Annual Report 2021
Department of Gastroenterology and Endoscopy
Tomonori Yano, Hiroaki Ikematsu, Yusuke Yoda, Kensuke Shinmura, Tomohiro Kadota, Tatsuro Murano, Keiichiro Nakajo, Kenji Takashima, Hironori Sunakawa, Atsushi Inaba, Tomohiro Mitsui
Introduction
The Department of Gastroenterology and Endoscopy consists of seven staff doctors specialized in endoscopic diagnosis and treatment for gastrointestinal tract and head and neck cancer. The mission of our department is to achieve the following tasks for cancer patients using endoscopy: early detection, less invasive treatment, and palliation for painful symptoms.
The Team and What We Do
The staff members of this department performed approximately 15500 endoscopic procedures in total and 2400 endoscopic resections of neoplastic lesions this year. While the cases decreased due to the pandemic of COVID-19 in 2020, in 2021, they recovered to more than in 2019 (Table 1). We also performed advanced endoscopic treatment including EMR/ESD for early cancer, salvage treatment such as ESD or photodynamic therapy (PDT) for local failure after radiotherapy for esophageal cancer, and palliative treatments for patients with symptomatic advanced cancer such as stent placement, percutaneous endoscopic gastrostomy, and balloon dilatation. Also, the upper GI group aggressively performed endoscopic treatment for early pharyngeal cancer through collaboration with the Department of Head and Neck Surgery. In addition, the colon group concentrated on diagnosis with fine magnified images using image-enhanced endoscopy for adenoma or early cancer, even in clinical practice. During daily endoscopic examinations, physicians access primary tumors through endoscopy, and can easily take numerous biopsy materials from cancerous lesions. Recently, a lot of molecular target agents are being developed and included in practice in oncology fields. Therefore, the position of endoscopy is becoming more important in clinical oncology as an easy-access tool for primary tumors.
Research activities
The major research activities at this department are translational (TR) research, innovation for new imaging and endoscopic equipment through collaboration with academia and companies, and clinical studies. In the TR research field, we collaboratively performed work with several divisions in the Exploratory Oncology Research and Clinical Trial Center in order to elucidate the microenvironment and immunological status of cancer in digestive tract and head and neck tumors using materials taken using endoscopy. In 2021, we published the results of several important research projects, including artificial intelligence developed with automated collection of annotated images from an endoscopy filing system, clinical research on endoscopic resection for neoplastic lesions of the digestive tract, and epidemiological research on esophageal cancer.
Clinical trials
We are conducting investigator-initiated clinical trials to obtain regulatory approval for a cryo-balloon ablation system for local failed esophageal cancer after endoscopic resection and photoimmunotherapy for patients with esophageal cancer or gastric cancer. We are also conducting a multi-institutional randomized control trial to evaluate new imaging compared with conventional imaging for detection of early cancer in the stomach. As a member institution of the JCOG-GI endoscopy study group, we are conducting a single-arm confirmatory trial of adjuvant chemoradiation for patients with high-risk rectal submucosal invasive cancer after local resection (JCOG1612), and participate in several randomized control trials to build the standards for endoscopic treatment for GI cancer.
Education
Two senior residents and eight residents belong to our department. Trainees performed duties under the training program with observation by each specialist. Also, they were educated not only in endoscopic diagnosis and endoscopic treatment strategies, but also pathological diagnosis and clinical and surgical oncology through cooperation with other departments. Furthermore, they actively presented their research work at international congresses, and published papers in international peer reviewed journals. They wrote several study protocols mainly for innovative development in endoscopic imaging and treatment. In 2021, we also innovated training equipment for endoscopic submucosal dissection for gastric cancer through collaborative research with a company.
Future Prospects
We would like to innovate new endoscopic imaging or treatment through robust collaboration with companies and academic institutions for cancer patients not only at present but also in the NEXT generation.
