Annual Report 2022
Department of Gastroenterology and Endoscopy
Tomonori Yano, Hiroaki Ikematsu, Kensuke Shinmura, Tomohiro Kadota, Tatsuro Murano, Keiichiro Nakajo, Hironori Sunakawa, Atsushi Inaba, Hiroki Yamashita
Introduction
The Department of Gastroenterology and Endoscopy includes seven staff doctors who specialize in the endoscopic diagnosis and treatment of gastrointestinal tract and head and neck cancer. The mission of our department is to achieve the following goals for patients with cancer using endoscopy: early detection, less invasive treatment, and palliation for painful symptoms.
The Team and What We Do
The staff members of this department perform approximately 16,000 endoscopic procedures in total and 2,500 endoscopic resections for neoplastic lesions annually (Table 1). We also performed advanced endoscopic treatment including EMR/ESD for early cancer, salvage treatment such as ESD and 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. The upper GI group aggressively performed endoscopic treatment for early pharyngeal cancer in collaboration with the Department of Head and Neck Surgery. The colon group focuses on the diagnosis with fine magnified images using image-enhanced endoscopy for adenoma and early cancer, even in clinical practice. During the daily endoscopic examination, physicians access primary tumors through endoscopy and easily biopsy numerous samples from cancerous lesions. Recently, a lot of molecular-target agents have been developed and included in practice in the oncology field. Endoscopy is therefore 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 corporations, and clinical studies. In the TR research field, we collaboratively perform studies with several divisions in the Exploratory Oncology Research and Clinical Trial Center to elucidate the microenvironment and immunological status of cancer in the digestive tract and head and neck using samples retrieved by endoscopy. In 2022, we published the results of several important studies, including a prospective study on the risk of transmission due to droplets and aerosols during endoscopic procedures, and clinical research of endoscopic resection for neoplastic lesions of the digestive tract.
Clinical Trials
We conduct investigator-initiated clinical trials to be regulatory approved of cryo-balloon ablation system for local failed esophageal cancer after endoscopic resection and photoimmunotherapy for patients with esophageal or gastric cancer. We also conduct a multi-institutional randomized control trial to evaluate new imaging compared with conventional imaging for early cancer detection in the stomach. As a member institution of the JCOG-GI endoscopy study group, we conduct and participate in several randomized control trials to establish the standard endoscopic treatment for GI cancer.
Education
Our department has two senior residents and eight residents. Trainees perform services in the training program under observation by each specialist. The trainees are educated not only for endoscopic diagnosis and endoscopic treatment strategies, but also for pathological diagnosis, clinical and surgical oncology through conferences with other departments. Furthermore, the trainees actively present their research work at international congresses, and publish papers in international peer-reviewed journals. The trainees have written several study protocols, mainly for innovative development in endoscopic imaging and treatment.
Future Prospects
We would like to innovate new endoscopic imaging and treatment strategies for patients with cancer through close collaboration with corporations and academic institutions, not only for the present but also for the NEXT generation.
List of papers published in 2022
Journal
1. Nihei K, Minashi K, Yano T, Shimoda T, Fukuda H, Muto M. Final Analysis of Diagnostic Endoscopic Resection Followed by Selective Chemoradiotherapy for Stage I Esophageal Cancer: JCOG0508. Gastroenterology, 164:296-299.e2, 2023
