Faculty Profiles - TANABE Shunsuke

Papers - TANABE Shunsuke

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Assistant-based standardization of prone position thoracoscopic esophagectomy. Reviewed

Yasuhiro Shirakawa, Kazuhiro Noma, Naoaki Maeda, Ryoichi Katsube, Shunsuke Tanabe, Toshiaki Ohara, Kazufumi Sakurama, Toshiyoshi Fujiwara

Acta medica Okayama 68 ( 2 ) 111 - 7 2014

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

Thoracoscopic esophagectomy in the prone position (TEPP) might enable solo-surgery in cases requiring resection of the esophagus and the surrounding lymph nodes due to the associated advantages of good exposure of the surgical field and ergonomic considerations for the surgeon. However, no one approach can be for all patients requiring extensive lymphadenectomy. We recently developed an assistant-based procedure to standardize exposure of the surgical field. Patients were divided into 1 of 2 groups:a pre-standardization group (n=37) and a post-standardization group (n=28). The thoracoscopic operative time was significantly shorter (p=0.0037) in the post-standardization group (n=28; 267 ± 31 min) than in the pre-standardization group (n=37;301 ± 53 min). Further, learning curve analysis using the moving average method showed stabilization of the thoracoscopic operative time after the standardization. No significant differences were found in the number of mediastinal lymph nodes dissected or intraoperative blood loss between the 2 groups. There were also no significant differences in the complication rate. Assistant-based surgery and standardization of the procedure resulted in a well-exposed and safe surgical field. TEPP decreased the operative time, even in patients requiring extensive lymphadenectomy.

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Direct observation diverticulectomy for Zenker's diverticulum carcinoma Reviewed

Toshiaki Ohara, Yasuhiro Shirakawa, Kazuhiro Noma, Naoaki Maeda, Ryouichi Katsube, Shunsuke Tanabe, Toshiyoshi Fujiwara

ESOPHAGUS 10 ( 4 ) 235 - 238 2013.12

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER JAPAN KK

Zenker's diverticulum carcinoma is a rare disease. Recent technological endoscopic innovation has enabled the detection of early stage Zenker's diverticulum carcinoma. Here we report a case in which a 56-year-old woman was diagnosed with early stage Zenker's diverticulum carcinoma. Narrow band imaging (NBI) endoscopic examination was useful for diagnosis and identifying the borders of the carcinoma. A successful surgical treatment was performed using direct observation diverticulectomy. A minimally invasive cervical procedure was used, and the area of the carcinoma was confirmed intraoperatively with Lugol's solution.

DOI： 10.1007/s10388-013-0376-6

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[Current status of neoadjuvant chemotherapy for advanced esophageal cancer]. Reviewed

Shunsuke Tanabe, Yasuhiro Shirakawa, Naoaki Maeda, Ryoichi Katsube, Toshiaki Ohara, Kazufumi Sakurama, Kazuhiro Noma, Toshiyoshi Fujiwara

Gan to kagaku ryoho. Cancer & chemotherapy 40 ( 12 ) 1612 - 4 2013.11

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

Since reported in the JCOG9907 trial, neoadjuvant chemotherapy prior to surgery has become the standard treatment for advanced (Stage II/III) esophageal cancers. However, more powerful neoadjuvant chemotherapy is required for the treatment of locally advanced cases or cases involving multiple lymph node metastases. At our institute, DCF therapy (docetaxel, cisplatin, and 5-fluorouracil) is administered selectively for the treatment of patients with far-advanced esophageal cancer. We treated 53 thoracic esophageal cancer patients who underwent surgery following neoadjuvant chemotherapy between January 2010 and December 2012. FP therapy (cisplatin and 5-fluorouracil) was administered to 43 patients, and DCF therapy to 7 patients who had far-advanced esophageal cancer. All patients treated with DCF therapy experienced grade 3 and 4 adverse events. With the exception of 1 patient, all patients who received DCF therapy could undergo curative surgery. DCF therapy could become an effective preoperative chemotherapy.