List of papers published in 2021
Journal
1. Horiuchi Y, Takizawa K, Yoshio T, Mizusawa J, Ono H, Hasuike N, Yano T, Yoshida N, Miwa H, Boku N, Terashima M, Muto M. Pretreatment risk factors for endoscopic noncurative resection of gastric cancers with undifferentiated-type components. Journal of gastroenterology and hepatology, 37:758-765, 2022
2. Yoshio T, Minashi K, Mizusawa J, Morita Y, Tajika M, Fujiwara J, Yamamoto Y, Katada C, Hori S, Yano T, Takizawa K, Fukuda H, Muto M. Effect of chemoradiation on the development of second primary cancers after endoscopic resection of T1 esophageal squamous cell carcinoma. Esophagus: official journal of the Japan Esophageal Society, 19:469-476, 2022
3. Sekiguchi M, Oda I, Morita S, Katai H, Yano T, Terashima M, Kataoka T, Muto M. Management of elderly patients with early gastric cancer in Japan. Japanese journal of clinical oncology, 52:425-432, 2022
4. Iwasaki M, Kanehara R, Yamaji T, Katagiri R, Mutoh M, Tsunematsu Y, Sato M, Watanabe K, Hosomi K, Kakugawa Y, Ikematsu H, Hotta K, Kunisawa J, Wakabayashi K, Matsuda T. Association of Escherichia coli containing polyketide synthase in the gut microbiota with colorectal neoplasia in Japan. Cancer science, 113:277-286, 2022
5. Kadota T, Sato D, Inaba A, Nishihara K, Takashima K, Nakajo K, Yukami H, Mishima S, Sawada K, Kotani D, Fujiwara H, Nakamura M, Hojo H, Yoda Y, Kojima T, Fujita T, Yano T. Long-term clinical outcomes of patients diagnosed with pT1a-muscularis mucosae with lymphovascular invasion or pT1b after endoscopic resection for cT1N0M0 esophageal squamous cell carcinoma. Esophagus: official journal of the Japan Esophageal Society, 19:153-162, 2022
6. Ikematsu H, Ishihara M, Okawa S, Minamide T, Mitsui T, Kuwata T, Ito M, Kinoshita T, Fujita T, Yano T, Omori T, Ozawa S, Murakoshi D, Irisawa K, Ochiai A. Photoacoustic imaging of fresh human surgically and endoscopically resected gastrointestinal specimens. DEN open, 2:e28, 2022
7. Sato D, Kadota T, Inaba A, Nishihara K, Takashima K, Nakajo K, Sawada K, Kotani D, Fujiwara H, Yoda Y, Kojima T, Fujita T, Fujii S, Yano T. Long-term clinical outcome after endoscopic resection of esophageal squamous cell carcinoma invading the muscularis mucosae without lymphovascular invasion. Gastrointestinal endoscopy, 95:634-641.e3, 2022
8. Shinmura K, Yamamoto Y, Inaba A, Okumura K, Nishihara K, Kumahara K, Sunakawa H, Furue Y, Ito R, Sato D, Minamide T, Suyama M, Takashima K, Nakajo K, Murano T, Kadota T, Yoda Y, Hori K, Oono Y, Ikematsu H, Yano T. The safety and feasibility of endoscopic submucosal dissection using a flexible three-dimensional endoscope for early gastric cancer and superficial esophageal cancer: A prospective observational study. Journal of gastroenterology and hepatology, 37:749-757, 2022
9. Yamashita H, Kadota T, Minamide T, Sunakawa H, Sato D, Takashima K, Nakajo K, Murano T, Shinmura K, Yoda Y, Ikematsu H, Yano T. Efficacy and safety of second photodynamic therapy for local failure after salvage photodynamic therapy for esophageal cancer. Digestive endoscopy: official journal of the Japan Gastroenterological Endoscopy Society, 34:488-496, 2022
10. Yano T, Yoda Y, Nonaka S, Abe S, Kawata N, Yoshio T, Sasaki T, Tanaka S, Sasaki F, Maekita T, Kitano M, Matsumoto K, Isayama H, Ono H. Pivotal trial of a biodegradable stent for patients with refractory benign esophageal stricture. Esophagus: official journal of the Japan Esophageal Society, 19:516-524, 2022
