Hodaka Numasaki

Comprehensive Registry of Esophageal Cancer in Japan, 2009

These data were first made available on January 2016, as the Comprehensive Registry of Esophageal Cancer in Japan, 2009. Not all the tables and figures are reprinted here. The authors were members of the Registration Committee for Esophageal Cancer, the Japan Esophageal Society, and made great contributions to the preparation of this material.

Application of laser-accelerated protons to the demonstration of DNA double-strand breaks in human cancer cells

We report the demonstrated irradiation effect of laser-accelerated protons on human cancer cells. In vitro (living) A549 cells are irradiated with quasimonoenergetic proton bunches of 0.8–2.4 MeV with a single bunch duration of 15 ns. Irradiation with the proton dose of 20 Gy results in a distinct formation of γ-H2AX foci as an indicator of DNA double-strand breaks generated in the cancer cells. This is a pioneering result that points to future investigations of the radiobiological effects of laser-driven ion beams. Unique high-current and short-bunch features make laser-driven proton bunches an excitation source for time-resolved determination of radical yields.

Comprehensive Registry of Esophageal Cancer in Japan, 2003

We are very pleased to publish the Comprehensive Registry of Esophageal Cancer in Japan, 2003, and thank all the members of the Japan Esophageal Society who made great contributions in preparing this material. We would like to review the history of the registry of esophageal cancer cases in Japan. The Registration Committee for Esophageal Cancer, the Japan Esophageal Society, has annually registered cases of esophageal cancer since 1976 and published the first issue of the Comprehensive Registry of Esophageal Cancer in Japan in 1979. The Act for the Protection of Personal Information was promulgated in 2003, and began to be enforced in 2005. The purpose of this Act is to protect the rights and interests of individuals while taking into consideration the usefulness of personal information, keeping in mind the remarkable increase in the use of personal information arising from the development of today’s advanced information and communications society. The registry of esophageal cancer cases has required some adjustments to comply with the Acts. The new registration system has been discussed for several years and was finally completed in 2008. The most important point was These data were first issued on 1 March, 2011, as the Comprehensive Registry of Esophageal Cancer in Japan, 2003. Not all pages are reprinted here; however, the original table and figure numbers have been kept. The authors were at the time members of the Registration Committee for Esophageal Cancer, the Japan Esophageal Society, and made great contributions in preparing this material.

Comprehensive Registry of Esophageal Cancer in Japan, 2006

We deeply appreciate the great contributions of many physicians in the registry of esophageal cancer cases. The Comprehensive Registry of Esophageal Cancer in Japan, 2006, was published here, despite some delay. The registry complies with the Act for the Protection of Personal Information. The encryption with a HASH function is used for ‘‘anonymity in an unlinkable fashion’’. We briefly summarized the Comprehensive Registry of Esophageal Cancer in Japan, 2006. Japanese Classification of Esophageal Cancer 9th and UICC TNM Classification 6th were used for cancer staging according to the subjected year. A total of 4994 cases were registered from 239 institutions in Japan. Tumor locations were cervical: 4.2 %, upper thoracic: 13.4 %, middle thoracic: 48.7 %, lower thoracic: 26.0 % and EG junction: 6.7 %. Superficial carcinomas (Tis, T1a, T1b) were 35.9 %. As for the histologic type of biopsy specimens, squamous cell carcinoma and adenocarcinoma accounted for 90.8 and 3.9 %, respectively. Regarding clinical results, the 5-year survival rates of patients treated using endoscopic mucosal resection, concurrent chemoradiotherapy, radiotherapy alone, chemotherapy alone, or esophagectomy were 84.5, 25.8, 22.0, 3.0, and 48.0 %, respectively. Esophagectomy was performed in 2545 cases. Concerning the approach used for esophagectomy, 15.4 % of the cases were treated These data were first made available on July 1, 2013, as the Comprehensive Registry of Esophageal Cancer in Japan, 2006. Not all the pages are reprinted here; however, the original table and figure numbers have been maintained.

