Faculty Profiles - SHIEN Tadahiko

Papers - SHIEN Tadahiko

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Metastasis-directed therapy for oligometastases in breast cancer. Reviewed International journal

Toshiyuki Ishiba, Ikuno Nishibuchi, Fumikata Hara, Naoto Shikama, Tadahiko Shien, Hiroji Iwata

Japanese journal of clinical oncology 2023.7

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

The concept of oligometastases was first proposed to describe a disease state between localized cancer and extensive metastasis. After the emergence of variations in the definition of oligometastasis, in April 2020 the European Society for Radiotherapy and Oncology and the European Organization for Research and Treatment of Cancer defined oligometastases as the presence of one to five metastatic lesions that can be safely treated. However, the pathogenesis of oligometastases remains unknown, and it is uncertain which patients will benefit from metastasis-directed therapy. Breast cancer with oligometastases is generally managed with systemic therapy. Retrospective studies have suggested that the addition of metastasis-directed therapy, such as surgery, radiofrequency ablation and stereotactic body radiation therapy, may increase overall survival in breast cancer patients with oligometastases, but as yet there have been no prospective studies. Phase II trials of stereotactic body radiation therapy or fractionated irradiation for oligometastases of breast cancer have demonstrated impressive rates of local control and overall survival. Although the efficacy of stereotactic body radiation therapy in the SABR-COMET was largely anticipated, it is noteworthy that only 18% of the patient population had breast cancer. For this reason, various trials were planned or are being conducted globally to investigate the efficacy of metastasis-directed therapy for oligometastases of breast cancer. Metastasis-directed therapy for oligometastases has been shown to be effective, and stereotactic body radiation therapy and other therapies are commonly used internationally and are considered to be safe. However, the efficacy of metastasis-directed therapy for oligometastases has not yet been proven. The results of future clinical trials are thus eagerly awaited.

DOI： 10.1093/jjco/hyad077

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Impact of Immediate Breast Reconstruction on Survival of Breast Cancer Patients: A Single-Center Observational Study. Reviewed

Yuko Mukai, Naruto Taira, Yukiko Kajiwara, Takayuki Iwamoto, Yohei Kitaguchi, Miho Saiga, Satoko Watanabe, Tadahiko Shien, Hiroyoshi Doihara, Yoshihiro Kimata

Acta medica Okayama 77 ( 3 ) 281 - 290 2023.6

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

Although immediate breast reconstruction following mastectomy has become increasingly common, its oncological safety has been debated. We enrolled patients with breast cancer who underwent surgery at Okayama University Hospital between 2007 and 2013. The primary outcome was relapse-free survival (RFS). Secondary outcomes were overall survival and the duration from the surgery to the initiation of adjuvant chemotherapy. We divided into immediate breast reconstruction, mastectomy alone, and breast conservative surgery groups. Outcomes were compared using Cox's regression analysis. A total of 614 patients were included (reconstruction: 125, mastectomy: 128, breast conservative surgery: 361). The median follow-up duration was 79.0±31.9 months. The immediate-reconstruction patients were younger, had more lymph node metastases, and more often received postoperative chemotherapy. The RFS was better after the breast conservative surgery compared to after reconstruction (hazard ratio 0.33, 95% confidence interval: 0.144-0.763). The proportion of local recurrence was highest in the reconstruction group. No patients in the reconstruction group underwent postoperative radiation therapy. However, reconstruction did not affect overall survival or the time to the initiation of adjuvant chemotherapy. Surgeons should explain the risks of breast reconstruction to their patients preoperatively. Careful long-term follow-up is required after such procedures.

