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川北 大介カワキタ ダイスケ

所属部署医学研究科耳鼻咽喉・頭頸部外科学分野
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Last Updated :2020/06/03

研究者基本情報

学位

  • 医学博士, 名古屋市立大学

所属学協会

  • 日本疫学会
  • 日本臨床腫瘍学会
  • 耳鼻咽喉科臨床学会
  • 日本頭頸部外科学会
  • 日本頭頸部癌学会
  • 日本耳鼻咽喉科学会

委員歴

  •   2018年09月 - 現在, 日本頭頸部癌学会, 頭頸部がん登録委員会委員
  •   2018年09月 - 現在, 日本頭頸部癌学会, 教育委員会委員
  •   2018年09月 - 現在, 日本頭頸部癌学会, 代議員

経歴

  •   2018年04月 - 現在, 名古屋市立大学大学院, 耳鼻咽喉・頭頸部外科, 講師
  •   2017年04月 - 2018年03月, 名古屋市立大学大学院, 耳鼻咽喉・頭頸部外科, 助教
  •   2016年07月 - 2017年03月, ユタ大学, ハンツマン癌研究所, 訪問研究員
  •   2016年04月 - 2016年06月, ミラノ大学, 医療統計学分野, 訪問研究員
  •   2013年04月 - 2016年03月, 名古屋市立大学大学院, 耳鼻咽喉・頭頸部外科, 助教
  •   2012年04月 - 2013年03月, 名古屋市立大学大学院, 耳鼻咽喉・頭頸部外科, 臨床研究医
  •   2010年04月 - 2012年03月, 愛知県がんセンター研究所, 疫学・予防部, リサーチレジデント
  •   2009年04月 - 2012年03月, 名古屋市立大学大学院医学研究科, 耳鼻咽喉・頭頸部外科, 大学院生
  •   2008年04月 - 2010年03月, 愛知県がんセンター中央病院, 頭頸部外科, レジデント
  •   2003年04月 - 2008年03月, 豊橋市民病院, 耳鼻咽喉科, 医師