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Closed LECSの開発と臨床応用

西崎正彦, 加藤大, 黒田新士, 田邊俊介, 堀直人, 岸本浩行, 香川俊輔, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 18 ( 7 ) 499 - 499 2013.11

HER2遺伝子導入技術を用いたHER2陰性癌細胞に対する分子標的光免疫療法(Neotargeting HER2 negative cancer cells with photoimmunotherapy by virally transduction of HER2- extracellular domain)

石田道拡, 香川俊輔, 下山京子, 竹原清人, 野間和広, 田澤大, 黒田新士, 岸本浩行, 田邊俊介, 松岡順治, 小林久隆, 篠原俊義

日本癌学会総会記事 72回 495 - 495 2013.10

Utilization of partition analysis to evaluate the incidence on deep vein thrombosis following esophagectomy Reviewed

Yasuhiro Fujiwara, Tomoki Yamatsuji, Shunsuke Tanabe, Kazufumi Sakurama, Takayuki Motoki, Munenori Takaoka, Takuya Fukazawa, Yasuhiro Shirakawa, Minoru Haisa, Junji Matsuoka, Yoshio Naomoto

Esophagus 10 ( 1 ) 1 - 5 2013.3

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

Background: We performed a retrospective observational study to examine the involvement of suspicious factors and causes of deep vein thrombosis using cases of esophagectomy that were done to treat esophageal carcinoma. Methods: The 144 patients received esophagectomy in Okayama University Hospital from January 2005 to June 2007. All patients had an enhanced CT or an ultrasound examination after their operations. The incidence of deep vein thrombosis was then determined. For cases that found deep vein thrombosis, the anticoagulant treatment was strengthened. When the thrombosis was already so large to be seen in the inferior vena cava, the IVC filter was left to prevent a pulmonary embolism. Using JMP5.0.1 statistical analysis software, we analyzed the relationship between various clinical factors and the incidence of deep vein thrombosis. Results: Using JMP5.0.1, factors causing deep vein thrombosis were analyzed and partitioning was done. The most significant risk factor causing deep vein thrombosis is leaving the central venous catheter inserted into the inguinal femoral area. Logistic analysis also showed that only the catheter if inserted from the inguinal femoral area, was significantly related to cause deep vein thrombosis (p &lt
0.0055). No other factor was a significant risk to cause deep vein thrombosis. Conclusions: We analyzed the relationship between suspicious factors and the causes of deep vein thrombosis in cases of esophagectomy. The most relevant factors were inserting the central venous catheter from the inguinal femoral route. This evidence can be applied to both pre-operative and postoperative management to prevent deep vein thrombosis. © 2012 The Japan Esophageal Society and Springer Japan.

DOI： 10.1007/s10388-012-0350-8

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Successfully treated pneumatosis cystoides intestinalis with pneumoperitoneum onset in a patient administered α-glucosidase inhibitor. Reviewed

Shunsuke Tanabe, Yasuhiro Shirakawa, Yuko Takehara, Naoaki Maeda, Ryoichi Katsube, Toshiaki Ohara, Kazufumi Sakurama, Kazuhiro Noma, Toshiyoshi Fujiwara

Acta medica Okayama 67 ( 2 ) 123 - 8 2013

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

An 80-year-old woman, who had been administered α-glucosidase inhibitor for diabetes, was brought to the hospital with the sensation of abdominal fullness and pain. Abdominal computed tomography indicated pneumatosis cystoides intestinalis (PCI) in the small intestinal wall, with free air within the abdomen. A blood examination showed no increases in white blood cells or C-reactive protein level. The patient's condition improved with conservative therapy. PCI with pneumoperitoneum induced by α-glucosidase inhibitor is rare, with only 27 cases (excluding the present case) reported in Japan to date. In PCI with pneumoperitoneum, differentiation from gastrointestinal perforation is important and following the clinical symptoms over time is vital.

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Jejunal interposition reconstruction with a stomach preserving esophagectomy improves postoperative weight loss and reflux symptoms for esophageal cancer patients. Reviewed International journal

Eiji Yamada, Yasuhiro Shirakawa, Tomoki Yamatsuji, Leon Sakuma, Munenori Takaoka, Takako Yamada, Kazuhiro Noma, Kazufumi Sakurama, Yasuhiro Fujiwara, Shunsuke Tanabe, Takeshi Nagasaka, Toshiyoshi Fujiwara, Yoshio Naomoto

