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  • 1
    Electronic Resource
    Electronic Resource
    Treatment for locally advanced esophageal carcinoma complicated by fistulas: Case report (1996)
    Springer
    International journal of clinical oncology 1 (1996), S. 176-181 
    Details
    ISSN: 1437-7772
    Keywords: esophageal carcinoma ; fistula ; prosthesis ; chemoradiotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two cases of advanced esophageal carcinoma complicated by fistula formation, treated with esophageal prostheses followed by chemotherapy or concurrent chemoradiotherapy, are reported. Chemoradiotherapy may be indicated in esophageal carcinoma cases with fistulas if an excellent antitumor response is expected. However, the indication for prosthesis insertion should be limited due to the risk of perforation, which may be a lethal complication.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02348385
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  • 2
    Electronic Resource
    Electronic Resource
    Significance of and problems in adopting response evaluation criteria in solid tumor RECIST for assessing anticancer effects of advanced gastric cancer (2000)
    Springer
    Gastric cancer 3 (2000), S. 128-133 
    Details
    ISSN: 1436-3305
    Keywords: Key words Gastric cancer ; Response outcomes ; RECIST ; WHO criteria ; Japanese criteria
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Background. The response evaluation criteria in solid tumor (RECIST) exclude the use of barium meal studies. This will deeply affect the Japanese criteria for evaluating the response in the primary lesion of gastric cancer. Methods. Of 280 patients with gastric cancer enrolled in a Japan Clinical Oncology Group (JCOG) phase III study, 255 had been assessed for response by the WHO and/or Japanese criteria. We selected these 255 patients as our subjects and reassessed their response outcomes by RECIST. Results. Of the 255 patients, 32 (13%) had no evaluable lesion other than the primary site, and 171 (67%) had some measurable lesion defined by the WHO criteria. Because the lesions in 129 of these 171 patients were 20 mm or more in size, only 51% of the 255 subjects were eligible for assessment of the target lesion by RECIST. In 162 of the 171 patients who had a lesion of 10 mm or more, response rates by the old and new criteria were nearly equal, in spite of the different methods of measurement. The response rate in the primary lesions assessed by the Japanese criteria was lowest among all the groups examined. Conclusion. The RECIST is simple and good for clinical practice. Nevertheless, the recommendation of 20 mm or more for target lesions, which may restrict the number of eligible patients, could be replaced by a size of 10 mm or more. Because the Japanese evaluation criteria are rigid and do not inflate the response rate, they can be used, as additional criteria for assessing the quality of response, when the RECIST is used.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00011706
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  • 3
    Electronic Resource
    Electronic Resource
    Long-term results for patients with unresectable gastric cancer who received chemotherapy in the Japan Clinical Oncology Group (JCOG) trials (2000)
    Springer
    Gastric cancer 3 (2000), S. 145-150 
    Details
    ISSN: 1436-3305
    Keywords: Key word Gastric cancer ; Chemotherapy ; Long-term survival
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Background. Despite recent developments in chemotherapeutic trials, the long-term results of chemotherapy remain to be clarified. We evaluated the impact of chemotherapy on long-term survival in patients with unresectable gastric cancer. Methods. Between 1985 and 1991, a total of 363 patients with gastric cancer were enrolled into a single randomized phase II study and into three series of phase II studies of the Japan Clinical Oncology Group. The chemotherapy regimens consisted of tegafur + mitomycin C (FTM), uracil-tegafur + mitomycin C (UFTM), 5′deoxy-flurorouridine + cisplatin (5′P), etoposide + doxorubicin + cisplatin (EAP), and 5-fluorouracil + cisplatin (FP). After a review of the 363 patients' case records, 226 patients who fulfilled the criteria of having "unresectable" factors prior to chemotherapy became the subjects for this analysis. Of the 226 patients, 50 were in the FTM regimen group, 39, in the UFTM; 49, in the 5′P; 42, in the EAP; and 46, in the FP group. Survival was updated continually. Results. Of the 226 patients, 22 (10%) survived longer than 2 years, and 8 (4%) have survived longer than 5 years. The 8 5-year survivors consisted of 6 patients who had para-aortic node metastases alone as an "unresectable factor", 1 who had para-aortic and cervical node metastases, and the remaining patient who had liver metastasis alone. Twenty-nine patients with para-aortic node metastasis alone had a significantly longer survival than the other 197 patients (P 〈 0.001). Conclusion. Systemic chemotherapy may offer some hope of achieving long-term survival in patients with unresectable gastric cancer, particularly when the patient has metastasis only to para-aortic nodes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00011709