研究活動情報

研究分野

  • ライフサイエンス, 耳鼻咽喉科学, 頭頸部外科

研究キーワード

    腺様嚢胞癌, 唾液腺導管癌, 唾液腺癌, がん疫学, 頭頸部癌

論文

  • Prognostic Implication of Histopathologic Indicators in Salivary Duct Carcinoma: Proposal of a Novel Histologic Risk Stratification Model., Masato Nakaguro, Yukiko Sato, Yuichiro Tada, Daisuke Kawakita, Hideaki Hirai, Makoto Urano, Tomotaka Shimura, Kiyoaki Tsukahara, Satoshi Kano, Hiroyuki Ozawa, Kenji Okami, Yuichiro Sato, Chihiro Fushimi, Akira Shimizu, Soichiro Takase, Takuro Okada, Hiroki Sato, Yorihisa Imanishi, Kuninori Otsuka, Yoshihiro Watanabe, Akihiro Sakai, Koji Ebisumoto, Takafumi Togashi, Yushi Ueki, Hisayuki Ota, Natsuki Saigusa, Hideaki Takahashi, Mizuo Ando, Toyoyuki Hanazawa, Toshitaka Nagao, The American journal of surgical pathology,   2019年11月22日, 査読有り, Salivary duct carcinoma (SDC) is a rare, aggressive malignancy that histologically resembles high-grade mammary duct carcinoma. Because of the rarity of this entity, data verifying the association between histologic features and patient survival are limited. We conducted a comprehensive histologic review of 151 SDC cases and performed an analysis of the association between various histomorphologic parameters and the clinical outcome with the aim of developing a histologic risk stratification model that predicts the prognosis of SDC patients. A multivariate analysis revealed that prominent nuclear pleomorphism (overall survival [OS]: P=0.013; progression-free survival [PFS]: P=0.019), ≥30 mitoses/10 HPF (PFS: P=0.013), high tumor budding (OS: P=0.011; PFS: P<0.001), and high poorly differentiated clusters (OS: P<0.001; PFS: P<0.001) were independent prognostic factors. Patients with vascular invasion demonstrated a marginally significant association with shorter PFS (P=0.064) in a multivariate analysis. We proposed a 3-tier histologic risk stratification model based on the total number of positive factors among 4 prognostically relevant parameters (prominent nuclear pleomorphism, ≥30 mitoses/10 HPF, vascular invasion, and high poorly differentiated clusters). The OS and PFS of patients with low-risk (0 to 1 point) (23% of cases), intermediate-risk (2 to 3 points) (54% of cases), and high-risk (4 points) (23% of cases) tumors progressively deteriorated in this order (hazard ratio, 2.13 and 2.28, and 4.99 and 4.50, respectively; Ptrend<0.001). Our histologic risk stratification model could effectively predict patient survival and may be a useful aid to guide clinical decision-making in relation to the management of patients with SDC.
  • Fiber intake and the risk of head and neck cancer in the prostate, lung, colorectal and ovarian (PLCO) cohort., Kawakita D, Lee YA, Gren LH, Buys SS, La Vecchia C, Hashibe M, International journal of cancer, 145, (9) 2342 - 2348,   2019年11月, 査読有り
  • Adverse respiratory outcomes among head and neck cancer survivors in the Utah Cancer Survivors Study., Kawakita D, Abdelaziz S, Chen Y, Rowe K, Snyder J, Fraser A, Smith K, Herget K, Deshmukh V, Newman M, Monroe M, Hashibe M, Cancer,   2019年11月, 査読有り
  • Oncolytic activity of HF10 in head and neck squamous cell carcinomas., Esaki S, Goshima F, Ozaki H, Takano G, Hatano Y, Kawakita D, Ijichi K, Watanabe T, Sato Y, Murata T, Iwata H, Shibamoto Y, Murakami S, Nishiyama Y, Kimura H, Cancer gene therapy,   2019年09月, 査読有り
  • Body mass index and the risk of head and neck cancer in the Chinese population., Chen Y, Lee YA, Li S, Li Q, Chen CJ, Hsu WL, Lou PJ, Zhu C, Pan J, Shen H, Ma H, Cai L, He B, Wang Y, Zhou X, Ji Q, Zhou B, Wu W, Ma J, Kawakita D, Boffetta P, Zhang ZF, Dai M, Hashibe M, Cancer epidemiology, 60, 208 - 215,   2019年06月, 査読有り
  • Phase II Trial of Trastuzumab and Docetaxel in Patients With Human Epidermal Growth Factor Receptor 2-Positive Salivary Duct Carcinoma., Hideaki Takahashi, Yuichiro Tada, Takashi Saotome, Kohei Akazawa, Hiroya Ojiri, Chihiro Fushimi, Tatsuo Masubuchi, Takashi Matsuki, Kaori Tani, Robert Y Osamura, Hideaki Hirai, Shuhei Yamada, Daisuke Kawakita, Kouki Miura, Shin-Etsu Kamata, Toshitaka Nagao, Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 37, (2) 125 - 134,   2019年01月10日, 査読有り, PURPOSE: Clinical evidence demonstrating the effectiveness of systemic therapy for advanced salivary duct carcinoma (SDC) is lacking because of the disease's rarity. We assessed the efficacy and toxicity of trastuzumab plus docetaxel in patients with locally advanced and/or recurrent or metastatic human epidermal growth factor receptor 2-positive SDC. PATIENTS AND METHODS: This was a single-center, single-arm, open-label, phase II study in Japan. The patients received trastuzumab at a loading dose of 8 mg/kg, followed by 6 mg/kg every 3 weeks. Docetaxel 70 mg/m2 was administrated every 3 weeks. The primary end point was the overall response rate; the secondary end points included the clinical benefit rate, progression-free survival, overall survival, and toxicity. This study is registered with the University Hospital Medical Information Network Clinical Trials Registry (Identification No. UMIN000009437). RESULTS: Fifty-seven eligible patients with SDC were enrolled. The overall response rate was 70.2% (95% CI, 56.6% to 81.6%), and the clinical benefit rate was 84.2% (95% CI, 72.1% to 92.5%). Median progression-free and overall survival times were 8.9 months (95% CI, 7.8 to 9.9 months) and 39.7 months (95% CI, not reached), respectively. The most frequent adverse event was anemia (52 patients [91%]), followed by a decreased WBC count (51 patients [89%]) and neutropenia (50 patients [88%]). The most frequently observed grade 4 adverse event was a decreased neutrophil count (34 patients [60%]). Grade 3 febrile neutropenia was reported in eight patients (14%). No grade 2 or greater adverse events of heart failure or left ventricular ejection fraction decline to less than 50% occurred. CONCLUSION: Our data show encouraging efficacy of trastuzumab plus docetaxel therapy in patients with human epidermal growth factor receptor 2-positive SDC, with a manageable toxicity profile.
  • Regulatory T cells expressing abundant CTLA-4 on the cell surface with a proliferative gene profile are key features of human head and neck cancer., Matoba T, Imai M, Ohkura N, Kawakita D, Ijichi K, Toyama T, Morita A, Murakami S, Sakaguchi S, Yamazaki S, International journal of cancer, 144, (11) 2811 - 2822,   2018年11月, 査読有り
  • The high expression of FOXA1 is correlated with a favourable prognosis in salivary duct carcinomas: a study of 142 cases., Urano M, Hirai H, Tada Y, Kawakita D, Shimura T, Tsukahara K, Kano S, Ozawa H, Okami K, Sato Y, Fushimi C, Shimizu A, Takase S, Okada T, Sato H, Imanishi Y, Otsuka K, Watanabe Y, Sakai A, Ebisumoto K, Togashi T, Ueki Y, Ota H, Sato Y, Saigusa N, Nakaguro M, Hanazawa T, Nagao T, Histopathology, 73, (6) 943 - 952,   2018年07月, 査読有り
  • A prospective phase II study of combined androgen blockade in patients with androgen receptor-positive metastatic or locally advanced unresectable salivary gland carcinoma., Fushimi C, Tada Y, Takahashi H, Nagao T, Ojiri H, Masubuchi T, Matsuki T, Miura K, Kawakita D, Hirai H, Hoshino E, Kamata S, Saotome T, Annals of oncology : official journal of the European Society for Medical Oncology, 29, (4) 979 - 984,   2018年04月, 査読有り
  • Processed meat and risk of selected digestive tract and laryngeal cancers., Rosato V, Kawakita D, Negri E, Serraino D, Garavello W, Montella M, Decarli A, La Vecchia C, Ferraroni M, European journal of clinical nutrition, 73, (1) 141 - 149,   2018年04月, 査読有り
  • Mutation analysis of the EGFR pathway genes, EGFR, RAS, PIK3CA, BRAF, and AKT1, in salivary gland adenoid cystic carcinoma., Saida K, Murase T, Ito M, Fujii K, Takino H, Masaki A, Kawakita D, Ijichi K, Tada Y, Kusafuka K, Iida Y, Onitsuka T, Yatabe Y, Hanai N, Hasegawa Y, Shinomiya H, Nibu KI, Shimozato K, Inagaki H, Oncotarget, 9, (24) 17043 - 17055,   2018年03月, 査読有り
  • Prognostic and histogenetic roles of gene alteration and the expression of key potentially actionable targets in salivary duct carcinomas., Tomotaka Shimura, Yuichiro Tada, Hideaki Hirai, Daisuke Kawakita, Satoshi Kano, Kiyoaki Tsukahara, Akira Shimizu, Soichiro Takase, Yorihisa Imanishi, Hiroyuki Ozawa, Kenji Okami, Yuichiro Sato, Yukiko Sato, Chihiro Fushimi, Hideaki Takahashi, Takuro Okada, Hiroki Sato, Kuninori Otsuka, Yoshihiro Watanabe, Akihiro Sakai, Koji Ebisumoto, Takafumi Togashi, Yushi Ueki, Hisayuki Ota, Mizuo Ando, Shinji Kohsaka, Toyoyuki Hanazawa, Hideaki Chazono, Yoshiyuki Kadokura, Hitome Kobayashi, Toshitaka Nagao, Oncotarget, 9, (2) 1852 - 1867,   2018年01月05日, 査読有り, The molecular characteristics of therapeutically-relevant targets and their clinicopathological implications in salivary duct carcinomas (SDCs) are poorly understood. We investigated the gene alterations and the immunoexpression of crucial oncogenic molecules in 151 SDCs. The mutation rates that were identified, in order of frequency, were as follows: TP53, 68%; PIK3CA, 18%; H-RAS, 16%; BRAF, 4%; and AKT1, 1.5%. PIK3CA/H-RAS/BRAF mutations were more common in de novo SDC than in SDC ex-pleomorphic adenoma. Furthermore, these mutations were mutually exclusive for HER2 overexpression/amplification. TP53 mutations were frequently detected in cases with the aberrant p53 expression, and TP53 missense and truncating mutations were associated with p53-extreme positivity and negativity, respectively. DISH analysis revealed no cases of EGFR amplification. The rates of PI3K, p-Akt, and p-mTOR positivity were 34%, 22%, and 66%, respectively; PTEN loss was observed in 47% of the cases. These expressions were correlated according to the signaling axis. Cases with PI3K negativity and PTEN loss appeared to show a lower expression of androgen receptor. In the multivariate analysis, patients with SDC harboring TP53 truncating mutations showed shorter progression-free survival. Conversely, p-Akt positivity was associated with a favorable outcome. This study might provide information that leads to advances in personized therapy for SDC.
  • Heterogeneous impact of smoking on major salivary gland cancer according to histopathological subtype: A case-control study., Sawabe M, Ito H, Takahara T, Oze I, Kawakita D, Yatabe Y, Hasegawa Y, Murakami S, Matsuo K, Cancer, 124, (1) 118 - 124,   2018年01月, 査読有り
