Annual Report 2019
Department of Esophageal Surgery
Hiroyuki Daiko, Junya Oguma, Koshiro Ishiyama, Daisuke Kurita, Kyohei Kanematsu, Kentaro Kubo, Yusuke Fujii
Introduction
The Department of Esophageal Surgery deals with neoplasms arising from the esophagus. The surgical management of esophageal cancer has been the main clinical research activity of this department. In particular, our department is striving to establish minimally invasive surgery that consists of neoadjuvant treatment followed by minimally invasive esophagectomy. Our department is conducting a study to define the role of surgery in the multimodal approach to the treatment of esophageal cancer, and is aiming for thoracolaparoscopic esophagectomy, which consists of thoracoscopic esophagectomy and laparoscopic reconstruction, to become a standard surgical procedure. Moreover, robotic esophagectomy and gastric reconstruction were introduced in 2018.
The Team and What We Do
The Department of Esophageal Surgery consists of three staff surgeons and four residents. An Esophageal Conference is held every Wednesday evening to discuss the diagnosis, staging, and treatment strategy for each patient and is attended by surgeons, medical oncologists, endoscopists, radiologists, radiation oncologists, and head & neck surgeons. Approximately four patients are operated upon every week. In 2019, 178 patients underwent esophagectomies, including 164 cases of thoracic esophageal cancer and 14 cases of cervical cancer. Transthoracic esophagectomies with extended lymph node dissection were performed on five cases. Thoracoscopic esophagectomies in the prone position with radical lymph node dissection were undertaken in 164 cases. Bilateral transcervical Mediastinoscopic laparoscopic assisted esophagectomy for patients above 80 or patients with multiple complications was undertaken in four cases. Postoperatively, within 30 days, one patient died due to complications after a salvage operation.
Research Activities
Currently, our department is examining the role of thoracolaparoscopic esophagectomy as a minimally invasive esophagectomy that consists of thoracoscopic esophagectomy and laparoscopic reconstruction. For patients without radical chemoradiotherapy, thoracoscopic esophagectomy in the prone position with radical lymph node dissection and laparoscopic reconstruction after esophagectomy for patients without a history of laparotomy are being attempted to make them a standard surgical procedure for esophageal cancer.
For treating patients aged over 80 years or at high risk, a two-stage surgical procedure divided into resection and reconstruction is being attempted.
A phase III study of tri-modality combination therapy with induction docetaxel, cisplatin, 5-fluorouracil (DCF) vs definitive chemoradiotherapy (dCRT) for locally advanced unresectable squamous cell carcinoma of the thoracic esophagus (JCOG1510, TRIANgLE trial) is ongoing.
A randomized controlled phase III study of minimally invasive versus open esophagectomy for thoracic esophageal cancer (JCOG1409, MONET trial) is ongoing.
A feasibility study of Nivolumab as neoadjuvant chemotherapy for locally esophageal carcinoma (JCOG1804E, FRONTiER) is ongoing.
Since 2000, our department has been performing salvage surgery for patients in whom definitive chemoradiotherapy has failed. The operative procedures and postoperative management have been refined gradually. Our department is also studying the role and efficacy of salvage surgery in the multimodal treatment of esophageal cancer.
List of papers published in 2019
Journal
1. Wada S, Inoguchi H, Sadahiro R, Matsuoka Y J, Uchitomi Y, Sato T, Shimada K, Yoshimoto S, Daiko H, Shimizu K. Preoperative Anxiety as a Predictor of Delirium in Cancer Patients: A Prospective Observational Cohort Study. World J Surg. 2019: 43(1):134-142
2. Hashimoto J, Kato K, Ito Y, Kojima T, Akimoto T, Daiko H, Hamamoto Y, Matsushita H, Katano S, Hara H, Tanaka Y, Saito Y, Nagashima K, Igaki H. Phase II feasibility study of preoperative concurrent chemoradiotherapy with cisplatin plus 5-fluorouracil and elective lymph node irradiation for clinical stage II/III esophageal squamous cell carcinoma. Int J Clin Oncol. 2019: 24(1):60-67
3. Nishiumi S, Fujigaki S, Kobayashi T, Kojima T, Ito Y, Daiko H, Kato K, Shoji H, Kodama Y, Honda K, Yoshida M. Metabolomics-based Discovery of Serum Biomarkers to Predict the Side-effects of Neoadjuvant Chemoradiotherapy for Esophageal Squamous Cell Carcinoma. Anticancer Res. 2019: 39(1):519-526.
4. Kurita D, Fujita T, Horikiri Y, Sato T, Fujiwara H, Daiko H. Non-occlusive mesenteric ischemia associated with enteral feeding after esophagectomy for esophageal cancer: report of two cases and review of the literature. Surg Today. 2019: 20;5(1):36.
5. Sato T, Fujita T, Fujiwara H, Daiko H. Internal hernia to the retrosternal space is a rare complication after minimally invasive esophagectomy: three case reports. Surg Case Rep.2019: 18;5(1):26.
6. Fujita T, Sato T, Sato K, Hirano Y, Fujiwara H, Daiko H. Clinical manifestation, risk factors and managements for postoperative chylothorax after thoracic esophagectomy. J Thorac Dis. 2019: 11(Suppl 3):S198-S201
7. Akio Sakaki, Jun Kanamori, Ataru Sato, NaoyaOkada, Koshiro Ishiyama, Daisuke Kurita, Junya Oguma,Hiroyaki Daiko. Case report: Gastric tube cancer after esophagectomy-Retrograde perfusion after proximal resection of right gastroepiploic artery. Int J Surg Case Rep. 2019:59:97-100.
