The University of Tokyo · Medicine
Professor Yoshikuni Kawaguchi's research lab specializes in hepatobiliary and pancreatic surgery, with a primary focus on improving outcomes in patients with colorectal liver metastases (CLM). The lab investigates prognostic biomarkers—particularly RAS and TP53 mutation status—and develops practical classification systems to stratify recurrence risk, enabling personalized treatment strategies. They also pioneer advanced surgical techniques, including fluorescence imaging for real-time visualization of the portal vein territory, enhancing the precision of anatomical liver resections. Their work bridges clinical oncology, surgical innovation, and molecular pathology to optimize patient prognosis.
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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