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Annual Report 2019

Department of Gastric Surgery

Takaki Yoshikawa, Yukinori Yamagata, Syo Otsuki, Tsutomu Hayashi, Takeyuki Wada, Hitoshi Katai

Introduction

 Our division surgically treats patients with gastric cancer and gastrointestinal stromal tumors (GIST) and also aims to contribute to people through the treatment we provide and the research we perform in this field. Our policies to achieve this goal are:

(1) To provide high-quality treatment for patients,

(2) To perform clinical tasks efficiently and

(3) To help refine treatment through clinical trials and research and provide high-quality education.

The Team and What We Do

(1) To provide high-quality treatment, we introduced a daily morning conference to determine the optimal treatment strategy for new patients. All staff members check the endoscopy and CT elements, determine the stage of the tumor based on uniform criteria, then discuss the treatment strategy for each patient, including any issues when applying standard treatment and whether the patient is a viable candidate for any clinical trials. As a special topic this year, we discussed the current status and applicability of the Enhanced Recovery After-Surgery program (ERAS) and introduced ERAS for perioperative care. Surgical morbidity and hospital stays were dramatically improved by ERAS care.

(2) To streamline clinical tasks, we prepared the medical documents for patients to ensure uniform explanation and a printed protocol at the conference room and outpatient clinic to check the applicability to the clinical trials. We also eased the burden on physicians and residents by eliminating the need for them to prepare the database.

(3) Our division operated on a total of 358 cases of gastric cancer and GIST this year (Table 1) and the proportion of laparoscopic surgery increased from 49% (2017) to 65% (2018) and 62% (2019) for distal / pylorus-preserving gastrectomy and from 12% (2017) to 21% (2018) and 44% (2019) for total / proximal gastrectomy. As a special topic this year, we introduced robot-assisted gastrectomy for gastric cancer (RAG). We performed 9 RA-distal gastrectomies and 1 proximal gastrectomy without morbidity. Conversely, there were many extended surgeries. We gained experience of numerous cases of D2 plus para-aortic nodal dissection following neoadjuvant chemotherapy for bulky nodal disease or para-aortic nodal metastasis and several cases of left upper abdominal exenteration for bulky GIST invading adjacent organs and lower mediastinal dissection through a trans-hiatal approach for gastric cancer invading the lower esophagus. We can provide any type of surgery for local control if applicable.

Table 1. Number of each type of surgery in 2019
Table 1. Number of each type of surgery in 2019

Table 1. Number of each type of surgery in 2019
Table 1. Number of each type of surgery in 2019

Research activities

 We published many English quality papers - more than 12 in the capacity of corresponding author and more than 22 as co-author.

Clinical trials

 We conducted and initiated JCOG1711, a phase III study to confirm the non-inferiority of omentum preservation to omentectomy combined with standard D2 gastrectomy in patients with T3-4 gastric cancer. The primary results of JCOG1401, a single arm phase-III study to confirm and evaluate the feasibility and safety of laparoscopic proximal / total gastrectomy, were published in Gastric Cancer (IF: 7.088). The primary results of JCOG0912, a phase III study to confirm non-inferiority of laparoscopic distal gastrectomy to open distal gastrectomy were published in Lancet Gastroenterology and Hepatology (IF: 14.789). Safety data of JCOG0501, a phase III trial to compare neoadjuvant chemotherapy followed by surgery and S-1 adjuvant chemotherapy and primary surgery followed by S-1 adjuvant chemotherapy, was also published in Gastric Cancer (IF: 7.088).

We also continued several collaborative studies with foreign countries such as England, the Netherlands, Singapore, and Germany. This year, research on surgical pathology using AI was published in Nature Medicine (IF: 36.130). Other translational research was published in European Journal of Cancer (IF: 7.257), Gastric Cancer (IF: 7.088), and Journal of Cancer (IF: 3.565).

