Annual Report 2024
Department of Neurosurgery and Neuro-Oncology
Yoshitaka Narita, Makoto Ohno, Shunsuke Yanagisawa, Daisuke Kawauchi, Takaki Omura, Takuma Aoki, Akiya Kawanishi
Introduction
We treat patients with primary and metastatic brain tumors. Approximately 300 patients were admitted and 171 craniotomies for tumor removal and biopsy were performed in 2024 including 73 gliomas, 62 brain metastases, 3 primary CNS lymphomas, and 15 meningiomas (Table 1). The extent of tumor removal was visualized on an intraoperative MRI in real time, contributing to safer and more precise surgery. Intraoperative monitoring with motor- and sensory-evoked potential (MEP and SEP) recordings and preoperative functional MRI and MR tractography were also used to preserve patient neurological function. Awake surgeries for 32 cases were also performed, particularly for the removal of gliomas near the speech center. Patients with malignant brain tumors underwent postoperative radiotherapy and chemotherapy. New intraoperative MRI was updated.
Table 1. Surgical cases for brain tumors
To perform a more effective chemotherapy regimen, molecular biological studies for drug resistance and growth factors, cell kinetic studies on individual tumors and several clinical trials are ongoing.
The Team and What We Do
A weekly conference on the treatment of patients with brain tumors is held with doctors from the Department of Radiation Oncology and Pathology and the Division of Brain Tumor Translational Research. Usually, 10-15 patients are hospitalized, and 3 or 4 of them undergo surgical treatment every week. Patients with malignant brain tumors receive postoperative radiotherapy and chemotherapy. Statistical analysis revealed that surgical removal of as much of the tumor as possible yielded better survival rates even for most malignant glioblastomas, which usually recur immediately after surgery without radiotherapy. Concomitant use of chemotherapy is considered to enhance the anti-tumor effect of radiotherapy.
The decision on the indication for surgery of metastatic brain tumors is not a simple one. Multiplicity of brain metastasis, the stage of the primary malignancy and the patient performance status should be carefully considered.
Research Activities
Gene expression profiles in malignant gliomas are analyzed to determine specific genes that influence the effects of chemotherapy and radiation therapy in cooperation with the Division of Brain Tumor Translational Research, the National Cancer Center Research Institute. The determination of the methylation status of O6-methylguanine-DNA methyltransferase (MGMT) and the mutation of IDH1/2 and TERT are also performed to predict the prognosis of patients with malignant gliomas within one week after surgery. Clinical sequence for 113 gene mutations, chromosomal abnormalities, and MGMT promoter methylation was performed within one month after surgery.
Clinical Trials
The Japan Clinical Oncology Group (JCOG)-Brain Tumor Study Group was organized in 2003 and multi-institutional randomized controlled trials are performed. “Randomized phase III study for unresectable WHO Grade II astrocytoma with radiotherapy alone or chemoradiotherapy with temozolomide (JCOG1303)”, Phase III randomized study for grade III gliomas (JCOG1016), and phase III study for glioblastoma (JCOG1308, JCOG1703, JCOG1910 and JCOG2209) are ongoing. These studies, under the surveillance of the JCOG, aim to establish a standard protocol for treating malignant brain tumor patients. Moreover, a proper methodology for performing randomized studies will be established in the field of neuro-oncology.
An investigator-initiated phase I/II clinical trial of metformin and temozolomide for newly-diagnosed glioblastomas, as well as a Phase III clinical trial of 64Cu-ATSM for malignant gliomas, have been performed under AMED grants.
Education
Our department plays a pivotal role in the JCOG-Brain Tumor Study Group and the brain tumor registry of Japan, and we have conducted many clinical trials and run the brain tumor registry. We educate many neurosurgeons and oncologists about surgical techniques of awake craniotomy and intraoperative MRI and the effective usage and adverse effects of many chemotherapeutic agents for malignant brain tumors.
Future Prospects
Malignant brain tumors, especially glioblastoma, still have worse prognosis among cancers. We continually strive to eradicate these brain cancers through a variety of clinical work and research.