DOI： 10.18926/AMO/65493

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一次乳房再建術後局所再発乳癌の予後日本乳癌学会班研究(枝園班)

関大仁, 荻谷朗子, 名倉直美, 志茂彩華, 成井一隆, 笹田伸介, 石飛真人, 野木裕子, 近藤直人, 櫻井照久, 山内智香子, 森弘樹, 雜賀美穂, 新倉直樹, 枝園忠彦

日本乳癌学会総会プログラム抄録集 31回 77 - 77 2023.6

トリプルネガティブ乳がんにおける免疫関連細胞の遺伝子発現の検討

高橋侑子, 突沖貴宏, 岩本高行, 岩谷胤生, 枝園忠彦

日本乳癌学会総会プログラム抄録集 31回 302 - 302 2023.6

CDK4/6阻害薬の有害事象中止に関する年齢の影響についての検討

仁科卓也, 谷岡真樹, 高田健二, 突沖貴宏, 高橋侑子, 岩本高行, 岩谷胤生, 枝園忠彦

日本乳癌学会総会プログラム抄録集 31回 270 - 270 2023.6

乳癌患者における術後ホルモン療法による関節痛の増悪頻度とリスク因子を検証する前向きコホート試験

宇野摩耶, 鳩野みなみ, 平成人, 大谷悠介, 鈴木陽子, 中本翔伍, 吉岡遼, 河田健吾, 高橋侑子, 突沖貴宏, 河内麻里子, 池田宏国, 岩本高行, 岩谷胤生, 吉富誠二, 小笠原豊, 原享子, 土井原博義, 枝園忠彦

日本乳癌学会総会プログラム抄録集 31回 328 - 328 2023.6

がんゲノム徹底討論! 乳癌における包括的ゲノム診療の実際 JBCRG REIWA studyを通して

増田紘子, 多田寛, 服部正也, 古川孝広, 原文堅, 田辺裕子, 相良安昭, 北川大, 枝園忠彦, 岩谷胤生, 八十島宏行, 上本康明, 吉村健一, 岩田広治, 増田慎三

日本乳癌学会総会プログラム抄録集 31回 28 - 28 2023.6

術前後の化学療法を併用した一次乳房再建は外科的腫瘍学的危険因子ではない日本乳癌学会班研究(枝園班)

野木裕子, 荻谷朗子, 志茂彩華, 名倉直美, 関大仁, 成井一隆, 櫻井照久, 雜賀美穂, 近藤直人, 笹田伸介, 石飛真人, 山内智香子, 森弘樹, 枝園忠彦

日本乳癌学会総会プログラム抄録集 31回 76 - 76 2023.6

An observational study of the impact of immediate breast reconstruction on perioperative inflammatory cytokines.

Yuko Mukai, Naruto Taira, Yohei Kitaguchi, Ryoko Nakagiri, Miho Saiga, Mariko Kochi, Takayuki Iwamoto, Tadahiko Shien, Hiroyoshi Doihara, Yoshihiro Kimata

Surgery today 2023.5

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

PURPOSE: Perioperative inflammatory cytokines may be related to cancer proliferation, although few studies have investigated this issue in patients undergoing breast reconstruction surgery. METHODS: We conducted a prospective study of patients scheduled for mastectomy only, mastectomy plus deep inferior epigastric perforator flap reconstruction (DIEP), or mastectomy plus tissue expander reconstruction (TE), with or without axial dissection (Ax), for primary breast cancer. Blood samples were collected for analysis of serum IL-6 and VEGF preoperatively, then within 24 h postoperatively (POD 1), and 4-6 days postoperatively (POD 4-6). We investigated the difference in serum cytokine levels over time for each surgical procedure and the difference in serum cytokine levels among the procedures at the three measurement time points. RESULTS: There were 120 patients included in the final analysis. Serum IL-6 was significantly higher than the preoperative level on POD 1 in patients who underwent mastectomy only, DIEP, or TE and Ax (+), with higher values persisting on POD 4-6 except in those who underwent DIEP. IL-6 was significantly higher after DIEP than after mastectomy only on POD 1, but no differences were observed at POD 4-6. VEGF did not differ significantly among the surgical procedures at any time. CONCLUSIONS: The increase in IL-6 was short term and immediate breast reconstruction is considered a safe procedure.