2. Suzuki H, Ono H, Hirasawa T, Takeuchi Y, Ishido K, Hoteya S, Yano T, Tanaka S, Toya Y, Nakagawa M, Toyonaga T, Takemura K, Hirasawa K, Matsuda M, Yamamoto H, Tsuji Y, Hashimoto S, Yuki M, Oyama T, Takenaka R, Yamamoto Y, Naito Y, Yamamoto K, Kobayashi N, Kawahara Y, Hirano M, Koizumi S, Hori S, Tajika M, Hikichi T, Yao K, Yokoi C, Ohnita K, Hisanaga Y, Sumiyoshi T, Kitamura S, Tanaka H, Shimoda R, Shimazu T, Takizawa K, Tanabe S, Kondo H, Iishi H, Ninomiya M, Oda I. Long-term Survival After Endoscopic Resection For Gastric Cancer: Real-world Evidence From a Multicenter Prospective Cohort. Clinical gastroenterology and hepatology, 21:307-318.e2, 2023
3. Kadota T, Ishihara R, Hatta W, Yoshida M, Kanzaki H, Kikuchi D, Ono Y, Abe S, Yamamoto Y, Yoshio T, Urabe Y, Yamaguchi N, Nagami Y, Iizuka T, Takahashi H, Oyama T, Yano T. Multi-institutional questionnaire on treatment strategies for superficial entire circumferential esophageal squamous cell carcinoma. DEN open, 3:e206, 2023
4. Murano T, Ikematsu H, Shinmura K, Okumura K, Kuwata T, Ushiama M, Yoshida T, Takashima K, Nakajo K, Kadota T, Yoda Y, Oono Y, Yano T. Endoscopic management of familial adenomatous polyposis targeting colorectal lesions greater than 5 mm in size: a single-center retrospective study. Familial cancer, 22:83-89, 2023
5. Ishikawa H, Yamada M, Sato Y, Tanaka S, Akiko C, Tajika M, Doyama H, Takayama T, Ohda Y, Horimatsu T, Sano Y, Tanakaya K, Ikematsu H, Saida Y, Ishida H, Takeuchi Y, Kashida H, Kiriyama S, Hori S, Lee K, Tashiro J, Kobayashi N, Nakajima T, Suzuki S, Mutoh M. Intensive endoscopic resection for downstaging of polyp burden in patients with familial adenomatous polyposis (J-FAPP Study III): a multicenter prospective interventional study. Endoscopy, 55:344-352, 2023
6. Kajiwara Y, Oka S, Tanaka S, Nakamura T, Saito S, Fukunaga Y, Takamatsu M, Kawachi H, Hotta K, Ikematsu H, Kojima M, Saito Y, Yamada M, Kanemitsu Y, Sekine S, Nagata S, Yamada K, Kobayashi N, Ishihara S, Saitoh Y, Matsuda K, Togashi K, Komori K, Ishiguro M, Kuwai T, Okuyama T, Ohuchi A, Ohnuma S, Sakamoto K, Sugai T, Katsumata K, Matsushita HO, Yamano HO, Eda H, Uraoka T, Akimoto N, Kobayashi H, Ajioka Y, Sugihara K, Ueno H. Nomogram as a novel predictive tool for lymph node metastasis in T1 colorectal cancer treated with endoscopic resection: a nationwide, multicenter study. Gastrointestinal endoscopy, 97:1119-1128.e5, 2023
7. Zhao Y, Peng F, Wang C, Murano T, Baba H, Ikematsu H, Li W, Goel A. A DNA Methylation-based Epigenetic Signature for the Identification of Lymph Node Metastasis in T1 Colorectal Cancer. Annals of surgery, 277:655-663, 2023
8. Sunakawa H, Yoda Y, Takahashi M, Arai K, Kano Y, Yamashita H, Aoyama N, Mitsui T, Inaba A, Takashima K, Nakajo K, Murano T, Kadota T, Shinmura K, Ikematsu H, Yano T. Prospective study on the risk of transmission due to droplets and aerosols during an endoscopic procedure and the usefulness of extraoral suction devices. Digestive endoscopy, 35:332-341, 2023
9. Mitsui T, Nakajo K, Takashima K, Murano T, Kadota T, Shinmura K, Yoda Y, Ikematsu H, Maeda S, Yano T. Usefulness of endoscopic ultrasound in predicting treatment efficacy of salvage endoscopic therapy for local failure after chemoradiotherapy for esophageal squamous cell carcinoma. Esophagus, 20:116-123, 2023
10. Sakamoto T, Ikematsu H, Tamai N, Mizuguchi Y, Takamaru H, Murano T, Shinmura K, Sasabe M, Furuhashi H, Sumiyama K, Saito Y. Detection of colorectal adenomas with texture and color enhancement imaging: Multicenter observational study. Digestive endoscopy, 35:529-537, 2023
11. Miyazaki K, Wada Y, Okuno K, Murano T, Morine Y, Ikemoto T, Saito Y, Ikematsu H, Kinugasa Y, Shimada M, Goel A. An exosome-based liquid biopsy signature for pre-operative identification of lymph node metastasis in patients with pathological high-risk T1 colorectal cancer. Molecular cancer, 22:2, 2023