  • The impact of folate intake on the risk of head and neck cancer in the prostate, lung, colorectal, and ovarian cancer screening trial (PLCO) cohort., Kawakita D, Lee YA, Gren LH, Buys SS, La Vecchia C, Hashibe M, British journal of cancer, 118, (2) 299 - 306,   2018年01月, 査読有り
  • Impact of oral hygiene on head and neck cancer risk in a Chinese population., Kawakita D, Lee YA, Li Q, Chen Y, Chen CJ, Hsu WL, Lou PJ, Zhu C, Pan J, Shen H, Ma H, Cai L, He B, Wang Y, Zhou X, Ji Q, Zhou B, Wu W, Ma J, Boffetta P, Zhang ZF, Dai M, Hashibe M, Head & neck, 39, (12) 2549 - 2557,   2017年12月, 査読有り
  • Dietary fiber intake and head and neck cancer risk: A pooled analysis in the International Head and Neck Cancer Epidemiology consortium, Daisuke Kawakita, Yuan-Chin Amy Lee, Federica Turati, Maria Parpinel, Adriano Decarli, Diego Serraino, Keitaro Matsuo, Andrew F. Olshan, Jose P. Zevallos, Deborah M. Winn, Kirsten Moysich, Zuo-Feng Zhang, Hal Morgenstern, Fabio Levi, Karl Kelsey, Michael McClean, Cristina Bosetti, Werner Garavello, Stimson Schantz, Guo-Pei Yu, Paolo Boffetta, Shu-Chun Chuang, Mia Hashibe, Monica Ferraroni, Carlo La Vecchia, Valeria Edefonti, INTERNATIONAL JOURNAL OF CANCER, 141, (9) 1811 - 1821,   2017年11月, 査読有り, The possible role of dietary fiber in the etiology of head neck cancers (HNCs) is unclear. We used individual-level pooled data from ten case-control studies (5959 cases and 12,248 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium, to examine the association between fiber intake and cancer of the oral cavity/pharynx and larynx. Odds Ratios (ORs) and their 95% Confidence Intervals (as) were estimated using unconditional multiple logistic regression applied to quintile categories of non-alcohol energy-adjusted fiber intake and adjusted for tobacco and alcohol use and other known or putative confounders. Fiber intake was inversely associated with oral and pharyngeal cancer combined (OR for 5th vs. 1st quintile category = 0.49, 95% CI: 0.40-0.59; p for trend <0.001) and with laryngeal cancer (OR = 0.66, 95% CI: 0.54-0.82, p for trend <0.001). There was, however, appreciable heterogeneity of the estimated effect across studies for oral and pharyngeal cancer combined. Nonetheless, inverse associations were consistently observed for the subsites of oral and pharyngeal cancers and within most strata of the considered covariates, for both cancer sites. Our findings from a multicenter large-scale pooled analysis suggest that, although in the presence of between-study heterogeneity, a greater intake of fiber may lower HNC risk.
  • Chemo-selection with docetaxel, cisplatin and 5-fluorouracil (TPF) regimen followed by radiation therapy or surgery for pharyngeal and laryngeal carcinoma, Takuma Matoba, Kei Ijichi, Takeshi Yanagi, Kayoko Kabaya, Daisuke Kawakita, Shintaro Beppu, Junichi Torii, Shingo Murakami, JAPANESE JOURNAL OF CLINICAL ONCOLOGY, 47, (11) 1031 - 1037,   2017年11月, 査読有り, Induction chemotherapy for patients with head and neck cancer is widely performed, and several advantages of induction chemotherapy have been reported. However, there is currently insufficient evidence to strongly recommend induction chemotherapy. In this study, we analyzed the outcomes for patients treated with induction chemotherapy and subsequent definitive treatments. Operable patients with untreated oropharyngeal, hypopharyngeal and laryngeal squamous cell carcinoma treated with induction chemotherapy were included in this retrospective study. We conducted induction chemotherapy using docetaxel, cisplatin and 5-fluorouracil and performed subsequent surgical treatment or radiotherapy according to the response to induction chemotherapy. A total of 65 patients were included in this study, and 50 patients (76.9%) had Stage IV tumors. The response to induction chemotherapy was CR in two patients, PR in 55 patients, and SD in eight patients. The subsequent definitive treatment was radiotherapy in 60 patients, and surgery in five patients. The 3-year overall survival rates for patients who received radiotherapy and surgery were 88.4% and 75.0%, respectively (P = 0.30). The 3-year disease-free survival rates for patients who received radiotherapy and surgery were 68.0% and 0%, respectively (P = 0.01). The 3-year laryngeal dysfunction free survival rates for patients who received RT and surgery were 77.8% and 0%, respectively (P < 0.01). We achieved favorable survival outcomes and high larynx preservation rates. Our results suggest that induction chemotherapy using TPF regimen is one of the optimal treatment strategies when treating head and neck cancers. Further prospective studies with a larger cohort are required to confirm our findings.
  • Alcohol and head and neck cancer, Daisuke Kawakita, Keitaro Matsuo, CANCER AND METASTASIS REVIEWS, 36, (3) 425 - 434,   2017年09月, 査読有り, In this article, we reviewed the association between alcohol drinking and head and neck cancer (HNC) and its subsites, using the available literature. Alcohol drinking is an established risk factor for HNC, and this association may be stronger among cancers of the oropharynx and hypopharynx than the oral cavity or larynx. In addition, higher alcohol consumption over a shorter period was more harmful than fewer alcohol consumption over a longer period, and the most frequently consumed alcoholic beverages in a population is likely to be associated with the highest risk of HNC in that population. The risk of HNC after >= 20 years of alcohol cessation appear to be similar to the risk among never drinkers. The interaction between genetic polymorphisms related to alcohol metabolism and alcohol drinking on the risk of HNC has been noted, and the prevalence of these genetic polymorphisms in each population should be of concern. Finally, the association between alcohol drinking and the survival of individuals with HNC remains unclear, and mortality due to competing causes should be considered in future research to evaluate this association.
  • Biomarker immunoprofile in salivary duct carcinomas: clinicopathological and prognostic implications with evaluation of the revised classification, Soichiro Takase, Satoshi Kano, Yuichiro Tada, Daisuke Kawakita, Tomotaka Shimura, Hideaki Hirai, Kiyoaki Tsukahara, Akira Shimizu, Yorihisa Imanishi, Hiroyuki Ozawa, Kenji Okami, Yuichiro Sato, Yukiko Sato, Chihiro Fushimi, Takuro Okada, Hiroki Sato, Kuninori Otsuka, Yoshihiro Watanabe, Akihiro Sakai, Koji Ebisumoto, Takafumi Togashi, Yushi Ueki, Hisayuki Ota, Toyoyuki Hanazawa, Hideaki Chazono, Robert Yoshiyuki Osamura, Toshitaka Nagao, ONCOTARGET, 8, (35) 59023 - 59035,   2017年08月, 査読有り, Salivary duct carcinoma (SDC) is an uncommon, aggressive malignant neoplasm histologically resembling high-grade mammary ductal carcinoma. SDC can arise de novo or ex pleomorphic adenoma. To clarify the correlation of biomarker immunoprofile with clinicopathological findings and clinical outcome of SDC, we conducted immunohistochemistry for EGFR, HER2, HER3, AR, CK5/6, p53, and Ki-67, along with HER2 fluorescence in situ hybridization in 151 SDCs. SDCs ex pleomorphic adenoma more commonly overexpressed EGFR, HER2, HER3, and Ki-67 than de novo SDCs (P = 0.015, < 0.001, 0.045, and 0.02, respectively). In multivariate analysis, AR-and CK5/6+ were associated with shorter progression-free survival (P = 0.027 and 0.004, respectively). Moreover, patients with p53-extreme negative/positive demonstrated poorer overall survival (P = 0.007). On assessing the revised classification by the combination of biomarker expression, the percentages of each subtype were as follows: 'apocrine A' (AR+/HER2-/Ki-67-low) (24%), 'apocrine B' (AR+/HER2-/Ki-67-high) (18%), 'apocrine HER2' (AR+/HER2+) (35%), 'HER2-enriched' (AR-/HER2+) (12%), and 'double negative' (AR-/HER2-) (11%). 'Double negative' was further subclassified into 'basal-like' (EGFR and/or CK5/6+) (7%) and 'unclassified' (3%). Consequently,patients with 'apocrine A' showed a better progression-free survival than those with any other subtypes. Our revised immunoprofiling classification was valuable for predicting the survival and might be useful in personalized therapy for patients with SDC.
  • Striated duct adenoma presenting with intra-tumoral hematoma and papillary thyroid carcinoma-like histology, Yohei Ito, Kana Fujii, Takayuki Murase, Kosuke Saida, Yoshihide Okumura, Hisashi Takino, Ayako Masaki, Shintaro Beppu, Daisuke Kawakita, Kei Ijichi, Hiroshi Inagaki, PATHOLOGY INTERNATIONAL, 67, (6) 316 - 321,   2017年06月, 査読有り, Striated duct adenoma of the salivary gland is a rare benign tumor characterized by unilayered duct epithelium and striations of the tumor cell membranes. To the best of our knowledge, only six cases have been reported in the literature. Here we report an additional case, which was complicated by an intra-tumoral hematoma on clinical presentation and by papillary thyroid carcinoma-like histology on intra-operative frozen section diagnosis. An asymptomatic 78-year-old male presented with a two-year-history of a painless tumor of the left parotid. An intra-tumoral hematoma, which is unusual for a salivary gland tumor, was suspected from results of pre-operative radiology. The patient then underwent a left parotidectomy. The intra-operative frozen section diagnosis indicated a benign tumor, although ectopic papillary thyroid carcinoma was raised as a differential diagnosis since the eosinophilic tumor cells occasionally possessed nuclear grooves and nuclear pseudo-inclusions. By precise histopathological examination using paraffin sections, the tumor was finally diagnosed as striated duct adenoma. This type of tumor has unique features of hypervascular stroma and papillary thyroid carcinoma-like nuclei. In our case, the former feature was associated with the intra-tumoral hematoma and the latter feature, with difficulty in frozen section tumor diagnosis.
