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Annual Report 2022

Department of Esophageal Surgery

Hiroyuki Daiko, Junya Oguma, Koshiro Ishiyama, Kyohei Kanematsu, Kentaro Kubo, Yuto Kubo, Daichi Utsunomiya, Shota Igaue

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, robot-assisted esophagectomy and gastric reconstruction have been implemented since 2018.

The Team and What We Do

 The Department of Esophageal Surgery consists of three staff surgeons and five 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 and radiation oncologists. Approximately, four patients undergo surgery every week. In 2022, 180 patients underwent esophagectomies. The number of patients who undergo robot-assisted esophagectomy is gradually increasing year by year.

Research Activities

 Currently, our department is examining the role of robotic surgery as a minimally invasive esophagectomy that consists of robotic esophagectomy and robotic reconstruction. Even for patients with radical chemoradiotherapy, these procedures are being attempted to make it a standard surgical treatment 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. Our institution developed bilateral transcervical esophagectomy. We are assessing the efficacy of a novel ultimate surgical approach for bilateral transcervical esophagectomy.

Clinical Trials

 We initiatively enroll patients in JCOG clinical study as a central institute of the JCOG esophageal cancer group. Current clinical studies in progress are mentioned as follows:

1.  A multicenter randomized controlled trial of esophagectomy with or without prophylactic supraclavicular node dissection: a phase 3 trial (JCOG2013 study).

2.  A randomized controlled phase II/III trial of neoadjuvant chemotherapy for Japanese patients with esophagogastric junction adenocarcinoma (JCOG2203 study).

3.  A randomized controlled phase III study comparing surgery alone versus adjuvant nivolumab versus adjuvant S-1 for locally advanced esophageal squamous cell carcinoma with no pathological complete response after neoadjuvant chemotherapy followed by curative esophagectomy (JCOG2206 study).

List of papers published in 2022

Journal

1. Matsuzaki J, Kato K, Oono K, Tsuchiya N, Sudo K, Shimomura A, Tamura K, Shiino S, Kinoshita T, Daiko H, Wada T, Katai H, Ochiai H, Kanemitsu Y, Takamaru H, Abe S, Saito Y, Boku N, Kondo S, Ueno H, Okusaka T, Shimada K, Ohe Y, Asakura K, Yoshida Y, Watanabe SI, Asano N, Kawai A, Ohno M, Narita Y, Ishikawa M, Kato T, Fujimoto H, Niida S, Sakamoto H, Takizawa S, Akiba T, Okanohara D, Shiraishi K, Kohno T, Takeshita F, Nakagama H, Ota N, Ochiya T. Prediction of tissue-of-origin of early stage cancers using serum miRNomes. JNCI cancer spectrum, 7:pkac080, 2023

2. Kadono T, Yamamoto S, Hirose T, Ikeda G, Ohara A, Itoyama M, Yokoyama K, Honma Y, Hashimoto T, Sekine S, Ishiyama K, Oguma J, Daiko H, Kato K. Safety and short-term efficacy of preoperative FOLFOX therapy in patients with resectable esophageal squamous cell carcinoma who are ineligible for cisplatin. Esophagus, 20:109-115, 2023

3. Hirano Y, Fujita T, Konishi T, Takemura R, Sato K, Kurita D, Ishiyama K, Fujiwara H, Oguma J, Itano O, Daiko H. Impact of pre-diabetes, well-controlled diabetes, and poorly controlled diabetes on anastomotic leakage after esophagectomy for esophageal cancer: a two-center retrospective cohort study of 1901 patients. Esophagus, 20:246-255, 2023

4. Hirano Y, Konishi T, Kaneko H, Itoh H, Matsuda S, Kawakubo H, Uda K, Matsui H, Fushimi K, Daiko H, Itano O, Yasunaga H, Kitagawa Y. Early postoperative non-steroidal anti-inflammatory drugs and anastomotic leakage after oesophagectomy. The British journal of surgery, 110:260-266, 2023

