Japanese Journal of Clinical Oncology

Sawabe,, Yuji;lida,, Shinji;Tabata,, Yuki;Yonemitsu,, Hiroshi

doi: 10.1093/oxfordjournals.jjco.a039647pmid: N/A

Abstract Erythrocytosis is occasionally observed in patients with hepatocellular carcinoma (HCC). The pathogenesis of the phenomenon remains uncertain. It has been speculated that tumors produce erythropoietin (Epo), and several studies on the Epo in tumor tissues have been reported. Using a sensitive enzyme linked immunosorbent assay, we measured the serum Epo concentration in 92 HCC patients and 30 liver cirrhosis (LC) patients. The levels of Epo in normal subjects, HCC patients and LC patients were 10.5±4.1 (mean±SD, mU/ml), 55.6±218.0 and 18.4±19.4, respectively. Some patients with high Epo values had low levels of hemoglobin (Hb), and a scatter-gram of the two parameters was similar to that in iron deficiency anemia. In patients whose Hb levels were more than 12 g/dl, we found Epo levels of 15.0±8.8 (mean±SD mU/ml) and 10.3±7.7 in HCC and LC, respectively. Epo values in HCC were significantly higher than those of normal subjects (P<0.001) and LC patients (P<0.05), and 18.2% (10/55) had concentrations above the upper limit of the normal range. The increase was not, however, a marked one. In conclusion, as the incidence of erythrocytosis was low (2.2%) in HCC patients, the high Epo values in some patients could be related to the abnormal production of Epo by HCC. Erythropoietin, Enzyme linked immunosorbent assay, Hepatocellular carcinoma, Erythrocytosis This content is only available as a PDF. © Oxford University Press

Tang,, Xiaohai;Muramatsu,, Yukio;Yajima,, Masazumi;Sonoda,, Takahiko

doi: 10.1093/oxfordjournals.jjco.a039648pmid: N/A

Abstract In order to improve the accuracy of magnetic resonance (MR) imaging assessment of myometrial invasion by endometrial cancer, the usefulness of a new diagnostic parameter, the endometriummyometrium (EM) ratio has been evaluated. EM ratio is the proportion of the widest length of endometrium to the length of myometrium measured at the same line, this being vertical to the parallel of the long axis of the uterine body in the sagittal plane of the MR images. Myometrial invasion was defined as a value of the EM ratio > 1 , and the tumor was limited to the endometrium for values < 1 . In 25 consecutive patients, both the EM ratio-based assessment and the well-established junctional zone-based asessment with T2-weighted MR imaging and enhanced MR imaging with gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) were compared with the results from pathological examinations of postoperative specimens. In identifying moymetrial invasion by endometrial cancer, the sensitivity of the EM ratio-based assessment was better than that of the junctional zone-based assessment. The overall sensitivity of the former was 96% in both the T2-weighted and enhanced MR imaging with Cd-OTPA, whereas that of the latter was 84% in the T2-weighted MR imaging and 72% (P<0.05) in the enhanced MR imaging. The use of the EM ratio with MR imaging improves the ability to assess myometrial invasion by endometrial cancer. Endometrium-myometrium ratio, Magnetic Resonance (MR) imaging assessment, Myometrial invasion, Endometrial cancer This content is only available as a PDF. Author notes *Present address: Department of Gynecological Oncology, Sichuan Cancer Hospital and Institute, Chengdu, Sichuan 610041, China © Oxford University Press

Nishio,, Makoto;Ohata,, Masahiro;Kobayashi,, Hisashi;Suruda,, Tadatoshi;Uetani,, Kousaku;Funasako,, Masato;Nishio,, Kazuto;Sasaki,, Yasutsuna;Saijo,, Nagahiro

