東京大学 · 医学
Kawaguchi教授の研究室は、結腸癌からの肝転移(CLM)の予後予測と治療戦略の最適化を目的とした多施設共同研究を推進しています。特にRAS・TP53遺伝子変異の組み合わせが再発リスクに持続的に影響することを解明し、再発-free生存期間の動的予測(conditional RFS)の有効性を示しています。また、蛍光色素を用いたリアルタイム肝動脈・門脈領域の可視化技術の開発を通じて、解剖的切除の精度向上にも貢献しています。
Figures are computed from collected data and may differ slightly.
This objective and practical classification system allows the stratification of LLR comprising the low (group I), the intermediate (group II), and the high (group III) grades.
<i>RAS</i> mutation status alone is not sufficient for precisely predicting prognosis after CLM resection.
The three-level classification may be useful in studies analysing open liver resection at Western and Eastern centres.
Conditional RFS is useful for updating prognosis after a given time interval without recurrence after CLM resection. Importantly, RAS/TP53 co-mutation has a persistent deleterious association with recurrence.
We have demonstrated the technical details of five types of fluorescence staining techniques. These techniques are safe to perform and facilitate clear visualization of the PV territory in real time, enhancing the efficacy of anatomical removal of such territories.
Kawaguchi, Yoshikuni MD; Ishizawa, Takeaki MD, PhD; Masuda, Koichi MD; Sato, Shoichi MD; Kaneko, Junichi MD, PhD; Aoki, Taku MD, PhD; Beck, Yoshifumi MD, PhD; Sugawara, Yasuhiko MD, PhD; Hasegawa, Kiyoshi MD, PhD; Kokudo, Norihiro MD, PhD Author Information
Colorectal liver metastases (CLM) are not always resectable at the time of diagnosis. An insufficient future liver remnant is a factor excluding patients from curative intent resection. To deal with this issue, two-stage hepatectomy was introduced approximately 20 years ago. It is a sequential treatment strategy for bilateral CLM, which consists of preoperative chemotherapy, portal vein embolization, and planned first and second liver resections. This study reviews current evidence supporting us
For patients who have undergone CLM resection, we propose surveillance every 3 to 4 months during years 0 to 2, every 3 to 4 months (if mutant RAS) versus every 4 to 6 months (if RAS wild-type) during years 2 to 4, and every 6 to 12 months if recurrence-free at 4 years.
The statins use reduced the risk of HCC recurrence after initial resection. Statins may have protective influences on HCC recurrence in patients who undergo initial liver resection.
The contour prognostic model, based on diameter and number of lesions considered as continuous variables along with RAS mutation, predicts overall survival after resection of colorectal liver metastasis.
Laparoscopic approach was clinically chosen for approximately 30% of all liver resections and for more than 60% of left lateral sectionectomy in selected centers worldwide.
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