5. Oguma J, Ishiyama K, Kurita D, Kanematsu K, Kubo K, Utsunomiya D, Yamamoto S, Honma Y, Kato K, Daiko H. Significance of lymphovascular invasion in esophageal squamous cell carcinoma undergoing neoadjuvant chemotherapy followed by esophagectomy. Esophagus, 20:215-224, 2023

6. Fukushima T, Watanabe N, Okita Y, Yokota S, Matsuoka A, Kojima K, Kurita D, Ishiyama K, Oguma J, Kawai A, Daiko H. The evaluation of the association between preoperative sarcopenia and postoperative pneumonia and factors for preoperative sarcopenia in patients undergoing thoracoscopic-laparoscopic esophagectomy for esophageal cancer. Surgery today, 2023

7. Oguma J, Ishiyama K, Kurita D, Kanematsu K, Kubo K, Utsunomiya D, Abe S, Makiguchi M, Nonaka S, Suzuki H, Yoshinaga S, Oda I, Saito Y, Daiko H. Oncologic significance of lymphovascular invasion in patients with superficial esophageal squamous cell carcinoma reaching the muscularis mucosae or with slight invasion of the submucosa. Surgery, 173:1162-1168, 2023

8. Mitani S, Kato K, Daiko H, Ito Y, Nozaki I, Kojima T, Yano M, Nakagawa S, Ueno M, Watanabe M, Tsunoda S, Abe T, Kadowaki S, Kadota T, Sasaki K, Machida R, Kitagawa Y. Second primary malignancies in patients with clinical T1bN0 esophageal squamous cell carcinoma after definitive therapies: supplementary analysis of the JCOG trial: JCOG0502. Journal of gastroenterology, 57:455-463, 2022

9. Ishiyama K, Oguma J, Kubo K, Kanematsu K, Kurita D, Daiko H. Salvage minimally invasive esophagectomy after definitive chemoradiotherapy for esophageal cancer can improve postoperative complications compared with salvage open esophagectomy. Surgical endoscopy, 36:3504-3510, 2022

10. Nozaki I, Machida R, Kato K, Daiko H, Ito Y, Kojima T, Yano M, Ueno M, Nakagawa S, Kitagawa Y. Long-term survival of patients with T1bN0M0 esophageal cancer after thoracoscopic esophagectomy using data from JCOG0502: a prospective multicenter trial. Surgical endoscopy, 36:4275-4282, 2022

11. Oguma J, Ishiyama K, Kurita D, Kanematsu K, Fujii Y, Kubo K, Yamamoto S, Honma Y, Kato K, Daiko H. Novel pathological staging for patients with locally advanced esophageal squamous cell carcinoma undergoing neoadjuvant chemotherapy followed by surgery. Esophagus, 19:214-223, 2022

12. 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

13. Kanamori K, Kurita D, Hirano Y, Ishiyama K, Oguma J, Masutomi K, Daiko H. Does synchronous early head and neck cancer with esophageal cancer need treatment after preoperative chemotherapy? General thoracic and cardiovascular surgery, 70:280-284, 2022

14. Sato K, Fujita T, Matsuzaki H, Takeshita N, Fujiwara H, Mitsunaga S, Kojima T, Mori K, Daiko H. Real-time detection of the recurrent laryngeal nerve in thoracoscopic esophagectomy using artificial intelligence. Surgical endoscopy, 36:5531-5539, 2022

15. Fujita T, Sato K, Ozaki A, Akutsu T, Fujiwara H, Kojima T, Daiko H. Propensity-Matched Analysis of the Short-Term Outcome of Robot-Assisted Minimally Invasive Esophagectomy Versus Conventional Thoracoscopic Esophagectomy in Thoracic Esophageal Cancer. World journal of surgery, 46:1926-1933, 2022

16. Ishiyama K, Oguma J, Kubo K, Kanematsu K, Fujii Y, Kurita D, Daiko H. Does Preoperative Corticosteroid Administration Improve the Short-Term Outcome of Minimally Invasive Esophagectomy for Esophageal Cancer? A Propensity Score-Matched Analysis. Annals of surgical oncology, 29:6886-6893, 2022

