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H Mieno

Publications and source records attributed to H Mieno.

28 records · Page 2Linked to original sources

The concepts, procedures, and problems related in endoscopic laser therapy of early gastric cancer. A retrospective study on early gastric cancer.

We report 34 cases of early gastric cancer in which endoscopic laser therapy was performed at the Kitasato University Hospital. The problems encountered were the size and location of the tumor, the presence of lymphatic metastasis or concomitant disorders, and technical problems associated with the irradiation procedure. Of the 34 cases, 22 cases were considered as completely cured (no malignancy was detected after laser therapy), 11 cases were incompletely cured (malignant cells were detected after laser therapy), and 1 case was undetermined.

Adenocarcinoma↗

[A case of advanced gastric cancer (Borrmann's type 2) that disappeared following short-term preoperative chemotherapy with UFT].

On June 2, 1988, a 63-year-old male visited Kitasato University East Hospital because of body weight loss. After an upper GI series and endoscopic examination the patient was diagnosed as having an advanced gastric cancer (Borrmann's type 2) that occupied the anterior wall of the mid portion of the stomach. Endoscopic biopsied specimens showed a poorly differentiated adenocarcinoma, histologically. Thus, the patient was administered UFT (600 mg/day) for preoperative chemotherapy for 3 weeks, and then underwent surgery on July 7, 1988. In a resected specimen, the cancerous lesion was found to have reduced in size and, macroscopically, had changed to a more flat type. Further, on histological examination, no cancerous cell were found in the primary lesion or in the regional lymph nodes in the resected specimen. Thus we report this case as representing a complete to UFT chemotherapy.

Adenocarcinoma↗

Modified treatment of early gastric cancer: evaluation of endoscopic treatment of early gastric cancers with respect to treatment indication groups.

The results of endoscopic treatment of early gastric cancers were evaluated. The lesions were divided into two groups: the group with an absolute indication (AI) and the other with a relative indication (RI) for endoscopic treatment. Endoscopic mucosal resection (EMR) was performed on 106 lesions in 104 patients. In addition, 108 patients were treated by laser irradiation (LI). The status of the patients were serially assessed during the postoperative period. The residual rate in AI patients who underwent EMR was 30.3%, whereas the rate in RI patients was 80%. The residual rate in 70 AI patients who underwent LI was 0%. Although the recurrence rate was 4.2%, the cumulative curative rate after additional treatments was 100%. The residual rate in RI patients who underwent LI was 17.4%, and the recurrence rate was 13.2%. The cumulative curative rate after additional treatments was 97.4%. In AI patients, the initial mode of treatment use was EMR. Patients who exhibited residual cancerous tissue after EMR or those in whom EMR was difficult to perform, either technically or otherwise, underwent LI. EMR was the first choice therapeutic technique because endoscopic specimens obtained could be subjected to histopathologic examination. In RI patients, the conventional operation was the therapeutic technique of first choice. The LI procedure was performed in those who either refused surgery or who could not undergo operative treatment for various reasons.

Combined Modality Therapy↗

Improvement in gastric histology following Helicobacter pylori eradication therapy in Japanese peptic ulcer patients.

We aimed to determine if successful or failed eradication of Helicobacter pylori with triple therapy causes any difference in gastric mucosal histology. Japanese H. pylori-positive patients with a healed peptic ulcer received high (n = 112) or low (n = 113) doses of triple therapy (omeprazole, amoxicillin and clarithromycin) for 1 week. Biopsies from the greater curvature of the central antrum and upper corpus were taken 6 weeks and 30 weeks after treatment completion, and gastric mucosal histology compared between successful (n = 171) and failed (n = 34) eradication groups. Morphological variables of gastritis were graded according to the updated Sydney System. Successful eradication therapy was defined as improvement in inflammation, neutrophil activity and atrophy; failed eradication therapy as improvement in inflammation and neutrophil activity only. Gastric mucosal atrophy gradually improved (in addition to improvements in inflammation and neutrophil activity) with successful eradication of H. pylori infection.

Aged↗

Recent results in the surgical treatment of gastric cancer according to the Japanese and TNM classification.

BACKGROUND: Recent outcomes based on surgical long-term follow-up of patients with gastric cancer using current staging systems have not been fully evaluated. MATERIALS AND METHODS: A total of 1357 patients with primary gastric carcinoma (911 males and 446 females, ranging in age from 20 to 87 years; average 59.1 years) who had undergone gastric resection between 1986 and 1996 were examined with respect to their clinicopathological features, surgical procedures and patient survival according to Japanese and UICC-TNM classifications. RESULTS: The 5-year survival rate was 95.3% for stage Ia, 85.5% for stage Ib, 73.8% for stage II, 45.7% for stage IIIa, 20.9% for stage IIIb, 17.3% for stage IVa and 5.8% for stage IVb (8.8% for IVa and IVb) on the Japanese classification. By way of contrast, the 5-year survival rate was 95.6% for stage Ia, 85.0% for stage Ib, 72.1% for stage II, 49.3% for stage IIIa, 30.2% for stage IIIb and 12.0% for stage IV on the TNM classification. CONCLUSION: Although minor problems are associated with both the Japanese and TNM classification systems, both appear to be clinically significant and appropriate independent predictors of prognosis. The findings of the present study provide important information for comparing results among different institutes and for introducing new clinical trials for gastric cancer at the beginning of the new century.

Adult↗

Results of resection of gastric cancer with distant metastases.

BACKGROUND/AIMS: The present study was carried out in order to examine the outcome of resection in cases of gastric cancer with distant metastases. METHODOLOGY: The survival rates of two hundred and eighty-one patients who had undergone resection for primary carcinomas of the stomach, and who had distant metastases according to the TNM classification, were studied. RESULTS: The 5-year survival rates for patients with metastasis to the peritoneum or group 3 nodes were 8.9% and 15.3% respectively and were significantly higher than the survival rates for patients with metastasis to the liver (0%), to group 4 nodes (2.2%) or to more than one site among the liver, lymph nodes and peritoneum (3.5%). Moreover, the 5-year survival rates for patients with metastasis to the peritoneum and N3 nodes increased significantly to 29.4% and 24.2%, respectively, when curative surgery was performed. CONCLUSIONS: The findings of the present study suggests that metastases to the adjacent peritoneum or group 3 nodes have a greater chance of being cured using radical surgery, and that gastrectomy with extended lymphadenectomy (D2-D3) may be used for advanced gastric cancer if there is no gross evidence of metastasis to the distant peritoneum, liver or group 4 nodes.

Case-Control Studies↗