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The evolution of surgical treatment for gastrointestinal cancers

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Abstract

Introduction

According to the latest Japanese nationwide estimates, over a million Japanese people are newly diagnosed with cancer each year. Since gastrointestinal cancers account for more than 40% of all cancer-related deaths, it is imperative to formulate effective strategies to control them.

Materials and methods, and results

Basic drug discovery research Our research has revealed that the abnormal expression of regulators of chromosomal stability is a cause of cancers and identified an effective compound against cancers with chromosomal instability. We revealed the molecular mechanism of peritoneal dissemination of cancer cells via the CXCR4/CXCL12 axis to CAR-like cells and identified an MEK inhibitor effective against these tumors. Residual tumor cells after chemotherapy in colorectal cancer are LGR5-positive cancer stem cells and their ability to eliminate reactive oxygen species is elevated. The development of surgical procedures and devices In cases of gastric tube reconstruction for esophageal cancer, we determined the anastomotic line for evaluating the blood flow using ICG angiography and measuring the tissue O2 metabolism. We established a novel gastric reconstruction method (book-binding technique) for gastric cancer and a new rectal reconstruction method focusing on the intra-intestinal pressure resistance for rectal cancer. We established a novel tissue fusion method, which allows contact-free local heating and retains tissue viability with very little damage, and developed an understanding of the collagen-related processes that underpin laser-induced tissue fusion. Strategy to prevent carcinogenesis We succeeded in cleaving hepatitis B virus DNA integrated into the nucleus of hepatocytes using genome editing tools. The development of HCC from non-alcoholic steatohepatitis (NASH) may be prevented by metabolic surgery.

Conclusion

We believe that these efforts will help to significantly improve the gastrointestinal cancer treatment and survival.

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Acknowledgements

Twenty seven of our studies have been financially supported by these agencies. I received the grants as the representative of these studies. We would like to extend our sincere appreciation to the Ministry of Education, Culture, Sports, Science and Technology; the Ministry of Health, Labour and Welfare; and the Japan Agency for Medical Research and Development.

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Authors and Affiliations

  1. Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan

    Yoshihiko Maehara

  2. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Yuji Soejima, Tomoharu Yoshizumi, Naoyuki Kawahara, Eiji Oki, Hiroshi Saeki, Tomohiko Akahoshi, Toru Ikegami, Yo-ichi Yamashita, Tadashi Furuyama, Keishi Sugimachi, Noboru Harada, Tetsuzo Tagawa, Norifumi Harimoto, Shinji Itoh, Hideto Sonoda, Koji Ando, Yuichiro Nakashima, Yoshihiro Nagao, Nami Yamashita, Yuta Kasagi, Takafumi Yukaya, Takeshi Kurihara, Ryosuke Tsutsumi, Shinkichi Takamori, Shun Sasaki & Masaki Mori

  3. Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan

    Yuji Soejima

  4. Department of General Surgical Science, Gunma University Graduate School of Medicine, Gunma, Japan

    Hiroshi Saeki & Norifumi Harimoto

  5. Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Tomohiko Akahoshi

  6. Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan

    Yo-ichi Yamashita

  7. Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan

    Keishi Sugimachi

  8. Department of Surgery, Imari Arita Kyoritsu Hospital, Saga, Japan

    Hideto Sonoda

  9. Department of Surgery, Fukuoka Higashi Medical Center, Fukuoka, Japan

    Yuta Kasagi

  10. Department of Surgery, Iizuka Hospital, Iizuka, Fukuoka, Japan

    Takafumi Yukaya

  11. Endoscopy and Endoscopic Surgery, Fukuoka Dental College, Fukuoka, Japan

    Tetsuo Ikeda

  12. R&D Laboratory for Innovative Biotherapeutics, Graduate School of Pharma-Ceutical Sciences, Kyushu University, Fukuoka, Japan

    Yoshikazu Yonemitsu & Koji Teraishi

  13. Department of Molecular Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan

    Takasuke Fukuhara

  14. Department of Molecular Cancer Biology, Graduate School of Pharmaceutical Sciences, Kyushu University, Fukuoka, Japan

    Hiroyuki Kitao, Makoto Iimori, Yuki Kataoka & Takeshi Wakasa

  15. Taiho Pharmaceutical Co. Ltd., Tokyo, Japan

    Yuki Kataoka & Takeshi Wakasa

  16. Chugai Pharmaceutical Co., Ltd., Kanagawa, Japan

    Masami Suzuki

  17. Ono Pharmaceutical Co., Ltd., Osaka, Japan

    Koji Teraishi

  18. Yakult Central Institute, Tokyo, Japan

    Yasuto Yoshida

Authors
  1. Yoshihiko Maehara
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  2. Yuji Soejima
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  3. Tomoharu Yoshizumi
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  4. Naoyuki Kawahara
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  5. Eiji Oki
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  6. Hiroshi Saeki
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  7. Tomohiko Akahoshi
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  8. Toru Ikegami
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  9. Yo-ichi Yamashita
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  10. Tadashi Furuyama
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  11. Keishi Sugimachi
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  12. Noboru Harada
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  13. Tetsuzo Tagawa
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  14. Norifumi Harimoto
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  15. Shinji Itoh
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  16. Hideto Sonoda
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  17. Koji Ando
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  18. Yuichiro Nakashima
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  19. Yoshihiro Nagao
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  20. Nami Yamashita
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  21. Yuta Kasagi
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  22. Takafumi Yukaya
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  23. Takeshi Kurihara
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  24. Ryosuke Tsutsumi
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  25. Shinkichi Takamori
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  26. Shun Sasaki
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  27. Tetsuo Ikeda
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  28. Yoshikazu Yonemitsu
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  29. Takasuke Fukuhara
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  30. Hiroyuki Kitao
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  31. Makoto Iimori
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  32. Yuki Kataoka
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  33. Takeshi Wakasa
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  34. Masami Suzuki
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  35. Koji Teraishi
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  36. Yasuto Yoshida
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  37. Masaki Mori
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Corresponding author

Correspondence to Yoshihiko Maehara.

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Conflict of interest

We disclose the following conflicts of interest. We offer our heartfelt gratitude to the cooperation extended by the research institutes of these four companies: Taiho Pharmaceutical, Chugai Pharmaceutical, Ono Pharmaceutical, and Yakult Honsha.

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Maehara, Y., Soejima, Y., Yoshizumi, T. et al. The evolution of surgical treatment for gastrointestinal cancers. Int J Clin Oncol 24, 1333–1349 (2019). https://doi.org/10.1007/s10147-019-01499-7

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  • DOI: https://doi.org/10.1007/s10147-019-01499-7

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