Annual Report 2020
Department of Gastroenterology and Endoscopy
Tomonori Yano, Hiroaki Ikematsu, Yusuke Yoda, Keisuke Hori, Kensuke Shinmura, Tomohiro Kadota, Tatsuro Murano, Keiichiro Nakajo, Kenji Takashima, Daiki Sato, Tatsunori Minamide, Hironori Sunakawa
Introduction
Department of Gastroenterology and Endoscopy consists seven staff doctors who specialize inthe endoscopic diagnosis and treatment of gastrointestinal tract and head and neck cancer. The mission of our department is to achieve the following goals for cancer patients using endoscopy: early detection, less invasive treatment, and palliation for painful symptoms.
The Team and What We Do
The staff members of this department perform approximately 15000 endoscopic procedures in total and 2000 endoscopic resections for neoplastic lesions annually; however, cases have decreased due to the COVID-19 pandemic (Table 1). We also performed advanced endoscopic treatment including EMR/ESD for early cancer, salvage treatment such as ESD and photodynamic therapy (PDT) for local failure after radiotherapy for esophageal cancer, and palliative treatments for patients with symptomatic advanced cancer, such as stent placement, percutaneous endoscopic gastrostomy, and balloon dilatation. The upper GI group aggressively performed endoscopic treatment for early pharyngeal cancer in collaboration with the Department of Head and Neck Surgery. The colon group concentrates on the diagnosis with fine magnified images using image-enhanced endoscopy for adenoma and early cancer, even in clinical practice. During the daily endoscopic examination, physicians access primary tumors through endoscopy and easily biopsy numerous samples from cancerous lesions. Recently, a lot of molecular-target agents have been developed and included in practice in the oncology field. Endoscopy is therefore becoming more important in clinical oncology as an easy access tool for primary tumors.
Research activities
The major research activities at this department are translational (TR) research, innovation for new imaging and endoscopic equipment through collaboration with academia and corporations, and clinical studies. In the TR research field, we collaboratively perform studies with several divisions in the Exploratory Oncology Research and Clinical Trial Center to elucidate the microenvironment and immunological status of cancer in the digestive tract and head and neck using samples retrieved by endoscopy. In 2020, we published the results of several important studies, including one on artificial intelligence for detecting superficial head and neck cancer, image analysis in the findings of oxygen saturation imaging, and endoscopic prediction for small colon polyps using narrow band imaging.
Clinical trials
We conduct investigator-initiated clinical trials of a cryo-balloon ablation system for local failure after endoscopic resection of esophageal cancer, as well as investigator-initiated clinical trials of photoimmunotherapy as an endoscopic procedure for patients with esophageal cancer or gastric cancer who cannot be treated with conventional treatments. As a member institution of JCOG-GI endoscopy study group, we conducted a single-arm confirmatory trial of adjuvant chemoradiation for patients with high-risk rectal submucosal invasive cancer after local resection (JCOG1612), and are participating in several randomized control trials to establish the standard endoscopic treatment for GI cancer.
Education
Our department has three senior residents and nine residents. Trainees perform services in the training program under observation by each specialist. The trainees are educated not only for endoscopic diagnosis and endoscopic treatment strategies but also for pathological diagnosis, clinical and surgical oncology through conferences with other departments. Furthermore, the trainees actively present their research work at international congresses and publish papers in international peer-reviewed journals. The trainee have written several study protocols, mainly for innovative development in endoscopic imaging and treatment.
Future Prospects
We would like to develop new endoscopic imaging and treatment strategies for cancer patients through close collaboration with corporations and academic institutions, not only for the present but also for the NEXT generation.