The Journal of surgical research 178 ( 2 ) 700 - 7 2012.12

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

BACKGROUND: Conventional reconstruction after an esophagectomy uses a gastric tube, which commonly causes several postoperative complaints such as gastric acid reflux in long-term survival cases. Intestinal interposition between the remnant esophagus and the stomach is an option to reduce complaints, and in this study, the advantages of jejunal interposition reconstruction with a stomach preserving esophagectomy (SPE) were assessed. MATERIALS AND METHODS: Eleven cases of jejunal interposition with an SPE and 16 cases with gastric tube reconstruction as a control were subject to a comparison of operation time, amount of bleeding, postoperative quality of life, and endoscopic findings. RESULTS: The SPE group had a longer operation time (SPE: 560 ± 121 min, control 414 ± 83 min, P = 0.038), whereas there was no significant difference in blood loss. Postoperative weight loss was significantly recovered in the SPE group (SPE versus control = 94.0 ± 5.4% versus 87.5 ± 4.7% at 3 mo, P = 0.017; 97.2 ± 7.5% versus 85.0 ± 5.2% at 6 mo, P = 0.010), and there was a significant decrease in the occurrence of reflux symptoms such as heartburn, odynophagia, and cough when jejunal interposition with an SPE was done. Furthermore, reflux esophagitis and Barrett's epithelium were found in six out of 12 cases (50%) of the control group by postoperative endoscopy, while no cases in the SPE group had either condition (P < 0.01). CONCLUSIONS: This reconstruction method is a promising option to improve postoperative quality of life, mainly due to the long-term elimination of reflux esophagitis, which assists in the recovery of postoperative weight loss.

DOI： 10.1016/j.jss.2012.07.057

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Clinicopathological characteristics of human epidermal growth factor receptor 2-positive Barrett's adenocarcinoma. Reviewed International journal

Takehiro Tanaka, Atsushi Fujimura, Koichi Ichimura, Hiroyuki Yanai, Yasuharu Sato, Katsuyohi Takata, Hiroyuki Okada, Seiji Kawano, Shunsuke Tanabe, Tadashi Yoshino

World journal of gastroenterology 18 ( 43 ) 6263 - 8 2012.11

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

AIM: To compare the clinicopathological characteristics of human epidermal growth factor receptor 2 (HER2)-positive and HER2-negative Barrett's adenocarcinoma in Japan. METHODS: We performed immunohistochemical analysis of HER2 in 30 samples taken from patients with Barrett's adenocarcinoma and dual color in situ hybridization in cases showing 2+ reactions. We compared the clinicopathological characteristics of HER2-positive and HER2-negative patients. RESULTS: HER2 positivity was identified in 8 (27%) carcinoma samples. We found that HER2 expression was associated with p53 overexpression (100% vs 52.6% in pT1 tumor; 100% vs 54.5% in all stage tumor, P < 0.05) and protruding lesions at the early disease stage. There was no association between the mucin phenotype of the carcinomas and prognosis. HER2 expression and low clinical stage were unexpectedly different between Barrett's adenocarcinoma patients and gastric cancer patients, but the macroscopic features may be associated with earlier diagnosis in these patients. CONCLUSION: Our results suggest that HER2-positive Barrett's adenocarcinomas are associated with p53 overexpression and lesion protrusion at the early disease stage.

DOI： 10.3748/wjg.v18.i43.6263

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ロボット支援下幽門側胃切除術の安全な導入

西崎正彦, 香川俊輔, 宇野太, 岸本浩行, 近藤喜太, 田邊俊介, 大原利章, 野間和広, 永坂岳志, 白川靖博, 藤原俊義

日本外科学会雑誌 113 ( 臨増2 ) 490 - 490 2012.3

各領域におけるロボット手術現状と今後の展望(消化器) ロボット支援下幽門側胃切除術の安全な導入を目指して導入初期3例の検討

西崎正彦, 香川俊輔, 宇野太, 岸本浩行, 近藤喜太, 田邊俊介, 野間和広, 永坂岳司, 白川靖博, 藤原俊義

日本内視鏡外科学会雑誌 16 ( 7 ) 247 - 247 2011.12

F-18 FDG PET/CT contributes to more accurate detection of lymph nodal metastasis from actively proliferating esophageal squamous cell carcinoma. Reviewed International journal