List of papers published in 2024
Journal
1. Takami H, Matsutani M, Suzuki T, Takabatake K, Fujimaki T, Okamoto M, Yamaguchi S, Kanamori M, Matsuda K, Sonoda Y, Natsumeda M, Ichinose T, Nakada M, Muroi A, Ishikawa E, Takahashi M, Narita Y, Tanaka S, Saito N, Higuchi F, Shin M, Mineharu Y, Arakawa Y, Kagawa N, Kawabata S, Wanibuchi M, Takayasu T, Yamasaki F, Fujii K, Ishida J, Date I, Miyake K, Fujioka Y, Kuga D, Yamashita S, Takeshima H, Shinojima N, Mukasa A, Asai A, Nishikawa R. Phase II trial of pathology-based tripartite treatment stratification for patients with CNS germ cell tumors: A long-term follow-up study. Neuro-oncology, 27:828-840, 2025
2. Ozeki Y, Honda-Kitahara M, Yanagisawa S, Takahashi M, Ohno M, Miyakita Y, Kikuchi M, Nakano T, Hosoya T, Sugino H, Satomi K, Yoshida A, Igaki H, Kubo Y, Ichimura K, Suzuki H, Masutomi K, Kondo A, Narita Y. Early progressive disease within 2 years in isocitrate dehydrogenase (IDH)-mutant astrocytoma may indicate radiation necrosis. Japanese journal of clinical oncology, 55:106-112, 2025
3. Sakurada K, Sato I, Ikeda M, Narita Y. Mental health status and associated factors of caregivers of patients with malignant brain tumors. Journal of neuro-oncology, 173:71-82, 2025
4. Deguchi S, Ohka F, Shiba Y, Yamaguchi J, Sato A, Shinjo K, Arakawa Y, Narita Y, Kondo Y, Saito R. Investigator-initiated phase I trial of an oligonucleotide therapeutic targeting long noncoding RNA TUG 1 for recurrent glioblastoma. BMC cancer, 25:251, 2025
5. Osawa S, Kawauchi D, Ohno M, Miyakita Y, Takahashi M, Yanagisawa S, Fujita S, Tsuchiya T, Matsumi J, Sato T, Narita Y. Outcomes of awake surgery for recurrent glioblastoma: A single-institution retrospective analysis. Journal of clinical neuroscience, 134:111113, 2025
6. Ono T, Uto M, Mineharu Y, Arakawa Y, Nakamura M, Nishio T, Igaki H, Nihei K, Ishikura S, Narita Y, Mizowaki T. Dummy run study for outlining and plan quality of intensity-modulated radiotherapy in elderly patients with newly diagnosed glioblastoma: The Japan clinical oncology group study JCOG1910 (AgedGlio-PIII). Radiation oncology (London, England), 20:32, 2025
7. Nakashima T, Yamamoto R, Ohno M, Sugino H, Takahashi M, Funakoshi Y, Nambu S, Uneda A, Yanagisawa S, Uzuka T, Arakawa Y, Hanaya R, Ishida J, Yoshimoto K, Saito R, Narita Y, Suzuki H. Development of a rapid and comprehensive genomic profiling test supporting diagnosis and research for gliomas. Brain tumor pathology, 41:50-60, 2024
8. Takamizawa S, Koyama T, Sunami K, Sudo K, Hirata M, Kubo T, Tao K, Cho H, Narita Y, Kato K, Yamazaki N, Ohe Y, Okusaka T, Matsui Y, Ogawa C, Yonemori K, Yamamoto N. Identification of barriers to implementation of precision oncology in patients with rare cancers. Cancer science, 115:2023-2035, 2024
9. Kubo T, Sunami K, Koyama T, Kitami M, Fujiwara Y, Kondo S, Yonemori K, Noguchi E, Morizane C, Goto Y, Maejima A, Iwasa S, Hamaguchi T, Kawai A, Namikawa K, Arakawa A, Sugiyama M, Ohno M, Yoshida T, Hiraoka N, Yoshida A, Yoshida M, Nishino T, Furukawa E, Narushima D, Nagai M, Kato M, Ichikawa H, Fujiwara Y, Kohno T, Yamamoto N. The impact of rare cancer and early-line treatments on the benefit of comprehensive genome profiling-based precision oncology. ESMO open, 9:102981, 2024