List of papers published in 2020
Journal
1. Takizawa K, Ono H, Hasuike N, Takashima A, Minashi K, Boku N, Kushima R, Katayama H, Ogawa G, Fukuda H, Fujisaki J, Oda I, Yano T, Hori S, Doyama H, Hirasawa K, Yamamoto Y, Ishihara R, Tanabe S, Niwa Y, Nakagawa M, Terashima M, Muto M. A nonrandomized, single-arm confirmatory trial of expanded endoscopic submucosal dissection indication for undifferentiated early gastric cancer: Japan Clinical Oncology Group study (JCOG1009/1010). Gastric Cancer, 24:479-491, 2021
2. Kadota T, Minashi K, Wakabayashi M, Yano T, Ezoe Y, Tsuchida T, Ono H, Iizuka T, Matsuura N, Oda I, Takizawa K, Katayama H, Fukuda H, Muto M. Diagnostic yield of conventional endoscopy with endoscopic ultrasonography for submucosal invasion of superficial esophageal squamous cell carcinoma: a post hoc analysis of multicenter prospective confirmatory study (JCOG0508). Esophagus, 18:604-611, 2021
3. Minamide T, Ikematsu H, Murano T, Kadota T, Shinmura K, Yoda Y, Hori K, Ito M, Yano T. Metachronous advanced neoplasia after submucosal invasive colorectal cancer resection. Sci Rep, 11:1869, 2021
4. Noguchi M, Shitara K, Kawazoe A, Yamamoto D, Takii Y, Saito Y, Sato T, Horimatsu T, Ishikawa H, Ito Y, Ito M, Ikematsu H. Short-term safety of adjuvant chemoradiotherapy after local resection for patients with high-risk submucosal invasive rectal cancer: a single-arm, multicenter phase II trial. Jpn J Clin Oncol, 51:707-712, 2021
5. Yoshida N, Doyama H, Yano T, Horimatsu T, Uedo N, Yamamoto Y, Kakushima N, Kanzaki H, Hori S, Yao K, Oda I, Katada C, Yokoi C, Ohata K, Yoshimura K, Ishikawa H, Muto M. Early gastric cancer detection in high-risk patients: a multicentre randomised controlled trial on the effect of second-generation narrow band imaging. Gut, 70:67-75, 2021
6. Sunakawa H, Hori K, Kadota T, Shinmura K, Yoda Y, Ikematsu H, Tomioka T, Akimoto T, Hayashi R, Fujii S, Yano T. Relationship between the microvascular patterns observed by magnifying endoscopy with narrow-band imaging and the depth of invasion in superficial pharyngeal squamous cell carcinoma. Esophagus, 18:111-117, 2021
7. Nakajo K, Yoda Y, Kadota T, Murano T, Shinmura K, Ikematsu H, Akimoto T, Yano T. Radial incision and cutting for dilation before endoscopic submucosal dissection in patients with esophageal cancer on the distal side of severe benign esophageal strictures. Dis Esophagus, 34:2021
8. Nishihara K, Hori K, Saito T, Omori T, Sunakawa H, Minamide T, Suyama M, Yamamoto Y, Yoda Y, Shinmura K, Ikematsu H, Yano T. A study of evaluating specific tissue oxygen saturation values of gastrointestinal tumors by removing adherent substances in oxygen saturation imaging. PLoS One, 16:e0243165, 2021
9. Ito R, Ikematsu H, Murano T, Shinmura K, Kojima M, Kumahara K, Furue Y, Sunakawa H, Minamide T, Sato D, Yamamoto Y, Takashima K, Yoda Y, Hori K, Yano T. Diagnostic ability of Japan Narrow-Band Imaging Expert Team classification for colorectal lesions by magnifying endoscopy with blue laser imaging versus narrow-band imaging. Endosc Int Open, 9:E271-E277, 2021