Shunsuke Tanabe, Yoshio Naomoto, Yasuhiro Shirakawa, Yasuhiro Fujiwara, Kazufumi Sakurama, Kazuhiro Noma, Munenori Takaoka, Tomoki Yamatsuji, Takao Hiraki, Yoshihiro Okumura, Masahiko Mitani, Mitsumasa Kaji, Susumu Kanazawa, Toshiyoshi Fujiwara

Clinical nuclear medicine 36 ( 10 ) 854 - 9 2011.10

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

PURPOSE: Evaluating the status of disease progression is critical for planning a therapeutic strategy for esophageal cancer. In this regard, F-18 fluorodeoxyglucose-labeled positron emission tomography (PET) is one of the most useful diagnostic modalities. However, there is room to improve its diagnostic performance, such as distinguishing lymph nodal metastases from false positives. In this study, we examined the diagnostic accuracy of fluorodeoxyglucose PET accompanied by computed tomography imaging (PET/CT) to detect regional lymph nodal metastasis from esophageal squamous cell carcinoma (ESCC). METHODS: A total of 102 patients diagnosed as ESCC were subjected to this study. These patients had a preoperative PET/CT examination to evaluate the existence of metastasis. The values of maximum standardized uptake value (SUVmax) in primary tumors and in metastasized lymph nodes were measured to analyze their relationship with various clinicopathologic characteristics including the status of tumor cell proliferation, which was assessed by immunohistochemistry for Ki-67. RESULTS: The SUVmax of the primary tumor was positively correlated with tumor size and vessel invasion, and was positively related with the SUVmax of lymph nodal metastasis, especially in cases of poorly differentiated ESCC. The SUVmax of metastasized lymph nodes was higher in larger-sized metastasized lymph nodes, whereas the Ki-labeling index of lymph nodal metastasis was positively related with the SUVmax per unit area (SUVmax/mm). The diagnostic accuracy of PET/CT (87.3%) was higher than that of conventional CT scans (78.4%). CONCLUSIONS: The improved diagnostic accuracy of PET/CT can be explained by its ability to detect actively progressive metastasis at an early phase regardless of size.

DOI： 10.1097/RLU.0b013e318217adc9

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胃癌に対するRobot Assisted Gastrectomyの導入経験

西崎正彦, 近藤喜太, 田邊俊介, 野間和広, 岸本浩行, 宇野太, 永坂岳司, 香川俊輔, 白川靖弘, 藤原俊義

日本消化器外科学会雑誌 44 ( Suppl.2 ) 185 - 185 2011.10

[Surgery for cancers at the esophagogastric junction and Barrett's esophageal cancers].

Yasuhiro Shirakawa, Shunsuke Tanabe, Kazuhiro Noma, Kazufumi Sakurama, Toshiyoshi Fujiwara

Nihon rinsho. Japanese journal of clinical medicine 69 Suppl 6 322 - 8 2011.8

Pertinence and Consequences of Simple Neck Dissection in Thoracic Esophageal Cancer Reviewed

NAOMOTO Yoshio, YAMADA Eiji, TANABE Shunsuke, FUJIWARA Yasuhiro, SAKURAMA Kazufumi, NOMA Kazuhiro, MOTOKI Takayuki, TAKAOKA Munenori, SHIRAKAWA Yasuhiro, YAMATSUJI Tomoki

Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) 35 ( 4 ) 509 - 515 2010.8

Language：Japanese Publisher：Japanese College of Surgeons

Purpose: We analyzed the pertinence and consequences of simple neck dissection minimizing surgical invasion in esophageal cancer.<BR>Subjects and Methods: Subjects numbered 425 men and women undergoing radical esophagectomy for thoracic esophageal cancer from 1997 to 2006. Supraclavicular lymph node #104 dissection was undertaken in those with middle thoracic (Mt) and lower thoracic (Lt) esophageal cancer lesions when node metastasis was suspected in radical diagnostics using, e. g., positron emission / computed tomography (PET–CT) and when intraoperative pathological examination indicated metastasis in pararecurrent nerve nodes #101 or #106.<BR>Results:In 89 cases involving #104 node dissection, 39 (43.8%) indicated node metastasis. In 254 not undergoing #104 node dissection, 6 (1.8%) involved neck node metastasis, with 3 requiring additional dissection. No statistically significant prognostic difference was seen in conducting #104 dissection.<BR>Conclusions: Combining radical diagnostics involving, e. g., PET–CT, and intraoperative pathological examination simplifies neck dissection in Mt and Lt esophageal cancer. Additional neck dissection is sufficient in treating neck node recurrence.

