Annual Report 2024
Department of Gastroenterology and Endoscopy
Tomonori Yano, Kensuke Shinmura, Tomohiro Kadota, Keiichiro Nakajo, Hironori Sunakawa, Atsushi Inaba, Hiroki Yamashita
Introduction
The Department of Gastroenterology and Endoscopy consists of 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 more than 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 or immune checkpoint inhibitors are developed and included in practice in the oncology field. 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 research (TR), 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 2024, we published the results of several important studies, including the results of a trial of the smartphone application for artificial intelligence-based evaluation of preparation before colonoscopy, phase I study of photoimmunotherapy in combination with nivolumab for advanced gastric cancer, and clinical research of endoscopic resection for neoplastic lesions of the digestive tract.
Clinical Trials
We conducted investigator-initiated clinical trials to be regulatory approved of cryo-balloon ablation system for local failed esophageal cancer after endoscopic resection and the device was regulatory approved this year. We also perform photoimmunotherapy for patients with esophageal cancer with the device development suitable for endoluminal illumination. We also conduct a multi-institutional randomized controlled trial to evaluate new imaging compared with conventional imaging for detection of early cancer in stomach. As a member institution of the JCOG-GI endoscopy study group, we conduct and participate in several randomized controlled trials to establish standard endoscopic treatment for GI cancer.
Education
Our department has two senior residents and nine residents. Trainees perform services in the training program under observation by each specialist. The trainees are educated not only in endoscopic diagnosis and endoscopic treatment strategies, but also in pathological diagnosis, clinical and surgical oncology through conferences with other departments. Furthermore, they actively present their research work at international congresses, and publish papers in international peer-reviewed journals. They wrote 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 2024
Journal
1. Minakata N, Ikematsu H, Kiyomi F, Inoue S, Akutagawa T, Watanabe T, Yano T, Shimoda R. Usefulness of virtual scale endoscope for early gastrointestinal lesions. DEN open, 5:e386, 2025
2. Sekiguchi M, Kawamura T, Horiguchi G, Mizuguchi Y, Takamaru H, Toyoizumi H, 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. Colorectal Neuroendocrine Neoplasm Detection Rate During Colonoscopy: Results From Large-Scale Data of Colonoscopies in Japan. The American journal of gastroenterology, 120:473-477, 2025
3. Watanabe T, Murano T, Ikematsu H, Shinmura K, Wakabayashi M, Minakata N, Maasa S, Mitsui T, Yamashita H, Inaba A, Sunakawa H, Nakajo K, Kadota T, Yano T. Impact of advanced endoscopy training on colonoscopy quality and efficiency. DEN open, 5:e70027, 2025
4. Ikematsu H, Takara Y, Nishihara K, Kano Y, Owaki Y, Okamoto R, Fujiwara T, Takamatsu T, Yamada M, Tomioka Y, Takeshita N, Inaba A, Sunakawa H, Nakajo K, Murano T, Kadota T, Shinmura K, Koga Y, Yano T. Possibility of determining high quantitative fecal occult blood on stool surface using hyperspectral imaging. Journal of gastroenterology, 60:77-85, 2025
5. Ishihara R, Kawachi H, Nakano K, Kadota T, Matsuno K, Takizawa A, Matsunaga T, Ishiyama A, Yano T, Takahashi H, Fujii S. Comprehensive pathological evaluation of risk factors for metastasis after endoscopic resection of superficial esophageal squamous cell carcinoma. Journal of gastroenterology, 60:131-140, 2025