10. Nakajima T, Sakamoto T, Hori S, Yamada S, Ikematsu H, Harada K, Chiu HM, Kiriyama S, Michida T, Hotta K, Sakamoto N, Abe T, Chino A, Fukuzawa M, Kobayashi N, Fukase K, Matsuda T, Murakami Y, Ishikawa H, Saito Y. Optimal surveillance interval after piecemeal endoscopic mucosal resection for large colorectal neoplasia: a multicenter randomized controlled trial. Surg Endosc, 2021
11. Ito R, Kadota T, Murano T, Yoda Y, Hori K, Minamide T, Sato D, Yamamoto Y, Takashima K, Shinmura K, Ikematsu H, Yano T. Clinical features and risk factors of gastric cancer detected by esophagogastroduodenoscopy in esophageal cancer patients. Esophagus, 18:621-628, 2021
12. Sekiguchi M, Kakugawa Y, Ikematsu H, Hotta K, Konda K, Tanaka Y, Takamaru H, Yamada M, Sakamoto T, Saito Y, Imai K, Ito S, Koga Y, Iwasaki M, Murakami Y, Matsuda T. Risk Stratification Score Improves Sensitivity for Advanced Colorectal Neoplasia in Colorectal Cancer Screening: The Oshima Study Workgroup. Clin Transl Gastroenterol, 12:e00319, 2021
13. Kadota T, Ikematsu H, Sasaki T, Saito Y, Ito M, Mizutani T, Ogawa G, Shitara K, Ito Y, Kushima R, Kanemitsu Y, Muto M. Protocol for a single-arm confirmatory trial of adjuvant chemoradiation for patients with high-risk rectal submucosal invasive cancer after local resection: Japan Clinical Oncology Group Study JCOG1612 (RESCUE study). BMJ Open, 10:e034947, 2020
14. Hironaka S, Komori A, Machida R, Ito Y, Takeuchi H, Ogawa G, Kato K, Onozawa M, Minashi K, Yano T, Nakamura K, Tsushima T, Hara H, Nozaki I, Ura T, Chin K, Fukuda H, Kitagawa Y. The association of primary tumor site with acute adverse event and efficacy of definitive chemoradiotherapy for cStage II/III esophageal cancer: an exploratory analysis of JCOG0909. Esophagus, 17:417-424, 2020
15. Kudo SE, Misawa M, Mori Y, Hotta K, Ohtsuka K, Ikematsu H, Saito Y, Takeda K, Nakamura H, Ichimasa K, Ishigaki T, Toyoshima N, Kudo T, Hayashi T, Wakamura K, Baba T, Ishida F, Inoue H, Itoh H, Oda M, Mori K. Artificial Intelligence-assisted System Improves Endoscopic Identification of Colorectal Neoplasms. Clin Gastroenterol Hepatol, 18:1874-1881.e2, 2020
16. Yoshida N, Hisabe T, Ikematsu H, Ishihara H, Terasawa M, Inaba A, Sato D, Cho H, Ego M, Tanaka Y, Yasuda R, Inoue K, Murakami T, Inada Y, Itoh Y, Saito Y. Comparison Between Linked Color Imaging and Blue Laser Imaging for Improving the Visibility of Flat Colorectal Polyps: A Multicenter Pilot Study. Dig Dis Sci, 65:2054-2062, 2020
17. Mori Y, Kudo SE, East JE, Rastogi A, Bretthauer M, Misawa M, Sekiguchi M, Matsuda T, Saito Y, Ikematsu H, Hotta K, Ohtsuka K, Kudo T, Mori K. Cost savings in colonoscopy with artificial intelligence-aided polyp diagnosis: an add-on analysis of a clinical trial (with video). Gastrointest Endosc, 92:905-911.e1, 2020
18. Itoh H, Nimura Y, Mori Y, Misawa M, Kudo SE, Hotta K, Ohtsuka K, Saito S, Saito Y, Ikematsu H, Hayashi Y, Oda M, Mori K. Robust endocytoscopic image classification based on higher-order symmetric tensor analysis and multi-scale topological statistics. Int J Comput Assist Radiol Surg, 15:2049-2059, 2020
