Faculty Profiles - TANABE Shunsuke

Papers - TANABE Shunsuke

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当院の直腸癌に対する肛門温存手術アプローチの変遷と術後排便障害の発生状況

庄司良平, 寺石文則, 近藤喜太, 重安邦俊, 菊地覚次, 黒田新士, 田邊俊介, 野間和広, 香川俊輔, 藤原俊義

日本消化器外科学会総会 78回 P244 - 8 2023.7

切除不能食道癌に対する根治を目指した治療戦略

前田直見, 野間和広, 橋本将志, 加藤卓也, 菊地覚次, 黒田新士, 田辺俊介, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 O8 - 5 2023.7

クローン病における肛門機能温存のための至適治療戦略

近藤喜太, 黒田新士, 田辺俊介, 菊地覚次, 野間和広, 吉田龍一, 楳田祐三, 寺石文則, 香川俊輔, 藤原俊義

日本消化器外科学会総会 78回 O13 - 8 2023.7

Case of robot-assisted salvage surgery for esophageal cancer with a mediastinal fistula after definitive chemoradiotherapy. Reviewed

Daisuke Kadowaki, Kazuhiro Noma, Masashi Hashimoto, Naoaki Maeda, Shunsuke Tanabe, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Asian journal of endoscopic surgery 16 ( 3 ) 505 - 509 2023.7

Language：English

Salvage surgery for esophageal cancer after definitive chemoradiotherapy (dCRT) is effective, but it is associated with a high rate of perioperative complications. The indications for robot-assisted minimally invasive esophagectomy (RAMIE) are expanding. However, there are few reports of salvage RAMIE. A 73-year-old man was referred to our hospital for residual esophageal cancer with a mediastinal fistula after dCRT. The perioperative diagnosis was T3N1M0-Stage III, and the salvage RAMIE was performed. Although the dissection was difficult due to fibrosis caused by dCRT and the esophageal mediastinal fistula, RAMIE was performed safely with no complications. Multiple features of RAMIE contributed to stable surgery. The monopolar dissection is effective for hard scar tissue caused by CRT and inflammation.

DOI： 10.1111/ases.13155

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【総論】サルコペニア・フレイルに対する周術期・外来管理の工夫食道癌周術期の早期多職種チーム医療介入は術後合併症を軽減させる

河崎健人, 野間和広, 橋本将志, 加藤卓也, 前田直見, 田辺俊介, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 WS4 - 2 2023.7

【総論】大腸癌以外のoligometastasisに対する集学的治療の現状と課題食道がん術後再発のOligomatastasisにおける長期予後に関わる因子の解明

松本祐, 野間和広, 橋本将志, 加藤卓也, 前田直見, 田辺俊介, 菊地覚次, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 WS5 - 8 2023.7

Overcoming cancer-associated fibroblast-induced immunosuppression by anti-interleukin-6 receptor antibody. Reviewed International journal

Noriyuki Nishiwaki, Kazuhiro Noma, Toshiaki Ohara, Tomoyoshi Kunitomo, Kento Kawasaki, Masaaki Akai, Teruki Kobayashi, Toru Narusaka, Hajime Kashima, Hiroaki Sato, Satoshi Komoto, Takuya Kato, Naoaki Maeda, Satoru Kikuchi, Shunsuke Tanabe, Hiroshi Tazawa, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Cancer immunology, immunotherapy : CII 72 ( 7 ) 2029 - 2044 2023.7

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

Cancer-associated fibroblasts (CAFs) are a critical component of the tumor microenvironment and play a central role in tumor progression. Previously, we reported that CAFs might induce tumor immunosuppression via interleukin-6 (IL-6) and promote tumor progression by blocking local IL-6 in the tumor microenvironment with neutralizing antibody. Here, we explore whether an anti-IL-6 receptor antibody could be used as systemic therapy to treat cancer, and further investigate the mechanisms by which IL-6 induces tumor immunosuppression. In clinical samples, IL-6 expression was significantly correlated with α-smooth muscle actin expression, and high IL-6 cases showed tumor immunosuppression. Multivariate analysis showed that IL-6 expression was an independent prognostic factor. In vitro, IL-6 contributed to cell proliferation and differentiation into CAFs. Moreover, IL-6 increased hypoxia-inducible factor 1α (HIF1α) expression and induced tumor immunosuppression by enhancing glucose uptake by cancer cells and competing for glucose with immune cells. MR16-1, a rodent analog of anti-IL-6 receptor antibody, overcame CAF-induced immunosuppression and suppressed tumor progression in immunocompetent murine cancer models by regulating HIF1α activation in vivo. The anti-IL-6 receptor antibody could be systemically employed to overcome tumor immunosuppression and improve patient survival with various cancers. Furthermore, the tumor immunosuppression was suggested to be induced by IL-6 via HIF1α activation.

