Yorihisa Urata

Case series of 17 patients with cholangiocarcinoma among young adult workers of a printing company in Japan.

An outbreak of cholangiocarcinoma occurred among workers in the offset color proof‐printing department at a printing company in Japan. The aim of this study was to clarify the characteristics of the patients with cholangiocarcinoma.

Adjuvant therapy after curative resection for hepatocellular carcinoma associated with hepatitis virus.

The outcome after curative resection for hepatocellular carcinoma (HCC) is still unsatisfactory because of the high rate of recurrence of HCC, including intrahepatic metastasis originating from the primary carcinoma and multicentric carcinogenesis after surgery. The rate of recurrence, particularly of multicentric carcinogenesis after surgery, is affected by persistent active hepatitis and hepatic fibrosis caused by chronic hepatitis B or C. In patients with hepatitis B virus (HBV)-related HCC, a high viral load is a strong risk factor for HCC recurrence. Nucleos(t)ide analogues improve the outcome after curative resection for HBV-related HCC. Interferon therapy improves the outcome after curative resection for hepatitis C virus (HCV)-related HCC by decreasing recurrence and preserving or improving liver function when treatment is successful. Low-dose intermittent interferon therapy has also been reported to be effective in suppressing HCC recurrence. New antiviral agents including protease or polymerase inhibitors are expected to be effective because these agents can eradicate HCV in most patients who receive such treatment.

Changes in Laboratory Test Results and Diagnostic Imaging Presentation before the Detection of Occupational Cholangiocarcinoma

Changes in Laboratory Test Results and Diagnostic Imaging Presentation before the Detection of Occupational Cholangiocarcinoma: Shoji KUBO, et al. Department of Hepato‐Biliary‐Pancreatic Surgery, Osaka City University Graduate School of Medicine—

Effect of interferon therapy on first and second recurrence after resection of hepatitis C virus-related hepatocellular carcinoma

Aim:  Several investigators have shown that interferon (IFN) therapy can suppress the recurrence of hepatocellular carcinoma (HCC) after curative treatment. We investigated the effect of IFN therapy on the first and second HCC recurrence following hepatic resection of hepatitis C virus (HCV)‐related HCC.

Management of hepatitis B virus infection during treatment for hepatitis B virus-related hepatocellular carcinoma.

Although liver resection is considered the most effective treatment for hepatocellular carcinoma (HCC), treatment outcomes are unsatisfactory because of the high rate of HCC recurrence. Since we reported hepatitis B e-antigen positivity and high serum hepatitis B virus (HBV) DNA concentrations are strong risk factors for HCC recurrence after curative resection of HBV-related HCC in the early 2000s, many investigators have demonstrated the effects of viral status on HCC recurrence and post-treatment outcomes. These findings suggest controlling viral status is important to prevent HCC recurrence and improve survival after curative treatment for HBV-related HCC. Antiviral therapy after curative treatment aims to improve prognosis by preventing HCC recurrence and maintaining liver function. Therapy with interferon and nucleos(t)ide analogs may be useful for preventing HCC recurrence and improving overall survival in patients who have undergone curative resection for HBV-related HCC. In addition, reactivation of viral replication can occur after liver resection for HBV-related HCC. Antiviral therapy can be recommended for patients to prevent HBV reactivation. Nevertheless, further studies are required to establish treatment guidelines for patients with HBV-related HCC.

The influence of postoperative glycemic control on recurrence after curative resection in diabetics with hepatitis C virus-related hepatocellular carcinoma

To elucidate the influence of diabetes on tumor recurrence after curative resection for hepatitis C virus (HCV)‐related hepatocellular carcinoma (HCC).

Features and outcome after liver resection for non-B non-C hepatocellular carcinoma.

BACKGROUND/AIMS We investigated the clinicopathological findings and outcome after surgery for hepatocellular carcinoma in patients without hepatitis B or C virus infection. METHODOLOGY Among 562 patients who underwent curative resection for hepatocellular carcinoma, the sera from 97 patients (B group) were positive for hepatitis B surface antigen alone, sera from 355 patients (C group) were positive for anti-hepatitis C virus antibody alone and sera from 104 patients (NBNC group) were negative for both hepatitis B surface antigen and anti-hepatitis C virus antibody. We compared the clinicopathological findings and postoperative outcomes in the 3 groups. RESULTS The prevalence of diabetes mellitus, hypertension, hyperlipidemia and alcohol abuse were higher in the NBNC group than in the other groups. The prevalence of obesity was higher in the NBNC group than in the B group. Non-alcoholic steatohepatitis was detected in 16 NBNC patients. The tumor- free survival rate was higher in the NBNC group than in the C group. CONCLUSIONS Obesity, diabetes mellitus, hypertension, hyperlipidemia, alcohol abuse and non-alcoholic steatohepatitis were the possible risk factors for hepatocellular carcinoma in the NBNC group. The patients in the NBNC group are expected to show a better outcome as compared to patients in the C group.

Long-term outcome of surgical treatment for ampullary carcinoma.

BACKGROUND/AIMS We aimed to clarify the surgical indication and describe the long-term surgical outcome for ampullary carcinoma. METHODOLOGY The long-term outcomes of 23 patients who underwent pancreaticoduodenectomy were retrospectively reviewed. The prognostic factors for cancer-specific survival and overall survival after surgery were investigated. RESULTS The cancer-specific 5-, 10- and 20-year survival rates after resection of the ampullary carcinoma were 52%, 43% and 43%, respectively, while the corresponding overall survival rates were 52%, 32% and 24%, respectively. Ten of the 11 patients with recurrent ampullary carcinoma died within 5 years after surgery. Four patients died because of pancreatic cancer, colon cancer, old age after curative resection of gastric cancer, and pneumonia at later than 5 years after the surgery. The risk factors for the short cancer-specific survival period were pancreatic invasion and lymph node metastasis, while those for the short overall survival period were pancreatic invasion and the tumor grade. CONCLUSIONS Our study indicates that recurrence of ampullary carcinoma within 5 years after its resection, especially in patients with pancreatic invasion or lymph node metastasis and development of other diseases after more than 5 years after the surgery should be carefully investigated.