  • Global trends in nasopharyngeal cancer mortality since 1970 and predictions for 2020: Focus on low-risk areas, Greta Carioli, Eva Negri, Daisuke Kawakita, Werner Garavello, Carlo La Vecchia, Matteo Malvezzi, INTERNATIONAL JOURNAL OF CANCER, 140, (10) 2256 - 2264,   2017年05月, 査読有り, Nasopharyngeal cancer (NPC) mortality shows great disparity between endemic high risk areas, where non-keratinizing carcinoma (NKC) histology is prevalent, and non-endemic low risk regions, where the keratinizing squamous cell carcinoma (KSCC) type is more frequent. We used the World Health Organization database to calculate NPC mortality trends from 1970 to 2014 in several countries worldwide. For the European Union (EU), the United States (US) and Japan, we also predicted trends to 2020. In 2012, the highest age-standardized (world standard) rates were in Hong Kong (4.51/100,000 men and 1.15/100,000 women), followed by selected Eastern European countries. The lowest rates were in Northern Europe and Latin America. EU rates were 0.27/100,000 men and 0.09/100,000 women, US rates were 0.20/100,000 men and 0.08/100,000 women and Japanese rates were 0.16/100,000 men and 0.04/100,000 women. NPC mortality trends were favourable for several countries. The decline was -15% in men and -5% in women between 2002 and 2012 in the EU, -12% in men and -9% in women in the US and about -30% in both sexes in Hong Kong and Japan. The favourable patterns in Europe and the United States are predicted to continue. Changes in salted fish and preserved food consumption account for the fall in NKC. Smoking and alcohol prevalence disparities between sexes and geographic areas may explain the different rates and trends observed for KSCC and partially for NKC. Dietary patterns, as well as improvement in management of the disease, may partly account for the observed trends, too. What's new? Nasopharyngeal cancer (NPC) shows major variations between high and low-risk areas. Over the last decade, lifestyle and dietary habits have changed worldwide, particularly in high-risk populations, and NPC management and treatment has improved. Here, the authors used the World Health Organization database to calculate NPC mortality trends from 1970 to 2014 in several countries worldwide. Declines in mortality were observed in most areas of the world for the major histological types, following patterns that are predicted to continue in the near future. Decreased salted fish and preserved food consumption and tobacco smoking may partly or largely explain these trends.
  • Heterogeneous impact of alcohol consumption according to treatment method on survival in head and neck cancer: A prospective study, Michi Sawabe, Hidemi Ito, Isao Oze, Satoyo Hosono, Daisuke Kawakita, Hideo Tanaka, Yasuhisa Hasegawa, Shingo Murakami, Keitaro Matsuo, CANCER SCIENCE, 108, (1) 91 - 100,   2017年01月, 査読有り, Alcohol consumption is an established risk factor, and also a potential prognostic factor, for squamous cell carcinoma of the head and neck (HNSCC). However, little is known about whether the prognostic impact of alcohol consumption differs by treatment method. We evaluated the association between alcohol drinking and survival by treatment method to the primary site in 427 patients with HNSCC treated between 2005 and 2013 at Aichi Cancer Center Central Hospital (Nagoya, Japan). The impact of alcohol on prognosis was measured by multivariable Cox regression analysis adjusted for established prognostic factors. Among all HNSCC patients, the overall survival rate was significantly poorer with increased levels of alcohol consumption in multivariable analysis (trend P = 0.038). Stratification by treatment method and primary site revealed that the impact of drinking was heterogeneous. Among laryngopharyngeal cancer (laryngeal, oropharyngeal, and hypopharyngeal cancer) patients receiving radiotherapy (n = 141), a significant dose-response relationship was observed (trend P = 0.034). In contrast, among laryngopharyngeal cancer patients treated with surgery (n = 80), no obvious impact of alcohol was observed. This heterogeneity in the impact of alcohol between surgery and radiotherapy was significant (for interaction, P = 0.048). Furthermore, among patients with oral cavity cancer treated by surgery, a significant impact of drinking on survival was seen with tongue cancer, but not with non-tongue oral cancer. We observed a significant inverse association between alcohol drinking and prognosis among HNSCC patients, and its impact was heterogeneous by treatment method and primary site.
  • Impact of hematological inflammatory markers on clinical outcome in patients with salivary duct carcinoma: a multi-institutional study in Japan, Daisuke Kawakita, Yuichiro Tada, Yorihisa Imanishi, Shintaro Beppu, Kiyoaki Tsukahara, Satoshi Kano, Hiroyuki Ozawa, Kenji Okami, Yuichiro Sato, Akira Shimizu, Yukiko Sato, Chihiro Fushimi, Soichiro Takase, Takuro Okada, Hiroki Sato, Kuninori Otsuka, Yoshihiro Watanabe, Akihiro Sakai, Koji Ebisumoto, Takafumi Togashi, Yushi Ueki, Hisayuki Ota, Tomotaka Shimura, Toyoyuki Hanazawa, Shingo Murakami, Toshitaka Nagao, ONCOTARGET, 8, (1) 1083 - 1091,   2017年01月, 査読有り, The prognostic role of modified Glasgow Prognostic Score (mGPS), neutrophil-to- lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with salivary duct carcinoma (SDC) remains unclear. We conducted a multi-institutional retrospective cohort study of 140 SDC patients. The survival impact of these hematological markers was evaluated using multivariate proportional hazard models. High mGPS (>= 1) was significantly associated with worse survival (3-year overall survival (OS): 16.7% vs 66.1%, p-value=0.003; 3-year progression-free survival (PFS): 0.0% vs 27.9%, p-value<0.001). Additionally, high C-reactive protein (CRP) (>= 0.39 mg/dl) was significantly associated with worse survival (3-year OS: 32.1% vs 68.2%, p-value= 0.001; 3-year PFS: 7.1% vs 31.1%, p-value<0.001). These associations were consistent with multivariate analysis adjusted for established prognostic factors. Although we also found significant association of high NLR (>= 2.5) with OS (HR 1.80; 95% confidence interval, 1.05-3.08) in multivariate analysis, this association were inconsistent with the results of PFS. In addition, we found no significant associations of PLR with survival. In conclusion, we found that mGPS, CRP and NLR were identified as prognostic factors associated with survival in SDC patients.
  • Dermopathy associated with cetuximab and panitumumab: investigation of the usefulness of moisturizers in its management., Watanabe S, Nakamura M, Takahashi H, Hara M, Ijichi K, Kawakita D, Morita A, Clinical, cosmetic and investigational dermatology, 10, 353 - 361,   2017年, 査読有り
  • Clinical Outcomes and Prognostic Factors for Salivary Duct Carcinoma: A Multi-Institutional Analysis of 141 Patients, Kuninori Otsuka, Yorihisa Imanishi, Yuichiro Tada, Daisuke Kawakita, Satoshi Kano, Kiyoaki Tsukahara, Akira Shimizu, Hiroyuki Ozawa, Kenji Okami, Akihiro Sakai, Yuichiro Sato, Yushi Ueki, Yukiko Sato, Toyoyuki Hanazawa, Hideaki Chazono, Kaoru Ogawa, Toshitaka Nagao, ANNALS OF SURGICAL ONCOLOGY, 23, (6) 2038 - 2045,   2016年06月, 査読有り, Among salivary gland malignancies, the prognosis of salivary duct carcinoma (SDC) is assumed to be the poorest. However, because of its low incidence, reliable survival estimates and prognostic factors based on a large number of patients remain to be elucidated, thereby making it impossible to standardize the optimal treatment for SDC. We performed this multi-institutional, retrospective analysis by collecting the clinical information of 141 patients with SDC without distant metastasis who underwent curative surgery as the initial treatment to elucidate overall survival (OS) and disease-free survival (DFS) along with their prognostic factors. The 3-year OS and DFS rates were 70.5 and 38.2 %, respectively. Multivariate analysis revealed that age a parts per thousand yen65 years (p < 0.001) and N1 and N2 (p = 0.047 and < 0.001, respectively) were independent prognostic factors for OS, whereas the primary site of the minor salivary and sublingual gland (p < 0.001) and N2 (p < 0.001) were those for DFS. The most common treatment failure was distant metastasis (55 patients, 39.0 %). For early parotid SDC, neither total parotidectomy in the patients with early T stage nor nerve resection in the patients without facial nerve palsy showed survival benefits. Advanced N stage independently affects both OS and DFS. Partial parotidectomy with facial nerve preservation could be a less invasive standard surgical procedure for parotid gland SDC in the early T stage without facial nerve palsy. Effective systemic therapy is imperative to improve DFS of SDC.
  • Prognostic Value of Drinking Status and Aldehyde Dehydrogenase 2 Polymorphism in Patients With Head and Neck Squamous Cell Carcinoma, Daisuke Kawakita, Isao Oze, Satoyo Hosono, Hidemi Ito, Miki Watanabe, Yasushi Yatabe, Yasuhisa Hasegawa, Shingo Murakami, Hideo Tanaka, Keitaro Matsuo, JOURNAL OF EPIDEMIOLOGY, 26, (6) 292 - 299,   2016年06月, 査読有り, Background: The association between alcohol drinking, aldehyde dehydrogenase 2 (ALDH2) polymorphism, and survival in patients with head and neck squamous cell carcinoma (HNSCC) remains unclear. Methods: We performed a retrospective cohort study of 267 HNSCC patients at Aichi Cancer Center. Of these, 65 patients (24%) were non-drinkers, 104 (39%) were light drinkers (ethanol < 46 g or < 5 days/week), 46 (17%) were moderate drinkers (ethanol intake 46-68 g/day and >= 5 days/week), and 52 (20%) were heavy drinkers (ethanol intake >= 69 g and >= 5 days/week). The prognostic value of pre-treatment drinking status and ALDH2 polymorphism was investigated using multivariate proportional hazard models. Results: Drinking status was associated with disease-free survival (DFS) in HNSCC patients, with marginal statistical significance (5-year DFS: 67.9% [95% confidence interval {CI}, 53.8-78.4%] for non-drinkers, 57.6% [95% CI, 47.4-66.6%] for light drinkers, 46.1% [95% CI, 30.8-60.1%] for moderate drinkers, and 43.5% [95% CI, 29.3-56.9%] for heavy drinkers; P = 0.088). However, this association lost significance when multivariate analyses were adjusted for established prognostic factors. ALDH2 genotype was not significantly associated with DFS in HNSCC patients (5-year DFS: 85.7% [95% CI, 53.9-96.2%] for Lys/Lys, 56.2% [95% CI, 47.4-64.1%] for Glu/Lys, and 50.5% [95% CI, 40.3-59.7%] for Glu/Glu; P = 0.154). After stratification by ALDH2 genotype, we observed a significant positive dose-response relationship between drinking status and DFS in HNSCC patients with ALDH2 Glu/Glu (P-trend = 0.029). Conclusions: In this study, we identified a significant positive dose-response relationship between pre-treatment drinking status and DFS in HNSCC patients with ALDH2 Glu/Glu. To confirm this association, further study is warranted.
