Japanese journal of clinical oncology最新文献

Objective: Esophageal cancer is one of the most lethal cancers worldwide. Loss of skeletal muscle after esophagectomy worsens prognosis; however, it remains unclear which musculoskeletal factors, such as muscle and fat mass, are associated with this loss. We investigated factors associated with postoperative skeletal muscle mass decrease in patients undergoing esophagectomy for esophageal cancer.

Methods: Fifty-two patients who underwent radical subtotal esophagectomy from 2021 to 2023 were reviewed. Changes in skeletal muscle mass index (SMI) were compared using multifrequency bioelectrical impedance analysis conducted at ~1 month and 3 months after surgery. Statistical analyses, including univariable and multivariable logistic regression, were performed to identify risk factors for decreased SMI.

Results: The analysis divided patients into increased and decreased SMI groups (32 and 20 patients, respectively). Multivariable logistic regression analysis identified risk factors for decreased SMI as fat mass (OR = 1.290, 95%CI: 1.080-1.540, P = .004), clinical stage, and forced expiratory volume in 1 s. Models incorporating other body composition variables showed that % body fat, visceral fat area, and body mass index (BMI) were also associated with decreased SMI. Patients with higher fat mass tended to have lower postoperative energy surplus (total caloric intake minus basal metabolic rate) (r = -0.538 P < .001). Patients in the decreased SMI group had significantly lower overall survival (log-rank, P = .048).

Conclusions: These findings indicate that postoperative skeletal muscle loss is associated with body composition characteristics beyond body weight or BMI, including fat mass. Prospective studies are needed to evaluate individualized muscle preservation programs based on comprehensive body composition assessment.

Background: We aimed to assess 15-year trends in the 5-year net survival for patients with colon or rectal cancer from 2000 to 2014 and registered in the 16 Japanese regional population-based cancer registries included in the CONCORD-3 study.

Methods: Data were included for adults (15-99 years) diagnosed with a cancer of the colon or rectum from 2000 to 2014 and followed up until 31 December 2014. We estimated the 5-year net survival by anatomic site, age, and stage using the Pohar Perme estimator. Age-standardized net survival was estimated using the International Cancer Survival Standard weights.

Results: We analyzed data on 247 682 and 102 776 patients with colon and rectal cancer, respectively. Age-standardized 5-year net survival increased from 63.4% (95% CI: 62.7%-64.0%) in 2000-2004 to 67.8% (67.3%-68.4%) in 2010-2014 for colon cancer and from 58.6% (57.6%-59.5%) to 64.8% (64.0%-65.7%) for rectal cancer over the same period. For both cancers, survival was lower for older patients (75-99 years) than other age groups. Five-year net survival was lower for right-sided than left-sided colon cancer. Five-year net survival was higher than 90% for localized cancers of both the colon and rectum throughout 2000-2014. Survival for regional and distant disease for both cancers improved.

Conclusions: For both colon and rectal cancers, the 5-year net survival improved from 2000 to 2014. However, no improvement was noted for older patients. These results may serve as evidence for developing new cancer control measures and treatment strategies, with a focus on older patients.

Background: We assessed survival trends and international comparisons of patients with cutaneous melanoma from Japanese regional population-based cancer registries participating in the CONCORD-3 study.

Methods: Subjects were patients aged 15-99 years diagnosed with cutaneous melanoma during 2000-2014, with follow-up completed either 5 years after diagnosis or through 31 December 2014. Five-year net survival was estimated by morphological type and calendar period of diagnosis, using the Pohar Perme estimator, and age-standardized using the International Cancer Survival Standard weights.

Results: Age-standardized 5-year net survival for cutaneous melanoma remained stable among 4018 eligible subjects as follows: 68.9% during 2000-2004 (862 patients), 68.3% during 2005-2009 (1819 patients), and 69.0% during 2010-2014 (1337 patients). Five-year net survival in 2010-2014 was highest for lentigo maligna melanoma (89.0%, 64 patients, not age-standardized), followed by superficial spreading melanoma (88.4%, 91 patients) and acral lentiginous melanoma (83.7%, 163 patients, not age-standardized). However, survival for malignant melanoma not otherwise specified (68.0%, 1120 patients) and nodular melanoma was lower (56.5%, 58 patients). Five-year net survival for all types of cutaneous melanoma combined during 2010-2014 was lower in Japan (69.0%) and South Korea (59.9%) than in Australia, France, Germany, Italy, UK, Canada and the US (>85.7%).

