The evolution of surgical treatment for gastrointestinal cancers

Int J Clin Oncol. 2019 Nov;24(11):1333-1349. doi: 10.1007/s10147-019-01499-7. Epub 2019 Sep 14.

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.

Keywords: Biomaterial collagen; Cancer odors; Chromosomal instability; Drug discovery; Gastrointestinal cancers; Metabolic surgery; Reconstruction after gastrointestinal surgery.

Publication types

  • Lecture

MeSH terms

  • Animals
  • Carcinoma, Hepatocellular / prevention & control
  • Carcinoma, Hepatocellular / therapy
  • Chemokine CXCL12 / metabolism
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / metabolism
  • Colorectal Neoplasms / surgery
  • Digestive System Surgical Procedures / methods*
  • Dogs
  • Esophageal Neoplasms / surgery
  • Gastrointestinal Neoplasms / metabolism
  • Gastrointestinal Neoplasms / mortality
  • Gastrointestinal Neoplasms / surgery*
  • Humans
  • Liver Neoplasms / prevention & control
  • Liver Neoplasms / therapy
  • Plastic Surgery Procedures / methods
  • Postoperative Care
  • Receptors, CXCR4 / metabolism
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery

Substances

  • CXCL12 protein, human
  • CXCR4 protein, human
  • Chemokine CXCL12
  • Receptors, CXCR4