Comprehensive Registry of Esophageal Cancer in Japan, 2002

We are very pleased to publish the Comprehensive Registry of Esophageal Cancer in Japan, 2002, we thank all the members of the Japan Esophageal Society who made great contributions in preparing this material. First of all, we describe the history of the registry of esophageal cancer cases in Japan. The Registration Committee for Esophageal Cancer of the Japan Esophageal Society, has registered cases of esophageal cancer since 1976 and published the fi rst issue of the Comprehensive Registry of Esophageal Cancer in Japan in 1979. The Act for the Protection of Personal Information was promulgated in 2003, and began to be enforced in 2005. The purpose of this Act is to protect the rights and interests of individuals while taking into consideration the usefulness of personal information, keeping in mind the remarkable increase in the use of personal information arising from the development of today’s advanced information and communications society. The registry of esophageal cancer cases has required some improvements to comply with the Acts. The new registration system has been considered for several years and was fi nally completed in 2008. The most important point was “anonymity in an unlinkable fashion” using encryption with a “hash function”. Finally, the registry resumed registering cases of esophageal cancer that had been treated in 2001. We briefl y summarized the Comprehensive Registry of Esophageal Cancer in Japan, 2002. A total of 4281 cases were registered from 222 institutions in Japan. As for the histologic type of cancer according to biopsy specimens, squamous cell carcinoma and adenocarcinoma accounted for 92.9% and 2.4%, respectively. Regarding clinical results, the 5-year survival rates of patients treated using endoscopic mucosal resection, concurrent chemoradiotherapy, radiotherapy alone, chemotherapy alone, or esophagectomy were 87.7%, 22.9%, 15.1%, 1.7%, and 44.1%, respectively. Concerning the approach used to perform an esophagectomy, 16.5% of the cases were performed endoscopically, that is, thoracoscopically, laparoscopically, or mediastinoscopically. Regarding the reconstruction route, the retrosternal, the posterior mediastinal and the intrathoracic route were used in 35.4%, 32.4% and 17.9% of cases, respectively. The percentage of operative deaths occurring within 30 days or less after operation and the percentage of postoperative hospital deaths occurring 31 days or more after operation were 1.2% (25 out of 2028 cases) and 2.0% (41 out of 2028 cases), respectively. We hope that this Comprehensive Registry of Esophageal Cancer in Japan for 2002 helps to improve all aspects of the diagnosis and treatment of esophageal cancer.

Japanese Structure Survey of Radiation Oncology in 2005 Based on Institutional Stratification of Patterns of Care Study

PURPOSE To evaluate the structure of radiation oncology in Japan in terms of equipment, personnel, patient load, and geographic distribution to identify and improve any deficiencies. METHODS AND MATERIALS A questionnaire-based national structure survey was conducted between March 2006 and February 2007 by the Japanese Society of Therapeutic Radiology and Oncology. These data were analyzed in terms of the institutional stratification of the Patterns of Care Study. RESULTS The total numbers of new cancer patients and total cancer patients (new and repeat) treated with radiotherapy in 2005 were estimated at approximately 162,000 and 198,000, respectively. In actual use were 765 linear accelerators, 11 telecobalt machines, 48 GammaKnife machines, 64 60Co remote-controlled after-loading systems, and 119 192Ir remote-controlled after-loading systems. The linear accelerator systems used dual-energy function in 498 systems (65%), three-dimensional conformal radiotherapy in 462 (60%), and intensity-modulated radiotherapy in 170 (22%). There were 426 Japanese Society of Therapeutic Radiology and Oncology-certified radiation oncologists, 774 full-time equivalent radiation oncologists, 117 medical physicists, and 1,635 radiation therapists. Geographically, a significant variation was found in the use of radiotherapy, from 0.9 to 2.1 patients/1,000 population. The annual patient load/FTE radiation oncologist was 247, exceeding the Blue Book guidelines level. Patterns of Care Study stratification can clearly discriminate the maturity of structures according to their academic nature and caseload. CONCLUSIONS The Japanese structure has clearly improved during the past 15 years in terms of equipment and its use, although the shortage of manpower and variations in maturity disclosed by this Patterns of Care Study stratification remain problematic. These constitute the targets for nationwide improvement in quality assurance and quality control.