DOI： 10.1007/s00595-023-02700-1

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内分泌外科手術での合併症を防ぐための試みわが国の甲状腺・副甲状腺手術による手術部位感染の現状と課題厚生労働省院内感染対策サーベイランス事業データベース解析

岩谷胤生, 吉本皓一, 突沖貴宏, 高橋侑子, 枝園忠彦

日本内分泌外科学会雑誌 40 ( Suppl.1 ) S121 - S121 2023.5

進行・再発乳癌における外科治療の意義と適応転移乳癌に対する局所療法のサブタイプ毎の意義と適応

枝園忠彦, 仁科卓也, 吉本晧一, 宇野摩耶, 中本翔伍, 大谷悠介, 突沖貴宏, 高橋侑子, 岩本高行, 岩谷胤生

日本外科学会定期学術集会抄録集 123回 SY - 1 2023.4

進行・再発乳癌における外科治療の意義と適応転移乳癌に対する局所療法のサブタイプ毎の意義と適応

枝園忠彦, 仁科卓也, 吉本晧一, 宇野摩耶, 中本翔伍, 大谷悠介, 突沖貴宏, 高橋侑子, 岩本高行, 岩谷胤生

日本外科学会定期学術集会抄録集 123回 SY - 1 2023.4

Safety and Efficacy of a Well-Fitting Brassiere after Breast Reconstruction: A Qualitative Study.

Satoko Watanabe, Miho Saiga, Takayuki Motoki, Tadahiko Shien, Naruto Taira, Hiroyoshi Doihara, Yoshihiro Kimata

Acta medica Okayama 77 ( 1 ) 11 - 19 2023.2

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

The importance of a well-fitted, comfortable brassiere to overall quality of life after breast reconstruction has not been evaluated. Our aim was to determine the impact of a semi-customized brassiere on patients' health-related quality of life after breast reconstruction. The subjects were prospective patients with mastectomy who were to undergo immediate or delayed breast reconstruction at our hospital. After surgery, a professional bra fitter sized each patient for a semi-customized brassiere and provided follow-up consultations. A self-reported questionnaire on breast aesthetics, postoperative pain, and satisfaction was used to assess the primary outcomes. Data were prospectively collected at baseline (before surgery) and at 1, 3, 6, and 12 months after surgery and analyzed. Forty-six patients (50 breasts) were included in the analysis. Consistent wearing of the brassiere reduced pain (p<0.05), with good overall satisfaction (p<0.001). Aesthetic scores on breast shape and size were higher with than without the custom brassiere at 3 months (p=0.02) and 6 months (p=0.03) after surgery. Wearing the brassiere reduced anxiety at all time points of measurement. A well-fitting brassiere ensured safety and provided a high degree of satisfaction without anxiety for patients after breast reconstruction.

DOI： 10.18926/AMO/64356

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Preferences Regarding Breast Surgery Omission Among Patients With Breast Cancer Who Receive Neoadjuvant Chemotherapy. International journal

Kaho Nakamura, Makoto Ishitobi, Chiya Oshiro, Hiroaki Shima, Eriko Takahashi, Takahiro Nakayama, Tadahiko Shien, Kanako Saito, Tsuguo Iwatani, Yukiko Seto, Kaori Terata, Goro Kutomi, Tomoko Ogawa, Hideo Inaji

In vivo (Athens, Greece) 37 ( 2 ) 794 - 800 2023

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

BACKGROUND/AIM: Currently, several ongoing prospective studies are investigating the safety of breast surgery omission in patients with breast cancer who are exceptional responders to neoadjuvant chemotherapy. However, there is little information about the preferences of these patients regarding omission of breast surgery. PATIENTS AND METHODS: We conducted a questionnaire survey to assess preferences regarding omission of breast surgery among patients with breast cancer who had human epidermal growth factor receptor 2-positive or estrogen receptor-negative tumors and good clinical response after neoadjuvant chemotherapy. Patients' estimation of the risk of ipsilateral breast tumor recurrence (IBTR) after definitive surgery or breast surgery omission was also assessed. RESULTS: Of 93 patients, only 22 (23.7%) said they would omit breast surgery. Under the scenario of omitting breast surgery, the 5-year IBTR rate estimated by patients who said they would omit breast surgery was significantly lower (median, 10%) than the rate estimated by patients who preferred undergoing definitive surgery (median, 30%) (p=0.017). CONCLUSION: The proportion of our surveyed patients who were willing to omit breast surgery was low. Patients who said they preferred to omit breast surgery overestimated the 5-year IBTR risk.