12. Matsumura T, Ebigbo A, Römmele C, Ikematsu H, Ishigami H, Suzuki T, Harada H, Yada T, Takatori Y, Takeuchi M, Okimoto K, Akizue N, Maruoka D, Kitagawa Y, Minamide T, Iwaki T, Amano Y, Matsusaka K, Nagashima K, Maehata T, Yahagi N, Messmann H, Kato N. Diagnostic Value of Adding Magnifying Chromoendoscopy to Magnifying Narrow-Band Imaging Endoscopy for Colorectal Polyps. Clinical gastroenterology and hepatology, 2023
13. Kano Y, Kadota T, Inaba A, Sunakawa H, Takashima K, Nakajo K, Murano T, Shinmura K, Yoda Y, Ikematsu H, Akimoto T, Yano T. Efficacy and safety of repeated endoscopic radial incision and cutting procedure for benign esophageal stricture. Endoscopy international open, 11:E230-E236, 2023
14. Takeuchi H, Ito Y, Machida R, Kato K, Onozawa M, Minashi K, Yano T, Nakamura K, Tsushima T, Hara H, Okuno T, Hironaka S, Nozaki I, Ura T, Chin K, Kojima T, Seki S, Sakanaka K, Fukuda H, Kitagawa Y. A Single-Arm Confirmatory Study of Definitive Chemoradiation Therapy Including Salvage Treatment for Clinical Stage II/III Esophageal Squamous Cell Carcinoma (JCOG0909 Study). International journal of radiation oncology, biology, physics, 114:454-462, 2022
15. 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
16. Ito R, Nakamura Y, Sunakawa H, Fujiwara H, Hojo H, Nakamura N, Fujita T, Yano T, Daiko H, Akimoto T, Yoshino T, Kojima T. Tumor response and survival outcomes of salvage concurrent chemoradiotherapy with three-dimensional conformal radiotherapy and 5-fluorouracil/platinum-based chemotherapy for postoperative locoregional recurrence of esophageal squamous cell carcinoma. Esophagus, 19:645-652, 2022
17. 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, 34:1042-1051, 2022
18. Ainechi D, Misawa M, Barua I, Larsen SLV, Paulsen V, Garborg KK, Aabakken L, Tønnesen CJ, Løberg M, Kalager M, Kudo SE, Hotta K, Ohtsuka K, Saito S, Ikematsu H, Saito Y, Matsuda T, Itoh H, Mori K, Bretthauer M, Mori Y. Impact of artificial intelligence on colorectal polyp detection for early-career endoscopists: an international comparative study. Scandinavian journal of gastroenterology, 57:1272-1277, 2022
19. Ohata K, Kobayashi N, Sakai E, Takeuchi Y, Chino A, Takamaru H, Kodashima S, Hotta K, Harada K, Ikematsu H, Uraoka T, Murakami T, Tsuji S, Abe T, Katagiri A, Hori S, Michida T, Suzuki T, Fukuzawa M, Kiriyama S, Fukase K, Murakami Y, Ishikawa H, Saito Y. Long-term Outcomes After Endoscopic Submucosal Dissection for Large Colorectal Epithelial Neoplasms: A Prospective, Multicenter, Cohort Trial From Japan. Gastroenterology, 163:1423-1434.e2, 2022
20. Yamamoto Y, Yoshida N, Yano T, Horimatsu T, Uedo N, Kawata N, Kanzaki H, Hori S, Yao K, Abe S, Katada C, Yokoi C, Ohata K, Doyama H, Yoshimura K, Ishikawa H, Muto M. Assessment of Outcomes From 1-Year Surveillance After Detection of Early Gastric Cancer Among Patients at High Risk in Japan. JAMA network open, 5:e2227667, 2022
21. Yoshida M, Takizawa K, Hasuike N, Ono H, Boku N, Kadota T, Mizusawa J, Oda I, Yoshida N, Horiuchi Y, Hirasawa K, Morita Y, Yamamoto Y, Muto M. Second gastric cancer after curative endoscopic resection of differentiated-type early gastric cancer: post-hoc analysis of a single-arm confirmatory trial. Gastrointestinal endoscopy, 95:650-659, 2022
22. 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
23. 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, 19:469-476, 2022
24. Kawamura T, Sekiguchi M, Takamaru H, Mizuguchi Y, Horiguchi G, Kato M, Kobayashi K, Sada M, Oda Y, Yokoyama A, Utsumi T, Tsuji Y, Ohki D, Takeuchi Y, Shichijo S, Ikematsu H, Matsuda K, Teramukai S, Kobayashi N, Matsuda T, Saito Y, Tanaka K. "Endoscopic" adenoma detection rate as a quality indicator of colonoscopy: First report from the J-SCOUT study. Digestive endoscopy, 2022
25. 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
26. Nakajo K, Inaba A, Aoyama N, Takashima K, Kadota T, Yoda Y, Morishita Y, Okano W, Tomioka T, Shinozaki T, Matsuura K, Hayashi R, Akimoto T, Yano T. The characteristics of missed pharyngeal and laryngeal cancers at gastrointestinal endoscopy. Japanese journal of clinical oncology, 52:575-582, 2022