8. Yachida T, Oda I, Abe S, Sekiguchi M, Nonaka S, Suzuki H, Yoshinaga S, Taniguchi H, Sekine S, Masugata H, Masaki T, Daiko H, Saito Y. Risk of Lymph Node Metastasis in Patients with the Superficial Spreading Type of Esophageal Squamous Cell Carcinoma.Digestion. 2019: "25:1-6. [Epub ahead of print]"
9. Fujita T, Okada N, Horikiri Y, Sato T, Fujiwara H, Mayanagi S, Kanamori J, Yamamoto H, Daiko H. Safety and efficacy of hydroxyethyl starch 6% 130/0.4/9 solution versus 5% human serum albumin in thoracic esophagectomy with 3-field lymph nodes dissection. Surg Today. 2019:49(5):427-434.
10. Nakanishi K, Daiko H, Kato F, Kanamori J, Igaki H, Tachimori Y, Koyanagi K.Efficacy of preserving the residual stomach in esophageal cancer patients with previous gastrectomy. Gen Thorac Cardiovasc Surg. 2019: 67(5):470-478.
11. Fujiwara H, Sato T, Okada N, Fujita T, Kojima T, Daiko H. Thoracoscopic esophagectomy with three-field lymphadenectomy for thoracic esophageal cancer in a patient with a double aortic arch: a report of a case. Surg Case Rep. 2019: 16;5(1):80.
12. Okada N, Daiko H, Kanamori J, Sato A, Horikiri Y, Sato T, Fujiwara H, Tomioka T, Fujita T, Kojima T, Fujii. Impact of pathologically assessing extranodal extension in the thoracic field on the prognosis of esophageal squamous cell carcinoma. Surgery. 2019:165(6):1203-1210.
13. Sudo K, Kato K, Matsuzaki J, Boku N, Abe S, Saito Y, Daiko H, Takizawa S, Aoki Y, Sakamoto H, Niida S, Takeshita F, Fukuda T, Ochiya T. "Development and Validation of an Esophageal Squamous Cell Carcinoma Detection Model by Large-Scale MicroRNA Profiling." JAMA Netw Open. 2019: 3;2(5):e194573.
14. Fujiwara H, Kanamori J, Nakajima Y, Kawano T, Miura A, Fujita T, Akita K,Daiko H. An anatomical hypothesis: a "concentric-structured model" for the theoretical understanding of the surgical anatomy in the upper mediastinum required for esophagectomy with radical mediastinal lymph node dissection. Dis Esophagus. 2019:1;32(8).
15. Terada M, Hara H, Daiko H, Mizusawa J, Kadota T, Hori K, Ogawa H, Ogata T,Sakanaka K, Sakamoto T, Kato K, Kitagawa Y. Phase III study of tri-modality combination therapy with induction docetaxel plus cisplatin and 5-fluorouracil versus definitive chemoradiotherapy for locally advanced unresectable squamous-cell carcinoma of the thoracic esophagus (JCOG1510: TRIANgLE). Jpn J Clin Oncol. 2019: 49(11)1055–1060
16. Iwabu J, Yamashita S, Takeshima H, Kishino T, Takahashi T, Oda I, Koyanagi K, Igaki H, Tachimori Y, Daiko H, Nakazato H, Nishiyama K, Lee YC, Hanazaki K, Ushijima T. FGF5 methylation is a sensitivity marker of esophageal squamous cell carcinoma to definitive chemoradiotherapy. Sci Rep. 2019: 16;9(1):13347.
17. Nambu M, Masuda T, Ito S, Kato K, Kojima T, Daiko H, Ito Y, Honda K, Ohtsuki S.Leucine-Rich Alpha-2-Glycoprotein 1 in Serum Is a Possible Biomarker to Predict Response to Preoperative Chemoradiotherapy for Esophageal Cancer. Biol Pharm Bull. 2019: 42(10):1766-1771.
18. Fujita T, Okada N, Horikiri Y, Sato T, Fujiwara H, Mayanagi S, Kanamori J,Yamamoto H, Daiko H. Reply to comment on "Ambiguity about the volume of colloids administration in a clinical study of thoracic esophagectomy precludes conclusion on renal safety of hydroxyethyl starch". Surg Today. 2019:49(10):886.
19. Kondo A, Nishizawa Y, Horikiri Y, Amemori H, Tsukada Y, Sasaki T, Kawai T,Daiko H, Ito M. A novel device designed to improve the operability of energy devices with foot pedals in endoscopic surgery: the Foot-Site Monitor. Surg Today. 2019:49(11):965-970.
20. Ishida T, Kanamori J, Daiko H. Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy:a case report. Surg Case Rep. Surg Case Rep. 2019: 11;5(1):195.
21. Kurokawa Y, Takeuchi H, Doki Y, Mine S, Terashima M, Yasuda T, Yoshida K,Daiko H, Sakuramoto S, Yoshikawa T, Kunisaki C, Seto Y, Tamura S, Shimokawa T,Sano T, Kitagawa Y. Mapping of Lymph Node Metastasis From Esophagogastric Junction Tumors: A Prospective Nationwide Multicenter Study. Ann Surg. 2019: [Online ahead of print.]