  • Functional Nerve Preservation in Extracranial Head and Neck Schwannoma Surgery, Kei Ijichi, Daisuke Kawakita, Shinichiro Maseki, Shintaro Beppu, Gaku Takano, Shingo Murakami, JAMA OTOLARYNGOLOGY-HEAD & NECK SURGERY, 142, (5) 479 - 483,   2016年05月, 査読有り, IMPORTANCE A schwannoma is an uncommon, benign neurogenic tumor of Schwann cells. Tumor enucleation is the recommended surgical method to preserve function of the original nerve, although enucleation does not guarantee completely intact nerve function after the operation. OBJECTIVE To establish a strategy for functional preservation in extracranial head and neck schwannoma treatment by using an electromyographic (EMG) system during tumor resection. DESIGN, SETTING, AND PARTICIPANTS A retrospective cohort study was conducted of 15 patients who underwent surgery for removal of schwannoma tumors between April 1, 2006, and March 31, 2015, at an academic tertiary referral center. Data analysis was conducted from April 3, 2006, to September 15, 2015. Neurogenic tumors were diagnosed according to preoperative findings, and during surgery tumors were exposed and given EMG-controlled electrical stimulation to analyze their origins. In motor nerve cases, the electrical activity of the muscle was measured and recorded by EMG. The tumor was then enucleated by incision along tumor fibers mapped using EMG stimulation. If a nerve bundle was visible, we incised along there and enucleated the tumor. INTERVENTIONS A strategy using electrical stimulation to improve preservation of nerve function in extracranial head and neck schwannoma operations. MAIN OUTCOMES AND MEASURES Frequency and duration of postoperative neurologic complications associated with functional preservation surgery with tumor enucleation was evaluated using EMG monitoring according to tumor origin. RESULTS Of the 15 patients with extracranial schwannoma, 9 (60%) were women (mean [SD] age, 36.3 [15.3] years). All 15 patients underwent surgery using a transcervical approach. The most common nerves of origin were the vagus nerve and the sympathetic chain. In sensory or sympathetic nerve cases, the EMG response was absent. Two of 5 patients with vagus schwannoma had postoperative temporary vocal nerve palsy. These symptoms showed improvement after 1 year. There was no tumor recurrence during the follow-up period in any patient. CONCLUSIONS AND RELEVANCE The strategy used here demonstrated a method of diagnosis and nerve preservation surgery for extracranial schwannomas. Nerve functionality was preserved in all vagus schwannoma cases. However, preservation of nerve function in sympathetic nerve schwannoma cases remains problematic and needs further investigation.
  • Androgen Receptor-Positive Mucoepidermoid Carcinoma: Case Report and Literature Review, Kenichiro Ishibashi, Yohei Ito, Kana Fujii, Ayako Masaki, Shintaro Beppu, Daisuke Kawakita, Kei Ijichi, Kazuo Shimozato, Hiroshi Inagaki, INTERNATIONAL JOURNAL OF SURGICAL PATHOLOGY, 23, (3) 243 - 247,   2015年05月, 査読有り, Androgen receptor (AR) is usually expressed in salivary duct carcinoma (SDC), but only infrequently in other carcinoma types including mucoepidermoid carcinoma (MEC). The clinicopathological characteristics of AR-positive MEC remain to be clarified. Here we report a case of AR-positive MEC. A 76-year-old man presented with a growing painless tumor of the right parotid. The resected tumor was a high-grade tumor with necroses. Since the tumor was positive for AR, GCDFP-15, and HER2, SDC was first suspected, but it was also positive for CK5/6 and P63, and negative for S-100 protein and -smooth muscle actin. In addition, scattered mucous secreting tumor cells were found in the tumor nests, and they were positive for Alcian blue. A diagnosis of AR-positive MEC was finally made. The patient died of the tumor 5 years after the surgery. The present case may expand the histopathological spectrum of high-grade MEC.
  • Mammary analogue secretory carcinoma of salivary glands: a clinicopathologic and molecular study including 2 cases harboring ETV6-X fusion., Ito Y, Ishibashi K, Masaki A, Fujii K, Fujiyoshi Y, Hattori H, Kawakita D, Matsumoto M, Miyabe S, Shimozato K, Nagao T, Inagaki H, The American journal of surgical pathology, 39, (5) 602 - 610,   2015年05月, 査読有り
  • Clinicopathological significance of androgen receptor, HER2, Ki-67 and EGFR expressions in salivary duct carcinoma., Tatsuo Masubuchi, Yuichiro Tada, Shin-ichiro Maruya, Yoshiyuki Osamura, Shin-etsu Kamata, Kouki Miura, Chihiro Fushimi, Hideaki Takahashi, Daisuke Kawakita, Seiji Kishimoto, Toshitaka Nagao, International journal of clinical oncology, 20, (1) 35 - 44,   2015年02月, 査読有り, BACKGROUND: Salivary duct carcinoma (SDC) is a highly aggressive disease which often metastasizes to distant sites, and there is no established standard therapy for this systemic disease. Given that SDC is biologically similar to breast and prostate cancer, anti-androgenic receptor (AR) and anti-human epidermal growth factor receptor 2 (HER2) therapies have the potential to exert effects, not only on patients with breast and prostate cancer but also on those with SDC. METHODS: The expression levels of HER2, epidermal growth factor receptor (EGFR), Ki-67, and AR were assessed in 32 patients with SDC, and their correlations with overall survival (OS) and disease-free survival (DFS) were analyzed retrospectively. SDC was classified into five subtypes using a method similar to that used for breast cancer. RESULTS: Anti-AR, HER2, and EGFR were positive in 23 (71.9 %), 14 (43.8 %), and 26 (81.3 %) cases, respectively. One or more of these 3 factors were positive in 30 (93.8 %) cases. The Ki-67 labeling index was greater than 15 % in all cases. While molecular status did not correlate with OS, EGFR and AR positivity were significantly associated with DFS in univariate analysis. Multivariate analysis revealed that EGFR was the only independent predictor of DFS. CONCLUSIONS: The statuses of some molecules are useful to predict DFS in patients with SDC. Ki-67 overexpression suggests that cytotoxic agents are effective for SDC. Since the majority of SDCs express AR, HER2, and/or EGFR, assessing and targeting these molecules are promising strategies to improve the prognosis of unresectable, metastatic or recurrent SDC, and a classification system according to the molecular expression status may be useful to select appropriate therapy.
  • Selection of Therapeutic Treatment with Alternating Chemoradiotherapy for Larynx Preservation in Laryngeal Carcinoma Patients, Kei Ijichi, Nobuhiro Hanai, Daisuke Kawakita, Taijiro Ozawa, Hidenori Suzuki, Hitoshi Hirakawa, Takeshi Kodaira, Shingo Murakami, Yasuhisa Hasegawa, JAPANESE JOURNAL OF CLINICAL ONCOLOGY, 44, (11) 1063 - 1069,   2014年11月, 査読有り, Objective: We analyzed the efficacy of treatments that included alternating chemoradiotherapy in laryngeal cancer patients. Methods: Alternating chemoradiotherapy consisted of chemotherapy with 5-fluorouracil (600 mg/m(2)/day) on Days 1-6 and cisplatin (80 mg/m(2)) on Day 7 followed by radiotherapy with 30 Gy. Additional chemoradiotherapy was administered to responders, and laryngectomy was performed in non-responders. The contribution of alternating chemoradiotherapy to laryngeal preservation was compared with that of radiotherapy in patients with T2 disease and with that of laryngectomy in patients with T3/T4 disease. Results: Analysis of 87 patients was conducted. The 5-year overall survival rate of T2 patients (n = 46) was 88.9% for definitive radiotherapy and 82.5% for alternating chemoradiotherapy. The laryngectomy-free rate in T2 patients was 90.5% for definitive radiotherapy and 80.0% for alternating chemoradiotherapy. In patients with T3/T4 disease (n = 41), the 5-year overall survival rate was 86.9% for alternating chemoradiotherapy and 67.4% for laryngectomy. The laryngectomy-free rate in T3/T4 patients was 91.7% for alternating chemoradiotherapy and 0.0% for laryngectomy. Conclusions: In advanced carcinoma of the larynx, alternating chemoradiotherapy treatment might enable larynx preservation.
  • Coffee and green tea consumption is associated with upper aerodigestive tract cancer in Japan, Isao Oze, Keitaro Matsuo, Daisuke Kawakita, Satoyo Hosono, Hidemi Ito, Miki Watanabe, Shunzo Hatooka, Yasuhisa Hasegawa, Masayuki Shinoda, Kazuo Tajima, Hideo Tanaka, INTERNATIONAL JOURNAL OF CANCER, 135, (2) 391 - 400,   2014年07月, 査読有り, The impact of coffee and green tea consumption on upper aerodigestive tract (UADT) cancer risk has not been established. Evaluation of the possible anticarcinogenic properties of their ingredients is confounded by the potential increase in risk owing to the high temperatures at which these beverages are generally consumed. We conducted a case-control study to evaluate the association between coffee and tea consumption and the risk of UADT cancer. The study enrolled 961 patients with UADT cancer and 2,883 noncancer outpatients who visited Aichi Cancer Center between 2001 and 2005. Information on coffee and green tea consumption and other lifestyle factors was collected via a self-administered questionnaire. Consumption of three or more cups of coffee per day had a significant inverse association with UADT cancer [odds ratio (OR) 0.73, 95% confidence interval (CI) 0.55-0.96]. In contrast, consumption of three or more cups of green tea per day had a significant positive association with UADT cancer (OR 1.39, 95% CI 1.13-1.70). These associations were evident for head and neck cancer but not for esophageal cancer. The association of coffee consumption with head and neck cancer was observed only among never smokers and alcohol drinkers. Similarly, the association of green tea consumption was observed among never smokers and never alcohol drinkers. No change in these associations was seen on stratification by each confounding factors. These findings suggest that consumption of coffee might be associated with a decreased risk of UADT cancer, whereas that of green tea might be associated with an increased risk. What's new? Coffee and green tea are both thought to protect against cancer; both contain anti-carcinogenic compounds, including caffeine and antioxidants. However, both drinks are generally consumed hot, and damage caused by hot drinks may contribute to esophageal cancer. In this study, the authors investigated the link between coffee and tea consumption and aerodigestive tract cancers. They found that people who drank 3 or more cups of coffee per day were less likely to develop upper aerodigestive tract cancers, while those who drank green tea had a higher risk.