Education

 Through an open conference to determine the tumor staging and treatment strategy, the trainees could study the nature of standard treatment, issues regarding the applicability of standard therapy and the nature of investigational treatment. They also could experience first / second assistance of surgery by experienced staff members, scopists conducting laparoscopic surgery, and even operators instructed by experienced staff members. To obtain certification from an endoscopic surgeon, trainees could experience animal training and receive video reviews from experienced staff members. This year, a chief resident obtained the certification from an endoscopic surgeon although the pass rate for that exam is around 20%. In our department, the pass rate has been over 80% since 2018.

 Our young surgeons also continued clinical research and published English papers: four papers in Gastric Cancer (IF: 7.088), two in Annals of Surgical Oncology (IF:4.061), one in Annals of Gastroenterological Surgery, and one in Surgery Today (IF: 1.878).

Future prospects

 We will continue providing high-quality treatment, streamlining clinical tasks and trials and conducting clinical research and education in the field of gastric surgery to contribute to people

List of papers published in 2019

Journal

1. Shitara K, Hara H, Yoshikawa T, Fujitani K, Nishina T, Hosokawa A, Asakawa T, Kawakami S, Muro K. Pertuzumab plus trastuzumab and chemotherapy for Japanese patients with HER2-positive metastatic gastric or gastroesophageal junction cancer: a subgroup analysis of the JACOB trial. Int J Clin Oncol, 25:301-311, 2020

2. Maeda M, Takeshima H, Iida N, Hattori N, Yamashita S, Moro H, Yasukawa Y, Nishiyama K, Hashimoto T, Sekine S, Ishii G, Ochiai A, Fukagawa T, Katai H, Sakai Y, Ushijima T. Cancer cell niche factors secreted from cancer-associated fibroblast by loss of H3K27me3. Gut, 69:243-251, 2020

3. Satoh T, Kang YK, Chao Y, Ryu MH, Kato K, Cheol Chung H, Chen JS, Muro K, Ki Kang W, Yeh KH, Yoshikawa T, Oh SC, Bai LY, Tamura T, Lee KW, Hamamoto Y, Kim JG, Chin K, Oh DY, Minashi K, Cho JY, Tsuda M, Tanimoto M, Chen LT, Boku N. Exploratory subgroup analysis of patients with prior trastuzumab use in the ATTRACTION-2 trial: a randomized phase III clinical trial investigating the efficacy and safety of nivolumab in patients with advanced gastric/gastroesophageal junction cancer. Gastric Cancer, 23:143-153, 2020

4. Wagner AD, Lordick F, Grabsch HI, Terashima M, Terada M, Yoshikawa T, Boku N, Kataoka K, Smyth EC, Mauer M, Haustermans K, Moehler MH. Multidisciplinary management of stage II-III gastric and gastro-oesophageal junction cancer. Eur J Cancer, 124:67-76, 2020

5. Yamaguchi T, Takashima A, Nagashima K, Makuuchi R, Aizawa M, Ohashi M, Tashiro K, Yamada T, Kinoshita T, Hata H, Kawachi Y, Kawabata R, Tsuji T, Hihara J, Sakamoto T, Fukagawa T, Katai H, Higuchi K, Boku N. Efficacy of Postoperative Chemotherapy After Resection that Leaves No Macroscopically Visible Disease of Gastric Cancer with Positive Peritoneal Lavage Cytology (CY1) or Localized Peritoneum Metastasis (P1a): A Multicenter Retrospective Study. Ann Surg Oncol, 27:284-292, 2020

6. Sato Y, Kurokawa Y, Doki Y, Mizusawa J, Tanaka K, Katayama H, Boku N, Yoshikawa T, Terashima M. A Phase II study of preoperative chemotherapy with docetaxel, oxaliplatin and S-1 in gastric cancer with extensive lymph node metastasis (JCOG1704). Future Oncol, 16:31-38, 2020

7. Hayashi T, Yoshikawa T, Kamiya A, Date K, Wada T, Otsuki S, Yamagata Y, Katai H, Nishida T. Is splenectomy for dissecting splenic hilar lymph nodes justified for scirrhous gastric cancer? Gastric Cancer, 2020