Efficacy of lymph node dissection by node zones according to tumor location for esophageal squamous cell carcinoma

BackgroundThe extent of node dissection in esophageal cancer surgery is usually estimated by the number of resected nodes, irrespective of the area of dissection. The efficacy of lymph node dissection by area was evaluated according to the location of the primary tumor.MethodsThe study group comprised the 3827 patients who underwent R0 esophagectomy with three-field lymph node dissection for squamous cell carcinoma, registered in a nationwide registry in Japan. The areas of lymph node were classified into zones according to AJCC Staging Manual. The Efficacy Index (EI) calculating the frequency and patient survival of metastases to each zone was investigated according to tumor location.ResultsThe EI was high in supraclavicular and upper mediastinal zones in patients with upper esophageal tumors, highest in upper mediastinal zone followed by supraclavicular and perigastric zones in patients with middle esophageal tumors, and highest in perigastric zone followed by upper and lower mediastinal zones in patients with lower esophageal tumors. In patients with middle and lower esophageal cT1 tumors, the EIs of upper mediastinal and perigastric zones were higher than middle and lower mediastinal zones.ConclusionThe EIs of each zone were differed by tumor location. The extent of lymph node dissection should be estimated by the dissected zones and modified by the tumor location. Supraclavicular dissection is indispensable for patients with upper esophageal tumors, and recommended for patients with middle esophageal tumors. Upper mediastinal dissection is recommended for all patients with thoracic esophageal squamous cell carcinoma, irrespective of the location.

Radiation Therapy for Esophageal Cancer in Japan: Results of the Patterns of Care Study 1999–2001

PURPOSE To describe patient characteristics and the process of radiotherapy (RT) for patients with esophageal cancer treated between 1999 and 2001 in Japan. METHODS AND MATERIALS The Japanese Patterns of Care Study (PCS) Working Group conducted a third nationwide survey of 76 institutions. Detailed information was accumulated on 621 patients with thoracic esophageal cancer who received RT. RESULTS The median age of patients was 68 years. Eighty-eight percent were male, and 12% were female. Ninety-nine percent had squamous cell carcinoma histology. Fifty-five percent had the main lesion in the middle thoracic esophagus. Fourteen percent had clinical Stage 0-I disease, 32% had Stage IIA-IIB, 43% had Stage III, and 10% had Stage IV disease. Chemotherapy was given to 63% of patients; 39% received definitive chemoradiotherapy (CRT) without surgery and 24% pre- or postoperative CRT. Sixty-two percent of the patients aged > or =75 years were treated with RT only. Median total dose of external RT was 60 Gy for definitive CRT patients, 60 Gy for RT alone, and 40 Gy for preoperative CRT. CONCLUSIONS This PCS describes general aspects of RT for esophageal cancer in Japan. Squamous cell carcinoma accounted for the majority of patients. The standard total external RT dose for esophageal cancer was higher in Japan than in the United States. Chemoradiotherapy had become common for esophageal cancer treatment, but patients aged > or =75 years were more likely to be treated by RT only.

Comprehensive Registry of Esophageal Cancer in Japan, 2010

These data were first made available on January 2017, as the Comprehensive Registry of Esophageal Cancer in Japan, 2010. Not all the pages are reprinted here.

Comprehensive Registry of Esophageal Cancer in Japan, 2008

We deeply appreciate the great contributions of many physicians in the registry of esophageal cancer cases. The Comprehensive Registry of Esophageal Cancer in Japan, 2008, was published here, despite some delay. The registry complies with the Act for the Protection of Personal Information. The encryption with a HASH function is used for ‘‘anonymity in an unlinkable fashion’’. We briefly summarized the Comprehensive Registry of Esophageal Cancer in Japan, 2008. Japanese Classification of Esophageal Cancer 10th and UICC TNM Classification 6th were used for cancer staging according to the subjected year. A total of 4925 cases were registered from 257 institutions in Japan. Tumor locations were cervical: 5.3 %, upper thoracic: 12.0 %, middle thoracic: 48.7 %, lower thoracic: 25.3 % and EG junction: 5.9 %. Superficial carcinomas (Tis, T1a, and T1b) were 35.3 %. As for the histologic type of biopsy specimens, squamous cell carcinoma and adenocarcinoma accounted for 89.3 % and 4.3 %, respectively. Regarding clinical results, the 5-year survival rates of patients treated using endoscopic mucosal resection, concurrent chemoradiotherapy, radiotherapy alone, chemotherapy alone, or esophagectomy were 85.7, 24.1, 23.4, 4.8, and 53.1 %, respectively. Esophagectomy was performed in 2657 cases. Concerning the approach used for These data were first made available on December 25, 2014, as the Comprehensive Registry of Esophageal Cancer in Japan, 2008. Not all the pages are reprinted here; however, the original table and figure numbers have been maintained.