  • Neck dissection after chemoradiotherapy for oropharyngeal and hypopharyngeal cancer: the correlation between cervical lymph node metastasis and prognosis, Nobuhiro Hanai, Daisuke Kawakita, Taijiro Ozawa, Hitoshi Hirakawa, Takeshi Kodaira, Yasuhisa Hasegawa, INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY, 19, (1) 30 - 37,   2014年02月, 査読有り, Background Recently, the role of chemoradiotherapy (CRT) for preserving organs in the treatment of head and neck cancer has been increasing. However, the indication for post-CRT neck dissection (ND) and its surgical extent is still controversial. The purpose of this study was to discuss the indications for post-CRT ND and the proper extent of the surgical procedure. Methods We performed a retrospective analysis on N2-3 oropharyngeal and hypopharyngeal squamous cell carcinoma (OHSCC) patients treated with CRT in our institute from 1995 to 2008, and determined the prognostic impact of post-CRT ND and the distribution of cervical lymph node (CLN) metastasis based on the pathological results of ND. Results The patients without pathological CLN metastases had good prognoses, whereas patients with pathological CLN metastases exhibited a significantly high recurrence rate (P = 0.033). Based on the pathological results of ND, performing selective ND at levels II-IV can contain 88 and 85 % of CLN metastasis of the oropharynx and hypopharynx, respectively. In all cases, when pathological CLN metastases were found at level V in ND following CRT, distant metastases developed. Conclusions The presence of pathological CLN metastasis affects prognosis, but also a diffuse distribution of CLN metastasis worsens prognosis; that is, the presence of CLN metastasis at level V after CRT appears to be an indicator of distant metastasis. Post-CRT ND may not make sense as a salvage intervention for improving the prognosis in such situations. We concluded that the proper extent of post-CRT ND of OHSCC is selective ND including levels II-IV.
  • The contribution of neck dissection for residual neck disease after chemoradiotherapy in advanced oropharyngeal and hypopharyngeal squamous cell carcinoma patients, Masahiro Suzuki, Daisuke Kawakita, Nobuhiro Hanai, Hitoshi Hirakawa, Taijiro Ozawa, Akihiro Terada, Koichi Omori, Yasuhisa Hasegawa, INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY, 18, (4) 578 - 584,   2013年08月, 査読有り, Planned neck dissection after chemoradiotherapy (CRT) has remained controversial in advanced oro- and hypopharyngeal squamous cell carcinoma (OHSCC) patients. We evaluated the survival contribution of neck dissection (ND) in OHSCC patients with residual nodal disease following CRT. We retrospectively evaluated 84 OHSCC patients with N2-3 disease treated at Aichi Cancer Center Hospital between 1995 and 2006. ND after CRT was performed for residual neck disease in 36 patients, but not in 48 patients to achieve a complete response. These two groups were analyzed in terms of both overall survival (OS) and regional control (RC), and surgical complications were evaluated. The 5-year OS was 76.7 % [95 % confidence interval (CI) 58.8-87.6] for the ND group and 73.9 % (58.6-84.3) for the non-ND group (P = 0.883). The 5-year RC was 91.6 % (76.1-97.2) for the ND group and 81.1 % (65.4-90.2) for the non-ND group (P = 0.252). Stratified by primary tumor site, the 5-year RC was 96.3 % (76.5-99.5) for the ND group, and 78.6 % (58.0-89.9) for the non-ND group (P = 0.072) in oropharyngeal squamous cell carcinoma patients, and 77.8 % (36.5-93.9) for the ND group and 85.9 % (54.0-96.3) for the non-ND group (P = 0.541) in hypopharyngeal squamous cell carcinoma patients. In addition, the complications after ND were tolerable. We demonstrated that ND was feasible, safe, and correlated with clinical outcomes in OHSCC patients with residual nodal disease after CRT.
  • Impact of positron emission tomography with the use of fluorodeoxyglucose on response to induction chemotherapy in patients with oropharyngeal and hypopharyngeal squamous cell carcinoma, Daisuke Kawakita, Takashi Masui, Nobuhiro Hanai, Taijiro Ozawa, Hitoshi Hirakawa, Akihiro Terada, Masami Nishio, Hiroshi Hosoi, Yasuhisa Hasegawa, ACTA OTO-LARYNGOLOGICA, 133, (5) 523 - 530,   2013年05月, 査読有り, Conclusion: Maximum standardized uptake values (SUVmax) have prognostic value for induction chemotherapy (ICT) response and survival in oropharyngeal and hypopharyngeal squamous cell carcinoma (OHSCC) patients. Pretreatment positron emission tomography with the use of fluorodeoxyglucose (F-18-FDG PET) may be an aid in deciding the treatment strategy in OHSCC patients. Objectives: We investigated the association between pretreatment F-18-FDG PET and response to ICT and survival in OHSCC patients. Methods: We conducted a retrospective cohort study of 58 OHSCC patients treated at Aichi Cancer Center Hospital. The predictive impact of SUVmax of the primary tumor site was evaluated using statistical multivariate proportional hazard models. Results: Thirty-one cases (53%) were located in the oropharynx and 27 (47%) in the hypopharynx. Median SUVmax was 11.6 (range 3.2-23.5), and was significantly higher in the 8 patients with less than stable disease than in the 50 with more than partial response (median SUVmax, 17.3 vs 11.1; p = 0.002). In multivariate analysis, hazard ratios for the medium and high SUVmax groups relative to the low group were 3.07 (95% confidence interval, 0.62-15.29; p = 0.170) and 4.71 (0.97-22.89; p = 0.055), respectively, and the dose-response relationship was statistically significant (p(trend) = 0.047). A similar tendency was observed on subclassification by oropharynx and hypopharynx.
  • Intraoperative Molecular Assessment for Lymph Node Metastasis in Head and Neck Squamous Cell Carcinoma Using One-Step Nucleic Acid Amplification (OSNA) Assay, Takashi Matsuzuka, Katsumasa Takahashi, Daisuke Kawakita, Naoyuki Kohno, Hiroshi Nagafuji, Koichi Yamauchi, Masahiro Suzuki, Tomohiro Miura, Nobuhiko Furuya, Yasushi Yatabe, Keitaro Matsuo, Koichi Omori, Yasuhisa Hasegawa, ANNALS OF SURGICAL ONCOLOGY, 19, (12) 3865 - 3870,   2012年11月, 査読有り, Conventional intraoperative pathological examination for Sentinel node navigation surgery (SNNS) has been controversial. We evaluated the efficacy of one-step nucleic acid amplification (OSNA) assay for intraoperative diagnosis of cervical lymph node (CLN) metastasis compared with histopathological examination in patients with head and neck squamous cell carcinoma (HNSCC). A total of 175 CLNs dissected from 56 patients with HNSCC who underwent surgery at Aichi Cancer Center, Kyorin University, Gunma University or Fukushima Medical University, between April 2008 and December 2011 were enrolled. CLN samples were sectioned into four equal pieces, with two of each used for OSNA assay and other histopathological examinations. The diagnostic value of OSNA assay in HNSCC patients in predicting the results of histopathological diagnosis was evaluated using the area under the receiver operating characteristic (AUROC) curve. OSNA assay showed acceptable efficacy in the detection of pathological CLN metastasis (AUROC 0.918, 95 % confidence interval [CI] 0.852-0.984). Regarding the CK19mRNA cutoff value, the optimum cutoff point in HNSCC patients was 131 copies/mu l (sensitivity: 82.4, 95 % CI 65.5-93.2; specificity: 99.3, 95 % CI 96.1-100.0; positive likelihood ratio 116.1; negative likelihood ratio 0.2]. We demonstrated that OSNA assay is useful in intraoperative diagnosis for CLN metastasis in patients with HNSCC. OSNA assay could be applied for SNNS in HNSCC patients.
  • Time to First Cigarette and Upper Aerodigestive Tract Cancer Risk in Japan, Keitaro Matsuo, Silvano Gallus, Eva Negri, Daisuke Kawakita, Isao Oze, Satoyo Hosono, Hidemi Ito, Shunzo Hatooka, Yasuhisa Hasegawa, Masayuki Shinoda, Kazuo Tajima, Carlo La Vecchia, Hideo Tanaka, CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, 21, (11) 1986 - 1992,   2012年11月, 査読有り, Background: Cigarette smoking is the major cause for upper aerodigestive tract (UADT) cancers. The time to first cigarette (TTFC) of the day is a distinct indicator of nicotine dependence, but scanty information is available on its possible relation with UADT cancers (oral, oropharyngeal, hypopharyngeal, laryngeal, nasopharyngeal, and esophageal cancers). Methods: This case control study includes a total of 1,009 incident UADT cancer cases and 3,027 age- and sex-matched noncancer controls admitted to the Aichi Cancer Center (Nagoya, Japan) between 2001 and 2005. We estimated OR and 95% confidence intervals (Cl) for TTFC using logistic regression models after adjustment for several potential confounders. Results: TTFC was inversely related to the risk of UADT cancer, and this association was consistent across subtypes of head and neck cancer and esophageal cancer. For all UADT cancers considered among ever smokers and after accurate allowance for smoking quantity and duration, besides other relevant covariates, compared with TTFC more than 60 minutes, the adjusted ORs were 1.40(95% Cl: 0.93-2.11) for 31 to 60 minutes, 1.76(95% CI: 1.20-2.58) for 6 to 30 minutes, and 2.43(95% CI: 1.64-3.61) for within 5 minutes. No significant heterogeneity was found in strata of sex, age, alcohol consumption, fruit and vegetable intake, and occupation for overall and site-specific analysis. Conclusion: Nicotine dependence, as indicated by the TTFC, is associated with increased risk of UADT cancers and is therefore an independent marker of exposure to smoking. Impact: Our result indicates more detailed risk evaluation of UADT cancers that is enabled by the TTFC. Cancer Epidemiol Biomarkers Prev; 21(11); 1986-92. (C)2012 AACR.