DOI： 10.21873/invivo.13143

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Physicians' perception about the impact of breast reconstruction on patient prognosis: a survey in Japan.

Rena Yamakado, Makoto Ishitobi, Naoto Kondo, Chikako Yamauchi, Shinsuke Sasada, Hiroko Nogi, Miho Saiga, Akiko Ogiya, Kazutaka Narui, Hirohito Seki, Naomi Nagura, Ayaka Shimo, Teruhisa Sakurai, Naoki Niikura, Hiroki Mori, Tadahiko Shien

Breast cancer (Tokyo, Japan) 30 ( 2 ) 1 - 7 2022.12

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

BACKGROUND: One barrier to the widespread use of breast reconstruction (BR) is physicians' perception that BR adversely affects breast cancer prognosis. However, there is limited information regarding physicians' understanding of the impact of BR on patient prognosis and which physicians have misunderstandings about BR. METHODS: We conducted an e-mail survey regarding the impact of BR on the prognosis of patients with breast cancer among members of the Japanese Breast Cancer Society. RESULTS: Of 369 respondents, 99 (27%) said that they believe BR affects patient prognosis. Female respondents and those who treat fewer new breast cancer patients per year were more likely to state that they believe BR affects patient prognosis (P = 0.006 and 0.007). Respondents who believed that BR affects patient prognosis underestimated 5-year overall survival rates in patients who receive BR and subsequently have local or regional recurrence in different sites. CONCLUSION: Our survey demonstrated that a quarter of respondents believe that BR affects patient prognosis and underestimate survival rates in patients who receive BR and have subsequent local or regional recurrence. Because of the lack of evidence regarding the impact of BR on patient prognosis, educating physicians by providing accurate knowledge regarding BR and patient prognosis is highly recommended.

DOI： 10.1007/s12282-022-01421-6

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Association of Genetic Polymorphism with Taxane-induced Peripheral Neuropathy: Sub-analysis of a Randomized Phase II Study to Determine the Optimal Dose of 3-week Cycle Nab-Paclitaxel in Metastatic Breast Cancer Patients.

Yuko Abe, Naruto Taira, Kosuke Kashiwabara, Junji Tsurutani, Masahiro Kitada, Masato Takahashi, Hiroaki Kato, Yuichiro Kikawa, Eiko Sakata, Yoichi Naito, Yoshie Hasegawa, Tsuyoshi Saito, Tsutomu Iwasa, Tsutomu Takashima, Tomohiko Aihara, Hirofumi Mukai, Fumikata Hara, Tadahiko Shien, Hiroyoshi Doihara, Shinichi Toyooka

Acta medica Okayama 76 ( 6 ) 661 - 671 2022.12

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

Chemotherapy-induced peripheral neuropathy (CIPN) is an important clinical challenge that threatens patients' quality of life. This sub-study of the ABROAD trial investigated the influence of single nucleotide polymorphisms (SNPs) on CIPN, using genotype data from a randomized study to determine the optimal dose of a 3-week-cycle regimen of nab-paclitaxel (q3w nab-PTX) in patients with metastatic breast cancer (MBC). Patients with HER2-negative MBC were randomly assigned to three doses of q3w nab-PTX (SD: 260 mg/m2 vs. MD: 220 mg/m2 vs. LD: 180 mg/m2). Five SNPs (EPHA4-rs17348202, EPHA5-rs7349683, EPHA6-rs301927, LIMK2-rs5749248, and XKR4-rs4737264) were analyzed based on the results of a previous genome-wide association study. Per-allele SNP associations were assessed by a Cox regression to model the cumulative dose of nab-PTX up to the onset of severe or worsening sensory neuropathy. A total of 141 patients were enrolled in the parent study; 91(65%) were included in this sub-study. Worsening of CIPN was significantly greater in the cases with XKR4 AC compared to those with a homozygote AA (HR 1.86, 95%CI: 1.00001-3.46, p=0.049). There was no significant correlation of CIPN with any other SNP. A multivariate analysis showed that the cumulative dose of nab-PTX was most strongly correlated with CIPN (p<0.01).