DOI： 10.4030/jjcs.35.509

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Other Link： http://search.jamas.or.jp/link/ui/2011131874

Preferential up-regulation of heparanase and cyclooxygenase-2 in carcinogenesis of Barrett's oesophagus and intestinal-type gastric carcinoma. Reviewed International journal

Ryotaro Sonoda, Yoshio Naomoto, Yasuhiro Shirakawa, Yasuhiro Fujiwara, Tomoki Yamatsuji, Kazuhiro Noma, Shunsuke Tanabe, Munenori Takaoka, Mehmet Gunduz, Hidetsugu Tsujigiwa, Hitoshi Nagatsuka, Nobuya Ohara, Tadashi Yoshino, Kaiyo Takubo, Michael Vieth, Noriaki Tanaka

Histopathology 57 ( 1 ) 90 - 100 2010.7

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

AIMS: Metaplastic changes secondary to chronic inflammation at the gastro-oesophageal junction and at the pyloric antrum are recognized as the premalignant conditions of Barrett's oesophageal adenocarcinoma and intestinal-type gastric carcinoma (GC), respectively. Heparanase (HPSE) and cyclooxygenase (COX)-2 have been proved to play critical roles in inflammation as well as in cancer. The aim was to examine the meaning of their expression in inflammation-related carcinogenesis. METHODS AND RESULTS: First, expression of HPSE and COX-2 in 78 clinical tissues of Barrett's oesophagus was examined by immunohistochemistry and in situ hybridization. Their expression was increased during the metaplasia-dysplasia sequence with increased neovascularization. Successively, their expression in Barrett's dysplasia was compared with that of GC (22 cases of diffuse-type and 10 of intestinal-type). Interestingly, the expression pattern in Barrett's dysplasia was similar to that in intestinal-type GC, which mainly arises from chronic inflammation. Furthermore, cultured cell lines isolated from differentiated GC tissues, which are often found to be of intestinal-type, revealed up-regulated mRNA expression of HPSE and COX-2. CONCLUSIONS: HPSE and COX-2 are preferentially up-regulated in Barrett's oesophagus and intestinal-type GC. These molecules may play an important role during the development of inflammation-related adenocarcinoma of the upper gastrointestinal tract.

DOI： 10.1111/j.1365-2559.2010.03594.x

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RAD001 offers a therapeutic intervention through inhibition of mTOR as a potential strategy for esophageal cancer. Reviewed International journal

Zhi Gang Wang, Takuya Fukazawa, Toshio Nishikawa, Nobuyuki Watanabe, Kazufumi Sakurama, Takayuki Motoki, Shinji Hatakeyama, Osamu Omori, Toshiaki Ohara, Shunsuke Tanabe, Yasuhiro Fujiwara, Munenori Takaoka, Yasuhiro Shirakawa, Tomoki Yamatsuji, Noriaki Tanaka, Yoshio Naomoto

Oncology reports 23 ( 4 ) 1167 - 72 2010.4

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

Esophageal cancer is one of the most frequently occurring cancers in the world. Targeting therapy strategy of cancer with specific inhibitors is developing and has showed promising antitumor efficacy. It is known that mTOR is an important controller of cell growth. RAD001 (everolimus) is a specific inhibitor of mTOR that can block the mTOR signaling pathway. The purposes of this study was to explore the inhibitory effects of RAD001 on mTOR signaling and the mechanism of cell growth suppression by RAD001. We examined both the expression of mTOR, p70S6K and S6 in SEG-1 esophageal cancer cells and KOB-13 normal esophageal epithelial cells and the efficacy of RAD001 against SEG-1 esophageal cancer cells. mTOR, p70S6K and S6 were overexpressed in SEG-1 esophageal cancer cells compared with KOB-13 normal esophageal epithelial cells. SEG-1 esophageal cancer cells were sensitive to RAD001. The survival rate of the cells treated with RAD001 over 0.33 microM was significantly different compared with that of control (P<0.01). RAD001 inhibited the phosphorylation of mTOR (Ser2448) and S6 (Ser240/244) in different grades and the expressions of mTOR, p70S6K and S6. As a result, RAD001 induced a dose-dependent decrease in cell proliferation, G1/S arrest and damage of cell shape. Taken together, these data showed that RAD001 can inhibit mTOR signaling and proliferation in SEG-1 esophageal cancer cells in vitro. It offers a therapeutic intervention through inhibition of mTOR as a potential strategy for esophageal cancer.