DOI： 10.1007/s00262-023-03378-7

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Outcomes of solitary postoperative recurrence of esophageal squamous cell carcinoma diagnosed with FDG-PET/CT and treated with definitive radiation therapy. Reviewed

Hiroki Ihara, Kotaro Yoshio, Shunsuke Tanabe, Soichi Sugiyama, Masashi Hashimoto, Naoaki Maeda, Shinsuke Akagi, Soshi Takao, Kazuhiro Noma, Takao Hiraki

Esophagus : official journal of the Japan Esophageal Society 20 ( 3 ) 548 - 556 2023.7

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

BACKGROUND: Surgical resection of esophageal cancer is frequently performed to achieve a complete cure. However, the postoperative recurrence rate is 36.8-42.5%, leading to poor prognosis. Radiation therapy has been used to treat recurrences; solitary recurrence has been proposed as a prognostic factor for radiation therapy, though its significance is unclear. 18F-fluorodeoxyglucose positron emission tomography is a highly accurate diagnostic modality for esophageal cancer. This retrospective study aimed to analyze the outcomes of solitary postoperative recurrences of esophageal squamous cell carcinoma diagnosed with 18F-fluorodeoxyglucose positron emission tomography and treated with definitive radiation therapy. METHODS: We examined 27 patients who underwent definitive radiation therapy for single or multiple postoperative recurrences of esophageal squamous cell carcinoma between May 2015 and April 2021. 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed within 3 months before the commencement of radiation therapy. Kaplan-Meier, univariate, and multivariate analyses were performed to examine the overall survival and identify potential prognostic factors. RESULTS: The 1-, 2-, and 3-year overall survival rates were 85.2%, 62.6%, and 47.3%, respectively, and solitary recurrence was the only significant factor associated with overall survival (P = 0.003). The 1-, 2-, and 3-year overall survival rates in patients with solitary recurrence were 91.7%, 80.2%, and 80.2%, respectively, and in patients with multiple recurrences they were 80.0%, 50.3%, and 25.1%, respectively. Multivariate analysis also showed solitary recurrence as a significant factor for overall survival. CONCLUSIONS: When diagnosed with 18F-fluorodeoxyglucose positron emission tomography/computed tomography, solitary recurrence appears to have a more favorable prognosis than multiple recurrences.

DOI： 10.1007/s10388-023-01000-4

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食道癌術後補助免疫療法中の早期再発リスクと免疫関連有害事象の検討

橋本将志, 野間和広, 加藤卓也, 前田直見, 田辺俊介, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 O27 - 5 2023.7

過不足ない縦郭腹部リンパ郭清と機能温存術後再建の両立を目指して岡山大学病院の現状と展望

加藤卓也, 野間和広, 橋本将志, 前田直見, 田辺俊介, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 O44 - 3 2023.7

進行食道癌症例に対する微量元素に着目した術前から術後外来までのseamlessな多職種周術期管理

田邊俊介, 野間和広, 橋本将志, 加藤卓也, 前田直見, 吉田龍一, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 P032 - 5 2023.7

