ERASL models was poorer for the Western patients than for the Japanese patients, who showed good performance. Recalibration of the models was performed, which improved the accuracy of predictions. However, in general, a model that explains the East-West difference or one tailored to Western patients still needs to be developed.

DOI： 10.1245/s10434-021-10235-3

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Heterogeneous distribution of Fusobacterium nucleatum in the progression of colorectal cancer. International journal

Shumpei Yamamoto, Hideaki Kinugasa, Mami Hirai, Hiroyuki Terasawa, Eriko Yasutomi, Shohei Oka, Masayasu Ohmori, Yasushi Yamasaki, Toshihiro Inokuchi, Keita Harada, Sakiko Hiraoka, Kazuhiro Nouso, Takehiro Tanaka, Fuminori Teraishi, Toshiyoshi Fujiwara, Hiroyuki Okada

Journal of gastroenterology and hepatology 36 ( 7 ) 1869 - 1876 2021.7

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

BACKGROUND AND AIM: Fusobacterium nucleatum (Fn) is involved in colorectal cancer (CRC) growth and is a biomarker for patient prognosis and management. However, the ecology of Fn in CRC and the distribution of intratumoral Fn are unknown. METHODS: We evaluated Fn and the status of KRAS and BRAF in 200 colorectal neoplasms (118 adenomas and 82 cancers) and 149 matched adjacent normal mucosas. The differentiation status between "surface" and "deep" areas of cancer tissue and matched normal mucosa were analyzed in 46 surgical samples; the Ki-67 index was also evaluated in these samples. RESULTS: Fusobacterium nucleatum presence in the tumor increased according to pathological stage (5.9% [adenoma] to 81.8% [stage III/IV]), while Fn presence in normal mucosa also increased (7.6% [adenoma] to 40.9% [stage III/IV]). The detection rates of Fn on the tumor surface and in deep areas were 45.7% and 32.6%, while that of normal mucosa were 26.1% and 23.9%, respectively. Stage III/IV tumors showed high Fn surface area expression (66.7%). Fn intratumoral heterogeneity (34.8%) was higher than that of KRAS (4.3%; P < 0.001) and BRAF (2.2%; P < 0.001). The Ki-67 index in Fn-positive cases was higher than that in negative cases (93.9% vs 89.0%; P = 0.01). CONCLUSIONS: Fusobacterium nucleatum was strongly present in CRC superficial areas at stage III/IV. The presence of Fn in the deep areas of adjacent normal mucosa also increased. The intratumoral heterogeneity of Fn is important in the use of Fn as a biomarker, as Fn is associated with CRC proliferative capacity.

DOI： 10.1111/jgh.15361

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肥満症に対する腹腔鏡下スリーブ状胃切除術の治療成績

香川俊輔, 黒田新士, 菊地覚次, 垣内慶彦, 寺石文則, 矢野修也, 吉田龍一, 楳田祐三, 野間和広, 藤原俊義

日本消化器外科学会総会 76回 P270 - 3 2021.7

高齢者胃癌に対する治療の工夫高齢者Stage IA胃癌の治療適応を考える

垣内慶彦, 菊地覚次, 黒田新士, 近藤喜太, 野間和広, 楳田祐三, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 WS10 - 6 2021.7

ロボット支援下観音開き法再建の手技上の有用性と注意点

黒田新士, 菊地覚次, 垣内慶彦, 近藤喜太, 野間和広, 楳田祐三, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 P174 - 7 2021.7

Intracorporeal semi-hand-sewn Billroth I reconstruction in total laparoscopic distal gastrectomy.

Satoru Kikuchi, Shinji Kuroda, Masahiko Nishizaki, Kazuya Kuwada, Nobuo Takata, Yoshihiko Kakiuchi, Shuya Yano, Kazuhiro Noma, Shunsuke Kagawa, Toshiyoshi Fujiwara

