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Biomedical subjects

M Tokushige

Publications and source records attributed to M Tokushige.

97 records · Page 6Linked to original sources
PubMedDate not supplied

Carcinomatous lymphatic invasion in early gastric cancer invading into the submucosa.

BACKGROUND: Lymphatic invasion is a risk factor for lymph node metastases in patients with gastric cancer. No studies have been reported, however, on the correlation between lymphatic invasion and lymph node metastasis in early gastric cancer invading into the submucosa. METHODS: We performed a retrospective analysis of lymphatic invasion in 170 patients with early gastric cancer invading into the submucosa. RESULTS: Lymphatic invasion was found in 76 patients. Lymphatic invasion correlated significantly with the presence of lymph node metastasis and vascular invasion (P < .05) and with the degree of cancerous submucosal involvement (P < .05). The presence of lymph node metastasis also correlated with the grade of submucosal invasion and lymphatic invasion. The 5-year survival of patients with lymphatic invasion was poorer than that of patients without lymphatic invasion (P < .05). Node-negative patients had similar survival, regardless of the presence of lymphatic invasion. All patients with severe lymphatic invasion had sm3 invasion and lymph node metastases. CONCLUSION: Although lymphatic invasion is the first stage of lymph node metastasis, lymphatic invasion in itself does not have clinical importance except for severe invasion in early gastric cancer. It is possible to predict lymph node metastases from the combined evaluation of degree of lymphatic invasion and submucosal involvement of the tumor in patients with early gastric cancer invading into the submucosa.

Aged↗
PubMedDate not supplied

Prognostic value of HLA-DR expression and dendritic cell infiltration in gastric cancer.

We attempted to correlate the expression of human leukocyte antigen DR (HLA-DR) and tumor infiltration by S-100-protein-positive dendritic cells with clinicopathologic features in 165 patients with gastric cancer. The expression of HLA-DR was correlated with the histologic type. Infiltration of dendritic cells correlated negatively with distant lymph node metastases, clinical stage, and peritoneal invasion. There was no correlation between the expression of HLA-DR and infiltration by dendritic cells. In patients with resectable gastric cancer, the grade of infiltrating dendritic cells may be a suitable predictor of prognosis.

Adult↗
PubMedDate not supplied

Strategy of gastric cancer in patients 85 years old and older.

BACKGROUND/AIMS: There is little information about the clinical and pathological features of patients with gastric cancer aged 85 years old and older. METHODOLOGY: We analyzed data of 197 gastric cancer patients aged 75 years and older. The patients were dividing into three age groups and we retrospectively studied 25 gastric cancer patients aged 85 years old and older and compared their clinical courses with those of 94 patients in their late 70s and 78 patients in their early 80s. RESULTS: The patients aged 85 years and older had a significantly higher rate of symptoms on admission such as gastric outlet obstruction and progressive anemia (64%), than did the other two age groups (p<0.05). Twenty-five percent of the oldest age group did not have surgery, and none had a D2 lymph node dissection. Perioperative complications were more frequent in the oldest group than in the youngest group (p<0.05). Survival in the oldest patients was not affected by surgical resection. CONCLUSIONS: These results indicate curative gastric surgery has a less positive impact in patients aged 85 years and older than younger patients. Treatment for gastric cancer in patients 85 years old and older should emphasize the palliation of symptoms but not curative resection.

Aged↗
PubMedDate not supplied

Clinical and pathologic features of early gastric cancer in elderly patients.

BACKGROUND/AIMS: The purpose of this study was to review the Clinicopathologic features of early gastric cancer in elderly patients. METHODOLOGY: Three hundred and seventy-two patients who underwent resection for early gastric cancer were divided into groups of patients younger and older than 70 years. The clinical and pathologic findings surgical treatment, and perioperative complications in the group of elderly patients with early gastric cancer were reviewed and compared to those of the younger group. RESULTS: Gastric cancer involving the lower third of the stomach, as well as histopathologically well-differentiated carcinomas, were significantly more prevalent in the older group. Pre-operatively, the older patients had a higher incidence of respiratory dysfunction and hypertension. D1 lymph node dissections were chosen frequently for older patients. Six older patients died within 2 months of hospitalization, while no younger patients died within this period. The mortality rate mas 11% in older patients undergoing D2 or greater extents of node dissection, although the mortality rate was only 2% in older patients undergoing a D1 or less dissection. The 5-year survival rate for older patients, including deaths unrelated to cancer, was 71%, which was significantly lower than that in the younger group. However, when only mortality from gastric cancer was considered, patient survival did not differ according to age. CONCLUSION: Given the high mortality in elderly patients unrelated to early gastric cancer, we concluded that node dissection should be limited to perigastric nodes according to tumor location in such patients.

Adenocarcinoma↗