11. Yano T. What is the next critical finding to change our mind in esophagogastroduodenoscopy? Digestive endoscopy: official journal of the Japan Gastroenterological Endoscopy Society, 34:766-768, 2022
12. Ikematsu H, Murano T, Shinmura K. Depth diagnosis of early colorectal cancer: Magnifying chromoendoscopy or image enhanced endoscopy with magnification? Digestive endoscopy: official journal of the Japan Gastroenterological Endoscopy Society, 34:265-273, 2022
13. Guarner-Argente C, Ikematsu H, Osera S, Fraile M, Ibañez B, Marra-López C, Jerusalén-Gargallo C, Alonso Aguirre PA, Martinez-Ares D, Soto S, Ramos Zabala F, Alvarez-Gonzalez MA, Rodriguez Sánchez J, Múgica F, Nogales Rincon O, Herreros de Tejada A, Redondo-Cerezo E, Martínez-Cara J, López-Rosés L, Rodriguez-Tellez M, Garcia-Bosch O, de la Peña J, Pellisé M, Rivero-Sanchez L, Saperas E, Pérez-Roldán F, Lopez Viedma B, González-Santiago JM, álvarez Delgado A, Cobian C, Pardeiro R, Valdivielso Cortázar E, Colan-Hernandez J, Gordillo J, Kaneko K, Albéniz E . Location, morphology and invasiveness of lateral spreading tumors in the colorectum differ between two large cohorts from an eastern and western country. Gastroenterologia y hepatologia, 45:440-449, 2022
14. Nomura H, Tsuji D, Ueno S, Kojima T, Fujii S, Yano T, Daiko H, Demachi K, Itoh K, Kawasaki T. Relevance of pharmacogenetic polymorphisms with response to docetaxel, cisplatin, and 5-fluorouracil chemotherapy in esophageal cancer. Investigational new drugs, 40:420-429, 2022
15. Saito E, Yano T, Hori M, Yoneoka D, Matsuda T, Chen Y, Katanoda K. Is young-onset esophageal adenocarcinoma increasing in Japan? An analysis of population-based cancer registries. Cancer medicine, 11:1347-1356, 2022
16. Du J, Kageyama SI, Yamashita R, Hirata H, Hakozaki Y, Okumura M, Motegi A, Hojo H, Nakamura M, Hirano Y, Sunakawa H, Minamide T, Kotani D, Tanaka K, Yano T, Kojima T, Ohashi A, Tsuchihara K, Akimoto T. Impacts of the STING-IFNAR1-STAT1-IRF1 pathway on the cellular immune reaction induced by fractionated irradiation. Cancer science, 113:1352-1361, 2022
17. Takashima K, Koga Y, Anzai T, Migita K, Yamaguchi T, Ishikawa A, Sakashita S, Yasunaga M, Yano T. Evaluation of Fluorescence Intensity and Antitumor Effect Using Real-Time Imaging in Photoimmunotherapy. Pharmaceuticals (Basel, Switzerland), 15:2022
18. Mitsui T, Kadota T, Wakabayashi M, Nakajo K, Shinmura K, Sunakawa H, Sato D, Minamide T, Takashima K, Murano T, Yoda Y, Ikematsu H, Yano T. Factors of technical difficulty in conventional and traction-assisted esophageal endoscopic submucosal dissection. Esophagus: official journal of the Japan Esophageal Society, 19:452-459, 2022
19. Ikematsu H, Murano T, Shinmura K. Detection of colorectal lesions during colonoscopy. DEN open, 2:e68, 2022
20. Nakajima T, Sakamoto T, Hori S, Yamada S, Ikematsu H, Harada K, Chiu HM, Kiriyama S, Michida T, Hotta K, Sakamoto N, Abe T, Chino A, Fukuzawa M, Kobayashi N, Fukase K, Matsuda T, Murakami Y, Ishikawa H, Saito Y. Optimal surveillance interval after piecemeal endoscopic mucosal resection for large colorectal neoplasia: a multicenter randomized controlled trial. Surgical endoscopy, 36:515-525, 2022