doi: 10.1093/oxfordjournals.jjco.a039649pmid: N/A

Abstract We performed a phase I trial to evaluate the toxicity and the maximum tolerated dose of high dose epirubicin on a three-consecutive-day schedule on Japanese patients with advanced non-small cell lung cancer. Fourteen patients were entered in the study. At least three patients were assigned to each different dose level. Epirubicin was given intravenously daily for three day by bolus injection. The dose was started at 60 mg/m2/course and escalated by 30 mg/m2/course. Granulocytopenia was found to be the dose limiting toxicity with a maximum tolerated dose of 150 mg/m2/course. Thrombocytopenia and non-hematological toxicities were mild and well tolerated. The maximum tolerated dose was lower than that in Europe and Canada. Partial responses were observed in two out of five patients on 150 mg/m2/course. The recommended phase II dose for high dose epirubicin was demonstrated to be 120 mg/m2/course. A further dose-escalating study of epirubicin in conjunction with the administration of granulocyte colony stimulating factor is scheduled for the determination of its antitumor activity in non-small cell lung cancer. Epirubicin, Phase I study, Pharmacokinetics, Pharmacodynamics This content is only available as a PDF. © Oxford University Press

Gohji,, Kazuo;Higuchi,, Akihiro;Maruyama,, Satoshi;Minayoshi,, Kenji;Fujii,, Akio;Itoh,, Noboru;Hasunuma,, Yukito;Tanaka,, Hiroyuki;Izumi,, Takehiro

doi: 10.1093/oxfordjournals.jjco.a039650pmid:

Fujita,, Shin;Teramoto,, Tatsuo;Watanabe,, Masahiko;Kodaira,, Susumu;Kitajima,, Masaki

doi: 10.1093/oxfordjournals.jjco.a039651pmid: N/A

Abstract In order to discover the incidence of recurrence and prognosis of patients with anastomotic leakage after colorectal surgery, 980 colorectal cancer patients who underwent anastomosis at Keio University Hospital between 1970 and 1990 were examined. Thirty-three patients (leakage group) out of the 980 exhibited anastomotic leakage. The incidence of local recurrence in the leakage group was significantly higher than in the no leakage group (P<0.01). The disease-free survival rate of the leakage group was significantly lower than that of the no leakage group in Dukes' A, B patients (P<0.01), but was not so in Dukes' C, D patients. These results suggested that anastomotic leakage after colorectal cancer surgery might enhance the incidence of local recurrence and make the prognosis poor. Risk factor, Anastomotic leakage, Colorectal cancer surgery, Poor prognosis, Recurrence This content is only available as a PDF. © Oxford University Press

Fujimoto,, Hiroyuki;Tobisu,, Ken-ichi;Mizutani,, Takashi;Sakamoto,, Michiie;Kakizoe,, Tadao

doi: 10.1093/oxfordjournals.jjco.a039652pmid: N/A

Abstract Two series of transitional cell carcinomas (TCC), one including 49 renal pelvic and/or ureteral cancers and the other 29 bladder cancers with concomitant ureteral involvement, were reviewed to establish the criteria for nephron-sparing surgery and for selecting the most appropriate surgical intervention for TCCs at the ureterovesical junction. The following categorization of tumors was made possible by histological mappings of step-sectioned surgical specimens from various surgical modes: 1) low grade papillary superficial tumor, 2) high grade papillary or non-papillary tumor with adjacent or skipped carcinoma in situ (CIS), 3) high grade non-papillary invasive tumor without CIS, 4) high grade papillary superficial tumor without CIS. We can, by comparing postoperative clinical courses, select the mode of surgery in the following manner: 1) nephronsparing surgery could be indicated in cases of low grade papillary tumor so far as a complete resection is possible; 2) in a case of high grade papillary or non-papillary tumor with adjacent or skipped CIS, extended resection of the urinary tract is required; 3) in a case of high grade non-pappillary tumor without CIS, complete en bloc resection of the tumor site, including surrounding organs, will be necessary. The possibility of organ-sparing surgery for early stage cancer without CIS at the ureterovesical junction has been suggested. Preoperative consideration of the above classifications for conservative surgery is also discussed. Transitional cell carcinoma, Renal pelvis and ureter, Surgical management This content is only available as a PDF. © Oxford University Press

Ohwada,, Susumu;lino,, Yuichi;Hosomura,, Yasuo;Kon,, Youichi;Kawashima,, Yoshiyuki;Kasahara,, Mureo;Tanahashi,, Yoshifumi;Nakamura,, Seiji;Joshita,, Takashi;Miyamoto,, Yukio;Ishida,, Tunehiro;Morishita,, Yasuo