8. Wada T, Yoshikawa T, Kamiya A, Date K, Hayashi T, Otsuki S, Yamagata Y, Katai H, Nishida T. A nodal diagnosis by computed tomography is unreliable for patients who need additional gastrectomy after endoscopic submucosal dissection. Surg Today, 2020

9. Yura M, Yoshikawa T, Otsuki S, Yamagata Y, Morita S, Katai H, Nishida T. Is surgery alone sufficient for treating T1 gastric cancer with extensive lymph node metastases? Gastric Cancer, 23:349-355, 2020

10. Takahashi K, Yoshikawa T, Morita S, Kinoshita T, Yura M, Otsuki S, Tokunaga M, Yamagata Y, Kaito A, Katai H. Different risks of nodal metastasis by tumor location in remnant gastric cancer after curative gastrectomy for gastric cancer. Gastric Cancer, 23:195-201, 2020

11. Kano K, Yamada T, Yamamoto K, Komori K, Watanabe H, Hara K, Shimoda Y, Maezawa Y, Fujikawa H, Aoyama T, Tamagawa H, Yamamoto N, Cho H, Shiozawa M, Yukawa N, Yoshikawa T, Morinaga S, Rino Y, Masuda M, Ogata T, Oshima T. Association Between Lymph Node Ratio and Survival in Patients with Pathological Stage II/III Gastric Cancer. Ann Surg Oncol, 2020

12. Kumazu Y, Hayashi T, Yoshikawa T, Yamada T, Hara K, Shimoda Y, Nakazono M, Nagasawa S, Shiozawa M, Morinaga S, Rino Y, Masuda M, Ogata T, Oshima T. Risk factors analysis and stratification for microscopically positive resection margin in gastric cancer patients. BMC Surg, 20:95, 2020

13. Nishikawa K, Murotani K, Fujitani K, Inagaki H, Akamaru Y, Tokunaga S, Takagi M, Tamura S, Sugimoto N, Shigematsu T, Yoshikawa T, Ishiguro T, Nakamura M, Hasegawa H, Morita S, Miyashita Y, Tsuburaya A, Sakamoto J, Tsujinaka T. Differences in disease status between patients with progression after first-line chemotherapy versus early relapse after adjuvant chemotherapy who undergo second-line chemotherapy for gastric cancer: Exploratory analysis of the randomized phase III TRICS trial. Eur J Cancer, 132:159-167, 2020

14. Fujikawa H, Koumori K, Watanabe H, Kano K, Shimoda Y, Aoyama T, Yamada T, Hiroshi T, Yamamoto N, Cho H, Shiozawa M, Yoshikawa T, Morinaga S, Rino Y, Masuda M, Ogata T, Oshima T. The Clinical Significance of Lymphovascular Invasion in Gastric Cancer. In Vivo, 34:1533-1539, 2020

15. Shimoda Y, Yamada T, Komori K, Watanabe H, Osakabe H, Kano K, Fujikawa H, Hayashi T, Cho H, Shiozawa M, Yoshikawa T, Morinaga S, Ota Y, Katsumata K, Tsuchida A, Ogata T, Oshima T. Effect of Muscle Mass Loss After Esophagectomy on Prognosis of Oesophageal Cancer. Anticancer Res, 40:2275-2281, 2020

16. Sato Y, Mizusawa J, Katayama H, Nakamura K, Fukagawa T, Katai H, Haruta S, Yamada M, Takagi M, Tamura S, Yoshimura T, Tokunaga M, Yoshikawa T, Boku N, Sano T, Sasako M, Terashima M. Diagnosis of invasion depth in resectable advanced gastric cancer for neoadjuvant chemotherapy: An exploratory analysis of Japan clinical oncology group study: JCOG1302A. Eur J Surg Oncol, 46:1074-1079, 2020

17. Terashima M, Yoshikawa T, Boku N, Ito S, Tsuburaya A, Iwasaki Y, Fukagawa T, Tokunaga M, Sano T, Sasako M. Current status of perioperative chemotherapy for locally advanced gastric cancer and JCOG perspectives. Jpn J Clin Oncol, 50:528-534, 2020