21. Ishihara R, Mizusawa J, Kushima R, Matsuura N, Yano T, Kataoka T, Fukuda H, Hanaoka N, Yoshio T, Abe S, Yamamoto Y, Nagata S, Ono H, Tamaoki M, Yoshida N, Takizawa K, Muto M. Assessment of the Diagnostic Performance of Endoscopic Ultrasonography After Conventional Endoscopy for the Evaluation of Esophageal Squamous Cell Carcinoma Invasion Depth. JAMA network open, 4:e2125317, 2021
22. Kobayashi S, Ueno M, Ogawa G, Fukutomi A, Ikeda M, Okusaka T, Sato T, Ito Y, Kadota T, Ioka T, Sugimori K, Sata N, Nakamori S, Shimizu K, Mizuno N, Ishii H, Furuse J. Impact of Renal Function on S-1 + Radiotherapy for Locally Advanced Pancreatic Cancer: An Integrated Analysis of Data From 2 Clinical Trials. Pancreas, 50:965-971, 2021
23. Wada Y, Shimada M, Murano T, Takamaru H, Morine Y, Ikemoto T, Saito Y, Balaguer F, Bujanda L, Pellise M, Kato K, Saito Y, Ikematsu H, Goel A. A Liquid Biopsy Assay for Noninvasive Identification of Lymph Node Metastases in T1 Colorectal Cancer. Gastroenterology, 161:151-162.e1, 2021
24. Mori Y, Kudo SE, Misawa M, Hotta K, Kazuo O, Saito S, Ikematsu H, Saito Y, Matsuda T, Kenichi T, Kudo T, Nemoto T, Itoh H, Mori K. Artificial intelligence-assisted colonic endocytoscopy for cancer recognition: a multicenter study. Endoscopy international open, 9:E1004-E1011, 2021
25. Kobayashi N, Takeuchi Y, Ohata K, Igarashi M, Yamada M, Kodashima S, Hotta K, Harada K, Ikematsu H, Uraoka T, Sakamoto N, Doyama H, Abe T, Katagiri A, Hori S, Michida T, Yamaguchi T, Fukuzawa M, Kiriyama S, Fukase K, Murakami Y, Ishikawa H, Saito Y. Outcomes of endoscopic submucosal dissection for colorectal neoplasms: Prospective, multicenter, cohort trial. Digestive endoscopy: official journal of the Japan Gastroenterological Endoscopy Society, 2021
26. Katada C, Muto M, Fujii S, Yokoyama T, Yano T, Watanabe A, Iizuka T, Yoshinaga S, Tateya I, Mitani H, Shimizu Y, Takahashi A, Kamijo T, Hanaoka N, Abe M, Shiotani A, Kano K, Asada Y, Matsuhashi T, Umeno H, Okami K, Goda K, Hori S, Ono Y, Terai S, Nagami Y, Takemura K, Kawada K, Ando M, Shimeno N, Arai A, Sakamoto Y, Ichinoe M, Nemoto T, Fujita M, Watanabe H, Shimoda T, Ochiai A, Kato T, Hayashi R. Transoral surgery for superficial head and neck cancer: National Multi-Center Survey in Japan. Cancer medicine, 10:3848-3861, 2021
27. Sunakawa H, Yoda Y, Takeshita N, Hasegawa H, Takashima K, Kadota T, Fujita T, Akimoto T, Fujii S, Yano T. Endoscopic resection combined with the Cryoballoon focal ablation system in the porcine normal esophagus: a preclinical study. BMC gastroenterology, 21:234, 2021
28. Yano T, Minamide T, Takashima K, Nakajo K, Kadota T, Yoda Y. Clinical Practice of Photodynamic Therapy Using Talaporfin Sodium for Esophageal Cancer. Journal of clinical medicine, 10:2021
29. Minamide T, Sashiyama H, Muramatsu Y, Yada T, Matsumura T, Takeda S, Suzuki T, Kakimoto T, Yano T, Yoshii K, Arai M, Uemura N, Yamaguchi T, Ikematsu H. Second-generation narrow-band imaging to detect colorectal adenomas: A prospective study including community hospitals. Journal of gastroenterology and hepatology, 36:3084-3091, 2021
30. Sato D, Takamatsu T, Umezawa M, Kitagawa Y, Maeda K, Hosokawa N, Okubo K, Kamimura M, Kadota T, Akimoto T, Kinoshita T, Yano T, Kuwata T, Ikematsu H, Takemura H, Yokota H, Soga K. Author Correction: Distinction of surgically resected gastrointestinal stromal tumor by near-infrared hyperspectral imaging. Scientific reports, 11:19030, 2021