Conclusions: International disparities in net survival for cutaneous melanoma may be attributable to differences in the distribution of histological sub-types of melanoma and to variation in the availability and utilization of treatment modalities. Continuous monitoring of cancer survival is crucial for developing effective cancer control strategies.

Background: We assessed survival trends for children with brain tumors, acute lymphoblastic leukemia (ALL), and lymphomas from 16 Japanese regional population-based cancer registries participating in CONCORD-3.

Methods: We analyzed data for children (0-14 years) diagnosed with a brain tumor, ALL, or lymphoma during 2000-14, with follow-up for at least 5 years after diagnosis or through 31 December 2014. Five-year net survival was estimated by calendar period of diagnosis, age group, and morphology group (for brain tumors), using the Pohar Perme estimator, and age standardized by assigning equal weights to the three age-specific estimates (0-4, 5-9, 10-14 years).

Results: Data on children with a brain tumor (n = 1293), ALL (1438), or lymphoma (508) were eligible. During 2010-14, age-standardized 5-year net survival was 69.6% for brain tumors, 87.6% for ALL, and 89.6% for lymphomas. Survival for ALL was 79.7% in 2000-4, and 87.6% in 2010-14. There were no notable trends for brain tumors or lymphomas. Point estimates of survival for these three childhood cancers in Japan were lower than in several of the Western countries that participated in CONCORD-3.

Conclusions: The improved survival for ALL probably reflects improved treatment, whereas the lack of improvement for brain tumors may reflect the difficulty in developing more effective treatment strategies for these aggressive tumors. Treatment for lymphomas was established in the 2000s. To evaluate cancer care for children in Japan, we need to continue to monitor survival, using population-based cancer registry data.

Background: Pancreatic and liver cancers are the 6th and 7th most common cancers in Japan and are major contributors to cancer mortality.

Methods: We used CONCORD-3 data to estimate survival for primary pancreas and liver cancers, registered in 16 population-based regional cancer registries. Five-year net survival was estimated with the Pohar Perme estimator for three periods (2000-2004, 2005-2009, 2010-2014), adjusted for age using International Cancer Survival Standard weights.

Results: We analysed data on 79 636 patients with pancreatic cancer and 122 792 patients with liver cancer. Carcinoma accounted for 91.4% of pancreatic cancers, and age-standardized 5-year net survival remained poor, from 6.4% (95% CI: 5.9%-6.9%) in 2000-2004 to 8.3% (7.8%-8.7%) in 2010-2014. Five-year net survival for localized disease increased slightly, from 39.3% (33.4%-45.2%) in 2000-2004 to 44.2% (36.8%-51.7%) in 2010-2014. Distant-stage pancreatic cancer survival remained <2% throughout 2000-2014. Hepatocellular carcinoma accounted for 83.7% of liver cancers. Five-year net survival increased from 27.4% (26.8%-28.1%) in 2000-2004 to 33.4% (32.7%-34.0%) in 2010-2014. Five-year net survival for localized liver cancer increased from 38.0% (35.3%-40.7%) in 2000-2004 to 48.8% (46.4%-51.3%) in 2010-2014, while distant-stage survival remained <5% throughout 2000-2014.

Conclusions: Five-year net survival remained poor for patients with pancreatic cancer in Japan throughout 2000-2014. Survival for liver cancer improved slightly. Early detection and improved diagnostic methods may help in reduce the proportion of patients diagnosed with advanced-stage.

Background: Pancreatic cancers other than pancreatic ductal adenocarcinoma (PDAC) are rare and heterogeneous, accounting for fewer than 5%-7% of all pancreatic cancers. These include acinar cell carcinoma, undifferentiated carcinoma, adenosquamous carcinoma, colloid carcinoma, neuroendocrine carcinoma (NEC), mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN), and invasive intraductal papillary mucinous carcinoma (IPMC). Optimal treatment strategies, including sequencing and later-line options, remain unclear. Although nanoliposomal irinotecan (nal-IRI) plus 5-fluorouracil (5-FU) and l-leucovorin (LV) is effective in gemcitabine-refractory PDAC, its role in these rare subtypes is unknown.