6. Yamamoto Y, Ishihara R, Kawakubo H, Nishikawa M, Yamamoto S, Kadota T, Abe S, Yoshida M, Tanaka T, Nagano H, Nakanishi H, Yoshizaki T, Waki K, Takahashi A, Kitagawa Y, Mizuno K, Kawada K, Kono Y, Katada C, Hashimoto T, Nagami Y, Yoshio T, Shimokawa T, Nihei K, Koyanagi K, Kato K, Yano T, Muto M, Kitagawa Y. Comparison of outcomes between surgery and chemoradiotherapy after endoscopic resection for pT1a-MM with lymphovascular invasion or pT1b esophageal squamous cell carcinoma: Japanese multicenter propensity score-matched study. Journal of gastroenterology, 60:43-54, 2025
7. Urabe A, Adachi M, Sakamoto N, Kojima M, Ishikawa S, Ishii G, Yano T, Sakashita S. Deep learning detected histological differences between invasive and non-invasive areas of early esophageal cancer. Cancer science, 116:824-834, 2025
8. Takizawa K, Ono H, Hasuike N, Takashima A, Minashi K, Boku N, Kushima R, Katayama H, Ogawa G, Fukuda H, Fujisaki J, Oda I, Yano T, Hori S, Doyama H, Hirasawa K, Yamamoto Y, Ishihara R, Tanabe S, Niwa Y, Nakagawa M, Terashima M, Muto M. Correction: A nonrandomized, single-arm confirmatory trial of expanded endoscopic submucosal dissection indication for undifferentiated early gastric cancer: Japan Clinical Oncology Group study (JCOG1009/1010). Gastric cancer, 28:556-558, 2025
9. Minamide T, Minakata N, Yamashita R, Sakashita S, Yoda Y, Ohashi A, Aoshima M, Kobayashi S, Yano T. Oxygen saturation imaging elucidates tumor heterogeneity in gastric cancer. DEN open, 5:e70077, 2025
10. Kano Y, Yamamoto Y, Ikematsu H, Sasabe M, Minakata N, Watanabe T, Yamashita H, Mitsui T, Inaba A, Sunakawa H, Nakajo K, Murano T, Kadota T, Shinmura K, Yano T. Investigation of vertical margin involvement in endoscopic resection for T1 colorectal cancer. Digestive endoscopy, 36:455-462, 2024
11. Saito Y, Sakamoto T, Dekker E, Pioche M, Probst A, Ponchon T, Messmann H, Dinis-Ribeiro M, Matsuda T, Ikematsu H, Saito S, Wada Y, Oka S, Sano Y, Fujishiro M, Murakami Y, Ishikawa H, Inoue H, Tanaka S, Tajiri H. First report from the International Evaluation of Endoscopic classification Japan NBI Expert Team: International multicenter web trial. Digestive endoscopy, 36:591-599, 2024
12. Ito S, Hotta K, Sekiguchi M, Takeuchi Y, Oka S, Yamamoto H, Shinmura K, Harada K, Uraoka T, Hisabe T, Sano Y, Kondo H, Horimatsu T, Kikuchi H, Kawamura T, Nagata S, Yamamoto K, Tajika M, Tsuji S, Kusaka T, Okuyama Y, Yoshida N, Moriyama T, Hasebe A, So S, Saito Y, Nakahira H, Ishikawa H, Matsuda T. Short-term outcomes of endoscopic resection for colorectal neuroendocrine tumors: Japanese multicenter prospective C-NET STUDY. Digestive endoscopy, 36:942-951, 2024
13. Tanaka H, Uraoka T, Kobayashi N, Ohata K, Takeuchi Y, Chino A, Yamada M, Tsuji Y, Hotta K, Harada K, Ikematsu H, Murakami T, Tsuji S, Katagiri A, Hori S, Michida T, Suzuki T, Fukuzawa M, Kiriyama S, Fukase K, Murakami Y, Ishikawa H, Nagahara A, Saito Y. Short-term and long-term outcomes of submucosal dissection for residual or recurrent colorectal tumors after endoscopic resection: Analysis of a multicenter prospective study. Digestive endoscopy, 36:1003-1011, 2024
14. Sekiguchi M, Suzuki H, Takizawa K, 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, Maeda Y, Oyama T, Takenaka R, Yamamoto Y, Shimazu T, Ono H, Tanabe S, Kondo H, Iishi H, Ninomiya M, Oda I. Potential for expanding indications and curability criteria of endoscopic resection for early gastric cancer in elderly patients: results from a Japanese multicenter prospective cohort study. Gastrointestinal endoscopy, 100:438-448.e1, 2024
15. Oka S, Tanaka S, Kajiwara Y, 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, Sugihara K, Ueno H. Treatment Decision for Locally Resected T1 Colorectal Carcinoma-Verification of the Japanese Guideline Criteria for Additional Surgery Based on Long-Term Clinical Outcomes. The American journal of gastroenterology, 119:2019-2027, 2024
16. Yano T, Hayashi Y, Ishihara R, Iijima K, Iwakiri K, Uesato M, Oyama T, Katada C, Kawada K, Kushima R, Tateishi Y, Fujii S, Manabe N, Minami H, Kawakubo H, Tsubosa Y, Yamamoto S, Kadota T, Minashi K, Takeuchi H, Doki Y, Muto M. Remarkable response as a new indicator for endoscopic evaluation of local efficacy of non-surgical treatments for esophageal cancer. Esophagus, 21:85-94, 2024