31. Hori K, Ikematsu H, Yamamoto Y, Matsuzaki H, Takeshita N, Shinmura K, Yoda Y, Kiuchi T, Takemoto S, Yokota H, Yano T. Detecting colon polyps in endoscopic images using artificial intelligence constructed with automated collection of annotated images from an endoscopy reporting system. Digestive endoscopy: official journal of the Japan Gastroenterological Endoscopy Society, 2021
32. Morita S, Goda K, Yano T, Kaise M, Kato M, Inoue H, Niwa Y, Kodashima S, Miyahara R, Ochiai A, Ikegami M, Hamatani S, Shimoda T, Ohkura Y, Aida J, Nakanishi Y, Yoshimura K, Ishikawa H, Takubo K, Muto M. Multicenter prospective in vivo study of an endocytoscope system (ECS) for superficial esophageal cancer. Journal of gastroenterology, 56:808-813, 2021
33. Ishikawa H, Mutoh M, Sato Y, Doyama H, Tajika M, Tanaka S, Horimatsu T, Takeuchi Y, Kashida H, Tashiro J, Ezoe Y, Nakajima T, Ikematsu H, Hori S, Suzuki S, Otani T, Takayama T, Ohda Y, Mure K, Wakabayashi K, Sakai T. Chemoprevention with low-dose aspirin, mesalazine, or both in patients with familial adenomatous polyposis without previous colectomy (J-FAPP Study IV): a multicentre, double-blind, randomised, two-by-two factorial design trial. The lancet. Gastroenterology & hepatology, 6:474-481, 2021
34. Noguchi M, Shitara K, Kawazoe A, Yamamoto D, Takii Y, Saito Y, Sato T, Horimatsu T, Ishikawa H, Ito Y, Ito M, Ikematsu H. Short-term safety of adjuvant chemoradiotherapy after local resection for patients with high-risk submucosal invasive rectal cancer: a single-arm, multicenter phase II trial. Japanese journal of clinical oncology, 51:707-712, 2021
35. Abe S, Takizawa K, Oda I, Mizusawa J, Kadota T, Ono H, Hasuike N, Yano T, Yamamoto Y, Horiuchi Y, Nagata S, Yoshikawa T, Terashima M, Muto M. Incidence and treatment outcomes of metachronous gastric cancer occurring after curative endoscopic submucosal dissection of undifferentiated-type early gastric cancer: Japan Clinical Oncology Group study-post hoc analysis of JCOG1009/1010. Gastric cancer: official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 24:1123-1130, 2021
36. Kadota T, Minashi K, Wakabayashi M, Yano T, Ezoe Y, Tsuchida T, Ono H, Iizuka T, Matsuura N, Oda I, Takizawa K, Katayama H, Fukuda H, Muto M. Diagnostic yield of conventional endoscopy with endoscopic ultrasonography for submucosal invasion of superficial esophageal squamous cell carcinoma: a post hoc analysis of multicenter prospective confirmatory study (JCOG0508). Esophagus: official journal of the Japan Esophageal Society, 18:604-611, 2021
37. Nakajo K, Yoda Y, Kadota T, Murano T, Shinmura K, Ikematsu H, Akimoto T, Yano T. Radial incision and cutting for dilation before endoscopic submucosal dissection in patients with esophageal cancer on the distal side of severe benign esophageal strictures. Diseases of the esophagus: official journal of the International Society for Diseases of the Esophagus, 34:2021
38. Ito R, Kadota T, Murano T, Yoda Y, Hori K, Minamide T, Sato D, Yamamoto Y, Takashima K, Shinmura K, Ikematsu H, Yano T. Clinical features and risk factors of gastric cancer detected by esophagogastroduodenoscopy in esophageal cancer patients. Esophagus: official journal of the Japan Esophageal Society, 18:621-628, 2021
39. Takamatsu T, Kitagawa Y, Akimoto K, Iwanami R, Endo Y, Takashima K, Okubo K, Umezawa M, Kuwata T, Sato D, Kadota T, Mitsui T, Ikematsu H, Yokota H, Soga K, Takemura H. Over 1000 nm Near-Infrared Multispectral Imaging System for Laparoscopic In Vivo Imaging. Sensors (Basel, Switzerland), 21:2021