Asian journal of endoscopic surgery 14 ( 3 ) 640 - 643 2021.7

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

INTRODUCTION: Intracorporeal Billroth I (B-I) reconstruction using an endoscopic linear stapler (ELS) is widely performed in total laparoscopic distal gastrectomy. However, conventional procedures require many ELSs for anastomosis. Here, we introduce the novel intracorporeal semi-hand-sewn (SHS) B-I reconstruction. MATERIALS AND SURGICAL TECHNIQUE: After the transection of stomach and duodenum using ELS following adequate lymph node dissection, small entry holes were made on the anterior wall in the greater curvature of the stomach and the duodenal stump. The posterior walls of both the remnant stomach and the duodenum were attached with the ELS and fired to create the posterior wall of the B-I anastomosis. All the transection line of the duodenum and one-third of the transection line of the stomach were dissected; finally the anterior wall suturing at the anastomotic site was performed by the laparoscopic hand-sewn technique. DISCUSSION: SHS procedure was performed for 17 gastric cancer patients. There were no intraoperative complications or conversions to open surgery. One intra-abdominal abscess was observed although there was no anastomotic leakage. The median reconstruction time was 48 minutes (32-63). The SHS procedure was safe, feasible, and economical, although it requires sufficient laparoscopic suturing and ligation skill.

DOI： 10.1111/ases.12887

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高度なHCCの治療を目的とする粒子線治療を先行させた肝移植

八木孝仁, 吉田龍一, 安井和也, 佐藤博紀, 楳田祐三, 吉田一博, 杭瀬崇, 高木弘誠, 藤原俊義

日本消化器外科学会総会 76回 P143 - 6 2021.7

肥満症に対する腹腔鏡下スリーブ状胃切除術の治療成績

香川俊輔, 黒田新士, 菊地覚次, 垣内慶彦, 寺石文則, 矢野修也, 吉田龍一, 楳田祐三, 野間和広, 藤原俊義

日本消化器外科学会総会 76回 P270 - 3 2021.7

IBD治療における外科医の役割 Colitis-associated neoplasiaに対する早期治療介入を目指した診療科横断的連携の重要性

高橋一剛, 近藤喜太, 重安邦俊, 菊地覚次, 矢野修也, 黒田新士, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 O33 - 5 2021.7

スキルス胃癌の制圧に向けての進歩癌および癌関連線維芽細胞を標的とした胃癌腹膜播種の新規治療戦略

菊地覚次, 小川俊博, 田渕幹康, 光井恵麻, 黒田新士, 野間和広, 楳田祐三, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 WS8 - 1 2021.7

Frailな高齢者大腸癌患者に対する周術期管理チーム介入後のアウトカムの検証と最近の取り組み

寺石文則, 武田正, 重安邦俊, 矢野修也, 近藤喜太, 黒田新士, 野間和広, 楳田祐三, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 P233 - 7 2021.7

術前診断に苦慮した、稀な形態を呈した胃粘膜下腫瘍の治療経験

猿渡和也, 野間和広, 前田直見, 菊地覚次, 田邊俊介, 黒田新士, 楳田祐三, 寺石文則, 白川靖博, 藤原俊義

日本消化器外科学会総会 76回 P230 - 1 2021.7

Cadaverトレーニングの現状と課題岡山大学における過去8年のCSTの傾向から見たCSTプログラム作成における要点

近藤喜太, 前田直見, 黒田新士, 田辺俊介, 野間和広, 楳田祐三, 寺石文則, 西崎正彦, 香川俊輔, 藤原俊義

日本消化器外科学会総会 76回 PD1 - 1 2021.7

家庭運営と消化器外科医を両立するリーダーを育てる男性消化器外科医のワークライフバランス実現に向けて男性育休を取得した経験から

坂本真樹, 黒田新士, 菊地覚次, 近藤喜太, 野間和広, 楳田祐三, 寺石文則, 仁熊健文, 片岡正文, 藤原俊義

日本消化器外科学会総会 76回 WS1 - 5 2021.7

切除後再発時期・生存期間に着目した膵癌治療成績の検討今後の治療方向性を探る

安井和也, 吉田龍一, 佐藤博紀, 楳田祐三, 吉田一博, 高木弘誠, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P224 - 4 2021.7

膵癌術後再発巣に対する局所療法の有用性の検討

佐藤博紀, 吉田龍一, 安井和也, 楳田祐三, 吉田一博, 高木弘誠, 黒田新士, 野間和広, 八木孝仁, 藤原俊義

日本消化器外科学会総会 76回 P224 - 3 2021.7

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Papers - FUJIWARA Toshiyoshi