10. Watanabe Y, Chen YW, Igaki H, Arakawa A, Tao K, Sugiyama M, Nakajima M, Shirakawa N, Yanagisawa S, Miyakita Y, Yoshida A, Isohashi K, Ono K, Narita Y, Ogawa C. Boron neutron capture therapy prolongs survival in a patient with a recurrent malignant peripheral nerve sheath tumor-A case report. Pediatric blood & cancer, 71:e31011, 2024
11. Yonezawa H, Narita Y, Nagane M, Mishima K, Terui Y, Arakawa Y, Asai K, Fukuhara N, Sugiyama K, Shinojima N, Aoi A, Nishikawa R. Three-year follow-up analysis of phase 1/2 study on tirabrutinib in patients with relapsed or refractory primary central nervous system lymphoma. Neuro-oncology advances, 6:vdae037, 2024
12. Kawaguchi Y, Watanabe Y, Miyakita Y, Ohno M, Ogawa C, Takahashi M, Yanagisawa S, Mukai T, Igaki H, Sugino H, Yoshida A, Narita Y. Successful treatment of pediatric patients with high-grade gliomas featuring leptomeningeal metastases by targeting BRAF V600E mutations with dabrafenib plus trametinib: two illustrative cases. International cancer conference journal, 13:256-262, 2024
13. Ohno M, Kawaguchi Y, Sugino H, Yoshida A, Takahashi M, Yanagisawa S, Osawa S, Tsuchiya T, Fujita S, Narita Y. Resection and postoperative pazopanib for intraspinal recurrent solitary fibrous tumor: illustrative case. Journal of neurosurgery. Case lessons, 8:CASE24217, 2024
14. Ohno M, Takahashi M, Yanagisawa S, Osawa S, Tsuchiya T, Fujita S, Igaki H, Narita Y. Development of a scoring system to predict local recurrence in brain metastases following complete resection and observation. Journal of neuro-oncology, 170:297-305, 2024
15. Osawa S, Miyakita Y, Takahashi M, Ohno M, Yanagisawa S, Kawauchi D, Omura T, Fujita S, Tsuchiya T, Matsumi J, Sato T, Narita Y. The Safety and Usefulness of Awake Surgery as a Treatment Modality for Glioblastoma: A Retrospective Cohort Study and Literature Review. Cancers, 16:2632, 2024
16. Tsuchiya T, Ohno M, Watanabe Y, Fujita S, Miyazaki B, Sugino H, Igaki H, Yoshida A, Takahashi M, Yanagisawa S, Osawa S, Ogawa C, Narita Y. Pediatric atypical teratoid/rhabdoid tumor in the cauda equina with rapid tumor progression: illustrative case. Journal of neurosurgery. Case lessons, 8:CASE24219, 2024
17. Fujita S, Ohno M, Osaki S, Sugino H, Yoshida A, Takahashi M, Yanagisawa S, Osawa S, Tsuchiya T, Narita Y. Novel case of anastomosing hemangioma of the extradural space: illustrative case. Journal of neurosurgery. Case lessons, 8:CASE24265, 2024
18. Tsuchiya T, Kawauchi D, Ohno M, Miyakita Y, Takahashi M, Yanagisawa S, Osawa S, Fujita S, Omura T, Narita Y. Risk Factors of Distant Recurrence and Dissemination of IDH Wild-Type Glioblastoma: A Single-Center Study and Meta-Analysis. Cancers, 16:2873, 2024