Methods: We retrospectively analyzed nine patients with one of these rare subtypes who received nal-IRI plus 5-FU and LV between June 2020 and November 2024. Efficacy and safety were evaluated.

Results: The cohort included two cases each of IPMC and adenosquamous carcinoma, and one case each of colloid carcinoma, undifferentiated carcinoma, acinar cell carcinoma, NEC, and MiNEN. Partial responses were observed in four patients, including undifferentiated carcinoma, acinar cell carcinoma, NEC, and MiNEN, even among tumors refractory to gemcitabine- or platinum-based regimens. Disease control was achieved in seven patients (77.8%). The median progression-free survival was 6.8 months. Disease control exceeding 12 months was observed in three patients. Median overall survival from first-line therapy was not reached. Treatment-related toxicities were generally manageable, with neutropenia being the most common grade ≥ 3 adverse event.

Conclusion: Nal-IRI plus 5-FU and LV showed antitumor activity and was tolerable among the nine patients analyzed in this study, suggesting it may be a therapeutic option in second- or later-line settings for rare pancreatic cancer.

Background: We assessed trends and international comparisons of net survival for patients with esophageal cancer using data from Japanese regional population-based cancer registries participating in the CONCORD-3 study.

Methods: The analysis included 63 631 patients aged 15-99 years diagnosed with esophageal cancer during 2000-14, with follow-up completed either 5 years after diagnosis or by 31 December 2014. Five-year net survival was estimated using the Pohar Perme estimator, by sex, anatomical subsite, calendar period of diagnosis, and extent of disease. Survival estimates were age-standardized using the International Cancer Survival Standard weights.

Results: During 2000-14, the age-standardized 5-year net survival for esophageal cancer improved from 27.7% (95% CI: 26.4%-29.0%) in 2000-04 to 36.0% (34.8%-37.3%) in 2010-14. This increase corresponded with a higher proportion of patients with localized disease. In 2010-14, survival was notably higher among women, at 42.6% (39.7%-45.5%), than among men, at 36.0% (34.8%-37.3%), and among patients aged 45-54 years at 39.7% (35.5%-44.0%), 55-64 years at 38.9% (37.0%-40.8%), and 65-74 years at 39.4% (37.8%-41.1%). Survival remained lower among the oldest patients, aged 75-99 years, at 29.0% (27.0%-31.0%). By anatomical subsite, survival was highest for the "abdominal, or lower third" segment of the esophagus, followed by the "thoracic, or middle third," while the "cervical, or upper third" showed the lowest survival.

Conclusion: Survival for esophageal cancer in Japan has improved, largely attributable to early detection. Variations by sex, age, and subsite were evident. Detailed analyses using population-based registry data will provide evidence to aid the development of effective cancer control strategies.

Background: We aimed at estimating trends in 5-year net survival for myeloid and lymphoid malignancies, by age group and morphological subtype, using data on patients diagnosed during 2000-2014 and registered by 16 Japanese population-based cancer registries participating in the CONCORD-3 study.

Methods: We analyzed data on adult patients (15-99 years) diagnosed with a myeloid or lymphoid malignancy during 2000-2014 and followed up to December 31, 2014. We estimated 5-year net survival by age group and morphological subtype with the Pohar Perme estimator, and age-standardized the estimates using International Cancer Survival Standard weights.

Results: Significant improvements were observed in five-year net survival for myeloid malignancies among patients aged 15-44 years (from 57.3% in 2000-2004 to 72.3% in 2010-2014) and 45-54 years (from 41.9% to 61.3% over the same period). For lymphoid malignancies, 5-year net survival improved for all ages, but the improvement was less pronounced for older patients. Five-year net survival improved by 10% or more for myeloproliferative neoplasms, classic Hodgkin's lymphoma, and follicular lymphoma. Moderate improvement was observed for diffuse B-cell lymphoma and acute myeloid leukemia.

Conclusions: Five-year net survival for patients with hematological malignancies improved throughout 2000-2014 in Japan. The improvement was more pronounced in younger than older patients. Continuous and detailed monitoring of cancer survival trends is crucial for devising effective control strategies for hematological malignancies. [221/250 words].