Shimizu,, Junzo;Murakami,, Shinya;Hayashi,, Yoshinobu;Odo,, Makoto;Morita,, Katsuya;Arano,, Yoshihiko;Ishikawa,, Noboru;Watanabe,, Yoh;Nonomura,, Akitaka

doi: 10.1093/oxfordjournals.jjco.a039654pmid: N/A

Abstract Primary pulmonary hemangiopericytoma is a very rare tumor. A case of the disease is reported, together with a review of the literature. The patient was a 78-year-old male, who was admitted to hospital with an abnormal shadow on his chest x-ray. A primary tumor, located in the left S4, was resected, and a final diagnosis of hemangiopericytoma of pulmonary origin was made. The disease recurred in the left lower lobe 14 months postoperatively. The patient received radiotherapy and is alive to date, 23 months after the operation. Hemangiopericytoma, Pulmonary origin, Recurrence This content is only available as a PDF. © Oxford University Press

Shinjo,, Kiyoshi;Miyake,, Nobumasa;Takahashi,, Yohei

doi: 10.1093/oxfordjournals.jjco.a039655pmid: N/A

Abstract A case of malignant giant cell tumor of the tendon sheath of the right hip, which developed in a 72-year-old Japanese woman, is described. The tumor exhibited histological similarities to a benign giant cell tumor of the tendon sheath (localized nodular tenosynovitis). The resected tumor, measuring 9×9×11 cm, was located in the adductor muscle and invaded the proximal femur and acetabulum. The nodule was encapsulated with a thin membrane which was soft and gelatinous in consistency and varied in color from yellow to brown. The synovium of the hip joint was normal. The primary lesion was composed of plump polyhedral and spindle-shaped cells. The nuclei were large, irregular and hyperchromatic, and contained prominent nucleoli. A moderated number of multinucleated giant cells was scattered throughout the lesion. There was little stromal collagen. In the majority of the specimens, pseudoglandular or alveolar spaces were predominant. An ultrastructural study demonstrated three cell types: fibroblast-like, histiocyte-like and an intermediate. The patient underwent reconstructive surgery with a Dacron fabric-enveloped alumina ceramic pelvic prosthesis and total hip components after resection of the primary lesion. Unfortunately, because of a local recurrence, a hemipelvectomy was required 10 months after the initial operation. At that time the intestines were involved with the recurrent tumor, and the patient subsequently died of perforative peritonitis. An autopsy revealed distant metastases to the right pelvis, urinary bladder, right ureter, ilium, mesenterium and lungs. Malignant giant cell tumor of the tendon sheath, Hip joint, Ultrastructure, Alumina ceramics, Dacron fabric This content is only available as a PDF. © Oxford University Press

Tsutsumi,, Masakazu;Kamiya,, Masuzo;Sakamoto,, Michiie;Tobisu,, Ken-ichi;Kakizoe,, Tadao

doi: 10.1093/oxfordjournals.jjco.a039656pmid: N/A

Abstract A 60-year-old male with a small cell carcinoma of the right lower ureter is presented. The tumor mainly comprised a small cell carcinoma but also included a full variety of histological types such as transitional cell carcinoma, squamous cell carcinoma, adenocarcinoma, leiomyosarcoma and chondrosarcoma. Immunohistochemical staining was positive for neuron specific enolase and cluster 1 small cell lung cancer antigen/N-CAM in the small cell carcinoma and S-100 in the chondrosarcoma component. The patient underwent a right nephroureterectomy, and received prophylactic radiation of the pelvic and para-aortic lymph node regions and cisplatin and etoposide combination chemotherapy. Eight months after the chemotherapy, a transitional cell carcinoma was found in the bladder neck, and a cystectomy with urethrectomy performed. To our knowledge, this is the second report of a small cell carcinoma originating from the ureter. Small cell carcinoma, Ureter, Nephroureterectomy, Radiation therapy, Cisplatin, Etoposide chemotherapy, Carcinosarcoma This content is only available as a PDF. © Oxford University Press