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  • 4
    Electronic Resource
    Electronic Resource
    Meeting report of the 72nd Japanese Gastric Cancer Congress (2000)
    Springer
    Gastric cancer 3 (2000), S. 1-8 
    Details
    ISSN: 1436-3305
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00011683
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  • 5
    Electronic Resource
    Electronic Resource
    Sequential methotrexate and 5-fluorouracil therapy for gastric cancer patients with bone metastasis (2000)
    Springer
    Gastric cancer 3 (2000), S. 19-23 
    Details
    ISSN: 1436-3305
    Keywords: Key words Methotrexate ; 5-Fluorouracil ; Gastric cancer ; Bone metastasis ; Disseminated intravascular coagulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. Patients with bone metastasis of gastric cancer occasionally experience disseminated intravascular coagulation (DIC), with a very poor prognosis. Methods. We treated 18 gastric cancer patients with bone metastasis with sequential methotrexate and 5-fluorouracil (sequential MTX/5-FU therapy). The treatment schedule comprised weekly administration of methotrexate (MTX; 100 mg/m2, i.v. bolus) followed by 5-fluorouracil (5-FU; 600 mg/m2, i.v. bolus) after an interval of 3 h. Calcium leucovorin (10 mg/m2, p.o. or i.v.) was administered six times, every 6 h starting 24 h after the administration of MTX. Results. In 11 patients with measurable metastatic lesions, the response rate was 64% (7/11). Nine patients (50%) had DIC before the initiation of chemotherapy, and 8 of them (89%) recovered from it. Two of these 9 patients (22%) survived for more than 1 year. The median survival times for all patients and for the 9 with DIC were 186 and 113 days, respectively. Grade 4 leukopenia was observed in 3 patients (17%). No treatment-related deaths occurred. Conclusion. Sequential MTX/5-FU therapy may have palliative potential and may be a feasible treatment for gastric cancer patients with bone metastasis with or without DIC.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00011684
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  • 6
    Electronic Resource
    Electronic Resource
    A model chemosensitivity test examining apoptosis in small specimens of gastric cancer (2000)
    Springer
    Gastric cancer 3 (2000), S. 39-44 
    Details
    ISSN: 1436-3305
    Keywords: Key words Chemosensitivity ; Apoptosis ; TUNEL ; Gastric cancer ; Small specimen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background. Because chemosensitivity tests usually require a large amount of tissue, they are not used routinely in patients with unresectable gastric cancer. The aim of this study was to investigate whether apoptosis can be used as a sensitivity assay for chemosensitivity in small gastric cancer specimens. Methods. Apoptosis, detected by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick labeling (TUNEL), was investigated in small specimens of the MKN-1, MKN-45, and TMK-1 human gastric cancer cell lines as a marker of chemosensitivity following exposure to antineoplastic agents. Results. Doxorubicin (DXR), SN-38 (active metabolite of irinotecan), and paclitaxel (Taxol) induced DNA fragmentation in MKN-45 and TMK-1 cells, but not in MKN-1. In contrast, neither 5-fluorouracil (5-FU) nor cisplatin (CDDP) induced DNA fragmentation in any of the three cell lines. Small pieces cut from tumors implanted in nude mice were exposed to the antineoplastic agents in culture medium for 24 h, and the percentage of TUNEL-positive cancer cells (TUNEL positivity) was examined. TUNEL positivity in all three cancers increased after exposure to DXR, SN-38, and Taxol, but not after exposure to CDDP or 5-FU. MKN-45 showed the highest TUNEL positivity with SN-38 and Taxol, and TMK-1 TUNEL positivity was highest with DXR. MKN-45 and TMK-1 were the most sensitive to these three antineoplastic agents in vitro, while MKN-1, with the lowest TUNEL positivity, was the least sensitive to these three antineoplastic agents. TUNEL positivity after exposure to Taxol correlated with the antitumor effects of this compound in an animal model. Conclusion. These results suggest that, in small gastric cancer specimens where apoptosis is implicated, TUNEL positivity may be applicable to a chemosensitivity test.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00011688
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  • 7
    Electronic Resource
    Electronic Resource
    Five-year survivor with liver metastasis from gastric cancer successfully treated with systemic chemotherapy (2000)
    Springer
    Gastric cancer 3 (2000), S. 106-109 
    Details
    ISSN: 1436-3305