17. Kurita D, Utsunomiya D, Kubo K, Fujii Y, Kanematsu K, Ishiyama K, Oguma J, Daiko H. Handgrip strength predicts early postoperative dysphagia after thoracoscopic-laparoscopic esophagectomy in male patients with esophageal cancer. Esophagus, 19:586-595, 2022

18. Kurita D, Sakurai T, Utsunomiya D, Kubo K, Fujii Y, Kanematsu K, Ishiyama K, Oguma J, Daiko H. Predictive Ability of the Five-time Chair Stand Test for Postoperative Pneumonia after Minimally Invasive Esophagectomy for Esophageal Cancer. Annals of surgical oncology, 29:7462-7470, 2022

19. Hirano Y, Konishi T, Kaneko H, Itoh H, Matsuda S, Kawakubo H, Uda K, Matsui H, Fushimi K, Daiko H, Itano O, Yasunaga H, Kitagawa Y. Impact of Prophylactic Corticosteroid Use on In-hospital Mortality and Respiratory Failure after Esophagectomy for Esophageal Cancer: Nationwide Inpatient Data Study in Japan. Annals of surgery, 2022

20. 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

21. Sadahiro R, Wada S, Matsuoka YJ, Uchitomi Y, Yamaguchi T, Sato T, Esaki M, Yoshimoto S, Daiko H, Kanemitsu Y, Kawai A, Kato T, Fujimoto H, Uezono Y, Shimizu K, Matsuoka H. Prevention of delirium with agitation by yokukansan in older adults after cancer surgery. Japanese journal of clinical oncology, 52:1276-1281, 2022

22. Hirano Y, Kaneko H, Konishi T, Itoh H, Matsuda S, Kawakubo H, Uda K, Matsui H, Fushimi K, Daiko H, Itano O, Yasunaga H, Kitagawa Y. Short-Term Outcomes of Epidural Analgesia in Minimally Invasive Esophagectomy for Esophageal Cancer: Nationwide Inpatient Data Study in Japan. Annals of surgical oncology, 29:8225-8234, 2022

23. Oguma J, Ozawa S, Ishiyama K, Daiko H. Clinical significance of sarcopenic dysphagia for patients with esophageal cancer undergoing esophagectomy: A review. Annals of gastroenterological surgery, 6:738-745, 2022

24. Kubo K, Oguma J, Utsunomiya D, Kanematsu K, Fujii Y, Kurita D, Ishiyama K, Abe S, Sekine S, Daiko H. Clinicopathological Features of Early-Stage Esophageal Carcinosarcoma. Case reports in gastroenterology, 16:569-576, 2022

25. Kojima K, Fukushima T, Kurita D, Matsuoka A, Ishiyama K, Oguma J, Daiko H. Perioperative Decrease in Tongue Pressure is an Intervenable Predictor of Aspiration After Esophagectomy. Dysphagia, 2022

26. Kanematsu K, Kudose Y, Utsunomiya D, Kubo K, Fujii Y, Kurita D, Ishiyama K, Oguma J, Daiko H. Surveillance Strategy after Curative Resection for Oesophageal Squamous Cell Cancer Using the Hazard Function. BMC cancer, 22:1245, 2022

27. Suzuki K, Yamaguchi T, Kohda M, Tanaka M, Takemura H, Wakita M, Tabe Y, Kato S, Nasu M, Hashimoto T, Mine S, Serizawa N, Tomishima K, Nagahara A, Matsuda T, Yamaji T, Tsugane S, Saito Y, Daiko H, Yoshikawa T, Kato K, Okusaka T, Ochiya T, Yamamoto Y, Yotsui S, Yamamoto T, Yamasaki T, Miyata H, Yasui M, Omori T, Ohkawa K, Ikezawa K, Nakabori T, Sugimoto N, Kudo T, Yoshida K, Ohue M, Nishizawa T. Establishment of preanalytical conditions for microRNA profile analysis of clinical plasma samples. PloS one, 17:e0278927, 2022