当院の直腸癌に対する肛門温存手術アプローチの変遷と術後排便障害の発生状況

庄司良平, 寺石文則, 近藤喜太, 重安邦俊, 菊地覚次, 黒田新士, 田邊俊介, 野間和広, 香川俊輔, 藤原俊義

日本消化器外科学会総会 78回 P244 - 8 2023.7

【総論】サルコペニア・フレイルに対する周術期・外来管理の工夫食道癌周術期の早期多職種チーム医療介入は術後合併症を軽減させる

河崎健人, 野間和広, 橋本将志, 加藤卓也, 前田直見, 田辺俊介, 寺石文則, 楳田祐三, 白川靖博, 藤原俊義

日本消化器外科学会総会 78回 WS4 - 2 2023.7

クローン病における肛門機能温存のための至適治療戦略

近藤喜太, 黒田新士, 田辺俊介, 菊地覚次, 野間和広, 吉田龍一, 楳田祐三, 寺石文則, 香川俊輔, 藤原俊義

日本消化器外科学会総会 78回 O13 - 8 2023.7

MicroRNAs associated with postoperative outcomes in patients with limited stage neuroendocrine carcinoma of the esophagus. Reviewed International journal

Tomoyuki Okumura, Tsutomu Fujii, Kenji Terabayashi, Takashi Kojima, Shigeru Takeda, Tomomi Kashiwada, Kazuhiro Toriyama, Susumu Hijioka, Tatsuya Miyazaki, Miho Yamamoto, Shunsuke Tanabe, Yasuhiro Shirakawa, Masayuki Furukawa, Yoshitaka Honma, Isamu Hoshino, Yoshihiro Nabeya, Hironori Yamaguchi, Shinji Uemoto, Yutaka Shimada, Hisahiro Matsubara, Soji Ozawa, Hiroyasu Makuuchi, Masayuki Imamura

Oncology letters 26 ( 1 ) 276 - 276 2023.7

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

Esophageal neuroendocrine carcinoma (E-NEC) is an aggressive disease with a poor prognosis. The present study aimed to assess the role of surgery in the treatment of patients with resectable E-NEC, and identify a microRNA (miRNA/miR) signature in association with positive postoperative outcomes. Between February 2017 and August 2019, 36 patients with E-NEC who underwent curative surgery at the Japan Neuroendocrine Tumor Society partner hospitals were enrolled in the study. A total of 16 (44.4%) patients achieved disease-free survival (non-relapse group), whereas 20 (55.6%) patients developed tumor relapse (relapse group) during the median follow-up time of 36.5 months (range, 1-242) after surgery with a 5-year overall survival rate of 100 and 10.8%, respectively (P<0.01). No clinicopathological parameters, such as histological type or TNM staging, were associated with tumor relapse. Microarray analysis of 2,630 miRNAs in 11 patients with sufficient quality RNA revealed 12 miRNAs (miR-1260a, -1260b, -1246, -4284, -612, -1249-3p, -296-5p, -575, -6805-3p, -12136, -6822-5p and -4454) that were differentially expressed between the relapse (n=6) and non-relapse (n=5) groups. Furthermore, the top three miRNAs (miR-1246, -1260a and -1260b) were associated with overall survival (P<0.01). These results demonstrated that surgery-based multidisciplinary treatment is effective in a distinct subpopulation of limited stage E-NEC. A specific miRNA gene set is suggested to be associated with treatment outcome.

DOI： 10.3892/ol.2023.13862

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Safe and curative modified two-stage operation for T4 esophageal cancer after definitive chemoradiotherapy: a case report. Reviewed International journal

Tasuku Matsumoto, Kazuhiro Noma, Naoaki Maeda, Takuya Kato, Kazuya Moriwake, Kento Kawasaki, Masashi Hashimoto, Shunsuke Tanabe, Yasuhiro Shirakawa, Toshiyoshi Fujiwara