27. 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
28. Fujita T, Sato K, Ozaki A, Tomohiro A, Sato T, Hirano Y, Fujiwara H, Yoda Y, Kojima T, Yano T, Daiko H. A novel imaging technology to assess oxygen saturation of the gastric conduit in thoracic esophagectomy. Surgical endoscopy, 36:7597-7606, 2022
29. Sawada K, Kotani D, Yukami H, Mishima S, Fujiwara H, Kadota T, Nakajo K, Yoda Y, Nakamura M, Hojo H, Yano T, Fujita T, Kojima T. Definitive chemoradiotherapy has comparable survival outcomes to esophagectomy in patients with clinical T1N0M0 esophageal squamous cell carcinoma: real-world data. International journal of clinical oncology, 27:1279-1288, 2022
30. 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
31. 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
32. 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, 34:1021-1029, 2022
33. Yano T. What is the next critical finding to change our mind in esophagogastroduodenoscopy? Digestive endoscopy, 34:766-768, 2022
34. 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
35. 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, 19:516-524, 2022
36. 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, 19:452-459, 2022
37. Yamashita H, Nakajo K, Takashima K, Murano T, Kadota T, Sinmura K, Yoda Y, Ikematsu H, Fujii S, Yano T. Recurrent metastasis risk factors in esophageal cancer after salvage endoscopic resection for local failure following chemoradiotherapy. Digestive endoscopy, 34:1356-1369, 2022
38. Yano T. Can endoscopic submucosal dissection be an appropriate initial treatment for T1 esophageal squamous cell carcinoma? Digestive endoscopy, 34:805-807, 2022
39. Shimoda R, Akutagawa T, Tomonaga M, Murano T, Shinmura K, Yoshioka M, Teramura Y, Kiyomi F, Ikematsu H. Estimating colorectal polyp size with a virtual scale endoscope and visual estimation during colonoscopy: Prospective, preliminary comparison of accuracy. Digestive endoscopy, 34:1471-1477, 2022
40. Yamashita H, Ikematsu H, Murano T, Aoyama N, Kano Y, Mitsui T, Sunakawa H, Shinmura K, Takashima K, Nakajo K, Kadota T, Yoda Y, Yano T. The usefulness of a double-balloon endolumenal interventional platform for colorectal endoscopic submucosal dissection by non-expert endoscopists in a porcine model (with video). Surgical endoscopy, 36:7818-7826, 2022
41. Nakajo K, Yoda Y, Yamashita H, Takashima K, Murano T, Kadota T, Shinmura K, Ikematsu H, Akimoto T, Yano T. Salvage endoscopic resection for cT1N0M0 local recurrence after chemoradiotherapy for esophageal squamous cell carcinoma: endoscopic submucosal dissection versus endoscopic mucosal resection. Japanese journal of clinical oncology, 52:982-991, 2022
42. Suto S, Matsuzaka M, Sawaya M, Sakuraba H, Mikami T, Matsuda T, Fujii T, Saito Y, Hotta K, Ikematsu H, Hanabata N, Saito H, Yoshida S, Fukuda S. Clinical Features of Fecal Immunochemical Test-Negative Colorectal Lesions based on Colorectal Cancer Screening among Asymptomatic Participants in Their 50s. Asian Pacific journal of cancer prevention, 23:2325-2332, 2022
43. Mitsui T, Yoda Y, Sunakawa H, Takayama S, Nishihara K, Inaba A, Sato D, Minamide T, Takashima K, Nakajo K, Murano T, Kadota T, Shinmura K, Ikematsu H, Yano T. Development of new gastric endoscopic submucosal dissection training model: A reproducibility evaluation study. Endoscopy international open, 10:E1261-E1267, 2022
44. Katada C, Yokoyama T, Hirasawa D, Iizuka T, Kikuchi D, Yano T, Honbu T, Yoshio T, Yoshimizu S, Ono H, Yabuuchi Y, Terai S, Hashimoto S, Takahashi K, Tanaka S, Urabe Y, Arima M, Tanabe S, Wada T, Furue Y, Oyama T, Takahashi A, Sakamoto Y, Muto M. Curative management after endoscopic resection for esophageal squamous cell carcinoma invading muscularis mucosa or shallow submucosal layer - multicenter real-world survey in Japan. The American journal of gastroenterology, 2022