17. Yamashita K, Oka S, Yamada T, Mitsui K, Yamamoto H, Takahashi K, Shiomi A, Hotta K, Takeuchi Y, Kuwai T, Ishida F, Kudo SE, Saito S, Ueno M, Sunami E, Yamano T, Itabashi M, Ohtsuka K, Kinugasa Y, Matsumoto T, Sugai T, Uraoka T, Kurahara K, Yamaguchi S, Kato T, Okajima M, Kashida H, Akagi Y, Ikematsu H, Ito M, Esaki M, Kawai M, Yao T, Hamada M, Horimatsu T, Koda K, Fukai Y, Komori K, Saitoh Y, Kanemitsu Y, Takamaru H, Yamada K, Nozawa H, Takayama T, Togashi K, Shinto E, Torisu T, Toyoshima A, Ohmiya N, Kato T, Otsuji E, Nagata S, Hashiguchi Y, Sugihara K, Ajioka Y, Tanaka S. Clinicopathological features and prognosis of primary small bowel adenocarcinoma: a large multicenter analysis of the JSCCR database in Japan. Journal of gastroenterology, 59:376-388, 2024
18. Sunakawa H, Yoda Y, Nonaka S, Suzuki H, Abe S, Ishiguro Y, Ikeno T, Wakabayashi M, Sato A, Nakajo K, Kadota T, Yano T. Prospective multicenter trial of the cryoballoon ablation system for superficial esophageal squamous cell carcinoma on post-endoscopic resection scars: a CRYO-SCAR study (EPOC1902). Gastrointestinal endoscopy, 100:429-437, 2024
19. Sekiguchi M, Kishida Y, Ikematsu H, Konno M, Mizuguchi Y, Hotta K, Imai K, Ito S, Takada K, Shiomi A, Yasui H, Tsukamoto S, Hirano H, Kobayashi N, Saito Y, Inaba A, Shinmura K, Konishi J, Ozawa H, Fujita S, Murakami Y, Matsuda T. Proportions and characteristics of interval cancer in annual fecal immunochemical test screening and postcolonoscopy colorectal cancer: Results from a Japanese multicenter prospective study using questionnaires, the C-DETECT study. Digestive endoscopy, 36:1140-1151, 2024
20. Furue Y, Yoda Y, Hori K, Nakajo K, Kadota T, Murano T, Shinmura K, Ikematsu H, Yano T. Outcomes of repeated endoscopic submucosal dissection for superficial Esophageal squamous cell carcinoma on endoscopic resection scar. Diseases of the esophagus, 37:doae018, 2024
21. Mimura T, Yamamoto Y, Suzuki H, Takizawa K, Hirasawa T, Takeuchi Y, Ishido K, Hoteya S, Yano T, Tanaka S, Kudara N, Nakagawa M, Mashimo Y, Ishigooka M, Fukase K, Shimazu T, Ono H, Tanabe S, Kondo H, Iishi H, Ninomiya M, Oda I. Risk factors for intraoperative and delayed perforation related with gastric endoscopic submucosal dissection. Journal of gastroenterology and hepatology, 39:1358-1366, 2024
22. Ueyama H, Hirasawa T, Yano T, Doyama H, Isomoto H, Yagi K, Kawai T, Yao K. Advanced diagnostic endoscopy in the upper gastrointestinal tract: Review of the Japan Gastroenterological Endoscopic Society core sessions. DEN open, 4:e359, 2024
23. Mitsui T, Sunakawa H, Yoda Y, Nishio M, Kondo S, Hamanaka J, Tokoro C, Nakajo K, Maeda S, Yano T, Hirasawa K. Novel gastric endoscopic submucosal dissection training model enhances the endoscopic submucosal dissection skills of trainees: a multicenter comparative study. Surgical endoscopy, 38:3088-3095, 2024
24. Kadota T, Abe S, Uedo N, Doyama H, Furue Y, Muto M, Nonaka S, Takamaru H, Murano T, Nakajo K, Tani Y, Okubo Y, Kawasaki A, Yoshida N, Watanabe A, Katada C, Tamaoki M, Yokoyama A, Furuya H, Ikeno T, Wakabayashi M, Yano T. Comparison of Effective Imaging Modalities for Detecting Gastric Neoplasms: A Randomized 3-Arm Phase II Trial. The American journal of gastroenterology, 119:2010-2018, 2024
25. Saito Y, Toyoshima N, Mizuguchi Y, Sakamoto T, Uraoka T, Ikematsu H, Tamai N, Matsuda T, Misawa M, Hotta K, Shibata T. Protocol for a prospective multicenter randomized controlled trial to evaluate the efficacy of texture and color enhancement imaging (TXI) observation in the detection of colorectal lesions (deTXIon study). Japanese journal of clinical oncology, 54:1052-1056, 2024