Surgical case reports 9 ( 1 ) 119 - 119 2023.6

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

BACKGROUND: The prognosis of esophageal cancer (EC) with organ invasion is extremely poor. In these cases, definitive chemoradiotherapy (CRT) followed by salvage surgery can be planned; however, the issue of high morbidity and mortality rates persists. Herein, we report the long-term survival of a patient with EC and T4 invasion who underwent a modified two-stage operation after definitive CRT. CASE PRESENTATION: A 60-year-old male presented with type 2 upper thoracic EC with tracheal invasion. First, definitive CRT was performed, which resulted in tumor shrinkage and improvement in the tracheal invasion. However, an esophagotracheal fistula subsequently developed, and the patient was treated with fasting and antibiotics. Although the fistula recovered, severe esophageal stenoses made oral intake impossible. To improve quality of life and cure the EC, a modified two-stage operation was planned. In the first surgery, an esophageal bypass was performed using a gastric tube with cervical and abdominal lymph node dissections. After confirming improved nutritional status and absence of distant metastasis, the second surgery was performed with subtotal esophagectomy, mediastinal lymph node dissection, and tracheobronchial coverage of the fistula. The patient discharged without major complications after radical resection and has been recurrence-free for 5 years since the start of treatment. CONCLUSION: A standard curative strategy could be difficult for EC with T4 invasion due to differences in the invaded organs, presence of complications, and patient condition. Therefore, patient-tailored treatment plans are needed, including a modified two-stage operation.

DOI： 10.1186/s40792-023-01692-x

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Assessing the Role of Perioperative Nutritional Education in Improving Oral Intake after Oesophagectomy: A Retrospective Study. Reviewed International journal

Mika Sonoi, Kazuhiro Noma, Shunsuke Tanabe, Naoaki Maeda, Yasuhiro Shirakawa, Hiroshi Morimatsu

Asian Pacific journal of cancer prevention : APJCP 24 ( 6 ) 2037 - 2041 2023.6

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

BACKGROUND: This study aimed to determine whether nutritional education, from the preoperative to postoperative period, and nutritional management designed to improve nutritional status alone, could improve patients' health-related self-management and nutritional management skills during the postoperative period. METHODS: We evaluated 101 hospitalised patients with oesophageal cancer who underwent surgery between 2015 and 2016 and received perioperative nutritional education (PERIO-N). The control group included 52 patients who underwent surgery between 2014 and 2015 and were supported only by normal interventions according to the Enhanced Recovery After Surgery protocol. The PERIO-N group paid specific attention to nutrition risk screening, nutrition assessment, nutrition monitoring, and lifestyle education. RESULTS: The patients in the PERIO-N group were 1.8 times more likely to be able to consume food orally than the control group (p=0.010). In the PERIO-N group, 50.5% of the patients could orally consume food, 42.6% received a combination of oral and enteral nutrition, and 6.9% only underwent enteral nutrition. In comparison, in the control group, 28.8% of the patients could orally consume food, 53.8% received a combination of oral and enteral nutrition, and 17.3% were only administered enteral nutrition (p=0.004). In addition, patients in the PERIO-N group were discharged at a 1.5 times higher rate than those in the control group (p=0.027). The readmission rate for malnutrition within 3 months was 4% in the PERIO group (5.4% for home discharge only) and 5.8% in the control group (10.5% for home discharge only) (p=0.61). CONCLUSION: This study found that perioperative nutrition education in patients who underwent oesophageal cancer surgery led to increase in the amount of oral intake at discharge. Moreover, the group that received nutrition education did not have an increased probability of hospitalisation due to the risk of malnutrition within 3 months after discharge.

DOI： 10.31557/APJCP.2023.24.6.2037

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cStage II/IIIA食道癌:DCF NAC後の術後補助療法とその適応 pN2以上の再発リスクに対する術後補助免疫療法の短期成績

橋本将志, 野間和広, 河崎健人, 國友知義, 賀島肇, 加藤卓也, 前田直見, 菊地覚次, 田辺俊介, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 77回 45 - 45 2023.6

巨大食道裂孔ヘルニアに対する治療の工夫と成績巨大食道裂孔ヘルニアの腹腔鏡根治術における再発軽減のための手術手技の工夫と成績

田辺俊介, 野間和広, 河崎健人, 國友知義, 橋本将志, 賀島肇, 加藤卓也, 前田直見, 菊地覚次, 白川靖博, 藤原俊義

日本食道学会学術集会プログラム・抄録集 77回 60 - 60 2023.6

当院におけるJz癌に対するoptimum surgical approach strategy

桂佑貴, 白川靖博, 石田道拡, 丁田泰宏, 井谷史嗣, 松川啓義, 塩崎滋弘, 田邊俊介, 野間和広, 藤原俊義

日本食道学会学術集会プログラム・抄録集 77回 93 - 93 2023.6

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Papers - TANABE Shunsuke