19. Oda I, Shimizu Y, Yoshio T, Katada C, Yokoyama T, Yano T, Suzuki H, Abiko S, Takemura K, Koike T, Takizawa K, Hirao M, Okada H, Yoshii T, Katagiri A, Yamanouchi T, Matsuo Y, Kawakubo H, Kobayashi N, Shimoda T, Ochiai A, Ishikawa H, Yokoyama A, Muto M. Long-term outcome of endoscopic resection for intramucosal esophageal squamous cell cancer: a secondary analysis of the Japan Esophageal Cohort study. Endoscopy, 52:967-975, 2020
20. Sato D, Takamatsu T, Umezawa M, Kitagawa Y, Maeda K, Hosokawa N, Okubo K, Kamimura M, Kadota T, Akimoto T, Kinoshita T, Yano T, Kuwata T, Ikematsu H, Takemura H, Yokota H, Soga K. Distinction of surgically resected gastrointestinal stromal tumor by near-infrared hyperspectral imaging. Sci Rep, 10:21852, 2020
21. Sasaki A, Nakamura Y, Togashi Y, Kuno H, Hojo H, Kageyama S, Nakamura N, Takashima K, Kadota T, Yoda Y, Mishima S, Sawada K, Kotani D, Kawazoe A, Kuboki Y, Taniguchi H, Kojima T, Doi T, Yoshino T, Yano T, Kobayashi T, Akimoto T, Nishikawa H, Shitara K. Enhanced tumor response to radiotherapy after PD-1 blockade in metastatic gastric cancer. Gastric Cancer, 23:893-903, 2020
22. Sato D, Motegi A, Kadota T, Kojima T, Bando H, Shinmura K, Hori K, Yoda Y, Oono Y, Zenda S, Ikematsu H, Akimoto T, Yano T. Therapeutic results of proton beam therapy with concurrent chemotherapy for cT1 esophageal cancer and salvage endoscopic therapy for local recurrence. Esophagus, 17:305-311, 2020
23. Katada C, Yokoyama T, Yano T, Oda I, Shimizu Y, Doyama H, Koike T, Takizawa K, Hirao M, Okada H, Yoshii T, Kubota Y, Yamanouchi T, Tsuda T, Omori T, Kobayashi N, Suzuki H, Tanabe S, Hori K, Nakayama N, Kawakubo H, Kakushima N, Matsuo Y, Ishikawa H, Yokoyama A, Muto M. Association between macrocytosis and metachronous squamous cell carcinoma of the esophagus after endoscopic resection in men with early esophageal squamous cell carcinoma. Esophagus, 17:149-158, 2020
24. Yano T, Wang KK. Photodynamic Therapy for Gastrointestinal Cancer. Photochem Photobiol, 96:517-523, 2020
25. Ishihara R, Arima M, Iizuka T, Oyama T, Katada C, Kato M, Goda K, Goto O, Tanaka K, Yano T, Yoshinaga S, Muto M, Kawakubo H, Fujishiro M, Yoshida M, Fujimoto K, Tajiri H, Inoue H. Endoscopic submucosal dissection/endoscopic mucosal resection guidelines for esophageal cancer. Dig Endosc, 32:452-493, 2020
26. Yano T. Paradox of age-specific incidence rates of second primary cancer in individuals with esophageal cancer. J Gastroenterol, 55:664-665, 2020
27. Murano T, Ikematsu H, Shinmura K, Ito R, Minamide T, Sato D, Yamamoto Y, Takashima K, Kadota T, Yoda Y, Hori K, Oono Y, Yano T. Endoscopic prediction of advanced histology in colorectal lesions sized <10 mm using the Japan Narrow-band imaging Expert Team classification. Dig Endosc, 32:785-790, 2020
28. Suyama M, Yoda Y, Yamamoto Y, Sunakawa H, Minamide T, Hori K, Ikematsu H, Yano T. Oxygen saturation imaging as a useful tool for visualizing the mode of action of photodynamic therapy for esophageal cancer. VideoGIE, 5:496-499, 2020