26. Habu T, Kumagai S, Bando H, Fujisawa T, Mishima S, Kotani D, Nakamura M, Hojo H, Sakashita S, Kinoshita T, Yano T, Mitsunaga S, Nishikawa H, Koyama S, Kojima T. Definitive chemoradiotherapy induces T-cell-inflamed tumor microenvironment in unresectable locally advanced esophageal squamous cell carcinoma. Journal of gastroenterology, 59:798-811, 2024
27. Tamaru Y, Kuwai T, Kajiwara Y, Oka S, Saito S, Fukunaga Y, Kawachi H, Takamatsu M, Hotta K, Ikematsu H, Kojima M, Saito Y, Kanemitsu Y, Yamada M, Sekine S, Tanaka S, Nagata S, Nakamura T, Yamada K, Konno M, Ishihara S, Saitoh Y, Matsuda K, Togashi K, Komori K, Ishiguro M, Okuyama T, Ohuchi A, Ohnuma S, Sakamoto K, Sugai T, Katsumata K, Matsushita HO, Yamano HO, Nakai K, Uraoka T, Akimoto N, Kobayashi H, Ajioka Y, Sugihara K, Ueno H. Long-Term Outcomes of Additional Surgery After Endoscopic Resection Versus Primary Surgery for T1 Colorectal Cancer. The American journal of gastroenterology, 119:2418-2425, 2024
28. Kadota T, Yano T. Is Lugol chromoendoscopy omissible in screening for esophageal squamous cell carcinoma? Digestive endoscopy, 36:1127-1129, 2024
29. Fujii S, Katada C, Watanabe H, Shimoda T, Ochiai A, Yokoyama T, Sakamoto Y, Kano K, Ichinoe M, Nemoto T, Fujita M, Tateishi Y, Sugiura H, Mikami T, Yano T, Kato T, Muto M, Hayashi R. Tumor thickness as a novel risk factor for lymph node metastasis by superficial squamous cell carcinoma of head and neck. Cancer science, 115:3169-3179, 2024
30. Inaba A, Shinmura K, Matsuzaki H, Takeshita N, Wakabayashi M, Sunakawa H, Nakajo K, Murano T, Kadota T, Ikematsu H, Yano T. Smartphone application for artificial intelligence-based evaluation of stool state during bowel preparation before colonoscopy. Digestive endoscopy, 36:1338-1346, 2024
31. Nakamura Y, Tsukada Y, Matsuhashi N, Murano T, Shiozawa M, Takahashi Y, Oki E, Goto M, Kagawa Y, Kanazawa A, Ohta T, Ouchi A, Bando H, Uchigata H, Notake C, Ikematsu H, Yoshino T. Colorectal Cancer Recurrence Prediction Using a Tissue-Free Epigenomic Minimal Residual Disease Assay. Clinical cancer research, 30:4377-4387, 2024
32. Tsuji S, Doyama H, Kobayashi N, Ohata K, Takeuchi Y, Chino A, Takamaru H, Tsuji Y, Hotta K, Harada K, Ikematsu H, Uraoka T, Murakami T, Katagiri A, Hori S, Michida T, Suzuki T, Fukuzawa M, Kiriyama S, Fukase K, Murakami Y, Ishikawa H, Saito Y. Outcomes of noncurative endoscopic submucosal dissection for T1 colorectal cancer: Prospective, multicenter, cohort study in Japan. Digestive endoscopy, 36:1369-1379, 2024
33. Oka S, Tanaka S, Kajiwara Y, 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, Sugihara K, Ueno H. Correction to: Treatment Decision for Locally Resected T1 Colorectal Carcinoma-Verification of the Japanese Guideline Criteria for Additional Surgery Based on Long-Term Clinical Outcomes. The American journal of gastroenterology, 119:2352, 2024
34. Inaba A, Ikematsu H, Kojima M, Sakamoto N, Wakabayashi M, Sunakawa H, Nakajo K, Murano T, Kadota T, Shinmura K, Yano T. Association between pathological T1 colorectal cancer with lymphoid follicular replacement and risk of lymph node metastasis. Journal of gastroenterology and hepatology, 39:2631-2638, 2024
35. Tanaka H, Koga Y, Sugahara M, Fuchigami H, Ishikawa A, Yamaguchi T, Banba A, Shinozaki T, Matsuura K, Hayashi R, Sakashita S, Yasunaga M, Yano T. Real-Time Fluorescence Monitoring System for Optimal Light Dosage in Cancer Photoimmunotherapy. Pharmaceuticals (Basel, Switzerland), 17:1246, 2024
36. Minakata N, Kadota T, Sakashita S, Inaba A, Sunakawa H, Takashima K, Nakajo K, Murano T, Shinmura K, Yoda Y, Ikematsu H, Fujita T, Kinoshita T, Yano T. Tumor thickness is associated with metastasis in patients with submucosal invasive adenocarcinoma of the esophagogastric junction. Diseases of the esophagus, 37:doae083, 2024
37. Ikuta S, Saito Y, Takata S, Nakatani Y, Nagatomo I, Shiba S, Takeda Y, Totoki Y, Mizutani S, Sunakawa H, Ikematsu H, Takamaru H, Kumanogoh A, Yachida S. Variability in non-tumor areas of colorectal cancer patients as revealed by endoscopic intestinal step biopsies. Molecular cancer, 23:249, 2024