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Missense polymorphisms of PTPRJ and PTPN13 genes affect susceptibility to a variety of human cancers. Reviewed International journal

Yuichiro Mita, Yukiko Yasuda, Akiko Sakai, Hiromasa Yamamoto, Shinichi Toyooka, Mehmet Gunduz, Shunsuke Tanabe, Yoshio Naomoto, Mamoru Ouchida, Kenji Shimizu

Journal of cancer research and clinical oncology 136 ( 2 ) 249 - 59 2010.2

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

PURPOSE: We investigated the association between incidence of various cancers and four single nucleotide polymorphisms (SNPs), two each in two protein tyrosine phosphatase (PTP) genes, PTPRJ and PTPN13, by a case-control study conducted in Japan. METHODS: The study samples comprised 819 cancer-free controls and 569 cancer cases including lung, head and neck, colorectal, and esophageal cancers. RESULTS: Compared with the major homozygotes at the Arg326Gln SNP in PTPRJ, a likely homologue of the mouse SCC1 (susceptible to colon cancer), Arg/Gln or Gln/Gln genotypes exhibited an increased colorectal cancer risk with adjusted odds ratios (aOR) of 1.71 (P = 0.021) and 3.74 (P = 4.14 x 10(-4)), respectively. Increased risks were observed with one or more of the combination genotypes of Gln276Pro and Arg326Gln in PTPRJ for most cancer types (aOR range 10.13-55.08, Bonferroni-corrected P = 0.0454-7.20 x 10(-9)). In the PTPN13, major homozygotes of Ile1522Met showed an increased risk for lung squamous cell carcinomas (aOR 1.86), compared to the heterozygotes. Increased risks were observed with at least one of the combination genotypes of the two SNPs, Ile1522Met and Tyr2081Asp, for all but esophageal cancer examined (aOR 3.36-13.75), compared with double heterozygotes. Moreover, these high risks were seen also when all cancer cases were combined (aOR 1.81-6.84). CONCLUSIONS: PTPRJ and PTPN13 SNPs were found to influence susceptibility to a wide spectrum of cancers. Because allelic frequencies of these SNPs are relatively common in many ethnic groups, these findings are worthy of further study.

DOI： 10.1007/s00432-009-0656-7

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小腸穿通した腹腔内異物に対し鏡視下手術が有用であった一例

近藤喜太, 田邊俊介, 藤原康宏, 野間和弘, 永坂岳司, 白川靖弘, 山辻知樹, 小林直哉, 猶本良夫

日本腹部救急医学会雑誌 30 ( 2 ) 330 - 330 2010.2

[The transition of therapy for recurrent esophageal cancer by PET-CT]. Reviewed

Yasuhiro Shirakawa, Shunsuke Tanabe, Yasuhiro Fujiwara, Kazuhiro Noma, Kazufumi Sakurama, Munenori Takaoka, Tomoki Yamatsuji, Minoru Haisa, Yoshio Naomoto

Gan to kagaku ryoho. Cancer & chemotherapy 36 ( 12 ) 2465 - 7 2009.11

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

In our institute, we introduced PET-CT examination as the preoperative and postoperative screening for esophageal cancer patients in April 2006. During two years before the introduction of PET-CT examination, we performed an intensive local control therapy (operation, RFA, definitive chemoradiotherapy) to 13 cases with single region recurrence (including 5 cases of cervical lymph nodes recurrence, 5 of local recurrence, 3 of distant metastatic recurrence). On the other hand, we performed an intensive local control therapy to 21 cases (including 4 cases of cervical lymph nodes recurrence, 10 of local recurrence, and 7 of distant metastatic recurrence) during two years after the introduction of PET-CT examination. In any pattern, there was a tendency of improvement in the prognosis of recurrent esophageal cancer patients. These results raised the possibility that PET-CT examination was useful for an early detection of the recurrent lesions in postoperative follow-up for esophageal cancer patients. And there might be a chance of curability in patients with single region recurrence by the early detection.

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