18. Watanabe H, Hayashi T, Komori K, Hara K, Maezawa Y, Kano K, Shimoda Y, Fujikawa H, Aoyama T, Yamada T, Yamamoto N, Cho H, Ito H, Shiozawa M, Yukawa N, Morinaga S, Yoshikawa T, Rino Y, Masuda M, Ogata T, Oshima T. Impact of Postoperative Complications on Recurrence in Patients With Stage II/III Gastric Cancer Who Received Adjuvant Chemotherapy With S-1. Anticancer Res, 40:1683-1690, 2020

19. Kumazu Y, Oba K, Hayashi T, Yamada T, Hara K, Osakabe H, Shimoda Y, Nakazono M, Nagasawa S, Rino Y, Masuda M, Ogata T, Yoshikawa T, Oshima T. Relationship Between the Waiting Times for Surgery and Survival in Patients with Gastric Cancer. World J Surg, 44:1209-1215, 2020

20. Tamagawa H, Aoyama T, Kano K, Numata M, Atsumi Y, Hara K, Kazama K, Koumori K, Murakawa M, Hashimoto I, Maezawa Y, Yamada T, Yukawa N, Yoshikawa T, Masuda M, Oshima T, Rino Y. The Impact of Intraoperative Blood Loss on the Long-term Prognosis after Curative Resection for Borrmann Type IV Gastric Cancer: A Retrospective Multicenter Study. Anticancer Res, 40:405-412, 2020

21. Kano K, Sakamaki K, Oue N, Kimura Y, Hashimoto I, Hara K, Maezawa Y, Aoyama T, Fujikawa H, Hiroshima Y, Yamada T, Tamagawa H, Yamamoto N, Ogata T, Cho H, Ito H, Shiozawa M, Yukawa N, Yoshikawa T, Morinaga S, Rino Y, Yasui W, Masuda M, Miyagi Y, Oshima T. Impact of the ESM-1 Gene Expression on Outcomes in Stage II/III Gastric Cancer Patients Who Received Adjuvant S-1 Chemotherapy. In Vivo, 34:461-467, 2020

22. Katai H, Mizusawa J, Katayama H, Morita S, Yamada T, Bando E, Ito S, Takagi M, Takagane A, Teshima S, Koeda K, Nunobe S, Yoshikawa T, Terashima M, Sasako M. Survival outcomes after laparoscopy-assisted distal gastrectomy versus open distal gastrectomy with nodal dissection for clinical stage IA or IB gastric cancer (JCOG0912): a multicentre, non-inferiority, phase 3 randomised controlled trial. Lancet Gastroenterol Hepatol, 5:142-151, 2020

23. Maezawa Y, Sakamaki K, Oue N, Kimura Y, Hashimoto I, Hara K, Kano K, Aoyama T, Hiroshima Y, Yamada T, Yamamoto N, Ogata T, Ito H, Cho H, Shiozawa M, Yoshikawa T, Morinaga S, Rino Y, Yasui W, Masuda M, Miyagi Y, Oshima T. High gamma-glutamyl hydrolase and low folylpolyglutamate synthetase expression as prognostic biomarkers in patients with locally advanced gastric cancer who were administrated postoperative adjuvant chemotherapy with S-1. J Cancer Res Clin Oncol, 146:75-86, 2020

24. Hara K, Hayashi T, Nakazono M, Nagasawa S, Shimoda Y, Kumazu Y, Yamada T, Yamamoto N, Shiozawa M, Morinaga S, Yoshikawa T, Rino Y, Masuda M, Ogata T, Oshima T. An easy and reliable method to close Petersen's defect using barbed suture to prevent internal hernia from developing after gastrectomy with Roux-en-Y reconstruction. Asian J Endosc Surg, 13:238-241, 2020

25. Yamagata Y, Saito K, Hirano K, Yoshioka R, Okuyama T, Takeshita E, Fujii A, Ban S, Tagaya N, Sameshima S, Noie T, Yamaguchi T, Oya M. Successful management of advanced gastric cancer with bulky lymph node metastases and tumor thrombus in the portal vein system: A case report. Int Surg, https://doi.org/10.9738/INTSURG-D-17-00135.1 , 2020