29. Yokoyama A, Katada C, Yokoyama T, Takizawa K, Yano T, Oda I, Shimizu Y, Nakanishi H, Koike T, Hirao M, Okada H, Yoshii T, Katagiri A, Yamanouchi T, Matsuo Y, Kawakubo H, Kobayashi N, Ishikawa H, Muto M. The Alcohol Use Disorders Identification Test and the risk of metachronous cancer after endoscopic resection of esophageal cancer. Carcinogenesis, 41:1049-1056, 2020
30. Nomura H, Tsuji D, Demachi K, Mochizuki N, Matsuzawa H, Yano T, Daiko H, Fujii S, Kojima T, Itoh K, Kawasaki T. ABCB1 and ABCC2 genetic polymorphism as risk factors for neutropenia in esophageal cancer patients treated with docetaxel, cisplatin, and 5-fluorouracil chemotherapy. Cancer Chemother Pharmacol, 86:315-324, 2020
31. Inaba A, Hori K, Yoda Y, Ikematsu H, Takano H, Matsuzaki H, Watanabe Y, Takeshita N, Tomioka T, Ishii G, Fujii S, Hayashi R, Yano T. Artificial intelligence system for detecting superficial laryngopharyngeal cancer with high efficiency of deep learning. Head Neck, 42:2581-2592, 2020
32. Shinozaki T, Katada C, Shiga K, Asakage T, Yokoyama T, Yano T, Oda I, Shimizu Y, Takemura K, Ishikawa H, Yokoyama A, Muto M. Effectiveness of planned surveillance for detecting second primary head and neck cancers after endoscopic resection of esophageal squamous cell carcinoma. Jpn J Clin Oncol, 50:1162-1167, 2020
33. Katada C, Yokoyama T, Yano T, Oda I, Shimizu Y, Takemura K, Koike T, Takizawa K, Hirao M, Okada H, Nakayama N, Kubota Y, Matsuo Y, Kawakubo H, Ishikawa H, Yokoyama A, Muto M. Association between the findings of metachronous secondary primary malignancies and the number of Lugol-voiding lesions. Dis Esophagus, 33:2020
34. Yamamoto Y, Kadota T, Yoda Y, Hori K, Hatogai K, Kojima T, Fujii S, Akimoto T, Yano T. Review of early endoscopic findings in patients with local recurrence after definitive chemoradiotherapy for esophageal squamous cell carcinoma. Esophagus, 17:433-439, 2020
35. Kadota T, Yoda Y, Hori K, Shinmura K, Oono Y, Ikematsu H, Yano T. Prophylactic steroid administration against strictures is not enough for mucosal defects involving the entire circumference of the esophageal lumen after esophageal endoscopic submucosal dissection (ESD). Esophagus, 17:440-447, 2020
36. Kakushima N, Yoshida N, Doyama H, Yano T, Horimatsu T, Uedo N, Yamamoto Y, Kanzaki H, Hori S, Yao K, Oda I, Tanabe S, Yokoi C, Ohata K, Yoshimura K, Ishikawa H, Muto M. Near-focus magnification and second-generation narrow-band imaging for early gastric cancer in a randomized trial. J Gastroenterol, 55:1127-1137, 2020
37. Matsuda T, Fujii T, Sano Y, Kudo SE, Oda Y, Hotta K, Shimoda T, Saito Y, Kobayashi N, Sekiguchi M, Konishi K, Ikematsu H, Iishi H, Takeuchi Y, Igarashi M, Kobayashi K, Sada M, Yamaguchi Y, Hasuda K, Shinohara T, Ishikawa H, Murakami Y, Taniguchi H, Fujimori T, Ajioka Y, Yoshida S. Randomised comparison of postpolypectomy surveillance intervals following a two-round baseline colonoscopy: the Japan Polyp Study Workgroup. Gut, 2020