  • Inverse association between yoghurt intake and upper aerodigestive tract cancer risk in a Japanese population, Daisuke Kawakita, Fumihito Sato, Satoyo Hosono, Hidemi Ito, Isao Oze, Miki Watanabe, Nobuhiro Hanai, Shunzo Hatooka, Yasuhisa Hasegawa, Masayuki Shinoda, Kazuo Tajima, Shingo Murakami, Hideo Tanaka, Keitaro Matsuo, EUROPEAN JOURNAL OF CANCER PREVENTION, 21, (5) 453 - 459,   2012年09月, 査読有り, Although the combination of tobacco smoking and alcohol drinking account for approximately 80% of upper aerodigestive tract (UADT) cancer risk, the role of dietary factors, including dairy products, in the risk of these cancers remains controversial. We aimed to evaluate the association between dairy product intake and UADT cancer risk in a Japanese population. We conducted a case-control study in 959 patients with UADT cancer and 2877 sex-and age-matched noncancer control subjects who visited the Aichi Cancer Center in Nagoya, Japan. Data on lifestyle factors, including diet, were obtained by self-administered questionnaire. Associations were assessed by multivariate logistic regression models that considered potential confounders. We found a significant inverse association between yoghurt intake and UADT cancer risk with multivariate-adjusted odds ratios and 95% confidence intervals for < 1 time/week, >= 1 time/week and < 1 time/day, and >= 1 time/day consumption of yoghurt of 0.70 (95% confidence interval: 0.54-0.91), 0.67 (0.54-0.84), and 0.73 (0.55-0.95) relative to nonconsumers (P-trend = 0.005). When stratified by primary tumor site, this association was significant among patients with hypopharyngeal, laryngeal, and esophageal cancer. However, we saw no significant association between milk or butter intake and UADT cancer risk. In this study, we found that a high intake of yoghurt may lower the risk of developing UADT cancer in a Japanese population. Further investigation of this association is warranted. European Journal of Cancer Prevention 21:453-459 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
  • Impact of smoking status on clinical outcome in oral cavity cancer patients, Daisuke Kawakita, Satoyo Hosono, Hidemi Ito, Isao Oze, Miki Watanabe, Nobuhiro Hanai, Yasuhisa Hasegawa, Kazuo Tajima, Shingo Murakami, Hideo Tanaka, Keitaro Matsuo, ORAL ONCOLOGY, 48, (2) 186 - 191,   2012年02月, 査読有り, The association between smoking status and survival in oral cavity squamous cell carcinoma (OSCC) patients remains unclear. Therefore, we evaluated the association between smoking status before treatment and clinical outcome in OSCC patients. We conducted a retrospective cohort study of 222 OSCC patients who were treated at Aichi Cancer Center in Japan. Of these, 82 patients (36.9%) were non-smokers, 65 (29.3%) were light smokers (pack-years smoking (PY) < 30), 54 (24.3%) were moderate smokers (30 <= PY < 60), and 21 (9.5%) were heavy smokers (60 <= PY). The survival impact of pre-treatment smoking status was evaluated using multivariate proportional hazard models. Five-year overall survival for non-, light, moderate, and heavy smokers was 72.9% (95% confidence interval CI): (61.4-81.5), 85.5% (74.0-92.2), 59.9% (44.3-72.4) and 69.0% (42.8-85.0). Adjusted hazard ratios (HRs) for moderate and heavy smokers in comparison with light smokers were 2.44 (1.07-5.57, P = 0.034) and 2.66 (0.97-7.33, P = 0.058) and the dose-response relationship among smokers was statistically significance (P-trend = 0.024). In addition, adjusted HR for non-smokers relative to light smokers was 2.27 (0.84-6.15, P = 0.108). We observed a suggestive heterogeneity in the impact of smoking status by treatment method (P for heterogeneity = 0.069). Effect of smoking was evident only among the chemoradiotherapy or radiotherapy group. In this study, we found the significant positive dose-response relationship among smokers on clinical outcome in OSCC patients and that non-smokers were worse prognosis than light smokers. In addition, this effect might differ by treatment method. (C) 2011 Elsevier Ltd. All rights reserved.
  • Association between dietary folate intake and clinical outcome in head and neck squamous cell carcinoma, D. Kawakita, K. Matsuo, F. Sato, I. Oze, S. Hosono, H. Ito, M. Watanabe, Y. Yatabe, N. Hanai, Y. Hasegawa, K. Tajima, S. Murakami, H. Tanaka, ANNALS OF ONCOLOGY, 23, (1) 186 - 192,   2012年01月, 査読有り, Background: The association between dietary folate intake, two polymorphisms in methylenetetrahydrofolate reductase (MTHFR) and thymidylate synthase (TYMS), and survival in head and neck squamous cell carcinoma (HNSCC) patients is not clarified. Patients and methods: We conducted a retrospective cohort study of 437 HNSCC patients treated at Aichi Cancer Center. We evaluated the survival impact of pretreatment dietary folate intake, which was estimated using a food-frequency questionnaire, and two polymorphisms, MTHFR C677T and a 6-bp insertion/deletion in the 3'-untranslated region of TYMS, using multivariate proportional hazard models. Results: Patients with high folate intake (>= 320 mu g/day; n = 144) had significantly higher survival than patients with low or medium folate intake (<320 mu g/day; n = 278; 79.1% versus 68.2%, respectively, P = 0.020). This association was consistent with multivariate analyses adjusted for established prognostic factors (hazard ratio 0.56; 95% confidence interval 0.37-0.84). MTHFR and TYMS polymorphisms did not show significant association with survival, although the TYMS 6-bp insertion allele showed potential association with a reduced risk of death. Notably, no significant interaction was observed between folate intake and the two examined polymorphisms. Conclusions: High pretreatment dietary folate intake was identified as an independent prognostic factor associated with improved clinical outcomes in HNSCC patients. Further study is warranted.
  • INVERSE ASSOCIATION BETWEEN TOOTHBRUSHING AND UPPER AERODIGESTIVE TRACT CANCER RISK IN A JAPANESE POPULATION, Fumihito Sato, Isao Oze, Daisuke Kawakita, Noriyuki Yamamoto, Hidemi Ito, Satoyo Hosono, Takeshi Suzuki, Takakazu Kawase, Hiroki Furue, Miki Watanabe, Shunzo Hatooka, Yasushi Yatabe, Yasuhisa Hasegawa, Masayuki Shinoda, Minoru Ueda, Kazuo Tajima, Hideo Tanaka, Keitaro Matsuo, HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, 33, (11) 1628 - 1637,   2011年11月, 査読有り, Background. Oral hygiene is attracting increasing attention as a potential risk factor for cancers. To investigate the association between toothbrushing frequency and upper aerodigestive tract (UADT) cancer, the authors conducted a large-scale case-control study. Methods. A total of 856 UADT cancer case participants and 2696 age-and sex-matched control subjects without cancer were included. Edentulous or participants with unknown frequency of toothbrushing or number of remaining teeth were excluded. Associations were assessed by odds ratios and 95% confidence intervals in logistic regression models with adjustment for potential confounders. Results. Compared with toothbrushing once per day, the adjusted odds ratio for brushing twice or more was 0.82 (95% confidence interval: 0.68, 0.99) whereas that for not brushing was 1.79 (0.79, 4.05). This association was observed especially in subjects who had a history of heavy smoking or drinking. Conclusions. The authors suggest that toothbrushing could have a protective effect for UADT cancer. (C) 2011 Wiley Periodicals, Inc. Head Neck 33: 1628-1637, 2011
  • Follow-up after intraoperative sentinel node biopsy of N0 neck oral cancer patients, Akihiro Terada, Yasuhisa Hasegawa, Yasushi Yatabe, Nobuhiro Hanai, Taijiro Ozawa, Hitoshi Hirakawa, Takashi Maruo, Daisuke Kawakita, Shinji Mikami, Atsushi Suzuki, Takuya Miyazaki, Tsutomu Nakashima, EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY, 268, (3) 429 - 435,   2011年03月, 査読有り, The objective of the study was to evaluate the validity of sentinel node (SN) biopsy in early oral cancer patients focusing on the accuracy of intraoperative diagnoses of SN status, recurrences in follow-up and impact on patient survival. Previously untreated N0 oral cancer patients were candidates for the study. Using a radioisotope method, an intraoperative SN biopsy was performed. Patients with a positive frozen section of SN underwent immediate neck dissection as a single-stage procedure; they were followed in our outpatient clinic. Forty-five cT1-2N0 patients with squamous cell carcinoma were analyzed. There were seven patients with positive SN, five of whom were detected by intraoperative frozen section analysis. The sensitivity, specificity and accuracy of the intraoperative frozen section analysis of SN were 71.4, 100 and 95.6%, respectively. There were 13 recurrences in the course of all patients treated. Those with positive SN showed a tendency toward recurrence. Three patients with negative SN suffered from delayed ipsilateral neck recurrence. These were considered false negatives at a rate of 7.9%. The 5-year overall survival rate of all patients was 91.1%. SN-positive patient survival was significantly poorer than that of SN-negative patients. Positive SN had a negative impact on the survival. SN biopsy was shown to be a valuable method for determining the neck status of early oral cancer patients. The concordance rate of intraoperative multislice frozen section analysis of SN and patient neck status at the time of operation was 95.6%. SN-positive patients exhibited a tendency toward cancer recurrence. There were three cases of false negatives not conforming to the SN concept and their rate was 7.9%. Positive SN had a negative impact on patient survival.