26. Nunobe S, Oda I, Ishikawa T, Akazawa K, Katai H, Isobe Y, Miyashiro I, Tsujitani S, Ono H, Tanabe S, Fukagawa T, Suzuki S, Kakeji Y. Surgical outcomes of elderly patients with Stage I gastric cancer from the nationwide registry of the Japanese Gastric Cancer Association. Gastric Cancer, 23:328-338, 2020

27. Hashimoto T, Ogawa R, Tang TY, Yoshida H, Taniguchi H, Katai H, Oda I, Sekine S. RHOA mutations and CLDN18-ARHGAP fusions in intestinal-type adenocarcinoma with anastomosing glands of the stomach. Mod Pathol, 32:568-575, 2019

28. Kurokawa Y, Takeuchi H, Doki Y, Mine S, Terashima M, Yasuda T, Yoshida K, Daiko H, Sakuramoto S, Yoshikawa T, Kunisaki C, Seto Y, Tamura S, Shimokawa T, Sano T, Kitagawa Y. Mapping of Lymph Node Metastasis From Esophagogastric Junction Tumors: A Prospective Nationwide Multicenter Study. Ann Surg, 2019

29. Yamada Y, Boku N, Mizusawa J, Iwasa S, Kadowaki S, Nakayama N, Azuma M, Sakamoto T, Shitara K, Tamura T, Chin K, Hata H, Nakamori M, Hara H, Yasui H, Katayama H, Fukuda H, Yoshikawa T, Sasako M, Terashima M. Docetaxel plus cisplatin and S-1 versus cisplatin and S-1 in patients with advanced gastric cancer (JCOG1013): an open-label, phase 3, randomised controlled trial. Lancet Gastroenterol Hepatol, 4:501-510, 2019

30. Sugawara S, Arai Y, Sone M, Nara S, Kishi Y, Esaki M, Shimada K, Katai H. Retrospective Comparative Study of Absolute Ethanol with N-Butyl-2-Cyanoacrylate in Percutaneous Portal Vein Embolization. J Vasc Interv Radiol, 30:1215-1222, 2019

31. Iwasaki T, Hiraoka N, Ino Y, Nakajima K, Kishi Y, Nara S, Esaki M, Shimada K, Katai H. Reduction of intrapancreatic neural density in cancer tissue predicts poorer outcome in pancreatic ductal carcinoma. Cancer Sci, 110:1491-1502, 2019

32. Yoshikawa T, Muro K, Shitara K, Oh DY, Kang YK, Chung HC, Kudo T, Chin K, Kadowaki S, Hamamoto Y, Hironaka S, Yoshida K, Yen CJ, Omuro Y, Bai LY, Maeda K, Ozeki A, Yoshikawa R, Kitagawa Y. Effect of First-line S-1 Plus Oxaliplatin With or Without Ramucirumab Followed by Paclitaxel Plus Ramucirumab on Advanced Gastric Cancer in East Asia: The Phase 2 RAINSTORM Randomized Clinical Trial. JAMA Netw Open, 2:e198243, 2019

33. Kuwata T, Yanagihara K, Iino Y, Komatsu T, Ochiai A, Sekine S, Taniguchi H, Katai H, Kinoshita T, Ohtsu A. Establishment of Novel Gastric Cancer Patient-Derived Xenografts and Cell Lines: Pathological Comparison between Primary Tumor, Patient-Derived, and Cell-Line Derived Xenografts. Cells, 8:585, 2019

34. Yoshikawa T, Aoyama T, Sakamaki K, Oshima T, Lin J, Zhang S, Sapari NS, Soong R, Tan I, Chan XB, Bottomley D, Hewitt LC, Arai T, Teh BT, Epstein D, Ogata T, Kameda Y, Miyagi Y, Tsuburaya A, Morita S, Grabsch HI, Tan P. Comprehensive biomarker analyses identifies HER2, EGFR, MET RNA expression and thymidylate synthase 5'UTR SNP as predictors of benefit from S-1 adjuvant chemotherapy in Japanese patients with stage II/III gastric cancer. J Cancer, 10:5130-5138, 2019