DOI： 10.18926/AMO/64116

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ASO Author Reflections: Is Nipple-Areolar Recurrence After Nipple-Sparing Mastectomy Simply a "Cosmetic Failure"? Reviewed International journal

Makoto Ishitobi, Tadahiko Shien

Annals of surgical oncology 2022.11

Classification of Local Recurrence After Nipple-Sparing Mastectomy Based on Location: The Features of Nipple-Areolar Recurrence Differ from Those of Other Local Recurrences. Reviewed International journal

Ayu Yamaguchi, Makoto Ishitobi, Naomi Nagura, Ayaka Shimo, Hirohito Seki, Akiko Ogiya, Teruhisa Sakurai, Yukiko Seto, Chiya Oshiro, Shinsuke Sasada, Michiko Kato, Takahiko Kawate, Naoto Kondo, Kazutaka Narui, Tsuyoshi Nakagawa, Hiroko Nogi, Chikako Yamauchi, Koichiro Tsugawa, Yuka Kajiura, Tadahiko Shien

Annals of surgical oncology 30 ( 3 ) 1678 - 1686 2022.11

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Little information is available about the clinical and pathologic characteristics of local recurrence (LR) after nipple-sparing mastectomy according to the locations of LR. METHODS: This study classified 99 patients into the following two groups according to the location of LR after nipple-sparing mastectomy: nipple-areolar recurrence (NAR) group and other locations of LR (oLR) group. The study evaluated whether the location of LR was associated with disease-free survival (DFS) after LR resection. RESULTS: For about half of the patients (44.4 %) with NAR, the primary cancer was estrogen receptor (ER)-negative and human epidermal growth factor receptor 2 (HER2)-positive. Conversely, in most of the patients with oLR (79.2 %), the primary cancer was ER-positive and HER2-negative. Among the LR tumors, the frequency of noninvasive carcinoma in the NAR tumors was significantly higher than in the oLR tumors (51.9 % vs 4.2 %, respectively). During a median follow-up period of 46 months, the location of LR was not associated with DFS after LR. In the NAR group, the presence or absence of LR tumor invasiveness was the only factor associated with DFS. In the oLR group, age at primary surgery was the only factor associated with DFS. CONCLUSION: This multi-institutional retrospective study demonstrated that the features of NAR, such as the characteristics of the primary and recurrent tumors and the prognostic factors after LR resection, were quite different from those of oLR.

DOI： 10.1245/s10434-022-12760-1

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乳がん手術におけるパラダイムシフト-EscalationとDe-escalation- 転移乳がんに対する局所療法はescalationかde-escalationか?

枝園忠彦, 戸嶋圭, 鈴木陽子, 宇野摩耶, 吉岡遼, 中本翔吾, 突沖貴宏, 高橋侑子, 岩本高行, 谷岡真樹, 岩谷胤生

日本癌治療学会学術集会抄録集 60回 OWS22 - 2 2022.10

乳がん手術におけるパラダイムシフト-EscalationとDe-escalation- 転移乳がんに対する局所療法はescalationかde-escalationか?

枝園忠彦, 戸嶋圭, 鈴木陽子, 宇野摩耶, 吉岡遼, 中本翔吾, 突沖貴宏, 高橋侑子, 岩本高行, 谷岡真樹, 岩谷胤生

日本癌治療学会学術集会抄録集 60回 OWS22 - 2 2022.10

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