    Keywords: Key words Five-year survivor ; Gastric cancer ; Alpha feto-protein ; Liver metastasis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a patient with liver metastasis from gastric cancer who has achieved a 5-year survival after systemic chemotherapy. The patient was diagnosed with advanced gastric cancer and received a total gastrectomy in August 1991, followed by adjuvant chemotherapy. Liver and lymph node metastases were detected in April 1994, and systemic chemotherapy with a combination of etoposide, doxorubicin, and cisplatin was initiated. Although the liver metastasis completely disappeared, lymph node metastasis at the falciform ligament of the liver and around the portal fissure remained after six courses of this therapy. A second type of chemotherapy, a combination of 5-fluorouracil and methotrexate, was then administered, 12 times, from December 1994 to May 1995, during which time no disease progression was observed. After surgery for the metastatic lymph nodes in August 1995, no progression was observed until December 1998, when a tumor thrombus was detected in the portal vein. Combination chemotherapy of irinotecan and cisplatin was initiated in January 1999. Although tumor regression was achieved after two courses of this, the disease continued to progress after five courses. In July 1999, a fourth type of chemotherapy, using 1 M tegafur-0.4 M gimestat-1 M otastat potassium (S-1), was initiated, and size reduction of the tumor thrombus was achieved; this therapy has continued to the time of submission of this report.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00011694
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  • 8
    Electronic Resource
    Electronic Resource
    Meeting report of the 71st Japanese Gastric Cancer Congress (1999)
    Springer
    Gastric cancer 2 (1999), S. 145-150 
    Details
    ISSN: 1436-3305
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s101200050038
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  • 9
    Electronic Resource
    Electronic Resource
    Endoscopic mucosal resection for colorectal neoplastic lesions (1994)
    Springer
    Diseases of the colon & rectum 37 (1994), S. 1108-1111 
    Details
    ISSN: 1530-0358
    Keywords: Endoscopic mucosal resection ; Endoscopic polypectomy ; Flat adenoma ; Flat cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Endoscopic mucosal resection, which is a new option for endoscopic polypectomy of colorectal polyps without stalks, was evaluated on its usefulness in polypectomy. METHODS: Three hundred thirty-seven lesions, which were removed by endoscopic mucosal resection between January 1990 and January 1993, were studied. The endoscopic configuration of neoplastic lesions were classified into four types: flat, sessile, large sessile with distinct lobulations, and semipedunculated. RESULTS: The 337 lesions included 243 adenomas, 30 mucosal cancers, 13 submucosal cancers, 3 carcinoids, 43 hyperplastic polyps, and 5 inflammatory polyps. Of the 286 neoplastic lesions, excluding 3 carcinoids, 137 were flat, 81 were sessile, 18 were large sessile, and 50 were semipedunculated. The 137 flat lesions consisted of 125 adenomas, 10 mucosal cancers, and 2 submucosal cancers. The rate of complete removal was related to their size and configuration and was 87 percent in flat neoplastic lesions. Lesion diameters of greater than 20 mm and the large sessile-type configurations were factors that were associated with incomplete removal. Two (0.7 percent) cases were complicated by perforations, and one (0.4 percent) case was complicated by bleeding. CONCLUSION: Endoscopic mucosal resection is an useful option for complete removal of colorectal nonpolypoid adenomas and cancers.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02049812
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  • 10
    Electronic Resource
    Electronic Resource
    Clinicopathologic features of early rectal carcinoma and indications for endoscopic treatment (1995)
    Springer
    Diseases of the colon & rectum 38 (1995), S. 959-963 
    Details
    ISSN: 1530-0358
    Keywords: Early rectal carcinoma ; Lymph node metastasis ; Endoscopic treatment ; Quality of life
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: This study was undertaken to clarify the indications for endoscopic treatment. METHODS: Clinical and pathologic features of 191 lesions in 180 patients with early rectal carcinoma were examined, including 110 intramucosal carcinomas and 81 carcinomas with submucosal invasion (submucosal carcinomas). All lesions had been endoscopically or surgically resected at the National Cancer Center Hospital between 1976 and 1990. RESULTS: Metastasis to regional lymph nodes (LN metastasis) was seen in 0 percent (0/39) of intramucosal carcinomas and 9.2 percent (6/65) of submucosal carcinomas in the surgically treated patients. The incidence of LN metastasis was higher for lesions larger than 10 mm in diameter, for those showing massive submucosal invasion, and for moderately differentiated adenocarcinomas. LN metastases were associated significantly with lymphatic invasion. CONCLUSIONS: These results suggest that early rectal carcinomas should be resected surgically if they 1) show massive submucosal invasion, 2) are classified as moderately differentiated adenocarcinomas, and 3) are larger than 10 mm in diameter. In patients with both scanty submucosal invasion and features of well-differentiated adenocarcinoma or intramucosal carcinoma and if no other risk factors for LN metastasis are present, such as lymphatic invasion by the primary lesion, surveillance may suffice after endoscopic resection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02049732
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