35. Yura M, Yoshikawa T. ASO Author Reflections: Splenic Hilar Nodal Dissection for Proximal Advanced Gastric Cancer. Ann Surg Oncol, 26:588-589, 2019

36. Hayashi M, Yoshikawa T, Yura M, Otsuki S, Yamagata Y, Morita S, Katai H, Nishida T. Does neoadjuvant chemotherapy cancel out the negative survival impact induced by surgical complications after gastrectomy? Gastric Cancer, 22:1274-1284, 2019

37. Yura M, Yoshikawa T, Otsuki S, Yamagata Y, Morita S, Katai H, Nishida T, Yoshiaki T. Oncological safety of proximal gastrectomy for T2/T3 proximal gastric cancer. Gastric Cancer, 22:1029-1035, 2019

38. Maezawa Y, Aoyama T, Kano K, Tamagawa H, Numata M, Hara K, Murakawa M, Yamada T, Sato T, Ogata T, Oshima T, Yukawa N, Yoshikawa T, Masuda M, Rino Y. Impact of the Age-adjusted Charlson comorbidity index on the short- and long-term outcomes of patients undergoing curative gastrectomy for gastric cancer. J Cancer, 10:5527-5535, 2019

39. Terasawa T, Hamashima C, Kato K, Miyashiro I, Yoshikawa T, Takaku R, Nishida H. Helicobacter pylori eradication treatment for gastric carcinoma prevention in asymptomatic or dyspeptic adults: systematic review and Bayesian meta-analysis of randomised controlled trials. BMJ Open, 9:e026002, 2019

40. Aoyama T, Yoshikawa T, Maezawa Y, Kano K, Numata M, Hara K, Komori K, Yamada T, Hayashi T, Sato T, Tamagawa H, Yukawa N, Rino Y, Masuda M, Ogata T, Cho H, Oshima T. The postoperative lean body mass loss at one month leads to a poor survival in patients with locally advanced gastric cancer. J Cancer, 10:2450-2456, 2019

41. Kather JN, Pearson AT, Halama N, Jäger D, Krause J, Loosen SH, Marx A, Boor P, Tacke F, Neumann UP, Grabsch HI, Yoshikawa T, Brenner H, Chang-Claude J, Hoffmeister M, Trautwein C, Luedde T. Deep learning can predict microsatellite instability directly from histology in gastrointestinal cancer. Nat Med, 25:1054-1056, 2019

42. Hewitt LC, Saito Y, Wang T, Matsuda Y, Oosting J, Silva ANS, Slaney HL, Melotte V, Hutchins G, Tan P, Yoshikawa T, Arai T, Grabsch HI. KRAS status is related to histological phenotype in gastric cancer: results from a large multicentre study. Gastric Cancer, 22:1193-1203, 2019

43. Watanabe M, Kinoshita T, Morita S, Yura M, Tokunaga M, Otsuki S, Yamagata Y, Kaito A, Yoshikawa T, Katai H. Clinical impact of splenic hilar dissection with splenectomy for gastric stump cancer. Eur J Surg Oncol, 45:1505-1510, 2019

44. Yoshida K, Kodera Y, Kochi M, Ichikawa W, Kakeji Y, Sano T, Nagao N, Takahashi M, Takagane A, Watanabe T, Kaji M, Okitsu H, Nomura T, Matsui T, Yoshikawa T, Matsuyama J, Yamada M, Ito S, Takeuchi M, Fujii M. Addition of Docetaxel to Oral Fluoropyrimidine Improves Efficacy in Patients With Stage III Gastric Cancer: Interim Analysis of JACCRO GC-07, a Randomized Controlled Trial. J Clin Oncol, 37:1296-1304, 2019

45. Terashima M, Iwasaki Y, Mizusawa J, Katayama H, Nakamura K, Katai H, Yoshikawa T, Ito Y, Kaji M, Kimura Y, Hirao M, Yamada M, Kurita A, Takagi M, Boku N, Sano T, Sasako M. Randomized phase III trial of gastrectomy with or without neoadjuvant S-1 plus cisplatin for type 4 or large type 3 gastric cancer, the short-term safety and surgical results: Japan Clinical Oncology Group Study (JCOG0501). Gastric Cancer, 22:1044-1052, 2019