MISC

  • 【アルコールと気管食道科】 アルコールと頭頸部癌, 川北 大介, 澤部 倫, 松尾 恵太郎, 日本気管食道科学会会報, 69, (5) 282 - 289,   2018年10月, 本論文では、アルコールの頭頸部癌への影響について、既存の報告を参考にまとめを行った。まずアルコールは頭頸部癌の確立した発症因子であり、部位別では中下咽頭癌への影響が強いとされている。また短期間でのアルコールの高用量摂取が、少量・長期摂取よりも発症リスクを上げるとの報告がある。禁酒による頭頸部癌発症リスクへの影響については、20年以上の禁酒で非飲酒者と同程度まで軽減できるとするが、重要な点として喫煙との交互作用を考慮する必要がある。アルコールの頭頸部癌発症リスクを考える上では、人種ごとのアルコール・アルデヒド脱水素酵素遺伝子多型の保有率の違いについて考慮する必要がある。最後にアルコールの頭頸部癌生存への影響は、現段階では不明確であり喫煙・飲酒関連疾患による他病死の影響を考慮する必要がある。(著者抄録)
  • small round cell tumorが疑われた乳児耳下部石灰化上皮腫例, 三好 晋平, 川北 大介, 波多野 克, 村上 信五, 耳鼻咽喉科臨床, 110, (12) 823 - 826,   2017年12月, 症例は1歳1ヵ月男児で、生後7ヵ月頃に右耳下部の腫脹に母親が気付いた。その後腫脹の増大を認めた。単純CTにて右耳下腺を圧排する15mm大の皮下腫瘤影を認めた。内部は充実性で、一部に高吸収域を認め、造影CTでは腫瘤影に明らかな造影効果を認めなかった。エコーガイド下に穿刺吸引細胞診を施行し、small round cell tumorと診断した。細胞診の結果から悪性腫瘍の可能性が高いと考え、腫瘍マーカーを含む血液検査、骨髄穿刺、PET-CTおよび腫瘍生検を行った。良性腫瘍である石灰化上皮腫の診断で摘出術を行った。病理診断は腫瘍生検における所見と同様、石灰化上皮腫に矛盾しない結果であった。顔面神経麻痺など重篤な術後合併症を認めず、経過は良好で術後3日目に軽快退院した。
  • 高齢者頭頸部癌におけるセツキシマブ併用IMRT療法の有効性と安全性に関する検討, 高野 学, 川北 大介, 伊地知 圭, 別府 慎太郎, 村上 信五, 頭頸部外科, 25, (3) 395 - 401,   2016年02月, 高齢者頭頸部癌に対しセツキシマブ併用強度変調放射線療法(IMRT)を施行した症例を検討した。セツキシマブ併用IMRTを施行した75歳以上の6例を対象とした。年齢中央値は80.5歳(76〜88)。IMRTの照射線量の中央値は66Gy(66〜70)であり、セツキシマブ6コース併用した。全例で放射線療法は休止なく施行でき、4例(66%)でセツキシマブ投与を完遂できた。一次治療効果は全例でCRであった。粘膜炎や嚥下機能障害が遷延し、入院期間が長期化する症例を認めた。せん妄・認知機能障害を2例に認めた。高齢者に対しての治療では他職種の介入も含めた積極的な支持療法が治療完遂のために重要であると考えられた。(著者抄録)
  • 甲状腺手術におけるAirwayscope、顔面神経刺激装置を用いた神経モニタリング, 伊地知 圭, 川北 大介, 村上 信五, 播磨 恵, 笹野 寛, 耳鼻咽喉科展望, 56, (5) 326 - 329,   2013年10月
  • 頭頸部再建におけるオトガイ下皮弁の有用性, 川北 大介, 花井 信広, 寺田 聡広, 小澤 泰次郎, 平川 仁, 丸尾 貴志, 三上 慎司, 鈴木 淳志, 宮崎 拓也, 村上 信五, 長谷川 泰久, 頭頸部外科, 22, (2) 215 - 220,   2012年10月, オトガイ下皮弁は1990年にMartinらによって報告された顔面動静脈の分枝であるオトガイ下動静脈を栄養血管にもつ頸部有茎筋皮弁である。当院では2008年12月-2009年12月までに19例でオトガイ下皮弁を施行した。原発部位は口腔13例、中咽頭1例、喉頭1例、頸部皮膚欠損2例に施行した。1例において部分壊死を認めたが、その他の症例は経過良好であり再発を認めていない。オトガイ下・顎下リンパ節に明らかな転移を認めない例、軟口蓋〜下咽頭までの範囲の欠損例、長時間手術・侵襲を避けたい高齢者・基礎疾患を有する例(糖尿病など)、比較的小範囲の欠損例(舌半切、喉頭半切程度)ではオトガイ下皮弁はよい適応と考える。(著者抄録)
  • 【頭頸部扁平上皮癌の最新情報】 頭頸部扁平上皮癌の疫学と発癌因子 タバコ・アルコールと頭頸部扁平上皮癌, 川北 大介, 村上 信五, 長谷川 泰久, 田中 英夫, 松尾 恵太郎, JOHNS, 28, (8) 1155 - 1159,   2012年08月
  • 当院における遊離皮弁を用いた頭頸部再建の術後安静度に関する検討, 神山 圭史, 兵藤 伊久夫, 長谷川 泰久, 寺田 聡広, 花井 信広, 小澤 泰次郎, 平川 仁, 川北 大介, 丸尾 貴志, 三上 慎司, 亀井 譲, 日本マイクロサージャリー学会会誌, 23, (4) 336 - 340,   2010年12月, 遊離皮弁を用いた頭頸部再建を行い、安静度制限の緩和を含む術後管理を行った39例(男25例・女14例・平均58.9歳)について報告した。原発腫瘍部位は口腔・口唇15例、下咽頭7例、中咽頭7例、その他10例で、用いた遊離皮弁は腹直筋21例、前外側大腿8例、その他10例であった。術直後より1日目の朝まではプロポフォール、ベクロニウムの経静脈投与下に人工呼吸器管理を行い、その後は安静度制限なしとして早期離床を図った。術後ADLの経過は坐位が平均1.2日、立位が2.3日、歩行が2.5日で、全例4日以内に歩行を開始し、2例は1日目より歩行可能であった。術後合併症として吻合部血栓や肺炎・深部静脈血栓症はなく、創感染9例、皮弁部分壊死4例、瘻孔3例などが生じた。術後出血を1例で認めたが、術当日の鎮静下に発生したものであり、安静度制限緩和との関係はなかった。部分壊死の3例と出血1例には再手術を行い、他の症例は保存的に治癒に至った。
  • 中下咽頭癌における計画的頸部郭清術の検討, 花井 信広, 長谷川 泰久, 寺田 聡広, 小澤 泰次郎, 平川 仁, 川北 大介, 丸尾 貴志, 三上 慎司, 頭頸部癌, 36, (3) 354 - 358,   2010年10月, 近年、頭頸部癌治療において、臓器温存を目的とした化学放射線療法の役割は増加している。しかし化学放射線療後の頸部リンパ節転移の制御法については意見が分かれる。計画的頸部郭清の効果と適応を明らかにするために、当科での過去の中・下咽頭癌に対するCRT施行の119例についてレトロスペクティブな検討を行った。頸部郭清例で頸部制御率、および生存率が非郭清例を上回っていた。そして画像診断上CRが達成されていない場合には、PNDが有意に頸部制御を改善した。この場合、経過を観察するよりも、すみやかにPNDをおこなうべきと考えた。また画像診断上でCRであれば仮に再発しても救済率が高く、PNDを省略できる可能性があるが、慎重な経過観察が必要である。更に病理学的転移の有無が予後因子となることが示された。画像診断では、PET-CTが最も正診率に優れ、有力な手段であることが判った。(著者抄録)
  • 頸部郭清の基本手技 全頸部郭清術, 寺田 聡広, 花井 信広, 小澤 泰次郎, 平川 仁, 川北 大介, 丸尾 貴志, 三上 慎司, 長谷川 泰久, 頭頸部外科, 19, (1) 33 - 37,   2009年06月, 全頸部郭清術は頭頸部外科医にとって必ず習得するべき基本的な手術手技である。下顎下縁、顎二腹筋後腹を上縁、鎖骨上縁を下縁、僧帽筋前縁を後縁、頸動脈鞘、前頸筋を前縁としこれを深頸筋膜の深層と浅層で包んだ状態で切除する。筆者らは先に郭清の上縁の処理をした後、下縁を処理し、郭清組織を後方から前方へ向かって、深頸筋面から剥離する。温存すべき神経、脈管を確実に同定温存することが肝要である。頸部解剖を理解し正しい剥離面を正確に進む技術が必要である。(著者抄録)
  • 中咽頭悪性腫瘍の手術の適応とその術式 中咽頭側壁癌の切除と再建, 花井 信広, 寺田 聡広, 小澤 泰次郎, 平川 仁, 川北 大介, 丸尾 貴志, 三上 慎司, 長谷川 泰久, 口腔・咽頭科, 22, (1) 11 - 15,   2009年03月, 中咽頭側壁癌の切除における1)lip splitting approach、2)下顎骨離断法、3)下顎骨区域切除について供覧した。中でも下顎骨離断法は上咽頭や頭蓋底にまで操作が及ぶ場合、ルビエールリンパ節転移を伴う場合、病変を直視下に一塊切除するのに有用である。非侵襲的な術式とはいえないが、術後の下顎形態、咬合・知覚ともに温存できる機能保存術式であることは強調されるべきことである。より安全、確実な切除を行うことは中咽頭癌に限らず、癌の治癒切除に不可欠な要素である。中咽頭側壁進行癌の切除における下顎骨離断法はそのための基本的かつ優れた術式だといってよい。(著者抄録)
  • 切除と再建 QOL向上を目指したseamless collaboration 脈管温存に留意した頸部郭清, 寺田 聡広, 兵藤 伊久夫, 長谷川 泰久, 花井 信広, 小澤 泰次郎, 平川 仁, 川北 大介, 三上 慎司, 丸尾 貴志, 神山 圭史, 頭頸部癌, 34, (3) 241 - 244,   2008年10月, 頭頸部癌の手術は局所切除と頸部郭清および再建からなり、切除医と再建外科医の共同作業である。局所切除において術後機能を重視することは当然であるが、これは根治性が担保されなければ成立しない。郭清においても根治性を損なうことなくリンパ組織を切除しなければならないが、N0における選択清郭は言うまでもなく、N+例においても転移リンパ節の癒着のない脈管の温存は可能である。再建外科医に再建をゆだねるにあたって可能な限り脈管を温存することで、遊離皮弁再建における血管吻合部位選択の幅が広がり、自由度の高い皮弁縫着を可能とすることで手術時間の短縮、周術期合併症の減少に寄与し、ひいては頭頸部癌患者の術後QOL向上に貢献することができると考える。(著者抄録)
  • ボリコナゾールが著効した蝶形骨洞侵襲型アスペルギルス症の2例, 川北 大介, 近藤 雅幸, 佐原 紀子, 波多野 克, 小山 新一郎, 吉田 梨帆, 村上 信五, 耳鼻咽喉科臨床, 100, (12) 973 - 978,   2007年12月, 症例1(78歳男性)。左眼痛、左視野狭窄を主訴とした。症例2(80歳男性)。両開眼困難を主訴とした。両症例ともCTで左蝶形骨洞内に内部不均一なモザイク像、周囲骨肥厚、骨欠損が認められ、左鼻内蝶形骨洞開放術を行なったところ、病理組織学的に蝶形骨洞侵襲型アスペルギルス症と診断された。症例1はMCFGにて初期治療を行うも症状が再燃し、ボリコナゾール(VCZ)に変更後、症状は軽快した。現在もVCZ内服中であるが副作用や再燃はみられていない。症例2は初期よりVCZを開始し、経過中に鼻内癒着除去術を要したが、その後はVCZの増量にて症状の改善が得られた。尚、いずれの症例も術後はアムホテリシンBを用いた局所洗浄処置ならびにステロイドパルス療法を併用し行なわれた。
  • アサガオ種子気管支異物の1例, 小山 新一郎, 川北 大介, 近藤 雅幸, 吉岡 正展, 村上 信五, 吉田 梨帆, 喉頭, 18, (2) 146 - 148,   2006年12月, 生後5ヵ月男児。アサガオの種子が入った容器を倒して複数の種子が口に入った。その後、咳、喘鳴の出現で受診したが、呼吸雑音なく胸部X線検査にも異常を認めなかったが、2日後のレントゲン検査で左肺の気腫状変化と縦隔の右異物を確認した。全身麻酔下で硬性気管支鏡検査を施行し、左主気管支に膿汁貯留を認め吸引除去したが、白色綿状の異物が存在し左主気管支を閉塞しておりこれを摘出した。異物は発芽して増大したアサガオ種子で、さらに深部に白色と黒褐色異物が複数存在しており、複数回の気管支鏡と挿管チューブの挿入で異物を摘出した。正常な気管支を確認し、呼吸音の左右差は消失し胸部レントゲン検査でも左肺透過性亢進、縦隔の右偏位所見も消失した。術後プレドニゾロンとセフォチアム投与、メプテン吸入を行い退院となった。

受賞

  •   2018年10月, 名古屋市立大学医学部同窓会, 瑞友会賞(学術部門)
  •   2016年, 日本癌治療学会, 最優秀演題
  •   2015年, 日本唾液腺学会, 奨励賞
  •   2014年, 日本唾液腺学会, 奨励賞
  •   2013年, 日本唾液腺学会, 奨励賞
  •   2012年03月, 名古屋市立大学大学院, 名古屋市立大学大学院優秀論文賞
  •   2012年, 名古屋市立大学医学部公衆衛生学教室, 奥谷賞
  •   2011年, 名古屋大学医学部予防医学教室, 甕哲司賞

教育活動情報

担当経験のある科目

  • 頭頸部腫瘍, 名古屋市立大学医学部


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