19. Motomura K, Sasaki K, Sugii N, Yamaguchi S, Inoue H, Oshima A, Tanaka K, Otani Y, Shirahata M, Shibahara I, Nagane M, Tsuzuki S, Matsutani T, Tsukamoto Y, Kijima N, Asano K, Ohno M, Inoue A, Mineharu Y, Miyake K, Mitobe Y, Hanihara M, Kawanishi Y, Deguchi S, Saito M, Matsuda R, Ujifuku K, Arita H, Sato Y, Yamashita S, Yonezawa U, Yamaguchi J, Momii Y, Ogawa T, Kambe A, Ohba S, Fukai J, Saito N, Kinoshita M, Sumi K, Otani R, Uzuka T, Takebe N, Koizumi S, Saito R, Arakawa Y, Narita Y. Cost of medical care for malignant brain tumors at hospitals in the Japan Clinical Oncology Group brain-tumor study group. Japanese journal of clinical oncology, 54:1123-1131, 2024
20. Oort Q, Reijneveld JC, Sikkes SAM, Koekkoek JAF, Boele F, Young T, Brannan C, Chalk T, Talacchi A, Mazzotta A, Narita Y, Sato H, Miyakita Y, Shamieh O, Alrjoob W, Pace A, Petranovic D, Ploh M, Capela A, Silva J, Hjermstad MJ, Purkart TU, Seidel C, Talhi N, Pichler J, Höllmüller I, Brown L, Hand M, Klein M, Aaronson NK, Uitdehaag BMJ, Taphoorn MJB, Dirven L. Instrumental activities of daily living in neuro-oncology: International validation of the EORTC IADL-BN32 questionnaire. European journal of cancer (Oxford, England : 1990), 212:114335, 2024
21. Kinoshita M, Fushimi Y, Masumoto T, Sasaki K, Sekita T, Natsume A, Wakabashi T, Komori T, Tsuzuki S, Muragaki Y, Motomura K, Saito R, Sato K, Beppu T, Takahashi M, Kuroda JI, Sonoda Y, Kobayashi K, Mishima K, Mitsuya K, Yamasaki F, Inoue A, Matsutani T, Nakamura H, Yamaguchi S, Ishikawa E, Nakaya M, Tanaka S, Ujifuku K, Uchida H, Kanamori M, Otani R, Kijima N, Nishida N, Yoshino A, Mineharu Y, Arakawa Y, Fukuda H, Narita Y. Image-based Re-evaluation of the JCOG0911 Study Focusing on Tumor Volume and Survival, Disease Progression Diagnosis, and Radiomic Prognostication for Newly Diagnosed Glioblastoma. Magnetic resonance in medical sciences, 2024
22. Kanamori M, Tsuzuki S, Shibahara I, Saito K, Shimoda Y, Tanaka K, Yamaguchi S, Natsumeda M, Matsutani T, Hanihara M, Nakada M, Kuroda JI, Matsuda M, Yoshimoto K, Yonezawa U, Sonoda Y, Takano K, Yonezawa H, Otani Y, Nakahara Y, Uchida M, Nonaka M, Mineharu Y, Kitamura Y, Yamashita S, Yamauchi T, Miyake Y, Deguchi S, Beppu T, Tamura K, Koizumi S, Hirose Y, Asano K, Hiruta R, Kinoshita M, Miyake K, Nakayama N, Inoue A, Ono T, Sasaki T, Akiyama Y, Fukami S, Yoshino A, Kawanishi Y, Asanome T, Yamaguchi T, Takahashi M, Yamasaki F, Arakawa Y, Narita Y. Impact of tumor-treating fields on the survival of Japanese patients with newly diagnosed glioblastoma: A multicenter, retrospective cohort study. Neuro-oncology advances, 6:vdae176, 2024
23. Hattori K, Makishima K, Suma S, Abe Y, Suehara Y, Sakamoto T, Kurita N, Ishii R, Matsuoka R, Matsuda M, Tsurubuchi T, Nishikawa R, Tanaka S, Mukasa A, Narita Y, Ichimura K, Nagane M, Takano S, Mathis BJ, Ishikawa E, Matsubara D, Chiba S, Sakata-Yanagimoto M. Association between microenvironment-related genes and prognosis of primary central nervous system lymphoma. EJHaem, 5:1201-1214, 2024
24. Tsuchiya T, Takahashi M, Ohno M, Yanagisawa S, Osawa S, Fujita S, Narita Y. Delayed Deep White Matter Ischemia After Resection of Gliomas by Awake Surgery. Neurosurgery practice, 5:e00105, 2024