46. Nishikawa K, Murotani K, Fujitani K, Inagaki H, Akamaru Y, Tokunaga S, Takagi M, Tamura S, Sugimoto N, Shigematsu T, Yoshikawa T, Ishiguro T, Nakamura M, Hasegawa H, Morita S, Miyashita Y, Tsuburaya A, Sakamoto J, Tsujinaka T. A study of second-line irinotecan plus cisplatin vs. irinotecan alone in platinum-na?ve patients with early relapse of gastric cancer refractory to adjuvant S-1 monotherapy: exploratory subgroup analysis of the randomized phase III TRICS trial. Cancer Chemother Pharmacol, 83:867-874, 2019

47. Katai H, Mizusawa J, Katayama H, Kunisaki C, Sakuramoto S, Inaki N, Kinoshita T, Iwasaki Y, Misawa K, Takiguchi N, Kaji M, Okitsu H, Yoshikawa T, Terashima M. Single-arm confirmatory trial of laparoscopy-assisted total or proximal gastrectomy with nodal dissection for clinical stage I gastric cancer: Japan Clinical Oncology Group study JCOG1401. Gastric Cancer, 22:999-1008, 2019

48. Kano K, Aoyama T, Maezawa Y, Hayashi T, Yamada T, Tamagawa H, Sato T, Cho H, Yoshikawa T, Rino Y, Masuda M, Oshima T, Ogata T. Postoperative Level of C-Reactive Protein Is a Prognosticator After Esophageal Cancer Surgery With Perioperative Steroid Therapy and Enhanced Recovery After Surgery Care. In Vivo, 33:587-594, 2019

49. Yamagata Y, Saito K, Hirano K, Oya M. Laparoscopic Transhiatal Thoracic Duct Ligation for Chylothorax after Esophagectomy. Thorac Cardiovasc Surg, 67:606-609, 2019

50. Takamaru H, Yoshinaga S, Takisawa H, Oda I, Katai H, Sekine S, Taniguchi K, Saito Y. Endoscopic Ultrasonography Miniature Probe Performance for Depth Diagnosis of Early Gastric Cancer with Suspected Submucosal Invasion. Gut Liver, 2019

51. Katayama H, Tsuburaya A, Mizusawa J, Nakamura K, Katai H, Imamura H, Nashimoto A, Fukushima N, Sano T, Sasako M. An integrated analysis of two phase II trials (JCOG0001 and JCOG0405) of preoperative chemotherapy followed by D3 gastrectomy for gastric cancer with extensive lymph node metastasis. Gastric Cancer, 22:1301-1307, 2019

52. Nakanishi K, Morita S, Taniguchi H, Otsuki S, Fukagawa T, Katai H. Diagnostic Accuracy and Usefulness of Intraoperative Margin Assessment by Frozen Section in Gastric Cancer. Ann Surg Oncol, 26:1787-1794, 2019

53. Sugimoto K, Ito T, Hulbert A, Chen C, Orita H, Maeda M, Moro H, Fukagawa T, Ushijima T, Katai H, Wada R, Sato K, Sakamoto K, Yu W, Considine M, Cope L, Brock MV. DNA methylation genome-wide analysis in remnant and primary gastric cancers. Gastric Cancer, 22:1109-1120, 2019

54. Nakamura Y, Yamanaka T, Chin K, Cho H, Katai H, Terashima M, Misawa K, Hirao M, Yoshida K, Oki E, Sasako M, Emi Y, Bando H, Kawashima Y, Fukunaga T, Gotoh M, Ishibashi T, Shitara K. Survival Outcomes of Two Phase 2 Studies of Adjuvant Chemotherapy with S-1 Plus Oxaliplatin or Capecitabine Plus Oxaliplatin for Patients with Gastric Cancer After D2 Gastrectomy. Ann Surg Oncol, 26:465-472, 2019